Inspection visit
Health inspection
8 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 8 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0550
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or
her rights.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 2. On 2/28/24
at 12:07 PM, V9 CNA (Certified Nursing Assistant) was sitting at a table feeding R71 while R56 sat at the
same table without a food tray in front of her. R96 was brought over to the same table as R71 and R56 and
did not have a food tray in front of her. V9 stated they have early trays for the residents that need to be fed
and they feed those residents before other residents are given their food trays. At 12:18 PM, R56 was given
her food tray and was able to feed herself. The food trays were removed from the food cart and were
delivered to residents at different tables. Some residents were eating at the same table while others waited
for their food trays. R96 was sitting at the table with R71 who had finished eating and R56 who had just
received her tray. R96 stated she wanted her food and that she was hungry. R96 stated she needed to be
fed. V13 (Activity Aide) told R96 he would look for her tray of food but he could not feed her because he
was an activity aide. R96 yelled, Help me, Help me!
On 2/28/24 at 1:26 PM, V10 (Social Services/Unit Director) stated the kitchen sends early trays first. We
have a list of early trays, those people need assistance and supervision for feeding. The other trays come
after that. We are trying to group them in groups so people can eat together, its a dignity issue for sure.
On 2/29/24 at 1:20 PM, V1 (Administrator) stated the facility doesn't have a resident rights or dignity policy.
V1 stated they follow the Illinois Long-Term Care Ombudsman Program Resident Rights for people in Long
Term Care Facilities booklet. The booklet showed, your facility must treat you with dignity and respect and
must care for you in a manner that promotes your quality of life.
The Face Sheet dated 2/29/24 for R56 showed medical diagnoses including cerebral aneurysm,
depression, hyperlipidemia, bipolar disorder, osteoporosis, chronic obstructive pulmonary disease, lack of
coordination, acute cystitis, and dementia.
The Care Plan dated 1/25/24 for R56 showed she is at risk for alteration in nutritional status, has mood
distress present with signs and symptoms of depression, and has anxiety. R56's care plan showed she has
been declining in health and requires the support of a long-term care setting and presents with some risk
for failure to thrive secondary to poor insight/awareness and making questionable decisions.
The Face Sheet dated 2/29/24 for R96 showed medical diagnoses including respiratory syncytial virus,
dementia, dysphagia, pneumonia, anorexia, anemia, hyperlipidemia, major depressive disorder, obstructive
sleep apnea, hypertension, macular degeneration, chronic obstructive pulmonary disease, gastritis, stage 4
pressure ulcer of the sacral region, chronic kidney disease, paroxysmal atrial fibrillation, and anxiety
disorder.
(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 15
Event ID:
145819
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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 0550
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Some
The Physician Progress Note dated 2/26/24 for R96 showed she is alert and oriented to person, time, and
place; she is forgetful. The physician's assessment and plan showed R96 has chronic kidney disease with
worsening creatinine; she is legally blind, has rheumatoid arthritis and a stage 4 pressure ulcer.
The Care Plan dated 12/29/23 for R96 showed she is at risk for alteration in nutritional status. R96's
nutritional status is compromised due to megestrol acetate; give 40 mg by mouth one time a day for
anorexia. R96 has an activity of daily living self care performance deficit related to reduce mobility, muscle
weakness and loss of vision from macular degeneration. Requires assistance to eat. R96 has a history of
depression and presents with symptoms of depression during the interview for depression assessment.
3. R260's face sheet showed she was admitted to the facility on [DATE] with diagnoses to include Multiple
Sclerosis, Respiratory Syncytial Virus Pneumonia, disorder of thyroid, degenerative disease of the nervous
system, adult failure to thrive, ileostomy status, and pressure ulcer of sacral region. R260's facility
assessment dated [DATE] showed she is dependent on staff for all cares.
On 2/27/24 at 1:59 PM, V19 CNA (Certified Nursing Assistant) and V20 RN (Registered Nurse) were
providing care for R260. The privacy curtain was not drawn between R260 and her roommate. R260's body
was completely exposed except an incontinence brief was tucked in her perineal area. R260's roommate
was sitting up in her bed using her tablet. While R260 was exposed, V20 was cleaning up feces that had
leaked from R260's colostomy bag and had ran down her side.
On 2/29/24 at 12:10 PM, V2 DON (Director of Nursing) said she would certainly expect them to pull the
privacy curtain to provide the resident privacy and make them feel more comfortable. It is important to
provide privacy for the resident's dignity.
The undated State of Illinois Residents' Rights for People in Long-term Care Facilities booklet provided by
the facility showed, . You have the right to . safety and good care. Your facility must provide services to keep
your physical and mental health, and a sense of satisfaction Privacy, Your medical and person care are
private .
Based on observation, interview, and record review the facility failed to provide dignity during dining and
personal cares for 5 of 5 residents (R56, R96, R105, R260, R402 ) reviewed for dignity in the sample of 18.
The findings include:
1. On 2/28/24 at 11:37 AM, R402 was sitting at the lunch table with R51 while R51 was being fed his meal.
R402 stated he does not have his food yet but that R51's food sure looks good. At another table, R80 was
being fed her meal while R105 watched her being fed and did not have her meal served yet.
On 2/28/24 at 11:42 AM, V11 (Rehab Aide) stated, The residents that get fed first need assistance with
meals so we give them more time to eat. It's kind of odd because other residents are waiting for their food
but we need to make sure the ones that need assistance have enough time to eat. It's only about a 15
minute difference.
On 2/28/24 at 12:04 PM, (27 minutes after the assisted residents began eating), the independent
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 2 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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 0550
Level of Harm - Minimal harm
or potential for actual harm
residents were beginning to be served on a random rotation, not by table. Residents were overheard
complaining about not getting food when everyone else at their table had food. Staff continued the same
meal service with no regard to resident complaints about the meal service.
Residents Affected - Some
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 3 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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
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
observation, interview, and record review the facility failed to provide oral care and failed to ensure a
resident received a shower for 2 of 3 residents (R301, R1) reviewed for Activities of Daily Living (ADLs) in
the sample of 18.
Residents Affected - Few
The findings include:
1. On 2/27/24 at 10:55 AM, R301 was lying on her back, in bed. R301's lips were dry and cracked. There
was a line of brown debris to the corners of her both, just below the lips. R301's tongue was dry and coated
in white material. R301's teeth were coated in a white film. During the interview, R301's voice was rasping
and her lips kept sticking to her teeth. R301 stated, Just a minute. It's so hard for me to talk. My mouth is so
dry. R301 closed her mouth and swallow. R301's speech was difficult to understand at times, due to the
dryness of her mouth, tongue, and lips. R301 said she had not received any oral care today. R301 said they
are supposed to help me brush my teeth in the morning, but no one has been in here yet. R301 did not
have any water at the bedside.
On 2/29/24 at 10:19 AM, R301 was sitting in a dialysis chair, outside the door to dialysis. V3 (Certified
Nursing Assistant - CNA) pushed R301 back to her room. V3 and V4 (CNAs) used a total lift machine to
transfer R301 from the dialysis chair to her bed. R301 had no water on her overbed table or her nightstand.
R301 had a surgical mask on. R301's voice was raspy and she asked V3 and V4 (CNAs) for coffee. R301
stated, I'm terribly thirsty. Please get me some coffee. R301 removed her surgical mask from her face.
R301's lips and tongue were dry. The surveyor asked R301 if she had oral care today and she said, Nope,
not yet. But boy am I dry.
R301's Face Sheet dated 2/29/24 showed diagnoses to include, but not limited to: iron deficiency anemia,
diabetes, obesity, hypercalcemia, bipolar disorder, depression, seizures, polyneuropathy, hypertension,
osteoarthritis, low back pain, endstage renal disease, dependence on renal dialysis, difficulty walking, lack
of coordination, and schizoaffective disorder.
R301's Physician Order Sheet showed an order initiated 2/16/24, Per Family CNA to help (resident) brush
teeth every shift.
R301's Care Plan initiated 2/15/24 showed, [R301] had an ADL self-care performance deficit and impaired
mobility . Interventions: .Personal Hygiene/Oral Care: I require weightbearing assistance with personal
hygiene and oral care.
R301's Nursing admission dated 2/15/24 showed she was alert to person and place; had the ability to
express ideas and wants; and had pink and moist lips, tongue, and mouth. This document showed R301
required set-up or clean-up assistance from staff for oral care.
R301's CNA Task Screen showed Oral Care should be completed Days/Evening and PRN (as needed) at
night.
R301's Oral Care CNA Task for the last 14 days showed on 2/27/24 oral care was not provided until 1:39
PM. R301 did not have any oral care documented on 2/21/24, 2/24/24, and 2/26/24.
On 2/29/24 at 10:16 AM, V3 (CNA) said oral care should be completed after breakfast and lunch.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 4 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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
On 2/29/24 at 10:34 AM, V4 (CNA) said oral care should be done every day. V4 said R301 is able to make
her needs known, but had been needing more assistance lately.
On 2/29/24 at 10:39 AM, V5 (RN - Registered Nurse) said the CNAs assist the resident's with oral care. V5
said oral care is important for hygiene and freshness.
Residents Affected - Few
On 2/29/24 at 11:04 AM, V2 (DON - Director of Nursing) said oral care should be done when the residents
get up and ready for the day and after meals. V2 said oral care is done to keep the mouth clean and
healthy.
The facility's Mouth Care Policy revised 1/14/22 showed, The facility shall administer proper oral care to its
residents in order to keep the lips and oral tissues moist, to cleanse and freshen the resident's mouth and
to prevent mouth infection .
2. On 2/27/24 at 11:15 AM, R1 was lying in bed, resting with her eyes closed. R1's hair was greasy and
unkempt. R1 had long fingernails with brown debris noted under the nailbeds. The skin on R1's arms and
upper chest was dry and flaky. R1 awoke to name, but said she was tired and requested an interview later.
On 2/28/24 at 9:27 AM, R1 said it had been 4 weeks since she had taken a shower or washed her hair. R1
stated, I'm pissed about it! I'm supposed to get a shower twice a week. I've been asking for one (a shower)
and keep getting told, I'm not on their list. My skin is getting itchy and it's super dry. R1's shoulder length,
gray hair was greasy and unkempt. R1 stated, I'm just mad about the shower. I'm starting to stink. R1 had a
knee immobilizer to her left stump.
R1's Face Sheet printed 2/29/24 showed diagnoses to include, but not limited to: left femur fracture,
dementia with severe behavioral disturbance, end-stage renal disease, dependence on dialysis, malaise,
fibromyalgia, morbid obesity, congestive heart failure, idiopathic peripheral neuropathy, adjustment disorder,
anxiety, diabetes, chronic pain, and generalized osteoarthritis.
R1's facility assessment dated [DATE] showed had moderate cognitive impairment; and was dependent on
staff assistance for shower/bathing.
The shower schedule for R1's floor showed R1 was scheduled for showers on Monday and Thursday,
during the day shift (7-3).
R1's Progress Notes showed on 2/28/24 R1 received scheduled bed bath. R1's progress notes did not
contain refusals of showers on other dates.
R1's Shower/Bathing & Skin Monitoring Task showed a bed bath was documented on 1/18, 2/1, and
2/16/24. (There was no shower documented on 1/22, 1/25, 1/29, 2/5, 2/8, 2/12, 2/15, 2/19, 2/22, or 2/26/24
- These are R1's scheduled shower days). There was no resident refusals documented in the past 30 days.
R1's Care Plan initiated 6/7/23 showed, [R1] has an ADL self-care performance deficit related to diabetes
mellitus due to underlying condition with diabetic neuropathy, end stage renal disease, neuromuscular
dysfunction of the bladder . Interventions: .Personal hygiene/oral care: I require weight-bearing assistance
with personal hygiene and oral care.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 5 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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
On 2/29/24 at 10:16 AM, V3 (CNA) said the resident showers are scheduled by the room number. V3 said
most residents get showers or baths 2 times a week, but some may have a different preference.
On 2/29/24 at 10:34 AM, V4 (CNA) said the showers are scheduled by the resident's room number. V4 said
the shower schedule is in the binder at the nurses' station and the CNAs use that to know who gets a
shower that day. V4 said after the shower, we chart in the computer. V4 said most residents get a shower at
lease once a week. V4 stated, I think she (R1) wants a bed bath. She doesn't go to the shower because
she can't get up in the chair. I'm not sure when she had a shower last.
On 2/29/24 at 10:39 AM, V5 (RN) said the frequency of showers depends on the residents, but most get
2-3 showers a week. V5 said the shower schedule is in the CNA's binder. V5 said she thinks R1 gets a
shower because she can get up with assistance, she just can't put any weight on her left stump. V5 said R1
is alert and oriented at this time and able to make her needs known.
On 2/28/24 at 11:04 AM, V2 (DON) said each floor has a shower schedule and most residents receive
showers twice a week. V2 said sometimes a resident will get a bed bath instead of a shower. V2 stated, It
depends on their preference. The showers should be charted in the computer. We don't use shower sheets
any more. Everything should be charted in the computer. The purpose of regular showers is to keep the
skin clean and it makes the resident feel good.
The facility's Shower and Hygiene Policy revised showed, It is the policy of this facility to ensure that
resident shower/hygienic care is provided by the nursing staff to promote cleanliness, provide comfort to the
resident, and observe the condition of the resident's skin. Procedures: 1. Administer resident shower once
weekly and/or as often as necessary. Any resident who needs hygienic care will be provided care to
promote hygiene (facial, body, perineal care, etc.) . 3. Shower refusal by the resident shall be relayed by the
assigned CNA to the charge nurse . Documentation (Shower Log/CNA Assignment Sheet): a. Date and
shift the shower/bath was performed. b. The name/title of the nursing staff who assisted the resident with
the shower/bath. c. Assessment data as to reddened areas and skin breakdown and to whom it was
reported to. d. If the resident refused the shower and/or if the shower was not administered and
interventions taken (e.g. bed bath/rescheduling the shower schedule consistent to facility protocol.)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 6 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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 0686
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, interview and record review the facility failed to ensure heels were off-loaded for a resident
with contractures and history of pressure injury to her heels for 1 of 10 residents (R67) reviewed for
pressure in the sample of 18.
Residents Affected - Few
The findings include:
On 2/28/24 at 10:15 AM, R67 was in bed on her left side with splints in place to her hands. R67 had braces
on her legs. The left side of R67's foot and heel was on the mattress of her bed not offloaded. R67 had a
scarred area to her left heel with some red discoloration in the middle of the scarred area.
On 2/28/24 at 1:15 PM, V7 (Wound Care Certified Nursing Assistant) and V8 LPN (Licensed Practical
Nurse/Wound Nurse) went into R67's room to change the dressing to her stage 4 pressure ulcer on her
sacrum. R67 was laying on her right side in bed with a thin pillow between her legs. The right side of R67's
foot and heel were resting on the mattress. V8 stated R67's left heel looked red where she had a previous
heel wound. V8 stated they are supposed to off-load R67's heels because of what she had before. V8
stated it is difficult to off-load R67 because she has contractures. Her daughter even bought her a specialty
pillow for it. The pillow is the one over there in the chair.
The Restorative Note dated 2/28/24 for R67 showed, Dressing to coccyx area changed this afternoon. Left
heel noted to have intact dark pink scar tissue. Skin remains intact. Able to palpate a clear thin scab. Wound
care specialist updated of findings with new order noted and carried out. Will continue to off-load and
monitor closely for any changes.
The Face Sheet dated 2/29/24 for R67 showed diagnoses including left sided hemiplegia and hemiparesis,
neuromuscular dysfunction of the bladder, peripheral vascular disease, dementia, contracture of left knee,
alzheimer's disease, contracture of left wrist, hypothyroidisam, hyperlipidemia, hypertension, heart failure,
cerebral infarction, asthma, dysphagia, and stage 4 pressure ulcer of sacral region.
The Physician Orders dated 2/29/24 for R67 showed, skin: heel offloading at all times while on bed.
The Skin/Wound note dated 2/19/24 at 9:11 AM showed, Preventative measures: Patient has limited
mobility. Please ensure that patient is turned and/or repositioned when in or out of bed as per facility
protocol. The patient has a pressure injury. Recommend ongoing pressure reduction and
turning/repositioning precautions per protocol, including pressure reduction to the heels and all bony
prominences. All prevention measures were discussed with the staff at the time of the visit.
The Care Plan dated 1/8/24 for R67 showed, R67 is a [AGE] year old female at risk for additional
breakdown related to need of total assistance with bed mobility, incontinent of bowel, age, left sided
hemiplegia, and the left side of her body contracted. Coccyx stage 4 pressure injury; Left lateral plantar foot
deep tissue injury (resolved); Left heel stage 2 pressure injury (resolved). Off load heels.
The Minimum Data Set, dated [DATE] for R67 showed she is dependent for all activities of daily
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 7 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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 0686
living.
Level of Harm - Minimal harm
or potential for actual harm
The facility's Skin Care Treatment Regimen policy (7/28/23) did not show off-loading as a preventative
measure for pressure injuries. The policy stated residents who are not able to turn and reposition
themselves will be turned and repositioned every two hours unless specified on the physician order sheet.
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 8 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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 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.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** 2. On 2/27/24
at 11:12 AM, R70 was sitting on the toilet in the bathroom in her room with her call light on. At 11:16 AM,
V6 CNA (Certified Nursing Assistant) was wearing a gait belt around her waist and went into R70's
bathroom to assist the resident and provide pericare. V6 assisted R70 to stand while holding onto the
resident's shirt and under R70's right arm. It took three attempts for the resident to stand. V6 instructed R70
to hold onto the grab bar and turn so V6 could clean R70 off with disposable wipes. R70 had urinated and
had small amount of a bowel movement. V6 cleaned R70 off with the disposable wipes while she was
standing at the grab bar. V6 put an incontinence brief on the resident and pulled her pants up. V6 instructed
R70 to reach back and grab onto the arms of her wheelchair to sit down. No gait belt was used during the
transfer.
On 2/28/24 at 3:03 PM, V11 (Rehab Aide) stated a gait belt is used when assisting residents with walking
and for all one person transfers. V11 stated they use the gait belt for anyone that needs 1 person
assistance. V11 stated they use the gait belt for safety purposes.
On 2/29/24 at 11:17 AM, V9 CNA stated a gait belt is used when they transfer a resident with 1 person. V9
stated it is for the security of the resident and the security of herself.
On 2/29/24 at 11:18 AM, V12 CNA stated R70 is one on one for transfers. V12 stated they use a gait belt
for transfers for R70. V12 stated R70 is pretty steady but does lean. V12 stated R70 wobbles back and forth
at times so it is for her safety.
The Face Sheet dated 2/29/24 for R70 showed diagnoses including dementia, heart failure, sarcopenia,
mitral valve insufficiency, hyperlipidemia, paroxysmal atrial fibrillation, hypertension, osteoarthritis, and
history of falling.
The Care Plan dated 2/14/24 for R70 showed, self- care deficit related to muscle weakness, difficulty
walking and reduced mobility. R70 requires extensive assistance of 1 staff with toileting. R70 requires
extensive assistance of 1 staff with transfers. R70 is at high risk for falls related to dementia, a history of
falling, and heart failure.
The Falls without report dated 12/13/23 for R70 showed she had a fall in the bathroom after bending down
while in her wheelchair. R70 slid out of her chair to the floor.
The Minimum Data Set, dated [DATE] for R70 showed she needs partial/moderate assistance for transfers.
The Fall Risk Evaluation dated 11/9/23 for R70 showed she is at high risk for falls.
The Facility's Gait Belt policy (7/28/23) showed, the facility will use gait or transfer belts to assist residents
needing limited to total assistance during transfers and walking.
Based on observation, interview, and record review, the facility failed to supervise a resident with dysphagia
during meal time for 1 resident (R8) and failed to transfer a resident with a gait belt for 1 resident (R70).
These failures apply to 2 of 10 residents reviewed for accidents in the sample of 18.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 9 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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 0689
The findings include:
Level of Harm - Minimal harm
or potential for actual harm
1. R8's electronic face sheet printed on 2/29/24 showed R8 has diagnoses including but not limited to
chronic obstructive pulmonary disease, dysphagia, chronic fatigue, dementia with behaviors, pseudobulbar
affect, delusional disorder, bipolar disorder, type 2 diabetes, and major depressive disorder.
Residents Affected - Few
R8's facility assessment dated [DATE] showed R8 has severe cognitive impairment and receives a
mechanically altered diet.
R8's physician's orders dated 10/9/23 showed, General diet, pureed texture, nectar thick liquids.
R8's nursing care plan dated 10/10/23 showed, Swallowing problems: some risk to potentially choke or
aspirate food or liquids. This problem is related to diagnosis of dysphagia.
R8's local hospital records dated 10/5/23 showed R8 had been sent to the hospital following a choking
episode and diagnosed with aspiration pneumonia.
On 2/27/24 at 11:51 AM, R8 was sitting up in her room in her reclining wheelchair by herself. R8 was
feeding herself her lunch meal that was a pureed diet with thickened liquids. R8 had consumed
approximately 50% of her meal at this time. No staff were present in R8's room during this observation.
On 2/29/24 at 11:55 AM, V17 (Therapy Director) stated, The last time speech therapy worked with (R8) was
in October 2023 and we recommended a pureed diet and nectar thick liquids. I would assume staff are
assisting her but I'm not sure if she eats in the dining room in a supervised area or not. I would just have to
refer to the speech therapy notes from that time to tell you if she needs to be supervised or not because the
speech therapist that evaluated her is not available.
R8's speech therapy Discharge summary dated [DATE] showed, Intake Protocol: To facilitate safety and
efficiency, it is recommended the patient use the following strategies and/or maneuvers during oral intake:
guided bolus/utensil placement, lingual sweep/reswallow, alternation of liquids/solids, effortful swallow and
general swallow techniques/precautions upright posture during meals, and upright posture for >30 mins
after meals. Supervision for oral intake=Close supervision.
As of 2/29/24, the facility stated they do not have a policy for resident receiving mechanically altered diets.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 10 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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 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 pharmacist.
Based on observation, interview, and record review, the facility failed to perform safe medication
administration for one residents (R7) of seven residents reviewed for medication administration on the total
sample list of 18.
The findings include:
R7's February 2024 medication administration record showed R7 receives aspirin 81mg (milligrams),
dutasteride 0.5mg, cranberry capsule 425mg, flomax 0.4mg, folic acid 800mg, isosorbide mononitrate ER
(extended release) 30mg, nifedipine ER 60mg, methocarbamol 750mg, and sodium bicarbonate 650mg at
9:00AM.
On 2/27/24 at 10:47 AM, V18 (Registered Nurse) took R7's medications into his room and set them on his
overbed table. V18 assessed R7 and then told him to take his medications and left the room. V18 stated, I
know he will take his medications, he's good about it. I have a few residents that I leave them in the room
for them. I know it's not best practice but this is a busy unit so we have to keep moving.
On 2/28/24 at 11:07 AM, V2 (Director of Nursing) stated, It is not our practice to leave medications at the
bedside for residents to take whenever they want. Medications are scheduled at a certain time for a reason
so we need to be sure they are taking them when they are supposed to. This is a poor practice and should
not be occurring.
The facility's policy titled, Medication Pass dated 7/28/23 showed, It is the policy of the facility to adhere to
all Federal and State regulations with medication pass procedures e. after medication is administered to
each resident, sign MAR (Medication Administration Record) that it was given .
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 11 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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 0759
Ensure medication error rates are not 5 percent or greater.
Level of Harm - Minimal harm
or potential for actual harm
Based on observation, interview, and record review, the facility failed to administer medications at ordered
times. There were 31 opportunities with 5 errors resulting in a 16.13% medication error rate. This applies to
2 of 7 residents (R7 and R84) reviewed in the medication pass on tthe total sample list of 18.
Residents Affected - Few
The findings include:
1. R7's February 2024 medication administration record showed R7 receives ferrous sulfate 325mg
(milligrams), methocarbamol 750mg, sodium bicarbonate 650mg, and adalat 60mg at 9:00 AM and 5:00
PM every day.
On 2/27/24 at 10:47 AM, V18 (Registered Nurse) took R7's medications into his room and set them on his
overbed table. V18 assessed R7 and then told him to take his medications and left the room. V18 stated, I
know he will take his medications, he's good about it. I have a few residents that I leave them in the room
for them. I know it's not best practice but this is a busy unit so we have to keep moving. (1 hour and 47
minutes past the ordered administration time).
2. R84's February 2024 medication administration record showed R84 receives Senna S 8.6/50mg at 9:00
AM and 5:00 PM every day.
On 2/27/24 at 10:49 AM, V18 administered R84's Senna (1 hour and 49 minutes past the ordered
administration time). V18 stated she knows these medications are late but she has a busy unit and she has
a lot of residents to take care of.
On 2/28/24 at 11:07 AM, V2 (Director of Nursing) stated, Medications are to be given one hour before and
one hour after the ordered administration time or else that is considered a medication error.
The facility's policy titled, Physician's Orders dated 7/28/23 showed, It is the policy of this facility to ensure
that all resident/patient medications, treatment, and plan of care must be in accordance to the licensed
physician's orders. The facility shall ensure to follow physician order as it is written in the POS (Physician's
Order Set).
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 12 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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 0761
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
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.
Based on observation, interview and record review the facility failed to refrigerate and label open insulin
vials with open and use by dates. This applies to 1 of 1 resident (R14) reviewed for Medication Storage in a
sample of 18.
The findings include:
1. On 2/27/24 at 1:28 PM, the 300 hall medication cart had R14's open, multi dose vial of Novolog insulin
with no open or use by date on it. The vial had 50 units left in it.
R14's Levemir flexpen had no open or use by date and had 150 units left in it.
R14's un-opened Tresiba pen was not refrigerated. The packaging for the Tresiba pen had a sticker on it
that shows to Refrigerate.
On 2/27/24 at 1:42 PM, V18 RN (Registered Nurse) said, We should have insulin dated so we know when it
was opened and when to discard it, and to ensure it remains effective. V18 said, We should be discarding it
after 28 days, but we wouldn't know the 28 days unless it was labeled with the opened date.
On 2/28/24 at 11:07 AM, V2 DON (Director of Nursing) said, insulin vial dates should contain the open and
use by dates, because without them you wouldn't know if the insulin was still good. V2 said, the purpose of
the use by date is to ensure that the medication is thrown out after the 28 days because it isn't good after
that.
R14's admission Record shows her diagnoses to include type 2 diabetes mellitus with hyperglycemia.
R14's POS (Physician Order Sheets) shows she takes Insulin Aspart 6 units SQ (subcutaneous) before
meals, Novolog insulin SQ for sliding scale insulin, and Tresiba Flex/touch 100 units/ml (milliliter) inject 45
unit in the morning.
The Medication Storage, Labeling, and Disposal Policy and Procedure (revised 8/24/23) shows, It is the
facility's policy to comply with federal regulations in storage, labeling and disposal of medications.
Procedures: 1. Medications from pharmacy will be labeled .to include the name of the resident, route of
administration, instructions, medication name (generic/brand), strength and expiration date when
applicable. 3. Medications will be stored safely under appropriate environmental controls.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 13 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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 0807
Level of Harm - Minimal harm
or potential for actual harm
Ensure each resident receives and the facility provides drinks consistent with resident needs and
preferences and sufficient to maintain resident hydration.
Based on observation, interview, and record review the facility failed to provide water/other liquids for a
resident for one of five residents (R301) reviewed for hydration in the sample of 18.
Residents Affected - Few
The findings include:
On 2/27/24 at 10:55 AM, R301 was lying on her back, in bed. R301's lips were dry and cracked. There was
a line of brown debris to the corners of her both, just below the lips. R301's tongue was dry and coated in
white material. R301's teeth were coated in a white film. During the interview, R301's voice was rasping and
her lips kept sticking to her teeth. R301 stated, Just a minute. It's so hard for me to talk. My mouth is so dry.
R301 closed her mouth and swallow. R301's speech was difficult to understand at times, due to the dryness
of her mouth, tongue, and lips. R301 said she had not received any oral care today. R301 did not have any
water at the bedside. R301 said a drink of water would be nice.
On 2/29/24 at 10:19 AM, R301 was sitting in a dialysis chair, outside the door to dialysis. V3 (Certified
Nursing Assistant - CNA) pushed R301 back to her room. V3 and V4 (CNAs) used a total lift machine to
transfer R301 from the dialysis chair to her bed. R301 had no water on her overbed table or her nightstand.
R301 had a surgical mask on. R301's voice was raspy and she asked V3 and V4 (CNAs) for coffee. R301
stated, I'm terribly thirsty. Please get me some coffee. R301 removed her surgical mask from her face.
R301's lips and tongue were dry. The surveyor asked R301 if she had oral care today and she said, Nope,
not yet. But boy am I dry. R301 did not have water on her bedside table or night stand.
R301's Face Sheet dated 2/29/24 showed diagnoses to include, but not limited to: iron deficiency anemia,
diabetes, obesity, hypercalcemia, bipolar disorder, depression, seizures, polyneuropathy, hypertension,
osteoarthritis, low back pain, endstage renal disease, dependence on renal dialysis, difficulty walking, lack
of coordination, and schizoaffective disorder.
R301's Physician Order Sheet did not show an order for a fluid restriction.
R301's Care Plan initiated 2/15/24 showed, [R301] has an ADL self-care performance deficit and impaired
mobility .
R301's Nursing admission dated 2/15/24 showed she was alert to person and place; had the ability to
express ideas and wants; and had pink and moist lips, tongue, and mouth.
On 2/28/24 at 9:27 AM, R1 (R301's roommate) said there is no regular time that the facility passes water.
R1 stated, They don't give my roommate water unless she asks for it and that's wrong. R1 had a pitcher of
room temperature water on her bedside table. The pitcher was half full and there was no ice.
During the Resident Council Meeting on 2/28/24, residents said that the facility does not pass water. They
said you only get water if you ask for it. They said it would be nice to have fresh water with ice in it. They
said you get some drinks with your meal trays, but the water pitchers do not get refreshed with ice and
water regularly.
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 14 of 15
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
145819
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
02/29/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Warren Barr Buffalo Grove
150 North Weiland Road
Buffalo Grove, IL 60089
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 0807
Level of Harm - Minimal harm
or potential for actual harm
On 2/29/24 at 10:16 AM, V3 (CNA - Certified Nursing Assistant) said water pitchers are delivered with the
lunch trays and the residents can ask for ice water then. V3 said the residents have to ask for water refills.
On 2/29/24 at 10:34 AM, V4 (CNA) said water is usually given to the residents during meal times. V4 said
she is not aware of any scheduled water pass, just at meal times.
Residents Affected - Few
On 2/29/24 at 10:39 AM, V5 (RN - Registered Nurse) said the nurses keep a pitcher of water on the
medication cart. V5 said the nurse provides water for the residents to take medications or the CNA can go
to the room where the water and ice is kept to fill a resident's pitcher. V5 said the water is provided during
meal times. V5 said R301 is able to make her needs known. V5 said proper hydration is an important
aspect of the resident's overall health.
The facility's Hydration Policy revised 7/28/23 showed, It is the facility's policy to ensure that residents are
adequately hydrated. Procedures: Encourage fluid intake unless contraindicated .
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145819
If continuation sheet
Page 15 of 15
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Back to topCitations
8 citations 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.
F550 - Resident Rights
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
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.
F686 - Skin Integrity
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
F689 - Accidents
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
F755 - Pharmacy Services
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
F759 - Medication Errors
Ensure medication error rates are not 5 percent or greater.
F761 - Labeling of Drugs and Biologicals
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.
F807 - Food and drink
Ensure each resident receives and the facility provides drinks consistent with resident needs and preferences and sufficient to maintain resident hydration.
FAQ · About this visit
Common questions about this visit
What happened during the February 29, 2024 survey of WARREN BARR BUFFALO GROVE?
This was a inspection survey of WARREN BARR BUFFALO GROVE on February 29, 2024. The surveyor cited 8 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at WARREN BARR BUFFALO GROVE on February 29, 2024?
Yes, 8 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her right..."
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.
Researching this visit professionally?Book a 15-minute calland we will walk through what we have on file.
Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.