F 0557
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Honor the resident's right to be treated with respect and dignity and to retain and use personal
possessions.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
interview and record review, the facility failed to answer call lights and provide care in a timely manner for 2
(R1, R2) of 4 residents reviewed for resident rights in a sample of 4. 1.) R1's admission Record documents
R1 was admitted to the facility on [DATE] and has a diagnosis of Epilepsy, Parkinson's Disease without
Dyskinesia, Essential Tremor, Chronic Obstructive Pulmonary Disease, Fibromyalgia, Chronic Kidney
Disease, Lack of Coordination, Generalized Anxiety Disorder, Hypothyroidism, and Major Depressive
Disorder.R1's Minimum Data Set (MDS) dated [DATE] documents R1 is cognitively intact, is dependent on
staff for toileting hygiene, showering/bating, and needs substantial/maximal assistance for personal
hygiene.R1's Care Plan Date Initiated 6/27/2025 documents the resident has an Activities of Daily Living
(ADL) self-care performance deficit related to epilepsy, tremors, Parkinson's, lack of coordination, muscle
wasting and atrophy.On 11/19/2025 at 8:00 AM R1 stated she has had to wait over an hour or more for her
call light to be answered for staff to help her to the restroom or provide care. R1 stated when her call light
isn't answered in a timely fashion, she feels like she does not matter to staff and it takes away her dignity,
self-respect, and self-worth. R1 stated staff rush to get any task done when they do answer her call light,
including bathing and cleaning up her and that makes her feel dirty.2.) R2's admission Record documents
R2 was originally admitted to the facility on [DATE] and has a diagnosis of Chronic Kidney Disease, Chronic
Obstructive Pulmonary Disease, Type 2 Diabetes Mellitus, Morbid (Severe) Obesity, Major Depressive
Disorder, Generalized Anxiety Disorder, Lack of Coordination, Heart Failure, and Hypertension.R2's MDS
dated [DATE] documents R2 is cognitively intact, needs supervision or touching assistance with toileting
hygiene, partial/moderate assistance with showering/bathing and personal hygiene, and occasionally
incontinent of bladder and bowel.R2's Care Plan Date Initiated 12/15/2023 documents the resident has an
ADL self-care performance deficit related to obesity, pain, difficulty walking.On 11/19/2025 at 8:21 R2
stated she has waited over an hour to have her call light answered and care provided. R2 stated when she
has had to wait a long time for her call light to be answered it makes her feel awful and like her needs don't
matter. R2 stated the facility has trouble with answering call lights in a timely fashion and this issue has
been brought up to the Administration with nothing done about it. On 11/19/2025 at 10:15 AM V10, Certified
Nursing Assistant (CNA), stated he knows residents have waited an hour or more for their call lights to be
answered and residents do not always receive timely care. On 11/19/2025 at 11:11 AM V3, Assistant
Director of Nursing (ADON), V3 stated all staff answer call lights and if a housekeeper or other staff
member answer the light and cannot help the resident, they will inform the proper staff member. V3 stated
she excepts staff to answer call lights promptly, usually within 3 minutes unless staff are in another
resident's room or providing care to a resident.The Facility's Resident Council Minutes dated 9/4/2025
documents Old Business (concerns) [NAME] call light response time is still slow. Nursing: Follow up from
August: Residents discussed this again [NAME]
(continued on next page)
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
Page 1 of 2
Event ID:
145136
Printed: 05/15/2026
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
145136
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
11/19/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Arcadia Care Auburn
304 Maple Avenue
Auburn, IL 62615
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 0557
Level of Harm - Minimal harm
or potential for actual harm
call light response time is still slow and said they see some improvement again depending on who was
working the hall. The Facility's Resident Council minutes dated 10/2/2025 documents Old Business
(concerns) [NAME] call light response time is still slow.The Facility's Call Light Policy Last Revised 01/2022
documents Purpose: To respond to residents' requests and needs in a timely and courteous manner.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145136
If continuation sheet
Page 2 of 2