Randolph County Care Center
Inspection Findings
F-Tag F0689
F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
we get report information from the nurse, we don't have time to go through the care plans. She (Resident R1) has not had a mat nor been on 15-minute checks.2.Resident R2's admission Record, print date of 10/23/25, documented Resident R2 has diagnoses including disorientation, osteoarthritis, hyperlipidemia, anxiety disorder, hypertension, and depression. Resident R2's MDS, dated [DATE REDACTED], documented Resident R2 is moderately cognitively impaired although at time of interview Resident R2 was severely cognitively impaired. This MDS also documented Resident R2 requires substantial to maximal assistance with transfers. Resident R2's Care Plan Report, undated, documented Resident R2 is high risk for falls related to gait/balance problems, incontinence, and unaware of safety needs. Interventions include ensure resident is wearing appropriate footwear when ambulating or mobilizing in wheelchair.Resident R2's Incident Report, dated 10/20/25, documented this nurse was notified by CNA that this resident was on the floor in her room.
Upon entering resident's room noted resident lying on her left side against the wall in front of her WC (wheelchair). Immediate action taken: Assessed for injuries. Noted hematoma to center of forehead and to
the left side of her forehead. Scant bleeding from her left cheek. Very small scrape to left cheek. Cleansed with NS (normal saline) and LOTA (left open to air). Sat resident up on her buttocks. No c/o pain other than
a headache. Assisted resident off the floor x2 assist and into her WC. Noted that resident's glasses were broken on the left side. VS (vital signs) obtained. Noted elevation in resident's BPs. On call doctor notified.
Order given to sent to ER for evaluation to rule out a brain bleed. On 10/23/25 at 12:13 PM Resident R2 was observed in the dining room in her wheelchair. Resident R2 was observed with bilateral black eyes and Resident R2 was wearing plain white socks. No non-skid material was on the bottom of Resident R2's socks.On 10/27/25 at 12:08 PM V2 DON (Director of Nursing) stated she expects fall interventions to be in place per the care plan. V2 stated (Resident R2) is supposed to have non-skid socks or shoes on at all times when she is up in her wheelchair.
V2 stated she was not aware (Resident R1) did not have her interventions in place on 10/23/25.The facility's Fall Policy, review date of 6/14/23, documented Mission Statement - to identify residents at risk for falls and provide guidelines for prevention and treatment post fall. All residents upon admission shall be assessed by
the licensed nurse using the Fall Risk Assessment Form. This form will be updated quarterly, annual, significant change, or post fall episode. It continues, Post Fall - resident is assessed by the licensed nurse for potential injury and obtain treatment as necessary with MD guidance, responsible party is also notified.
All falls are investigated to determine cause (avoidable or unavoidable), correction and prevention. Vital signs and condition are monitored by licensed nurse, care plan adjusted as needed to prevent additional falls. Care plan interventions reviewed with POA (Power of Attorney) and residents as needed.
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
11/19/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Randolph County Care Center
312 West Belmont Sparta, IL 62286
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 F0725
F 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
V1 Administrator stated the facility does not have a staffing policy and they follow the state guidelines. V1 stated when she started working at the facility, they were running 8 CNAS on the day shift for 43 residents, that's craziness, we can't survive with that staffing ratio. V1 stated she took down 1 shower aid position and
they now run 6 CNAS on the day shift plus a shower aid and 6 CNAS on the evening shift.The facility's Daily Census report, dated 10/27/25, documented there are 53 residents residing at the facility with 28 residents residing on the first floor and 25 residing on the second floor.
Event ID:
Facility ID:
If continuation sheet
Randolph County Care Center in SPARTA, 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 SPARTA, 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 Randolph County Care Center or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.