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Complaint Investigation

Southgate Health Care Center

Inspection Date: November 19, 2025
Total Violations 1
Facility ID 145386
Location METROPOLIS, IL
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Inspection Findings

F-Tag F0925

Environmental Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0925

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Level of Harm - Minimal harm or potential for actual harm

Based on observation, interview and record review the facility failed to maintain the kitchen free from roaches. This failure has the potential to affect all 94 residents residing in the facility.Findings include:On 11/18/25 at 10:25 AM, a cockroach was crawling across the back of the hand washing sink in the kitchen.On 11/18/25 at 10:33 AM, a cockroach was crawling along the wall under the 3-compartment sink

in the kitchen.On 11/18/25 at 11:28 AM, two cockroaches were crawling along the wall next to the three-compartment sink in the kitchen.On 11/18/25 at 10:28 AM, V3 (Cook) said the kitchen had a lot of cockroaches and had been trying to get rid of them since V3 started in January of 2025. V3 said a pest control company would come to the facility once a month and the cockroach problem would get better, but

they would slowly return. V3 said staff tried to keep the kitchen as clean as possible to decrease the cockroach population.On 11/18/25 at 3:50 PM, V4 (Chief Executive Officer) said the dietary manager should have told us there were roaches in the kitchen and he would have called the exterminator to come back and spray. V4 said he had called the pest control company to ask what they were using to exterminate

the cockroaches and question why kitchen was still infested. V4 said the pest control company told him the kitchen was large, and they had been trying to exterminate the cockroaches and V4 said he told the pest control company they were going to have to try harder because this was unacceptable.The facility's 11/18/25 Pest Control policy documented in part .This policy establishes standardized procedures for preventing, identifying, reporting, and treating pest activity within the facility. Reporting. 1. Staff must report any pest activity immediately to: Maintenance Director. 3. Maintenance will notify the contracted pest control provider if immediate treatment is required outside of their monthly inspection. The facility's 11/18/25 Daily Census documented 94 total residents living in the facility.

Residents Affected - Many

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:

📋 Inspection Summary

Southgate Health Care Center in METROPOLIS, IL inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

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 METROPOLIS, 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 Southgate Health Care Center or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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