Arc At Chillicothe
Inspection Findings
F-Tag F0689
F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Based on record review and interview the facility failed to ensure the resident's environment was free of hazards to prevent falls for one of three residents (Resident R1) reviewed for accidents in the sample of five.Findings include:Resident R1's Progress Notes dated 8/16/25 at 12:29 PM and signed by V5 (RN/Registered Nurse) documents, Per (V6/CNA/Certified Nursing Assistant), (V6) tripped in (Resident R1's) room on the air mattress cord and fell, tipping (Resident R1's) wheelchair over. (Resident R1) fell out of her (high back padded wheelchair) and hit her head
on the (mechanical lift) machine. (Resident R1) noted to have a small amount of blood present to the right side of (Resident R1's) head. Area cleansed (and) bleeding stopped. PRN (as needed) Dilaudid and Xanax administered. (V3/Resident R1's Power of Attorney/POA) left voicemail to call facility. On call nurse and hospice notified. (V4/Resident R1's Physician) notified. Neuro (Neurological) checks initiated.Resident R1's IDT (Inter-Disciplinary Team) Fall Follow-Up Progress Note dated 8/18/25 at 3:06 PM documents, IDT met regarding recent fall (8/16/25). (Resident R1) was tipped out of wheelchair by (CNA/V6). Root cause: (V6) got wheelchair caught on cord from air mattress and tripped and accidentally tipped wheelchair. Intervention: Rearrange room for better ease of equipment.On 10/9/25 at 10:02 AM V6 (CNA) stated, On 8/16/5 sometime around noon I was getting (Resident R1) ready. I took (Resident R1) into her room and turned (Resident R1's) chair around. The cords at the end of the bed were pulled out from under the bed and lying on the floor in front of (Resident R1's) wheelchair. I was just trying to lift the back of (Resident R1's) wheelchair up to get the wheelchair over the cord. I went to push (Resident R1) forward to try to unravel the cord that was wrapped around Resident R1's wheelchair wheel and picked up the back of (Resident R1's) wheelchair. When I tipped (Resident R1's) wheelchair up, (Resident R1) fell out forward onto the floor. (Resident R1) was sitting up straight and I should have put the back of the wheelchair back to keep (Resident R1) from falling out. (Resident R1) landed on the floor in front of her wheelchair. The side of (Resident R1's) head was bleeding.On 10/14/25 at 11:00 AM V2 (Director of Nursing) stated V6 should have moved Resident R1's cord out of the way before trying to push Resident R1's wheelchair over the cord to prevent Resident R1 from falling out of the wheelchair. V2 stated V6 should not have lifted the back of Resident R1's wheelchair.The facility's Fall Prevention Program policy dated 10/2024 documents, Purpose: To assure the safety of all residents in the facility, when possible. The program will include measures which determine the individual needs of each resident by assessing the risk of falls and implementation of appropriate interventions to provide necessary supervision and assistive devices are utilized as necessary. Programs will monitor the program to assure ongoing effectiveness. Standards: Fall/safety interventions may include but are not limited to: The resident's environment will be kept of clutter which would affect ambulation and remove hazards.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
ARC AT CHILLICOTHE in CHILLICOTHE, IL inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in CHILLICOTHE, IL, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from ARC AT CHILLICOTHE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.