Odd Fellow-rebekah Home
Inspection Findings
F-Tag F0755
F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
nurse can call the regular pharmacy provider, which has an on-call service available 24 hours per day; however, the on-call service might be located in California. V2 further stated that the on-call service would call area pharmacies to locate one able to fill the needed medication. V2 additionally stated that if a resident is out of a medication, they typically only need one or two doses before the regular pharmacy delivery arrives, making it difficult to find a pharmacy willing to fill an order for one or two pills, especially if the facility is not a regular customer. V2 concluded by stating that the special on-call delivery might still take up to 12 hours, at which point it would be just as effective to wait for the regular daily pharmacy delivery.
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
11/26/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Odd Fellow-Rebekah Home
201 Lafayette Avenue East Mattoon, IL 61938
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 F0760
F 0760
Ensure that residents are free from significant medication errors.
Level of Harm - Minimal harm or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, interview, and record review, the facility failed to ensure that a resident was free from a significant medication error involving an anti-seizure medication. This failure affected one resident (Resident R2) out of three reviewed for anti-seizure medications on the sample list of three.Findings include: Resident R2's Census Detail dated 11/25/25 documented that Resident R2 was admitted to the facility on [DATE REDACTED].Resident R2's Medical Diagnoses List dated 11/25/25 documented that Resident R2's medical diagnoses included epilepsy.Resident R2's Physician Prescription Facsimile from the neurologist (V6), dated 9/22/2025, documented an order for Resident R2 to take two tablets of Keppra 250 milligrams (mg) by mouth twice a day, totaling 500 mg twice daily.Resident R2's Physician Order Sheet entry dated 6/12/2024 documented an order for Resident R2 to receive Levetiracetam oral tablets, 250 mg, to be given by mouth twice a day.On 11/25/2025 at 11:45 a.m., V3, Licensed Practical Nurse, stated she gave Resident R2 one tablet of Keppra 250 mg that morning during her medication administration pass. V3 verified the order
in Resident R2's Medication Administration Record (MAR) as one tablet of Keppra 250 mg by mouth twice a day.On 11/25/2025 at 11:55 a.m., a bubble pack of Keppra 500 mg was observed for Resident R2, documenting that one 500 mg tablet was to be given by mouth twice a day. The bubble pack was retrieved from the medication cart by V3. Handwritten on the medication bubble pack was 1/2 tab. V3 stated that 1/2 tab indicated one-half of a tablet was to be given at each dose, equaling a 250 mg dose twice daily.On 11/25/2025 at 12:15 p.m., Resident R2's MAR documented that Resident R2 had been administered Keppra 250 mg by mouth twice a day from 9/1/2025 through the morning dose on 11/25/2025.On 11/25/25 at 2:48 p.m., V2, Director of Nursing, confirmed that the most recent physician order from the neurologist (V6) was for Keppra 250 mg with instructions to administer two 250 mg tablets twice daily, for a total of 500 mg twice daily. V2 stated the facsimile did not have a signature from facility nursing staff and the document must have been uploaded into Resident R2's electronic medical record prior to the nurses transcribing the new order onto Resident R2's Physician Order Sheet. V2 confirmed that the current dose should be 500 mg twice daily.
Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
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Facility ID:
If continuation sheet
ODD FELLOW-REBEKAH HOME in MATTOON, 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 MATTOON, 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 ODD FELLOW-REBEKAH HOME or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.