Abbington Vlge Nrsg & Rhb Ctr
Abbington Vlge Nrsg & Rhb Ctr in ROSELLE, IL — inspection on September 29, 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.
Inspection Findings
Review of R7's care plan showed R7 was dependent on two staff for transfers with a mechanical lift and was incontinent of bowel/bladder. R7 was care planned for being upset after five minutes if a CNA did not arrive to assist him and care planned to allege that he was waiting for hours.
On 9/24/25 at 3:250 PM, R7 stated it took over an hour for staff to arrive to change his soiled incontinence brief. R7 stated he had the same incontinence brief on since 8:30 AM that morning. 3.
Face Sheet, dated 9/25/25, shows R9 had a diagnosis of hemiplegia and hemiparesis following a cerebral infarction affecting her left non-dominant side. MDS, dated [DATE], shows R9 was cognitively intact, was completely dependent on staff for toileting hygiene, and was always incontinent of bowel and bladder.
Review of R9's care plan showed R9 was incontinent of bowel/bladder, was dependent on staff assistance for toileting, and required the assistance of two staff utilizing a mechanical lift for transfers.
The care plan showed R9 was to be provided incontinence care after each incontinence episode. On 9/25/25 at 11:35 AM, R9 stated she usually waits an hour for CNAs on the first and second shifts to arrive to change her soiled incontinence briefs.
146065 09/29/2025
Abbington Vlge Nrsg & Rhb Ctr 31 West Central Roselle, IL 60172
applies to 4 of 5 residents (R1, R5, R7, and R9) reviewed for food palatability in a sample of 5.
The
9/24/25 at 1:10 AM, R1 stated his food was often served late and the hot food was cold. 2. MDS, dated [DATE], shows R7 was cognitively intact. On 9/24/25 at 3:50 PM, R7 stated his food is served cold and usually an hour late. 3. MDS, dated [DATE], shows R9 was cognitively intact. On 9/25/25 at 11:35 AM, R9 stated the food was often served late and cold. 4. MDS, dated [DATE], shows R5's cognition was severely impaired. On 9/24/25 at 11:55 AM, R5 stated her food is often served late and the hot food is cold. 5.
Resident Council Meeting Minutes, dated 6/27/25, show the residents in the meeting complained that the breakfast meals were always cold when they received them.
Resident Council Meeting Minutes, dated 7/25/25, show the residents stated the kitchen food continued to arrive cold, and the CNAs (Certified Nursing Assistants) were taking too long to pass meal trays to residents.
Emergency Food Committee Meeting Minutes, dated 9/12/25, shows Residents will have lunch in the dining room to improve food temps. On 9/27/25 at 8:26 AM, V1 (Administrator) stated the facility did not have a policy on food palatability or food temperature expectations at the point of service to residents.
146065 09/29/2025
Abbington Vlge Nrsg & Rhb Ctr 31 West Central Roselle, IL 60172
Based on observation, interview and record review, the facility failed to serve resident meals at
receiving oral diets.
The findings include: On 9/24/25 in the main dining room, meal times were posted stating that Breakfast would be served at 8:30 AM, Lunch would be served at 12:30 PM and Dinner would be served at 5:30 PM. On 9/24/25 in the main dining room lunch trays began to be delivered at 12:50 PM and were finished being served by 1:00 PM. On 9/24/25 during facility tour, R1, R2, R4, R5 and R7 all stated the meals at the facility were served late. R2 and R4 stated the meal trays arrived 30-45 minutes late, R6 stated sometimes the food came 20 minutes late, and R7 stated the food was usually served an hour late and sometimes received lunch at 1:15 PM. On 9/25/25 at 11:35 AM, R9 stated the food was usually served more than 30 minutes late. On 9/24/25 at 12:23 PM, V4 (Certified Nursing Assistant) stated the meal trays were usually served approximately 25 minutes late. On 9/24/25 at 11:03 AM, V5 (Cook) stated the food service was staffed with two aides in the morning but they were reduced to one aide which slowed down meal service. V5 stated the meal service may be later depending on how many items must be placed on the tray. V12 (Food Service Worker) stated the latest the staff have finished lunch was 1:15 PM. V12 stated in the past they were able to finish plating meals at 12:30 PM. On 9/25/25 at 8:40 AM, V8 (Food Service Manager) stated he was back from vacation and would serve as a second aide to ensure that meals were served on time. On 9/25/25 at 8:45 PM, V1 (Administrator) stated V8 returned from vacation and would serve as the second aide to make sure the meals were served on time.
Facility Bed Roster, dated 9/23/25, shows the facility census was 61 residents. On 9/28/25, V1 (Administrator) stated there was one resident in the facility who did not receive oral diets.
Resident Council Meeting Minutes, dated 7/25/25, shows the residents expressed concerns that the staff were taking too long to pass trays to residents.
Resident Council Meeting Minutes, dated 8/29/25, show, Lunch keeps coming later and later.
Facility Meal Schedule Policy, undated, shows, Three meals will be served daily at similar times as served in the community.
The policy states mealtimes will be posted throughout the facility where they are accessible to residents and visitors.
Frequently Asked Questions
More Reports
Source: This inspection report was downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases nursing home inspection reports in bulk. The findings reflect what state surveyors documented in the official Form CMS-2567 Statement of Deficiencies on the date of the inspection.
Plan of correction not included: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to their state survey agency and those responses may not appear in CMS public data at the time of release. The absence of a plan of correction in this report does not mean one was not filed. Readers who want information about corrective steps taken by the facility are encouraged to contact the facility or their state survey agency directly.
Corrections may have been made: This report reflects conditions observed on the date of the survey. The facility may have implemented staffing changes, additional training, policy revisions, or other corrective actions since this report was issued. We publish what CMS provides and encourage readers to seek current information from the facility.