Centralia Manor
CENTRALIA MANOR in CENTRALIA, IL — inspection on September 9, 2025.
Found 7 citations. Severity: Standard violations.
Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.
Inspection Findings
jeopardy to resident health or safety
training program.
When there is more than one (1) person on duty in the facility, at least one (1) person on duty shall be so certified.
Any facility employee who is on duty may be utilized to assist in these medical emergencies.
Signs and Symptoms: 1.
Immediate loss of consciousness. 2.
Absence of palpable carotidal or femoral pulse. 3.
Absence of audible heart sounds. 4.
Absence of breath sounds or air movement throughout the nose or mouth. 5.
Convulsions (may or may not be present). 6.
Dilation of pupils of eyes. 7.
Ashen gray color.
Treatment: 8.
Note the time as soon as the cardiac arrest is determined.
Summon help immediately. 9.
Provide CPR if determine appropriate according to the POLST/DNR form. CPR should be performed in accordance with the guidelines set by American Heart Association or the American Red Cross. 10.
Utilize AED (Automated External Defibrillator) according to instructions on machine for use.The Immediate Jeopardy that began on [DATE] was removed [DATE].
The deficient practice was corrected on [DATE] after the facility took the following action to correct the noncompliance: Facility administrator (V1) and DON (V2) were in-serviced by the regional nurse (V13) on [DATE] on the emergencies policy 3.06, specifically regarding cardiac arrest and CPR.DON (V2) initiated and completed in-servicing with all nursing staff on [DATE], on the emergencies policy 3.06 specifically regarding cardiac arrest and CPR.DON (V2) initiated and completed in-servicing with all nursing staff on [DATE] on location of code status/POLST for residents.V11 (RN) did not return to work after [DATE].Plan was added to the facility QA (Quality Assurance) program regarding CPR and code status on [DATE].The facility DON or designee will audit 10 employees per week for a month to ensure that location of code status/POLST is known and understanding of the emergencies policy.This will remain as part of the facility QA process for continued monitoring.Completion Date: [DATE].
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
09/09/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Centralia Manor
1910 East McCord Rte 161 East Centralia, IL 62801
SUMMARY STATEMENT OF DEFICIENCIES
Based on interview and record review the facility was unable to provide reproducible evidence annual training was completed for all staff.
This failure has the potential to affect all 66 residents currently residing at the facility.
Findings Include: The facility Resident Directory dated 9/3/2025 documents there are 66 residents currently residing at the facility.
Review of the facility training/in-service records do not document specific annual training for all staff. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate documentation annual training had been completed for all staff.The facility Policy 1.10 on Inservice Training revised on 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel. 2. To provide continuing education opportunities and promote job satisfaction
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
09/09/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Centralia Manor
1910 East McCord Rte 161 East Centralia, IL 62801
SUMMARY STATEMENT OF DEFICIENCIES
Based on interview and record review the facility failed to ensure staff were trained on effective communications.
This has the potential to affect all 66 residents currently residing at the facility.
Findings Include: The facility Resident Directory dated 9/3/2025 documents there are 66 residents currently residing at the facility.
Review of the facility training/in-service records do not document effective communication training for staff. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate documentation effective communication training had been completed for all staff.
The facility Policy 1.10 on Inservice Training revised 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel. 2. To provide continuing education opportunities and promote job satisfaction
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
09/09/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Centralia Manor
1910 East McCord Rte 161 East Centralia, IL 62801
SUMMARY STATEMENT OF DEFICIENCIES
Based on interview and record review the facility failed to ensure all staff were trained on resident rights.
This has the potential to affect all 66 residents residing at the facility.
Findings Include:The facility Resident Directory dated 9/3/2025 documents there are 66 residents currently residing at the facility.
Review of the facility training/in-service records do not document staff were trained on resident rights. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate documentation staff had been trained on resident rights.
The facility Policy 1.10 on Inservice Training revised 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel. 2. To provide continuing education opportunities and promote job satisfaction
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
09/09/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Centralia Manor
1910 East McCord Rte 161 East Centralia, IL 62801
SUMMARY STATEMENT OF DEFICIENCIES
Based on interview and record review the facility was unable to provide reproducible evidence staff were trained on compliance and ethics.
This failure has the potential to affect all 66 residents residing at the facility.
Findings Include:The facility Resident Directory dated 9/3/2025 documents there are 66 residents currently residing at the facility.
Review of the facility training/in-service records do not document specific compliance and ethics training for all staff. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate documentation compliance and ethics training had been completed for all staff.
The facility Policy 1.10 on Inservice Training revised 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel.
- To provide continuing education opportunities and promote job satisfaction
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
09/09/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Centralia Manor
1910 East McCord Rte 161 East Centralia, IL 62801
SUMMARY STATEMENT OF DEFICIENCIES
Based on interview and record review the facility failed to ensure required in-service training for CNA's (Certified Nursing Assistants) was completed.
This has the potential to affect all 66 residents currently residing at the facility.
Findings Include:The facility Resident Directory dated 9/3/2025 documents there are 66 residents currently residing at the facility.
Review of the facility training/in-service records do not document specific the required annual in-service training for CNA's was completed. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate documentation the required CNA training had been completed.
The facility Policy 1.10 on Inservice Training revised 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel. 2. To provide continuing education opportunities and promote job satisfaction
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
09/09/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Centralia Manor
1910 East McCord Rte 161 East Centralia, IL 62801
SUMMARY STATEMENT OF DEFICIENCIES
Based on interview and record review the facility failed to ensure staff were trained on behavioral health services.
This failure has the potential to affect all 66 residents currently residing at the facility.
Findings Include:The facility Resident Directory dated 9/3/2025 documents there are 66 residents currently residing at the facility.
Review of the facility training/in-service records do not document behavioral health services training for all staff. On 9/8/25 at 12:18 PM, V1 (Administrator) notified this surveyor via email they were unable to locate staff were trained on behavioral health services.
The facility Policy 1.10 on Inservice Training revised 2/25/19 documents, Policy: The facility shall provide an on-going inservice program designed to cover job skill, training, and on-going education.
The Administrator shall coordinate inservice training and provide appropriate documentation to indicate time, program content, and personnel attending.
Purpose: 1. To enhance the training capabilities of all personnel. 2. To provide continuing education opportunities and promote job satisfaction
Facility ID: