Forest View Rehab & Nursing Center
Inspection Findings
F-Tag F0803
F 0803 Level of Harm - Minimal harm or potential for actual harm
services or designee will be responsible for assuring that all foods needed for meal assembly are present at
the appropriate time.4. The meal will be checked against the therapeutic diet spread sheet to assure that foods are served as listed on the menu. 6. Each meal will be checked for: a. Correct name, room number, and diet order b. Accuracy of following the therapeutic diet extension c. Proper portion sizes.
Residents Affected - Many
FORM CMS-2567 (02/99) Previous Versions Obsolete
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
09/17/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Forest View Rehab & Nursing Center
535 South Elm Itasca, IL 60143
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)
F-Tag F0804
F 0804
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Level of Harm - Minimal harm or potential for actual harm
Based on observation, interview, and record review, the facility failed to follow the facility's policy to serve food at a palatable temperature. This applies to 6 of 6 residents (Resident R1, Resident R2, Resident R3, Resident R4, Resident R5, and Resident R6) reviewed for dietary services in the sample 6. The findings include: On September 15, 2025, at 11:48 AM, during lunch tray line service with V5 (Cook) and V6 (Cook), V5 and V6 served resident room meal trays on hard plastic, non-warmed, room temperature plates with lids. V5 and V6 did not use thermal bases or heated plates. On September 15, 2025, at 12:47 PM, V6 prepared a test meal tray. V6 used a hard plastic, non-warmed plate and placed cheese tortellini with meat sauce, green beans, and one piece of a plain breadstick. V6 placed a lid on the plate and placed the plate directly onto a serving tray. The tray was placed on an open-air unit meal cart with the 1 North resident meal trays. At 12:51 PM, the meal cart was delivered to the 1 North resident hallway with the other resident meal trays. At 1:10 PM, when the last resident meal tray was delivered, V5 took the temperatures of the food on the test tray. V5 said the temperature of pasta with meat sauce was 110 degrees Fahrenheit and the green beans were 110 degrees Fahrenheit. The pasta with meat sauce and the green beans tasted lukewarm. On September 15, 2025, at 4:54 PM, Resident R1 said her warm food is frequently served cold. On September 15, 2025, at 2:55 PM, Resident R2 said his warm food is usually served cold. On September 15, 2025, at 5:23 PM, Resident R3 said the facility food is disastrous and is almost always not served warm enough. On September 16, 2025, at 2:38 PM, Resident R4 said the warm food is frequently served cold. On September 16, 2025, at 2:40 PM, Resident R5 said he gets served cold food when it is supposed to be warm. On September 16, 2025, at 2:40 PM, Resident R6 said food that is supposed to be warm is served cold and the food that is supposed to be cold is served warm. On September 16, 2025, at 12:28 PM, V4 (Dietitian) said the dietary staff should be using heated plates, warming bases, plate covers, and closed carts to transport food to resident rooms. V4 said the base and the lid help to maintain food temperatures.
V4 said it is her expectation the food served to residents should not be less than 125 degrees Fahrenheit.
The facility's policy titled, Food Temperatures at Point of Service dated July 14, 2023, shows, Policy: Food will be prepared, held, and served in a manner that preserves nutritive value and palatability.Procedure:.4.
Best efforts will be made to present hot food hot and cold foods cold at point of service by using thermal lids and bases, heated or chilled plates and thermal pellets as necessary. The facility policy titled, Food Temperature Resident Service dated April 2022, shows, Policy: The facility will ensure foods are served in
an attractive and at temperature that is palatable and acceptable to the residents. Procedure:.3. Food will be transported to the dining rooms or resident rooms in methods that maintain the proper temperatures of
the food. 4. Hot foods will be served to the residents at a temperature palatable and acceptable to the resident, general practice should not be less than 125F.
Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
Event ID:
Facility ID:
If continuation sheet
FOREST VIEW REHAB & NURSING CENTER in ITASCA, IL inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
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 ITASCA, 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 FOREST VIEW REHAB & NURSING CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.