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
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
interview and record review the facility failed to perform wound treatment as ordered for 3 or 3 residents
(R4, R6, R9), reviewed for Quality of Care in a sample of 3. Finding Include:1. On 7/18/2025 at 12:06 PM
R4 stated while admitted to the facility he did not always receive his dressing change to his left knee as
ordered.R4's Undated Face Sheet documents R4 was admitted to the facility on [DATE] and has a
diagnosis of Pain in the Left Knee, Morbid Obesity, Presence of Left Artificial Knee Joint, and
Hypertension.R4's Quarterly Minimum Data Set (MDS) dated [DATE] documents R4 is cognitively intact,
needed supervision/touching assistance with showering/bathing, lower body dressing, personal hygiene,
rolling left and right, sitting to standing, and chair/bed to chair transfers.R4's Care Plan date initiated
4/7/2025 documents skin complications related to right knee surgery, skin at risk for skin complications
related to impaired mobility and obesity.R4's Physician Order dated 5/15/2025 at 10:09 AM documents
cleanse wound to left knee with wound cleanser, pat dry, pack with iodoform packing gauze, and cover with
bordered gauze. Change daily and as needed (PRN), one time a day for to promote wound healing.R4's
May Treatment Administration Record (TAR) dated 5/1/2025 through 5/31/2025 reviewed with no treatment
documented on 5/21/2025, 5/26/2025, 5/27/2025, 5/30/25, and 5/31/2025.R4's June TAR dated 6/1/2025
through 6/30/2025 reviewed with no treatment documented on 6/3/2025, 6/4/2025, 6/5/2025, 6/10/2025,
6/12/2025, 6/13/2025, 6/17/2025, and 6/18/2025.2. On 7/22/2025 at 3:46 PM R6 stated the facility changes
the dressing to his left middle finger most days, but not every day.On 7/22/2025 at 3:46 PM V10, Licensed
Practical Nurse (LPN)/Wound Nurse, completed R6's dressing change to R6's left middle finger.R6's
Undated Face Sheet documents R6 was admitted to the facility on [DATE] and has a diagnosis of Type 2
Diabetes and Hypertension.R6's MDS dated [DATE] documents R6 is moderately cognitively intact and
needs partial/moderate assistance with showering/bathing.R6's Care Plan date initiated 1/17/2024
documents skin: at risk for skin complications related to Cerebrovascular Accident (CVA) and
malnutrition.R6's Physician Order dated 6/20/2025 at 9:59 AM documents cleanse left hand with wound
cleanser daily apply xeroform, 4x4 and gauze wrap once daily and PRN.R6's June Treatment
Administration Record (TAR) dated 6/1/2025 through 6/30/2025 reviewed with no treatment documented on
6/24/2025, 6/26/2025, and 6/28/2025.R6's July TAR dated 7/1/2025 through 7/31/2025 reviewed with no
treatment documented on 7/10/2025, 7/11/2025, 7/19/2025, and 7/20/2025.3. On 7/22/2025 at 3:19 PM R9
stated the facility staff does not change the dressing to his left lower leg daily, and he has gone multiple
days without the dressing being changed. On 7/22/2025 at 3:23 PM V10, LPN/Wound Nurse completed
R9's dressing change to R9's left lower leg.R9's Undated Face Sheet documents R9 was initially admitted
to the facility on [DATE] and has a diagnosis of Cellulitis of the Right and Left Lower Limb, Hypertension,
and Congestive Heart Failure.R9's MDS dated [DATE] documents R9 is cognitively intact, needs
supervision or touching assistance with lower body dressing, and needs partial/moderate assistance with
showering/bathing and personal hygiene.R9' Care Plan with dated initiated 3/5/2024
Residents Affected - Few
(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 6
Event ID:
145427
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
145427
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
07/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Nexus at Alton
3523 Wickenhauser
Alton, IL 62002
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 0684
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
documents skin: at risk for skin complications related to venous hypertension.R9's Physician Order dated
6/20/2025 at 6:13 PM documents cleanse bi-lateral shin apply xeroform and border gauze, then apply ace
bandages to both legs one time a day for swelling and blisters once daily and PRN if needed.R9's June
Treatment Administration Record (TAR) dated 6/1/2025 through 6/30/2025 reviewed with no treatment
documented on 6/24/2025, 6/26/2025, and 6/28/2025.R9's July TAR dated 7/1/2025 through 7/31/2025
reviewed with no treatment documented on 7/10/2025, 7/11/2025, 7/17/2025, 7/19/2025, and 7/20/2025.
On 7/22/2025 at 10:20 AM V2, Director of Nursing (DON), stated when a dressing change is completed it is
to be signed off on the resident's TAR. V2, DON, stated dressing changes should be documented as soon
as they are done and if a resident's TAR does not have any documentation on a day, it would appear as if
the dressing change was not performed. On 7/22/2025 at 3:40 PM V10, LPN/Wound Nurse, stated when a
resident's dressing change is completed it is documented on the resident's TAR.The Facility's Skin
Management: Monitoring of wounds and documentation policy dated 1/2022 documents It is important that
the facility have a system in place to assure that the protocols for daily monitoring and for periodic
documentation of measurements, terminology, frequency of assessment, and documentation are
implemented consistently throughout the facility.
Event ID:
Facility ID:
145427
If continuation sheet
Page 2 of 6
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
145427
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
07/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Nexus at Alton
3523 Wickenhauser
Alton, IL 62002
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 0755
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a
licensed pharmacist.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
interview and record review the facility failed to administer medications as ordered for 4 of 5 residents (R4,
R6, R7, and R9) in a sample of 5.Finding Include:1. On 7/18/2025 at 12:06 PM R4 stated while admitted to
the facility he did not always receive his medications daily.R4's Undated Face Sheet documents R4 was
admitted to the facility on [DATE] and has a diagnosis of Pain in the Left Knee, Chronic Diastolic
(Congestive) Heart Failure, Morbid Obesity, Epilepsy, Cortical Age-Related Cataract, Low-Tension
Glaucoma, Cardiomegaly, Barrett's Esophagus, Hypothyroidism, and Hypertension.R4's Quarterly
Minimum Data Set (MDS) dated [DATE] documents R4 is cognitively intact, needed supervision/touching
assistance with showering/bathing, lower body dressing, personal hygiene, rolling left and right, sitting to
standing, and chair/bed to chair transfers.R4's Physician Order dated 4/1/2025 at 4:25 PM documents
Bumetanide Oral Tablet 1 MG (Bumetanide) Give 1 tablet by mouth one time a day every other day.R4's
Physician Order dated 4/1/2025 at 4:25 PM documents Aspirin Oral Capsule 81 MG (Aspirin) Give 1
capsule by mouth one time a day.R4's Physician Order dated 4/1/2025 at 4:25 PM documents
Lansoprazole Oral Capsule Delayed Release 30 MG (Lansoprazole) Give 1 capsule by mouth two times a
day. R4's Physician Order dated 4/1/2025 at 4:25 PM documents Apixaban Oral Tablet 2.5 MG (Apixaban)
Give 1 tablet by mouth two times a day.R4's Physician Order dated 4/1/2025 at 4:56 documents Famotidine
Oral Tablet 20 MG (Famotidine) Give 2 tablet by mouth at bedtime. R4's Physician Order dated 4/1/2025 at
4:56 PM documents Latanoprost Ophthalmic Solution 0.005 % (Latanoprost) Instill 1 drop in both eyes at
bedtime.R4's Physician Order dated 4/1/2025 at 4:56 PM documents Lansoprazole Oral Capsule Delayed
Release 30 MG (Lansoprazole) Give 1 capsule by mouth two times a day.R4's Physician Order dated
4/1/2025 at 5:20 PM documents Levothyroxine Sodium Oral Tablet 200 MCG (Levothyroxine Sodium) Give
1 tablet by mouth in the morning, take with 25 mcg tablet. R4's Physician Order dated 4/1/2025 at 5:20
documents Levothyroxine Sodium Oral Tablet 25 MCG (Levothyroxine Sodium) Give 1 tablet by mouth in
the morning, take with 200 mcg tablet.R4's Physician Order dated 4/1/2025 at 5:24 PM documents
Loratadine Oral Capsule 10 MG (Loratadine) Give 1 capsule by mouth one time a day. R4's Physician
Order dated 4/1/2025 at 5:24 PM documents Lisinopril Oral Tablet 10 MG (Lisinopril) Give 1 tablet by mouth
one time a day.R4's Physician Order dated 4/1/2025 at 5:50 PM documents Phenytoin Sodium Extended
Capsule 100 MG Give 3 capsule by mouth at bedtime.R4's Physician Order dated 4/1/2025 at 5:56 PM
documents Propranolol HCl Oral Tablet 60 MG (Propranolol HCl) Give 1 tablet by mouth one time a
day.R4's Physician Order dated 4/1/2025 at 5:58 PM documents Tamsulosin HCl Oral Capsule 0.4 MG
(Tamsulosin HCl) Give 1 capsule by mouth two times a day.R4's May Medication Administration Record
(MAR) dated 5/1/2025 through 5/31/2025 does not document R4 received Levothyroxine 200 mg,
Levothyroxine 25 mg, and Claritin 10 mg as ordered on 5/13/2025 and 5/21/2025 at 6:00 AM. R4's May
MAR dated 5/1/2025 through 5/31/2025 does not document R4 received Atorvastatin 10mg, Famotidine 20
mg 2 tablets, Latanoprost Ophthalmic Solution 0.005% 1 drop, Phenytoin Sodium Extended Capsule 100
mg, Apixaban 2.5 mg, Lansoprazole Delayed Release Capsule 30 mg 3 capsules, and Tamsulosin 0.4 mg
as ordered on 5/31/2025 at 8:00 PM. R4's May MAR dated 5/1/2025 through 5/31/2025 does not document
R4 received Levothyroxine 200 mg, Levothyroxine 25 mg, and Claritin 10 mg as ordered on 5/13/2025 and
5/21/2025 at 6:00 AM. R4's June MAR dated 6/1/2025 through 6/30/2025 does not document R4 received
Claritin 10 mg, Levothyroxine 200 mg, and Levothyroxine 25 mg as ordered on 6/1/2025 at 6:00 AM. R4's
June MAR dated 6/1/2025 through 6/30/2025 does not document R4 received Bumetanide 1 mg, Lisinopril
10 mg, Propranolol 60 mg, Apixaban 2.5 mg, Lansoprazole 30 mg, Tamsulosin 0.4 mg as ordered on
6/5/2025 at 9:00 AM. R4's June MAR dated 6/1/2025 through 6/30/2025 does not document R4 received
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145427
If continuation sheet
Page 3 of 6
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
145427
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
07/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Nexus at Alton
3523 Wickenhauser
Alton, IL 62002
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 0755
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Claritin 10 mg, Levothyroxine 200 mg, and Levothyroxine 25 mg as ordered on 6/1/2025 at 6:00 AM. R4's
June MAR dated 6/1/2025 through 6/30/2025 does not document R4 received Bumetanide 1 mg, Lisinopril
10 mg, Propranolol 60 mg, Apixaban 2.5 mg, Lansoprazole 30 mg, Tamsulosin 0.4 mg as ordered on
6/5/2025 at 9:00 AM.2. R6's Undated Face Sheet documents R6 was admitted to the facility on [DATE] and
has a diagnosis of Type 2 Diabetes, Hyperlipidemia, Bipolar Disease, Seizures, and Hypertension.R6's
MDS dated [DATE] documents R6 is moderately cognitively intact and needs partial/moderate assistance
with showering/bathing.R6's Physician Order dated 10/14/2024 at 1:03 PM documents Aspirin Oral
Capsule 81 MG (Aspirin) Give 1 capsule by mouth one time a day.R6's Physician Order dated 10/14/2024
at 1:04 PM documents Clopidogrel Bisulfate Oral Tablet 75 MG (Clopidogrel Bisulfate) Give 1 tablet by
mouth one time a day.R6's Physician Order dated 10/14/2024 at 1:05 PM documents Caplyta Oral Capsule
42 MG (Lumateperone Tosylate) Give 1 capsule by mouth one time a day.R6's Physician Order dated
10/14/2024 at 1:11 PM documents Atorvastatin Calcium Oral Tablet 80 MG (Atorvastatin Calcium) Give 1
tablet by mouth one time a day.R6's Physician Order dated 10/14/2024 at 1:13 PM documents Valproate
Sodium Oral Solution 250 MG/5ML (Valproate Sodium) Give 10 ml by mouth with meals.R6's Physician
Order dated 10/14/2024 at 1:14 PM documents Venlafaxine HCl Oral Tablet 75 MG (Venlafaxine HCl) Give
1 tablet by mouth with meals.R6's Physician Orders dated 1/8/2025 at 11:05 AM documents Lisinopril Oral
Tablet 5 MG (Lisinopril) Give 0.5 tablet by mouth one time a day related.R6's Physician Order dated
1/23/2025 at 9:42 AM documents GLUCERNA two times a day.R6's Physician Order dated 3/16/2025 at
4:54 AM documents cloNIDine HCl Oral Tablet 0.2 MG (Clonidine HCl) Give 1 tablet by mouth three times a
day.R6's Physician Order dated 3/16/2025 at 4:55 AM documents busPIRone HCl Oral Tablet 15 MG
(Buspirone HCl) Give 1 tablet by mouth three times a day.R6's June MAR dated 6/1/2025 through
6/30/2025 does not document R6 received Valproate Sodium Oral Solution 250mg/5 ml take 10 ml and
Venlafaxine HCL 75 mg as ordered on 6/4/2025 at 12:00 PM.R6's June MAR dated 6/1/2025 through
6/30/2025 does not document R6 received Buspirone 15 mg and Clonidine 0.2 mg as ordered on 6/4/2025
at 2:00 PM.R6's June MAR dated 6/1/2025 through 6/30/2025 does not document R6 received Valproate
Sodium Oral Solution 250mg/5 ml take 10 ml and Venlafaxine HCL 75 mg as ordered on 6/4/2025 at 6:00
PM.R6's June MAR dated 6/1/2025 through 6/30/2025 does not document R6 received Buspirone 15 mg
and Clonidine 0.2 mg as ordered on 6/5/2025 at 8:00 AM.R6's June MAR dated 6/1/2025 through
6/30/2025 does not document R6 received Aspirin 81mg, Atorvastatin Calcium 80 mg, Caplyta 42 mg,
Clopidogrel Bisulfate 75 mg, Lisinopril 5 mg take 1/2 tablet, Glucerna, Valproate Sodium Oral Solution
250mg/5 ml take 10 ml, and Venlafaxine HCL 75 mg as ordered on 6/5/2025 at 9:00 AM.R6's June MAR
dated 6/1/2025 through 6/30/2025 does not document R6 received Valproate Sodium Oral Solution
250mg/5 ml take 10 ml and Venlafaxine HCL 75 mg as ordered on 6/5/2025 at 12:00 PM.R6's June MAR
dated 6/1/2025 through 6/30/2025 does not document R6 received Buspirone 15 mg and Clonidine 0.2 mg
as ordered on 6/5/2025 at 2:00 PM.3. R7's Undated Face Sheet documents R7 was admitted to the facility
on [DATE] and has a diagnosis of Hypertension, Gastro-Esophageal Reflux Disease, Chronic Ischemic
Heart Disease, Peripheral Vascular Disease, and Hypertension.R7's MDS dated [DATE] documents R7 is
mildly cognitively impaired, needs supervision or touching assistance with toileting hygiene,
showering/bathing, personal hygiene.R7's Physician Order dated 2/12/2025 at 3:57 PM documents Aspirin
81 Oral Tablet Chewable (Aspirin) Give 81 mg by mouth one time a day.R7's Physician Order dated
2/12/2025 at 4:13 PM documents Folic Acid Oral Tablet 1 MG (Folic Acid) Give 1 mg by mouth one time a
day.R7's Physician Order dated 2/12/2025 at 4:33 PM documents Keppra Oral Tablet 500 MG
(Levetiracetam) Give 500 mg by mouth two times a day.R7's Physician Order dated 2/12/2025 at 4:35 PM
documents Metoprolol Tartrate Oral Tablet (Metoprolol Tartrate) Give 25 mg by mouth two times a day.R7's
Physician Order dated 2/12/2025 at 4:36 PM documents
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145427
If continuation sheet
Page 4 of 6
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
145427
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
07/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Nexus at Alton
3523 Wickenhauser
Alton, IL 62002
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 0755
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Protonix Tablet Delayed Release 40 MG (Pantoprazole Sodium) Give 1 tablet by mouth two times a
day.R7's Physician Order dated 2/21/2025 at 4:40 PM documents Thiamine HCl Oral Tablet 100 MG
(Thiamine HCl) Give 100 mg by mouth one time a day.R7's Physician Order dated 6/12/2025 at 5:10 PM
documents Vitamin D3 Oral Capsule 1.25 MG (50000 UT) (Cholecalciferol) Give 1 capsule by mouth one
time a day every 7 day(s) for Vitamin D deficiency for 8 Weeks.R7's Physician Order dated 6/19/2025 at
1:32 PM documents Sucralfate Tablet 1 GM Give 1 tablet by mouth three times a day.R7's June MAR dated
6/1/2025 through 6/30/2025 does not document R7 received Sucralfate Oral Suspension 10 ml as ordered
on 6/4/2025 at 12:00 PM.R7's June MAR dated 6/1/2025 through 6/30/2025 does not document R7
received Sucralfate Oral Suspension 10 ml as ordered on 6/4/2025 at 6:00 PM.R7's June MAR dated
6/1/2025 through 6/30/2025 does not document R7 received Aspirin 81 mg, Folic Acid 1 mg, Thiamine HCL
100 mg, Keppra 500 mg, Metoprolol Tartrate 25 mg, Protonix Delayed Release 40 mg as ordered on
6/5/2025 at 9:00 AM.R7's June MAR dated 6/1/2025 through 6/30/2025 does not document R7 received
Sucralfate Oral Suspension 10 ml as ordered on 6/5/2025 at 12:00 PM.4. On 7/22/2025 at 3:19 PM R9
stated there have been days where he does not receive all his medications but cannot recall a particular
date. R9's Undated Face Sheet documents R9 was initially admitted to the facility on [DATE] and has a
diagnosis of Cellulitis of the Right and Left Lower Limb, Chronic Obstructive Pulmonary Disease,
Gastro-Esophageal Reflux Disease, Hypertension, and Congestive Heart Failure.R9's MDS dated [DATE]
documents R9 is cognitively intact, needs supervision or touching assistance with lower body dressing, and
needs partial/moderate assistance with showering/bathing and personal hygiene.R9's Physician Order
dated 4/8/2025 at 2:24 PM documents Metformin HCL Oral Tablet 500 mg (Metformin HCL) Give 2 tablets
by mouth two times a day.R9's Physician Order dated 4/8/2025 at 3:11 PM documents Polyethylene Glycol
3350 Oral Packet 17 gm (Polyethylene Glycol 3350) Give 1 packet by mouth two times a day.R9's Physician
Order dated 4/8/2025 at 3:20 PM documents Spironolactone Oral Tablet 25 MG (Spironolactone) Give 0.5
tablet by mouth one time a day.R9's Physician Order dated 4/9/2025 at 12:07 PM documents Protonix
Tablet Delayed Release 20 MG (Pantoprazole Sodium) Give 1 tablet by mouth one time a day.R9's
Physician Order dated 4/9/2025 at 12:07 PM documents Eliquis Oral Tablet 5 mg (Apixaban) Give 1 tablet
by mouth two times a day.R9's Physician Order dated 4/9/2025 at 12:08 PM documents Trelegy Ellipta
Inhalation Aerosol Powder Breath Activated 100-62.5-25 MCG/ACT (Fluticasone-Umeclidinium-Vilanterol) 1
puff inhale orally one time a day.R9's Physician Order dated 4/9/2025 at 12:08 PM documents Vitamin D3
Oral Tablet 50 MCG (2000 UT) (Cholecalciferol) Give 1 tablet by mouth one time a day.R9's Physician
Order dated 4/9/2025 at 12:09 PM documents Vitamin-B Complex Oral Tablet (B-Complex Vitamins) Give 1
tablet by mouth in the morning.R9's Physician Order dated 4/9/2025 at 12:09 PM documents Aspirin 81
Oral Tablet Chewable (Aspirin) Give 81 mg by mouth one time a day.R9's Physician Order dated 4/9/2025
at 12:13 PM documents Ipratropium-Albuterol Solution 0.5-2.5 (3) mg/3ml 3 ml inhale orally three times a
day.R9's Physician Order dated 4/9/2025 at 12:14 PM documents Alprazolam Oral Tablet 0.5 mg
(Alprazolam) Give 1 tablet by mouth three times a day.R9's Physician Order dated 4/9/2025 at 12:14 PM
documents Buspirone HCL Oral Tablet 10 mg (Buspirone HCL) Give 15 mg by mouth three times a
day.R9's Physician Order dated 4/9/2025 at 12:15 PM documents Magnesium Oral Tablet (Magnesium)
Give 400 mg by mouth three times a day.R9's Physician Order dated 4/9/2025 at 12:16 PM documents
Ferrous Sulfate Tablet 325 (65 Fe) mg Give 1 tablet by mouth two times a day.R9's Physician Order dated
4/9/2025 at 12:16 PM documents Fish Oil Oral Capsule 1000 MG (Omega-3 Fatty Acids) Give 1 capsule by
mouth in the morning.R9's Physician Order dated 4/9/2025 at 12:17 PM documents Calcium 600 Oral
Tablet (Calcium Carbonate) Give 1 tablet by mouth one time a day.R9's Physician Order dated 4/9/2025 at
12:18 PM documents Tacrolimus Oral Capsule 0.5 mg (Tacrolimus) Give 1 capsule by mouth two times a
day.R9's
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145427
If continuation sheet
Page 5 of 6
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
145427
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
07/25/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Nexus at Alton
3523 Wickenhauser
Alton, IL 62002
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 0755
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Physician Order dated 4/9/2025 at 12:18 PM documents Potassium Chloride ER Tablet Extended Release
20 meq Give 1 tablet by mouth three times a day.R9's Physician Order dated 4/9/2025 at 12:35 PM
documents Pregabalin Oral Capsule 100 mg (Pregabalin) Give 1 capsule by mouth two times a day.R9's
Physician Order dated 4/9/2025 at 12:36 PM documents Jardiance Oral Tablet 10 MG (Empagliflozin) Give
1 tablet by mouth one time a day.R9's Physician Order dated 5/13/2025 at 2:48 PM documents Lasix Oral
Tablet 40 mg (Furosemide) Give 1 tablet by mouth 2 times a day.R9's June MAR dated 6/1/2025 through
6/30/2025 does not document R9 received Metformin HCL 500 mg 2 tablets, Tacrolimus 0.5 mg,
Alprazolam 0.5 mg, Buspirone HCL 10 mg take 15 mg, Ipratropium-Albuterol Solution 0.5-2.5 mg/3 ml,
Magnesium 400 mg, and Potassium Chloride Extended Release 20meq as ordered on 6/1/2025 at 6:00
AM.R9's June MAR dated 6/1/2025 through 6/30/2025 does not document R9 received Metformin HCL 500
mg 2 tablets and Tacrolimus 0.5 mg as ordered on 6/4/2025 at 6:00 PM.R9's June MAR dated 6/1/2025
through 6/30/2025 does not document R9 received Alprazolam 0.5 mg, Buspirone HCL 10 mg take 15 mg,
Ipratropium-Albuterol Solution 0.5-2.5 mg/3 ml, Magnesium 400 mg, and Potassium Chloride Extended
Release 20meq as ordered on 6/4/2025 at 12:00 PM.R9's June MAR dated 6/1/2025 through 6/30/2025
does not document R9 received Lasix 40 mg as ordered on 6/4/2025 at 4:00 PM.R9's June MAR dated
6/1/2025 through 6/30/2025 does not document R9 received Aspirin 81 mg, Calcium 600 mg, Fish Oil 1000
mg, Jardiance 10 mg, Protonix Delated Release 20 mg, Spironolactone 25 mg take 1/2 tablet, Trelegy
Ellipta Inhalation Aerosol Powder Breath Activated 100-62.5-25 MCG/ACT 1 puff, Vitamin D3 50 mcg,
Vitamin-B Complex 1 tablet, Eliquis 5 mg, Ferrous Sulfate 325 mg, Lasix 40 mg, Polyethylene Glycol 3350
Oral [NAME] 17 gm, Pregabalin 100 mg, as ordered on 6/5/2025 at 9:00 AM.R9's June MAR dated
6/1/2025 through 6/30/2025 does not document R9 received Alprazolam 0.5 mg, Buspirone HCL 10 mg
take 15 mg, Ipratropium-Albuterol Solution 0.5-2.5 mg/3 ml, Magnesium 400 mg, and Potassium Chloride
Extended Release 20meq as ordered on 6/5/2025 at 12:00 PM.On 7/22/2025 at 10:20 AM V2, Director of
Nursing (DON), stated when a medication is given, the medication should be documented as soon as is
dispensed on the resident's MAR. V2, DON, stated if the resident's MAR does not have any documentation
on a day, then the medication was not given.The Facility's Medication Administration Policy last revised
5/2017 documents All medication are administered safely and appropriately to aid residents to overcome
illness relieve and prevent symptoms and help in diagnosis. Document as each medication is prepared on
the MAR.
Event ID:
Facility ID:
145427
If continuation sheet
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