Pavilion Of Waukegan
Inspection Findings
F-Tag F0675
F 0675
Honor each resident's preferences, choices, values and beliefs.
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 provide Resident R1 with the necessary care and services to maintain the highest practicable physical and psychosocial well-being for 1 of 6 residents (Resident R1) reviewed for quality of care in the sample of 6.The findings include:On 10/27/25 at 10:35AM, Resident R1 was lying
in bed watching television. Resident R1 sat up on the side of the bed and placed her feet on the floor. Resident R1 said, a couple of weeks ago one of the CNAs (Certified Nursing Assistant) took my vital signs and said, I am going to help you with your shower. I told the CNA I can do it myself. I have been here 5 years and only needed someone to help me with my back. The CNA's hands were all over me. I told the CNA to stop. The CNA said, take it easy. In the past, the staff would provide privacy while I washed myself. The staff may have washed my back, now I have a back brush; no one is touching me again. When the CNA started washing me. I told the CNA to stop. The CNA thought I was being funny. I said, you are a sex maniac. You do not belong in the health field. I got myself dressed. I have not seen the CNA after that. When I do it myself, I do not have to rush. I do not have to worry about being looked at. I feel I do a better job. I feel so good, so clean, I am happy.On 10/27/25 at 12:16PM, V10 (CNA) said, Resident R1 can wash independently. Resident R1 will often give herself a sponge bath instead of taking a shower. There have been times where I will go to get Resident R1 ready for
the shower and Resident R1 has already completed the bath. Resident R1 does not like to be touched by anyone, ever. Resident R1 refuses the skin check, always.On 10/27/25 at 2:35PM, V9 (CNA) said, staff will always be in the shower room with every resident. We allow the resident to be as independent as their ability allow. We want to maintain the resident's functional ability.On 10/28/25 at 10:15AM, V5 (CNA) said, I do not usually work on Resident R1's unit. I'm the first CNA that showered Resident R1. One of the nurses told me I cannot force the resident to take
a shower. I explained to the nurse that I re-direct the residents. I re-directed Resident R1. I explained the rationale and Resident R1 agreed. Resident R1 is alert. Resident R1 knows what is going on. If Resident R1 did not want the shower, Resident R1 would be resistive. Resident R1's Minimum Data Set, dated [DATE REDACTED] shows, Brief Interview for Mental Status 15/15 Mentally Intact. No upper or lower extremity impairment. Shower: Supervision with touch assist.Resident R1's Care Plan on 10/11/25 shows, Focus: The resident has an ADL self-care performance deficit. Date Initiated: 03/22/2019.
Goal: The resident will maintain current level of function through the review date. Interventions: Encourage
the resident to use bell to call for assistance. Praise all efforts at self-care. Resident R1's Bathing/Shower preferences was not initiated in the Care Plan until 10/13/2025.Resident R1's Abuse Investigation date 10/13/2025 shows, on 10/11/2025 V5 (CNA) made (Resident R1) feel uncomfortable when the CNA offered to help. The CNA was not aware of Resident R1's showering preferences.
Residents Affected - Few
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:
Pavilion Of Waukegan in WAUKEGAN, 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 WAUKEGAN, 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 Pavilion Of Waukegan or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.