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Complaint Investigation

Countryside Care Center

September 3, 2025 · Macomb, IL · 400 West Grant Street
Citations 3
CMS Rating 1/5
Beds 62
Provider ID 146080
Healthcare Facility
Countryside Care Center
Macomb, IL  ·  View full profile →
Inspection Summary

COUNTRYSIDE CARE CENTER in MACOMB, IL — inspection on September 3, 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.

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Inspection Findings

FF0684
Quality of Life and Care Deficiencies
Actual Harm

would do nothing but sit at the nursing station and watch movies on (V8's) phone, and that they never saw (V8) take the medication cart up and down the hallway for the heavy 6:00 am medication pass or passing medications. I think that (V8) was very strategic with certain Resident's depending on their cognition as far as not giving medications. I told V1 (Administrator), V19 (Former Director of Nursing/DON), V5 (Assistant Director of Nursing/ADON) multiple times about (V8) not doing the job, then I would come on shift and have to clean everything up and deal with it. (V8) should have given medications and sent out (R4) and (R9) to the hospital way before us first shift nurses got in.

Those poor Residents sat there for hours without (V8) monitoring or helping them.On 8/30/25 at 11:44 am, V8 (Agency Registered Nurse/RN) stated They came to me about (R9) not breathing well, but (R9) had COPD for gosh sakes, so (R9) was not going to be breathing well. I did give (R9) a nebulizer that morning, but I did not sign it out. (R4) was so confused, did anyone take into consideration that (R4) probably does not remember getting his medications.

Honestly, does it really matter on medications if a dose, here or there, does get missed. As far as I am concerned, if I signed it, I gave it.On 9/2/25 at 9:54 am, V4 (Ombudsman) stated, I heard they had problems with a night shift nurse over there, from the Residents.

Something with medications and not sending people out to the hospital.On 8/29/25 at 11:10 am, V5 (Assistant Director of Nursing/ADON) stated, I did hear the staff and Residents complaining about (V8) not doing his job. We needed our third shifts covered and needed him still to come in. I am not quite sure if (V19/Former DON) was still working here or not, so I am not sure who really took care of the issues. (V8) was in charge of the entire building on night shift, since there was only one nurse on duty. I would hear that he would leave sometimes for lunch and that definitely was not allowed. We ended up terminating (V8) through the Agency due to all of these issues.On 8/29/25 at 10:10 am, V1 (Administrator) stated, (V8) was employed through an Agency and because we were aware that (V8) was not performing the job duties, so we ‘DNR'd/Do Not Rehire. (V8), so basically (V8) was terminated.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

09/03/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Countryside Care Center

400 West Grant Street Macomb, IL 61455

SUMMARY STATEMENT OF DEFICIENCIES

the corner of the mat to keep it flat. It lasted a couple of days then it rolled back up again.On 8/28/25 at 4:45 PM V4/Ombudsman stated that she had come into the facility and saw R1's face was bruised under both eyes and across R1's nose. R1 told V4 that she (R1) had tripped over a rug. V4 also stated that she was told by R2/Resident Council President that management was made aware of the rug being a trip hazard before R1 fell.On 8/29/25 at 10:05 AM, V1/Administrator stated that there was a nine foot long by four-foot-wide nonskid mat in front of the entry door.

The mat extended past the front of the staff breakroom.

The weekend before R1 fell on Tuesday 8/5/25 the residents had complained to V13/Registered Nurse that the rug was in disrepair and needed replaced. V13 told V1 about the residents' complaints. A new mat was ordered on 8/4/25 but the worn mat was not removed until after R1 tripped and hit her head on the staff breakroom door.

After R1's injury on 8/5/25 the rug was removed to prevent any other accidents.On 8/29/25 at 11:36 AM, V14/Maintenance stated that a few days before R1 tripped they (staff) had talked about removing the rug.

They were saying Someone is going to trip over it then (R1) did. I carried it (the mat) to the dumpster the same day that (R1) fell.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

09/03/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Countryside Care Center

400 West Grant Street Macomb, IL 61455

SUMMARY STATEMENT OF DEFICIENCIES

co-workers and that V6's contract was not going to be renewed.On 8/29/25 1:50 pm, V5 (Assistant Director of Nursing/ADON) stated (V19/Former Director of Nursing) put her notice in and I think her last day was 6/10/25, then we went without a Director of Nursing for a while. (V6) was on a thirteen-week contract, but (V6) got terminated for multiple reasons. (V6) was not documenting falls and medications, although (V6) was asked to several times. I know there was an issue with (R5's) Morphine because almost a whole bottle went missing on V6's shift and the Morphine was not documented by (V6), they never found the narcotic count sheet or the bottle of Morphine. I am not sure who investigated that, I never heard much more about it.On 8/30/25 at 10:30 am, V23 (Corporate Nurse) stated, (V6/Contracted LPN) was a contracted employee on a 13-week contract, but we terminated the contract on 8/11/25. We did not do an entire investigation on this missing Morphine. I cannot see where Pharmacy, Physician, Residents or other employees were interviewed. We never found the empty bottle of Morphine either.

Facility ID:

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 MACOMB, 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 COUNTRYSIDE CARE CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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