Public Record
The Pavilion on Main Street
Operated by Pavilion Healthcare
From CMS
Facility profile
- CMS overall rating
- 2 / 5
- Certified beds
- 113
- Avg. residents per day
- 89.4
*CMS Five-Star
*CMS
*CMS
Inspection record
On record from CMS
- Health citations
- 33
- Fire safety findings
- 25
- Inspections on file
- 12
- Last inspection
- 2025-10-09
*CMS
*CMS
*CMS
*CMS
Citations
33 citations on record
Each deficiency cited on a CMS health inspection of this facility, sourced from the federal record. Open a report for the raw CMS Scope and Severity grade on each finding.
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.
- 0689Generalpotential for harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0689Seriousactual harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0755Generalpotential for harm
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- 0584Generalpotential for harm
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- 0677Generalpotential for harm
Provide care and assistance to perform activities of daily living for any resident who is unable.
- 0684Generalpotential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 0692Seriousactual harm
Provide enough food/fluids to maintain a resident's health.
- 0759Generalpotential for harm
Ensure medication error rates are not 5 percent or greater.
- 0803Generalpotential for harm
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
- 0804Generalpotential for harm
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- 0689Seriousactual harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0812Generalpotential for harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- 0882Generalpotential for harm
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0755Generalpotential for harm
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- 0812Generalpotential for harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- 0625Generalpotential for harm
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
- 0686Generalpotential for harm
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- 0684Generalpotential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 0689Generalpotential for harm
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- 0690Generalpotential for harm
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- 0694Generalpotential for harm
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
- 0697Seriousactual harm
Provide safe, appropriate pain management for a resident who requires such services.
- 0725Generalpotential for harm
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- 0755Generalpotential for harm
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- 0761Generalpotential for harm
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
- 0880Generalpotential for harm
Provide and implement an infection prevention and control program.
- 0677Generalpotential for harm
Provide care and assistance to perform activities of daily living for any resident who is unable.
- 0684Generalpotential for harm
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- 0686Generalpotential for harm
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- 0755Generalpotential for harm
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
- 0760Generalpotential for harm
Ensure that residents are free from significant medication errors.
Inspection history
Every health inspection on record
Each CMS health inspection of this facility, and the deficiencies the surveyors cited. Where the verbatim Form 2567 statement of deficiencies is on file, it links to the full report.
- Inspection1 deficiency
145712 10/09/2025 Pavilion on Main Street, The 515 North Main Sandwich, IL 60548 F 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents…
Read full statement of deficiencies - Inspection2 deficiencies
145712 09/18/2025 Pavilion on Main Street, The 515 North Main Sandwich, IL 60548 F 0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Level of Harm - Actual harm Residents Affected - Few **NOTE- TERMS IN BRACKETS HAVE…
Read full statement of deficiencies - Inspection10 deficiencies
145712 08/27/2025 Pavilion on Main Street, The 515 North Main Sandwich, IL 60548 F 0584 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving…
Read full statement of deficiencies - Inspection2 deficiencies
145712 07/23/2025 Pavilion on Main Street, The 515 North Main Sandwich, IL 60548 F 0880 Provide and implement an infection prevention and control program. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based…
Read full statement of deficiencies - Inspection2 deficiencies
145712 10/30/2024 Pavilion on Main Street, The 515 North Main Sandwich, IL 60548 F 0755 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed…
Read full statement of deficiencies - View inspection reportInspectionFire Safety9 deficiencies
- View inspection reportInspection1 deficiency
- Inspection11 deficiencies
145712 09/28/2023 Pavilion on Main Street, The 515 North Main Sandwich, IL 60548 F 0677 Provide care and assistance to perform activities of daily living for any resident who is unable. Level of Harm - Minimal harm or potential for actual harm **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO…
Read full statement of deficiencies - View inspection reportInspectionFire Safety11 deficiencies
- Inspection2 deficiencies
145712 05/17/2023 Pavilion on Main Street, The 515 North Main Sandwich, IL 60548 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…
Read full statement of deficiencies
Showing the 10 most recent inspections. 2 earlier inspections are also on record.
Ownership
Pavilion Healthcare
5nursing homes nationwide, in CMS records
All 5 are in Illinois.
Counted from the chain CMS itself discloses for this home, which matches CMS Care Compare. ReadyRule's own common-control analysis is a separate and broader lens, and the two can differ.
FAQ
Questions and answers
- What is The Pavilion on Main Street?
- The Pavilion on Main Street is a Medicare- and Medicaid-certified nursing home in Sandwich, IL, tracked by the Centers for Medicare & Medicaid Services (CMS). Its CMS Certification Number (CCN) is 145712.
- What is the CMS rating for The Pavilion on Main Street?
- The Pavilion on Main Street has a CMS overall rating of 2 out of 5 stars. CMS rates nursing homes on health inspections, staffing, and quality measures.
- How many beds does The Pavilion on Main Street have?
- The Pavilion on Main Street is certified for 113 beds. It serves an average of 89.4 residents per day.
- How many citations does The Pavilion on Main Street have?
- The Pavilion on Main Street has 33 citations on record from CMS health inspections, each tied to a federal deficiency tag.
- When was The Pavilion on Main Street last inspected?
- The Pavilion on Main Street was last inspected on October 9, 2025. CMS surveys nursing homes about once a year and after complaints.
- What can I do if I have concerns about care at this facility?
- Start by raising the concern with the facility administrator or director of nursing. Every state also runs a free long-term care ombudsman program that advocates for residents and families; the federal Eldercare Locator at eldercare.acl.gov can connect you with yours. Complaints about quality of care can also be filed with your state survey agency.
*Sourced from the Centers for Medicare & Medicaid Services (CMS). See the official record on CMS Care Compare. If you believe any information is inaccurate, report it here.
/nursing-home/145712-pavilion-on-main-street-the