F 0725
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in
charge on each shift.
Based on interview and record review, the facility failed to ensure sufficient licensed nursing staff were
present for each shift in each building. This failure has the potential to affect all 54 residents residing in the
South Building.Findings include:The Facility Assessment Tool dated 12/2024 through 12/2025 documents
the following: Staffing Plan for licensed nurses including Registered Nurse (RN) and Licensed Practical
Nurses (LPN): Refer to facility assessment and CMS minimum staffing rule. This same record further
documents staffing should include one RN each shift and three LPN's for night shift.The Daily Nurse
Staffing Sheets dated 1/1/2026 through 1/20/2026 documents no RN coverage for at least 8 consecutive
hours a day on 1/3/2026, 1/4/2026, 1/11/2026, and 1/17/2026. This same record documents on 1/17/2026,
the facility had no RN's and/or LPN's working the 11pm to 7am shift in the South Building. Further
documents two LPN's working night shift in the north building.On 1/21/26 at 9:16am, V8 Assistant Director
of Nursing confirmed there was no RN coverage for 8 consecutive hours in the facility on 1/3/2026,
1/4/2026, 1/11/2026, and 1/17/2026. V8 stated the nursing management staff are on-call on weekends if
needed.On 1/21/25 at 2:50pm, V2 Director of Nursing stated V2 was notified by V1 Administrator at 8pm on
1/17/26 of no nursing coverage for the 11pm to 7am shift for the south building. V2 stated V2 worked from
3am to 5am.The Facility's Midnight Census Report dated 1/15/2026 documents 54 residents reside in the
south building of the facility.
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 2
Event ID:
145753
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
145753
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
01/21/2026
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
LA Bella of Danville
1701 North Bowman
Danville, IL 61832
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 0727
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on
a full time basis.
Based on interview and record review, the facility failed to have a Registered Nurse (RN) providing services
for at least eight consecutive hours a day, seven days a week. This failure has the potential to affect all 138
residents currently residing in the facility.Findings include:The Facility Assessment Tool dated 12/2024
through 12/2025 documents the following: Staffing Plan for licensed nurses including Registered Nurses
(RN): Refer to facility assessment and CMS minimum staffing rule. This same record further documents
staffing should include one RN per shift.The Daily Nurse Staffing Sheets dated 1/1/2026 through 1/20/2026
documents no RN coverage for at least 8 consecutive hours a day on 1/3/2026, 1/4/2026, 1/11/2026, and
1/17/2026.On 1/21/26 at 9:16am, V8 Assistant Director of Nursing confirmed there was no RN coverage for
8 consecutive hours in the facility on 1/3/2026, 1/4/2026, 1/11/2026, and 1/17/2026. V8 stated the nursing
management staff are on-call on weekends if needed.Resident Council Meeting Minutes for October,
November, and December 2025 document short staffing and staffing concerns.The Facility's Midnight
Census Report dated 1/15/2026 documents 138 residents reside in the facility.
Event ID:
Facility ID:
145753
If continuation sheet
Page 2 of 2