Lee Manor
LEE MANOR in DES PLAINES, IL — inspection on March 27, 2026.
Found 1 citation. 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
dependent residents.
This applies to 4 of 4 residents (R1-R4) reviewed for incontinence care in a
per the Minimum Data Set (MDS) dated [DATE].
The MDS also documents that R1 is dependent on toileting hygiene.On 3/27/26 at 9:40 AM, R1 was observed in his bed, pointing to his soaked incontinent brief.
Upon the writer's request, V4 (Certified Nursing Assistant / CNA) checked on R1 for incontinence and observed R1 with a brownish colored urine-soaked incontinent brief.On 3/27/26 at 9:40 AM, V4 stated that she started at 7:00 AM and didn't get a chance to change R1.A review of the R1's incontinent care plan document interventions, including clean peri-area with each incontinent episode.2.R2 is a [AGE] year-old male with severely impaired cognition as per the MDS dated [DATE].
The MDS also documents that R1 is dependent on toileting hygiene.On 3/27/26 at 10:10 AM, R2 was observed on his low bed with two incontinent briefs on and mattress linen wet.
The inner brief was observed to be urine-soaked with a brownish discoloration.On 3/27/26 at 10:10 AM, V6 (CNA) stated, R2 is peeing a lot, and that's why I put him on two diapers. I am going to change him with only one diaper now.A review of R1's incontinent care plan document interventions, including assisting the resident by toileting frequently.3.R3 is an [AGE] year-old female with moderate cognitive impairment as per the MDS dated [DATE].
The MDS also documents that R1 is dependent on toileting hygiene.On 3/27/26 at 10:15 AM, R3 was observed in her bed with a brownish discolored, urine-soaked incontinent brief.On 3/27/26 at 10:15 AM, V7 (CNA) stated, R3 was changed around 7:00 AM by night CNA, and I am going to change her now.A review of the R3's incontinent care plan document interventions, including: Assist the resident by toileting frequently.4.R4 is a [AGE] year-old female with severely impaired cognition as per the MDS dated [DATE].
The MDS also documents that R1 is dependent on toileting hygiene.On 3/27/26 at 10:20 AM, R3 was observed in her bed with a urine-soaked brief with brownish discoloration even to the outside of the brief and mild wet padding.On 3/37/26 at 1022 AM, V8 (Hospice CNA) stated that she visits R4 twice per week and that she is going to change R4 now.A review of the R4's incontinent care plan document interventions, including incontinent care after every diaper change.On 3/27/26 at 1:45 PM, V2 (Director of Nursing / DON) stated, It's not acceptable to leave residents with urine-soaked, brownish-colored incontinent briefs. I will talk to my staff on putting two diapers on residents and to check on residents frequently.
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 TITLE (X6) DATE REPRESENTATIVE'S SIGNATURE