Inspection·March 21, 2025

F 0565 Honor the resident's right to organize and participate in resident/family groups in the facility. Level of Harm - Minimal harm or potential for actual harm Based on record review and interview the facility failed to only allow residents in the resident council meeting, failed to record attendance at resident council meeting minutes, failed to identify residents who had concerns during resident council meeting minutes and failed to resolve concerns voiced in the resident council meeting. These failures have the potential to affect all 62 residents who currently reside in the facility. Residents Affected - Many Findings Include: The Illinois Long Term Care Ombudsman Resident Council Tool Kit for Staff Liaison documents A resident council is an independent group of long term care facility residents who typically meet at a minimum of once a month to discuss concerns and suggestions in the facility and to plan activities that are important to them. Resident Councils are structured in various ways, but usually every resident living in a facility is an automatic member of the council. All grievances raised during the meeting should be recorded in the minutes. Responses to grievances should be received in a timely manner as indicated in the facility's grievance policy. Responses should be specific and should be reflected in subsequent minutes. The Illinois Long Term Care Ombudsman Program Resident Council Tool Kit for Staff Liaison documents Families and friends of residents who live in the community retain the right to form family councils. If there is a family council in the facility, or if one is formed at the request of family members or the ombudsman, a facility shall make information about the family council available to all current and prospective residents, their families and their representatives. The information shall be provided by the family council, prospective members or the ombudsman. The Facility's Resident Council Minutes dated 4/6/24 document We had 14 residents at council. Also in attendance were two family members. The Resident Council Minutes did not document the names of anyone present other than V8 (Activity Director). The Facility's Resident Council Minutes dated 5/2/24 document Environmental Services: sides of toilets not being cleaned and wiped down. 3 out of 6 residents had this problem. The Resident Council Minutes did not document the names of the residents with this concern or what the plan was to address this concern. The Resident Council Minutes for the next month dated 6/6/2024 did not document any resolution to this concern. The Facility's Resident Council Minutes dated 5/2/24 document We had 6 residents at council. Also in attendance was the food and nutrition director. The Resident Council Minutes did not document the names of any of the residents at the meeting, nor did the minutes address the reasoning for the food and nutrition director in the meeting or who invited that person. (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 5 Event ID: 145703 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 145703 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/21/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Silvis Center for Nursing Rehab & Care 1455 Hospital Road Silvis, IL 61282 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)