Avantara Lake Zurich
Inspection Findings
F-Tag F0561
F 0561 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, interview, and record review the facility failed to ensure a resident was treated in a dignified manner for 1 of 5 residents (Resident R1) reviewed for dignity in the sample of 5. The findings include: On 8/26/25 at 9:54 AM, Resident R1 was in bed in her room. Resident R1 moved slowly as she sat up in bed. Resident R1 said the first night she was here, she had to go to the bathroom and couldn't find her call light. Resident R1 said she uses the bedpan since she has a broken pelvis and is working with therapy on getting up to the bathroom. Resident R1 said no one was coming to check on her and she ended up going in her brief. Resident R1 said she was sitting in urine and yelling for someone to come help her. Resident R1 said she was so frustrated and humiliated, and she called 911 to get help. Resident R1 said while she was on the phone with 911, the nurse came in and asked if she called 911 and what she needed. Resident R1 said she needed to be changed and then staff came to help her. Resident R1 said at first, she was frustrated and humiliated but then it became scary that no one was there to help her. Resident R1 said she felt helpless and that is why she called 911. On 8/26/25 at 11:49 AM, V5 Licensed Practical Nurse said he received a call from the police that the resident in room [ROOM NUMBER] needed help and couldn't find her call light. V5 said he went to Resident R1's room and asked her if she called 911 and what she needed. V5 said Resident R1 told him she couldn't find her call light and she had needed to use the bedpan and be changed. V5 said
he told Resident R1 he would send the Certified Nursing Assistant (CNA) to help her and then left the room to go back to the police who were holding on the phone.On 8/26/25 at 12:14 PM, V7 CNA said he was told by V5 that Resident R1 had called the police and needed to be changed. V7 said when he went into Resident R1's room, her call light was tied to the bed rail, but Resident R1 said she didn't see it there. V7 said Resident R1 was very frustrated about not being able to use the bedpan and being wet. V7 said Resident R1's brief was wet with urine. V7 said Resident R1 is alert and oriented. On 8/26/25 at 11:07 AM, V4 Registered Nurse said she took care of Resident R1 on day after her admission. V4 said she got in report from the nurse that Resident R1 had called the police because she couldn't find
the call light, but the call light was beside her. V4 said Resident R1 reported to her that she was waiting for over an hour for someone to come around, no one was coming and she needed help, couldn't find the call light so
she called 911. V4 said Resident R1 is a former nurse, is alert and oriented, and knows when she needs to use the bed pan. V4 said Resident R1 was very frustrated and should not have to feel like that.Resident R1's Progress Note dated 8/20/25 shows admitted a [AGE] year old female from hospital via stretcher accompanied by paramedics.
Primary diagnosis is closed fracture of left inferior pubic ramus non-surgical. Resident is alert and oriented times three.The facility's Privacy and Dignity Policy dated 7/3/25 shows It is the facility's policy to ensure that resident's privacy and dignity is respected by the staff at all times.
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
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
AVANTARA LAKE ZURICH in LAKE ZURICH, 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 LAKE ZURICH, 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 AVANTARA LAKE ZURICH or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.