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Complaint Investigation

Pleasant Meadows Senior Living

Inspection Date: October 2, 2025
Total Violations 2
Facility ID 146037
Location CHRISMAN, IL
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Inspection Findings

F-Tag F0689

Quality of Life and Care Deficiencies
Harm Level: Immediate Jeopardy

F 0689 Level of Harm - Immediate jeopardy to resident health or safety Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

completed for Resident R1, and Resident R1 was placed on 15-minute monitoring checks for 3 days to monitor exit-seeking behavior. On 9/7/25, V4 Social Service Director completed an audit of all wandering residents, and no issues were identified.Training for all staff was initiated on 9/25/2025 by V2 Director of Nursing and V5 Maintenance Director. Training included identifying exit-seeking behaviors, placing wander alert band immediately when identified at risk, physician orders, and where to locate the wander guard bands. The training also included the location of wander guard exit doors, and alarm panels, immediate response to a door alarm or wander guard alarm and completing safety checks indoors and outdoors to ensure that all residents are safe. The training included The Door Alarm and Missing Person and Elopement Policy and Procedures. The Missing Person and Elopement Policy and Procedures were reviewed 9/25/2025 by the Corporate Clinical Director. Care Plans were reviewed and revised as necessary by V4 Social Services Director to update interventions as appropriate on 9/25/2025.On 9/25/25, V5 Maintenance Director began audits of all exit doors with plans to conduct audits five days a week for six weeks, and then weekly to ensure proper function of all door alarms. On 9/25/25, V2 started audits of all residents at risk for wandering and will continue the audits on a weekly basis for six weeks to be sure Elopement Assessments and Care Plans are up to date with accurate information and interventions are in place. On 9/30/25 at 2:00 PM V2 stated V5 and V2 will bring the audits to the Quality Assurance meetings to be reviewed by the interdisciplinary team weekly, monthly, and quarterly. This was also confirmed with V1 and V5.The facility presented an abatement plan to remove the immediacy on 9/26/25 at 2:29 PM. The survey team reviewed

the abatement plan and was unable to accept the plan to remove the immediacy. The abatement plan was returned 9/26/25 at 3:51 PM. The facility presented a revised abatement plan to remove the immediacy on 9/26/25 at 4:51 PM. The survey team reviewed the abatement plan and was unable to accept the plan to remove the immediacy. The abatement plan was returned 9/29/25 at 9:27 AM. The facility presented a revised abatement plan to remove the immediacy on 9/29/25 at 10:40AM. The survey team reviewed the abatement plan and was able to accept the plan to remove the immediacy. The abatement plan was approved on 9/29/25 at 11:01 AM.

Event ID:

Facility ID:

If continuation sheet

Printed: 04/13/2026 Form Approved OMB No. 0938-0391

Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION

(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:

(X2) MULTIPLE CONSTRUCTION

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

10/02/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Pleasant Meadows Senior Living

400 West Washington Chrisman, IL 61924

For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG

SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)

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F-Tag F0842

Resident Assessment and Care Planning Deficiencies
Harm Level: Potential for More Than Minimal Harm

Federal health inspectors cited PLEASANT MEADOWS SENIOR LIVING in CHRISMAN, IL for a deficiency under regulatory tag F-F0842 during a complaint investigation conducted on 2025-10-02.

Category: Resident Assessment and Care Planning Deficiencies

The facility was found deficient in the following area: Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.

While no actual harm was documented, there was potential for more than minimal harm to residents.

This was one of 2 deficiencies cited during this inspection of PLEASANT MEADOWS SENIOR LIVING.

Correction Status: Deficient, Provider has date of correction.

The facility reported correction as of 2025-10-03.

📋 Inspection Summary

PLEASANT MEADOWS SENIOR LIVING in CHRISMAN, IL inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

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 CHRISMAN, 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 PLEASANT MEADOWS SENIOR LIVING or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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