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Inspection visit

Health inspection

PEARL OF ROLLING MEADOWS,THECMS #1453501 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

This survey cited 1 deficiency. The full statement and the facility’s plan of correction follow, verbatim from the federal record.

145350 03/14/2025 Pearl of Rolling Meadows,the 4225 Kirchoff Road Rolling Meadows, IL 60008
F 0684 Provide appropriate treatment and care according to orders, resident’s preferences and goals. Level of Harm - Minimal harm or potential for actual harm Based on interview and record review the facility failed to provide Quality of Care/Treatment related to clinical management of Urinary Tract Infection (UTI) affecting 1 of 4 (R3) residents reviewed for Quality of Care/Treatment. Residents Affected - Few Findings Include: On 3/11/2025 at 11:05 AM V3 (Assistant Director of Nursing/IP) stated on 1/13/2025, he received an order from V18 (Nurse Practitioner) to start R3 with antibiotic Bactrim twice a day for 3 days. V3 stated he entered the order into the electronic medication administration (EMAR) to reflect first dose in 1800 to be administered by nurse on duty. Bactrim antibiotic was ordered STAT from Pharmacy and delivered on 1/14/2025 at 12:31AM to facility. V3 stated first dose of antibiotic can be obtained in the facility convenience box (also known as pixes, capsca). V16 (Licensed Practical Nurse/LPN) nurse to give the first dose acknowledged she did not give the Bactrim as ordered on 1/13 at 1800 to R3. V13 (Licensed Practical Nurse), AM shift nurse on 1/14/25, verbally stated she gave the antibiotic Bactrim on 1/14/2025 at 0900 but acknowledged not signing the EMAR. V13 said EMAR is signed as soon as medication is given, I should have signed the EMAR. On 3/13/2025 at 11AM, V2 (Director of Nursing) said medication should be given as ordered and nurse to sign off on the EMAR for record administration. Review of R3's Electronic Medication Administration (EMAR) dated 1/1/2025 - 1/31/2025 indicated no nursing signature of administration on 1/13/2025 in 1800 and 1/14/2025 at 0900. Review of Progress Note Effective date 1/11/2025 at 11:54 Type: Medical Practitioner Note (Physician/NP) read: Late Entry: received a call from nurse that patient is complaining of pain with urination. Okay to collect UA with culture reflex. Nurse to call with results. Review of V14 (Licensed Practical Nurse/LPN) 1/11/2025 Progress Note read: Received new order to collect UA, may straight cath if necessary. Review of Order Summary Report, Order date 1/11/2025 read: Culture, Urine. No other order reviewed for UA (Urinalysis) on 1/11/2025. On 3/13/2025 at 11:28 AM, V18 said she was not aware that the order put in by the nurse on 1/11/25 was only for culture and UA was not done. On 3/11/2025 at 12:32 PM, V6 (Restorative Nurse) denied the allegation of R3 sustaining a fall due to urinary tract infection (UTI). V6 stated R3's Fall incident on 12/18/24 investigated with root cause analysis of R3 going to bathroom unassisted. On 12/22/24 R3 sustained another fall with root cause of transferring without assist. V6 stated care plan was updated on both fall incident and R3 has not had any fall since the last one in December. Page 1 of 2 145350 145350 03/14/2025 Pearl of Rolling Meadows,the 4225 Kirchoff Road Rolling Meadows, IL 60008
F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Reviewed R3's medical record: Fall Assessments (on Admission, Quarterly, Other) and Care Plan, no concern. Rounds to facility conducted. No resident complaint about Quality of Care/Treatment. Reviewed Facility Policies and Procedure: Fall Prevention and Management, revised 4/8/2024, Medication Administration, revision date 8/1/24, Antibiotic Stewardship, dated reviewed 8/20/22, Resident Change in Condition Notification, date revised 12/18/23, no concern. 145350 Page 2 of 2

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Citations

1 citation recorded*CMS

What do CMS severity letters mean?

Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.

General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.

Each letter combines severity with scope: how many residents the deficiency affected.

  • 0684GeneralS&S Dpotential for harm

    F684 - Quality of care

    Provide appropriate treatment and care according to orders, resident’s preferences and goals.

FAQ · About this visit

Common questions about this visit

What happened during the March 14, 2025 survey of PEARL OF ROLLING MEADOWS,THE?

This was a inspection survey of PEARL OF ROLLING MEADOWS,THE on March 14, 2025. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.

Were any deficiencies cited at PEARL OF ROLLING MEADOWS,THE on March 14, 2025?

Yes, 1 deficiency was cited, each with a CMS Scope and Severity grade. The first was: "Provide appropriate treatment and care according to orders, resident’s preferences and goals."

What type of survey was this?

This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.

SourceView on CMS Care Compare

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Next steps

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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.