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 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 PROTECT CONFIDENTIALITY** Based on
interview and record review, the facility failed to provide timely and thorough incontinence care for a
dependent resident who requires assistance with toileting and hygiene for one of four residents (R1)
reviewed for incontinence care in the sample of four.
Residents Affected - Few
Findings include:
R1's Face Sheet documented an admission date of 1/31/24 and listed diagnoses including Cerebral
Infarction, Diabetes Type 2, and Transient Cerebral Ischemic Attacks. R1's 2/5/24 MDS (Minimum Data Set)
documented a Brief Inventory for Mental Status Score of 8, indicating R1 has moderate deficits in cognitive
functioning. The same MDS documented that R1 is always incontinent of both bowel and bladder and is
dependent on staff for toileting and hygiene. R1's Care Plan dated 2/12/24 documented a problem
area,Resident experiences bladder and bowel incontinence, with a corresponding intervention, Provide
incontinence care after each incontinent episode.
On 2/28/24 at 8:55am, V5, Family Member, stated R1 was admitted to the facility on [DATE]. V5 stated R1
previously had a stroke, has periods of confusion, and is dependent on staff for activities of daily living. V5
stated V5 was informed by V6, Family Member, that when V6 visited R1 on 2/21/24, V6 found R1 lying in
her bed, covered with dried feces. V5 stated V6 is R1's Power of Attorney, but they both share responsibility
for R1's care.
On 2/28/24 at 10:20am, V1, Administrator, stated on 2/21/24, V6 approached V2, Director of Nurses, on
2/21/24 to say that R1 had been covered in feces. V1 stated V3, R1's CNA(Certified Nursing Assistant) that
afternoon, stated to V2 that he did not do mandatory beginning of shift rounds with the outgoing day shift
CNA,V4. V1 stated later that afternoon, V3 was written up for not performing his job duties, which V3
refused to sign, and V3 left the facility, upset. V1 stated V3 said V4 had assured him all the residents under
her care were clean and dry when she left at 2:00pm. V1 stated when V3 became aware R1 was soiled, he
immediately cleaned her up, and R1 got a shower later that afternoon. V1 stated V3 has been employed by
the facility since mid December 2023, and there have been no previous issues with his performance.
On 2/28/24 at 10:50am, V2 stated she requires the outgoing and oncoming CNAs to round together at shift
change to make sure residents are clean and dry, and V3 admitted he had not done shift change rounds
with V4. V2 stated she re-educated V3 and V4 about this requirement. V2 stated she interviewed R1, who
did not remember the incident.
On 2/28/24 at 11:30am, R1 was in the dining room awaiting lunch service. R1 appeared adequately
groomed and was odor free. R1 was alert only to herself. R1 stated she did not recall the above
(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:
145807
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
145807
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Helia Healthcare of Newton
300 S Scott Street
Newton, IL 62448
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 0677
referenced incident that occurred on 2/21/24.
Level of Harm - Minimal harm
or potential for actual harm
On 2/28/24 at 11:45am, V6 stated he visited R1 on 2/21/24 at about 4:00pm to 4:15pm. V6 stated when he
arrived, R1 had dried feces all over her, the bed, her hands, and the wall and was crying. V6 stated he
found V3 and told V3 R1 needed to be cleaned and changed immediately. V6 stated he then informed V7,
Minimum Data Set Coordinator, about what happened and that he was very unsatisfied with the care.
Residents Affected - Few
On 2/28/24 at 12:50am, V4 stated on 2/21/24 she worked 6:00am to 2:00pm. V4 stated she changed R1
about 1:00pm after R1 had been incontinent of feces. V4 stated at 2:00pm shift change, R1 had again been
incontinent of feces and V4 was changing her when V3 came in and helped her. V4 stated she and V3 did
not do shift change rounds on anybody but R1.V4 stated although she had not done anything wrong, she
got, Talked to about making sure they check and change everybody every two hours.
On 2/28/24 at 1:45pm, V3 stated on 2/21/24 he came in at 2:00pm to cover for another staff member, as V3
usually works 10:00pm to 6:00am. V3 stated when he arrived at 2:00pm, he helped V4 change R1. V3
stated at 4:00pm he went in to check on R1, and found V6 in the room. V3 stated V3 found that R1 had
been incontinent of feces and so he changed her. V3 stated the feces was not on the wall or the bed, but
there was some on her hands, which he cleaned. V3 stated he then left and went to take care of other
residents. V3 stated shortly thereafter,I got pulled into the office by (V2) and (V7), they said there was a
complaint that I left (feces) on (R1's) fingers and that (V6) had tried to wipe it off and it was dry. V3 stated
he refused to sign the document because he hadn't done anything wrong. V3 stated he left at 5:00pm, not
because he was angry, but that was when he was supposed to leave, and he came back at 10::00pm to
work his normal shift. V3 stated he did not get re-educated after this incident. V3 stated dependent
residents are to be checked and changed every two hours. V3 stated administration has since implemented
a shift change check off list which both the outgoing and oncoming CNAs sign off on.
On 2/28/24 at 2:10pm, V6 was again interviewed. V6 stated on 2/21/24, he went into R1's room at about
4:30pm, and nobody was in the room except R1. V6 stated R1 was in bed, with dried feces on her hands,
clothes, bed, and the adjacent wall. V6 stated he found V3 and told him R1 needed to be cleaned up. V6
stated he then stepped out into the hall while this took place. V6 stated when he returned to R1's room, V3
was still in the room but had finished cleaning R1. V6 stated R1 still had feces on her shirt, and he had to
ask V3 to change it. V6 stated after V3 left, V6 noticed there was still dried feces on R1's hands, so V6
cleaned R1's hands which he stated was difficult since it was dried on. V6 stated, By then they were getting
ready to start supper and I guess they were going to be ok with letting her eat supper with feces on hands.
On 2/28/2 at 2:30pm, V7 stated on 2/21/24 at about 4:00pm, she was approached by V6, who stated R1
had a bowel movement and had dried feces on her hands. V7 stated V6 didn't say anything about R1's
clothing, bed, or wall being dirty, nor about her hands still being dirty. V7 stated she and V2 then addressed
with V3 the importance of between shift rounds, but V3 did not feel he had done anything wrong, and that
V3 stated he had been checking on her every two hours and R1 must have been incontinent in between
checks.
V3's Employee Disciplinary Action document dated 2/21/24 stated,Resident had dried feces per family.
Staff not performing job duties.
A Grievance/Concern/Complaint Form dated 2/21/24 documented,(V6) entered room to find resident had
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145807
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
145807
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Helia Healthcare of Newton
300 S Scott Street
Newton, IL 62448
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 0677
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
bowel movement and needed cleaned up and showered. Recommendation/Action Taken: Resident cleaned
and showered. Staff disciplined related to care concern.
A Toileting Policy dated July 2014 documented,It is the policy of (the facility) to make sure all of our
residents toileting needs are met. Procedure: 2. Check each resident at least every two hours and/or as
needed and change if found incontinent.
An undated Residents Rights Policy stated, Your facility must treat you with dignity and respect and must
care for you in a manner that promotes your quality of life.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145807
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.
F677 - A resident who is unable to carry out activities of daily living receives
Provide care and assistance to perform activities of daily living for any resident who is unable.
FAQ · About this visit
Common questions about this visit
What happened during the February 29, 2024 survey of HELIA HEALTHCARE OF NEWTON?
This was a inspection survey of HELIA HEALTHCARE OF NEWTON on February 29, 2024. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at HELIA HEALTHCARE OF NEWTON on February 29, 2024?
Yes, 1 deficiency was cited, each with a CMS Scope and Severity grade. The first was: "Provide care and assistance to perform activities of daily living for any resident who is unable."
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
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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.