Inspection visit
Inspection
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.
F 0602
Protect each resident from the wrongful use of the resident's belongings or money.
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 ensure a resident was free of theft by a visitor for 1 of 3
residents (R1) reviewed for theft in the sample of 6.
Residents Affected - Few
The findings include:
On 6/13/25 at 2:01 PM, R1 said she was going on a weekend visit with her daughter. R1 said she knew her
money was stolen. R1 said she was going out with her daughter (6/3/25) and she had taken money out to
pay for dinner. R1 said she tried to give her daughter $80, but her daughter wouldn't accept the money. R1
said she put it in her wallet and her purse hangs on a hook inside her room. R1 said she getting ready to go
for a meal with friends and realized that the money was gone. R1 said she reported it to staff right away and
they searched her room for the money. R1 said they couldn't find it and she knew it was stolen. R1 said it
was upsetting and embarrassing to have her money stolen out of her room. R1 said they showed me a
picture of some boy, but I didn't know him. V7 (R1's daughter) said at first the facility thought that R1 had
given her the money, but I told them I didn't accept the money. V7 said we don't normally keep that much
money in mom's room. V7 said R1 didn't want to tell anyone the money was missing because she was
embarrassed. V7 stated, My brother told her if you don't press charges, then they may do it to someone
else. But [R1] didn't want to press charges. V7 said the hook, where she hung her purse, was next to the
head of the bed, near the door. V7 said it wouldn't take much time or effort to get into R1's purse. V7 said
R1 knew that her money was stolen.
R1's Facesheet dated 6/13/25 showed she had diagnoses to include, but not limited to: protein-calorie
malnutrition, squamous cell carcinoma of scalp and neck, basal cell carcinoma of right shoulder, anxiety,
osteoporosis, adult failure to thrive, and major depressive disorder.
R1's facility assessment dated [DATE] showed she was cognitively intact.
R1's undated Final Abuse Investigation Findings showed, Social Services reviewed video surveillance
within the period of time the resident reported her money being taken from her room. Upon review, Social
Services watched an individual enter [R1's] room, multiple times, beginning at 6:13 PM on 6/5/25 and
ending at 6:24 PM on 6/5/25. The first time the individual entered the room was due to being given the
incorrect room number, as he was there to see his grandfather. However, after further review the individual
still continued to enter [R1's] room even after being walked to his grandfather's room by staff. Social
Services, in addition to staff interviews, interviewed with the individual's grandfather (a resident in the
facility) and a visiting family member that was present at the time of the interview. Both gentlemen identified
the individual and provided Social Services with a first and last name; (V6 -R4's grandson) . Upon
investigation, the findings indicate abuse has occurred.
(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 3
Event ID:
145495
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
145495
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/13/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Medina Nursing Center
402 South Center Street
Durand, IL 61024
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 0602
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
The findings conclude that [R1] is, in fact, a victim of misappropriation of resident property and does
classify as abuse. The suspected abuser is a family member of another resident and is not affiliated with
[the facility.] .
On 6/13/25 at 10:04 AM, V9 (Registered Nurse - RN) said she worked at the facility for six years. V9 said
R1 approached her and reported she was missing $80. V9 said R1 was going out to eat with friends when
she noticed the $80 was not in her purse. V9 said R1 was fretting about the money being stolen. V9 said R1
was sure the money was stolen. V9 said R1 said she was going to give the money to her daughter, but she
wouldn't take the money. V9 said R1 told her the money was there Tuesday (6/3/25) and not it's not (6/7/25).
V9 said e checked her room and couldn't locate the money. V9 said notified V5 (Social Services Director SSD) and completed a missing item from. V9 said V5 took over the investigation. V9 said she was shown a
photo, but she didn't recognize the person. V9 said R1 is completely alert and oriented and can tell you
exactly what happened.
On 6/13/25 at 12:38 PM, V13 (Helper) said he doesn't provide direct care to the residents, but helps with
refilling waters, taking resident snacks, and bringing them to and from the dining room. V13 said he didn't
see V6 (R4's grandson) enter the building, but he saw him down in the lounge. I was with residents and he
asked where R4 was. I showed him R4's room and he said he was told a different room number. He said he
went into R1's room instead of R4's room. V13 said V6 said he was R4's grandson and he had a little box of
cookies with him. V13 said he didn't think anything of it, until he was shown a picture and asked if he knew
who V6 was. V13 said he told V5 (SSD) what he knew, but he wasn't aware that R1 was missing money.
V13 said R1 is alert and oriented and pretty independent.
On 6/13/25 at 12:18 PM, V5 (SSD) and V2 (Director of Nursing) were both present for V5's interview. V5
said she was notified that R1's money was missing on Monday (6/9/25). V5 said she interviewed R1 and
she reported she had $80 to give to her daughter on 6/3/25, but her daughter refused to take the money. V5
said R1 said she put the $80 in her purse and later in the week she went to have a meal with friends. V5
said R1 was getting her stuff ready to go out and noticed her money was missing. V5 said R1 reported they
had checked her room for the money and she was adamant that it was stolen. V5 said she started the
investigation by reviewing the security cameras on who was coming and going out of R1's room. V5 said R1
was very independent, so most staff interactions were brief. V5 said she noticed suspicious activity on
6/5/25. V5 said a suspected individual went into R1's room several times. V5 said she didn't recognize V6
(R4's grandson), so she took a screenshot and asked staff if they knew who he was. V5 said V13 (Helper)
was observed on the cameras, talking to V6. V5 said V13 reported V6 was R4's grandson and was looking
for his room. V5 said a downstairs camera caught V6 saying R4 was his grandpa. V5 said she took the
screenshot to R4's room and R4, as well as his son, identified V6 and provided the facility with his full
name. V5 said when V6 (R4's grandson) initially arrived at the facility through the Team B entrance, he
asked V17 (CNA) for R4's room number and V17 accidentally provided the wrong room number (R1's
room). V5 said V6 (R4's grandson) walked in the room briefly and relayed to staff that it was not his
grandpa's room, that [R1's] name was on the door. V5 said after he acknowledged that wasn't R4's room,
he entered the room again, then went to the lounge and encountered V13 (Helper). V5 said the cameras
showed V13 (Helper) was talking to V6 (R4's grandson) as V13 directed him to R4's room. V5 said V6 (R4's
grandson) entered R1's room two additional times after this. V5 said the doors clearly showed it was R1's
room and V6 acknowledged that he saw R1's name on the camera earilier. V5 stated, He had no reason to
go back in her room. V5 said we followed our policy and notified the police, but R1 didn't want to pursue any
charges. V5 said R1 was very embarrassed and tried to say it was her fault. V5 stated, I told her it's her
right to have money in her home. Her dignity was threatened and that's not right. She seems okay, but I
don't
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145495
If continuation sheet
Page 2 of 3
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
145495
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/13/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Medina Nursing Center
402 South Center Street
Durand, IL 61024
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 0602
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
know how I would feel. I just want to give her the money. They (residents) shouldn't have to worry about
someone stealing from their rooms. I took this investigation very seriously. V2 and V5 said the facility did
substantiate theft/misappropriation of R1's property.
The facility's Abuse, Neglect, and Exploitation Policy (reviewed/revised 5/16/25) showed, It is the policy of
this facility to provide protections for the health, welfare, and rights of each resident by developing and
implementing written policies and procedures that prohibit and prevent abuse, neglect, exploitation, and
misappropriation of resident property .
Event ID:
Facility ID:
145495
If continuation sheet
Page 3 of 3
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Back to topCitations
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.
F602 - The resident has the right to be free from abuse, neglect, misappropriation of re
Protect each resident from the wrongful use of the resident's belongings or money.
FAQ · About this visit
Common questions about this visit
What happened during the June 13, 2025 survey of MEDINA NURSING CENTER?
This was a inspection survey of MEDINA NURSING CENTER on June 13, 2025. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at MEDINA NURSING CENTER on June 13, 2025?
Yes, 1 deficiency was cited, each with a CMS Scope and Severity grade. The first was: "Protect each resident from the wrongful use of the resident's belongings or money."
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
Next steps
Concerned about a resident’s care?Find your local ombudsman through the Eldercare Locatoror file a complaint with your state survey agency.
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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.