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Complaint Investigation

Imboden Creek Senior Living

September 5, 2025 · Decatur, IL · 180 West Imboden
Citations 4
CMS Rating 1/5
Beds 95
Provider ID 145945
Healthcare Facility
Imboden Creek Senior Living
Decatur, IL  ·  View full profile →
Inspection Summary

IMBODEN CREEK SENIOR LIVING in DECATUR, IL — inspection on September 5, 2025.

Found 4 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.

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Inspection Findings

FF0580
Resident Rights Deficiencies
Potential for More Than Minimal Harm

Based on interview and record review, the facility failed to notify a family member of an accident for one of three residents (R1) reviewed for resident injury in the sample list of 12.

Findings include:R1's undated Diagnoses list includes fracture of other parts of the pelvis, subsequent encounter for fracture with routine healing, Chronic Pain due to trauma, other reduced mobility, unspecified abnormalities of Gait and Mobility, and unsteadiness on feet.R1's Care Plan dated 10/15/24, documents impaired cognitive function or impaired thought processes, impaired decision-making, long-term memory loss, short term memory loss related to age, history of falling, and decreased mobility with an intervention for an alarm when R1 is in the chair related to impulsivity. R1's Fall Risk Evaluation dated 6/13/25, documents R1 is at risk for falls due to intermittent confusion, being chair bound, and requiring use of assistive devices.On 9/3/25 at 9:30 AM V1 Administrator stated on 8/26/25 R1 was observed on the floor on R1's buttocks. V1 stated V3 Licensed Practical Nurse (LPN) found R1 as V3 was walking by and heard yelling so V3 told V4 LPN and V5 Certified Nursing Assistant (CNA). V1 stated R1 had a bruise to her right temple and right arm and a small bruise on her left forearm. V1 stated the family was not notified at that time. On 9/4/25 at 11:15 AM, V4 LPN stated V4 got to the facility around 2:15 PM. V4 stated when V4 walked in she punched the time clock, and another nurse V3 LPN was yelling that R1 was on the floor. V4 stated V4 told another nurse V7 LPN that V4 would go check on R1 for V7. V4 stated V5 CNA came in the room also and R1 was sitting on her buttocks right in front of her wheelchair. V4 stated R1 likes to transfer herself and it looked like that's what R1 was trying to do. V4 stated R1 did not remember what happened when asked. V4 stated V4 did an assessment on R1 and took R1's vital signs. V4 stated she gave R1's vital signs to V7 on a piece of paper but was unsure if V7 actually got the vital signs. V4 stated she did not document any assessment, vital signs, or any information about R1's fall and did not contact R1's family, V1 Administrator or V2 Director of Nurses. V4 stated V4 knows she is supposed to call the family and tell V1 Administrator. V4 stated V4 thought V7 was doing to do all that. V4 stated V7 did not go down to the room where R1 was found.The facility's Accidents and Incidents (WLC) - Investigation and Reporting policy dated Revised July 2017, directs staff to document the date and time resident's family member is notified of an accident.

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

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

09/05/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Imboden Creek Senior Living

180 West Imboden Decatur, IL 62521

SUMMARY STATEMENT OF DEFICIENCIES

Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review, the facility failed to protect the resident's right to be free from physical abuse for one (R3) resident of three residents reviewed for abuse in a sample list of 12.Findings include: The facility's Initial Report, dated 8/2/25, documents R2 and R3 made unwanted contact with one another. R2 yelled at R3 stating she stole my fan, I'm going to knock her head off as the reason for R2 making the unwanted contact with R3.

This report also documents the resident (R3) was struck with an open hand in a smacking motion by R2.R2's undated Diagnoses include anxiety disorder, unspecified; Restlessness and Agitation; and Mild Cognitive Impairment of uncertain or unknown etiology.R2's Care Plan, dated 8/10/24, documents R2 has the potential to demonstrate verbally abusive behaviors Poor impulse control Verbal aggression towards staff and roommate, behavior problem with roommate and potential to demonstrate physical behaviors, Dementia, poor impulse control, and anger.R2's Minimum Data Set (MDS), dated [DATE], documents R2 is cognitively intact.R3's undated diagnoses list documents R3's diagnoses as Cognitive Communication Deficit, general anxiety disorder, unspecified Dementia with unspecified severity without Behavioral Disturbances, Psychotic Disturbances, Mood Disturbances, and Major Depressive Disorder.R3's Care Plan, dated 12/15/24, documents R3 as having Impaired Cognitive function related to Dementia, Communication Problem related to Dementia, Impaired Visual Function, Behavior problems, and Major Depression.On 9/3/25 at 2:53 PM, V6, Certified Nursing Assistant/CNA, stated both R2 and R3 were sitting in their wheelchairs at the nurse's station and R2 started yelling at R3 that R3 took R2's fan. V6 stated, As we were backing (R3) up away from (R2), (R2) reached over and hit (R3) on the shoulder two times with an open hand.On 9/4/25 at 11:43 AM, V3, Licensed Practical Nurse/LPN, stated the incident between R2 and R3 happened after dinner. V3 stated R2 was having a bad day. V3 stated she heard R2 say you stole my fan to R3. V3 stated a CNA (unknown) went to pull R2 away from R3 (both in wheelchairs), and R2 made a motion with her arm/hand like R2 was going hit R3 and R2's fingertips grazed R3's shoulder. V3 stated R2 had an open hand, but only her fingertips grazed R3. V3 stated R3 asked what happened because R2 was yelling at R3 and R3 said what did I do wrong? V3 stated R2 can get agitated and yell. V3 stated R2 and R3 were once in a room together but R3 was moved to another room because R2 would yell at R3.The facility's Abuse Policy, dated 8/16/19, documents the facility affirms the right of the residents to be free from abuse and therefore prohibits abuse of the residents and has attempted to establish a resident sensitive and resident secure environment.

This same policy also documents the facility is committed to protecting the residents from abuse by anyone including other residents.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

09/05/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Imboden Creek Senior Living

180 West Imboden Decatur, IL 62521

SUMMARY STATEMENT OF DEFICIENCIES

Based on interview and record review, the facility failed to timely review and revise comprehensive care plans.

This failure affects three residents (R1, R2, R3) of three residents reviewed for care plans in the sample list of 12 residents.Findings include:R1's most current Care Plan is dated 11/9/24. R2's most current Care Plan is dated 9/16/24, and R3's most current Care Plan is dated 12/15/24.On 9/4/24 at 10:49 AM, V1 Administrator stated, we don't have anyone at this facility doing care plans, it's all done at the corporate level.The facility's policy Care Plans, Comprehensive Person-Centered dated Revised December 2016, documents their policy is a comprehensive, person-centered care plan that includes measurable objectives and timetables to meet the resident's physical, psychosocial and functional needs is developed and implemented for each of the residents.

This same policy documents the care plan will identify problem areas and their causes and develop interventions that are targeted and meaningful to the residents.

This same policy documents the Interdisciplinary Team must review and update the care plan when there has been a significant change, when the desired outcome is not met, and at least quarterly in conjunction with the required quarterly Minimum Data Set (MDS) assessment.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

09/05/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Imboden Creek Senior Living

180 West Imboden Decatur, IL 62521

SUMMARY STATEMENT OF DEFICIENCIES

Based on observation, interview, and record review, the facility failed to implement a fall intervention for one resident (R1) of three residents reviewed for resident injury in the sample list of 12.Findings include:R1's undated Diagnoses list includes fracture of other parts of the pelvis, subsequent encounter for fracture with routine healing, Chronic Pain due to trauma, other reduced mobility, unspecified abnormalities of Gait and Mobility, and unsteadiness on feet.R1's Care Plan, dated 10/15/24, documents impaired cognitive function or impaired thought processes, impaired decision-making, long-term memory loss, short term memory loss related to age, history of falling, and decreased mobility with an intervention for an alarm when in the chair related to impulsivity. R1's Fall Risk Evaluation, dated 6/13/25, documents R1 is at risk for falls due to intermittent confusion, being chair bound, and requiring use of assistive devices.Throughout the survey, on 9/3/24, 9/4/25, and 9/5/25, there was no alarm present in R1's wheelchair while R1 was present in the wheelchair. On 9/3/25 at 10:30 AM, R1 stated once in a great while, she will try to transfer by herself. R1 stated she has lost count of how many times she has fallen recently. At this same time, R1 was observed to have faded bruising on right and left arms and right temple, and no alarm was present in R1's wheelchair.On 9/5/25 at 10:45 AM, V3, Licensed Practical Nurse, stated R1's Care Plan documents R1 should have a chair alarm. V3 stated, I need to get an alarm.On 9/3/25 at 11:22 AM, V5, Certified Nurse Aide, stated R1 uses a bed alarm and chair alarm, and everyone tries to look out for R1 because she goes all over the place in her wheelchair, and she tries to transfer herself all day, every day.

Facility ID:

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 DECATUR, 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 IMBODEN CREEK SENIOR LIVING or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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