Arc At Hickory Point
ARC AT HICKORY POINT in FORSYTH, IL — inspection on September 3, 2025.
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
the rib cage) and found there to be a displacement or a deformity in her rib cage.
Computed Tomography (CT) scan of R1's chest, dated 7/10/25, documents R1 had multiple left-sided rib fractures, a collection of blood in the chest cavity, and a left sided collapsed lung. A follow-up X-ray of R1's chest, dated 7/10/25, documents R1's left-sided collapsed lung had worsened, was moderate in size, and had an increase in bleeding and bruising.
This x-ray also documents multiple rib fractures.On 9/03/25 at 9:45 AM, V10, Licensed Practical Nurse, stated she was the nurse caring for R1 at the time of R1's fall. V10 stated R1 was a known fall risk and R1 didn't have any fall interventions in place. On 9/03/25 at 12:48 PM, V11, CNA, stated R1 was a known fall risk, and the only intervention she knew of was to put R1's bed in the low position.On 9/3/25 at 1:35 PM, V14, MDS/Care Plan Coordinator, stated she did a Baseline Care Plan for R1 on admission, and it included falls as a problem. V14 stated the only intervention that was marked on the Care Plan was for staff to ensure R1 was wearing appropriate footwear. V14 stated other fall interventions should have been on the R1's Care Plan for the prevention of falls.On 9/03/25 at 2:27 PM, V15, CNA, stated she knew R1 was a fall risk and there were no fall interventions in place that she was aware of.On 9/03/25 at 2:38 PM, V16, CNA, stated she didn't know R1 was a fall risk, but some of the CNA's would put R1's bed in the low position. V16 stated there were no other fall interventions.On 9/03/25 at 1:40 PM, V13, Assistant Director of Nursing/LPN, confirmed R1's fall risk assessment was completed on 6/29/25, and R1's score was 13, indicating she was at a high risk for falls. V13 stated fall risk assessments are completed to determine a resident's risk for falls and to develop appropriate interventions according to the resident's risk.On 9/03/25 at 2:54 PM, V12, Regional Nurse Consultant, stated they have an IT (Information Technology) issue with Care Plans, and fall interventions should have been in place.On 9/03/25 at 1:35 PM, V2, Director of Nursing, stated R1 was pleasantly confused and easily redirected. V2 stated R1 was a fall risk, and that having fall interventions in place could have changed R1's outcome. On 9/03/25 at 3:47 PM, V17, Physician (former Medical Director), stated if there had been proper fall protocols and precautions in place for R1 it might have changed R1's outcome.
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