Flanagan Rehabilitation & Hcc
FLANAGAN REHABILITATION & HCC in FLANAGAN, IL — inspection on September 18, 2025.
Found 3 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
Based on interview and record review the facility failed to ensure care plans included problems, goals, and interventions to address diagnoses and medication use for two of three residents (R2, R3) reviewed for medications in the sample list of three.
Findings include:1.) R2's active diagnoses list includes epileptic seizures related to external causes, not intractable, without status epilepticus. R2's September 2025 Medication Administration Record (MAR) documents R2 receives Lamotrigine 200 milligrams (mg) by mouth twice daily for seizures since 2/3/24 and Phenytoin Sodium100 mg give two capsules by mouth twice daily for seizures since 5/24/25.R2's active care plan does not include a problem, goal, and interventions for R2's seizure disorder and seizure medications. On 9/18/25 at 12:55 PM V2 Director of Nursing confirmed R2's seizure disorder and seizure medications were not on R2's care plan. V2 stated V2 is responsible for updating the care plans and V2 will update R2's care plan. 2.) R3's September 2025 MAR documents R3 receives Tramadol (opioid) 50 mg one tablet by mouth daily since 4/18/23. R3's active care plan does not have a problem, goal, and interventions for opioid use and monitoring, including risk for constipation. On 9/18/25 at 12:55 PM V2 confirmed R3's care plan does not address Tramadol use, interventions, and risk for constipation. V2 stated V2 will need to update R3's care plan.
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
09/18/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Flanagan Rehabilitation & Hcc
201 East Falcon Highway Flanagan, IL 61740
SUMMARY STATEMENT OF DEFICIENCIES
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on interview and record review the facility failed to implement a bowel program for one of three residents (R3) reviewed for medications in the sample list of three.
Findings include:R3's August and September 2025 Medication Administration Records document R3 receives Tramadol (opioid) 50 milligrams by mouth daily since 4/18/23 and Milk of Magnesia 30 milliliters daily as needed for constipation.
These records document R3 does not receive any scheduled bowel medications and did not receive any doses of Milk of Magnesia.
R3's Minimum Data Set, dated [DATE] documents R3 has severe cognitive impairment and requires dependence on staff for toileting hygiene. R3's active care plan does not address R3's Tramadol use and monitoring, including risk for constipation. R3's Bowel Tracking Report with date range 8/20/25-9/18/25 documents the following: Large on 8/20/25.
None 8/21/25-8/23/25.
Large on 8/24/25.
None 8/25/25-8/27/25.
Large on 8/28/25.
None 8/29/25-9/1/25.
Large on 9/2/25.
None on 9/3/25 and 9/4/25.
Large on 9/5/25.
Two to three daily 9/6/25-9/8/25.
Once on 9/9/25 and 9/10/25.
None 9/11/25-9/13/25.
Large on 9/16/25.
None 9/17/25 and 9/18/25. R3's Nursing Notes with range 8/15/25-9/18/25 do not document R3 was assessed for constipation, offered Milk of Magnesia, or offered any other bowel interventions. On 9/18/25 at 11:29 AM V4 Registered Nurse stated the (electronic medical software) triggers an alert if a resident doesn't have a bowel movement (BM) for three or more days. V4 stated the Certified Nursing Assistants (CNAs) document the residents' BMs. V4 stated R3 has Milk of Magnesia to administer daily as needed. V4 stated R3 has occasional constipation, but nothing frequent. V4 confirmed R3 does not have orders for any other bowel medications. On 9/18/25 at 11:55 AM V3 CNA stated V3 is assigned to R3's care today and R3 has not had a BM today. V3 stated BMs are documented by the CNAs in (electronic medical software) and complaints of constipation are reported to the nurses. V3 stated R3's BMs are generally soft, but R3 has constipation about once per week. On 9/18/25 at 12:55 PM V2 Director of Nursing confirmed R3's care plan does not address opioid use and monitoring, including risk for constipation. V2 stated the facility has a bowel protocol to follow, which V2 will provide. V2 stated the (electronic medical software) sends an alert after three full days have passed with no BM, and continues to alert until addressed/resolved with BM documented. V2 reviewed R3's bowel tracking 30 day report, and confirmed duration of days with no BMs recorded. V2 stated R3 had BMs on day four, so the system would not have prompted an alert. V2 stated V2 will have to see if the system can be changed to alert on day two. V2 stated V2 would expect Milk of Magnesia to be given on day four of no BM. V2 stated V2 might look into getting R3 something scheduled routinely for R3's bowels. V2 confirmed risk of constipation with opioid use. At 2:45 PM V2 stated V2 followed up with corporate staff, and the facility does not have a bowel protocol; it is individually based on each resident's needs and bowel patterns. V2 stated it would also be based on if the resident was experiencing any symptoms such as nausea, vomiting, decreased appetite; which R3 has not had.
Facility ID:
IDENTIFICATION NUMBER:
A.
Building
COMPLETED
09/18/2025
STREET ADDRESS, CITY, STATE, ZIP CODE
Flanagan Rehabilitation & Hcc
201 East Falcon Highway Flanagan, IL 61740
SUMMARY STATEMENT OF DEFICIENCIES
which caused her to have withdrawal symptoms. V7 states that any decrease of a controlled substance could cause harm if stopped abruptly without tapering and could lead to seizures, altered mental status, dizziness, syncope, and unresponsiveness. V7 stated from his clinical standpoint that stopping R1's Ativan abruptly caused R1 to become unresponsive and fall, resulting in admission into the hospital.
The Facilities Medication Administration Policy Documents that Any changes in medication orders must be documented in the resident's medical record and Medication administration records should be maintained for each resident and must be up to date and easily accessible.
Facility ID: