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Inspection visit

Health inspection

GOLDWATER PONTIAC NURSING HOMECMS #1459301 citation on this visit
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.

145930 09/27/2023 Goldwater Pontiac Nursing Home 1225 South Ewing Drive Pontiac, IL 61764
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 on observation, interview, and record review the facility failed to ensure employees with symptoms of COVID-19 were tested for COVID-19 and excluded from resident contact while symptomatic. This failure had the potential to affect eight (R6, R7, R8, R9, R10, R11, R12, and R13) of thirteen residents reviewed for COVID-19 on the sample list of 13. Residents Affected - Some Findings include: On 9/25/23 at 8:45 AM, a sign posted on the facility's front door stated that the facility was experiencing a COVID-19 outbreak. On 9/25/23 at 10:09 AM, V3 Infection Preventionist stated the facility's COVID-19 outbreak began on 9/16/23. V3 stated V6 Certified Nurse's Assistant (CNA) and V10 CNA both tested positive on 9/17/23. On 9/25/23 at 10:57 AM, V6 CNA stated she tested positive for COVID-19 on 9/16/23. V6 stated she was working on the floor and started feeling dizzy and getting a migraine. V6 stated it was about 10 AM when she started feeling this way. V6 stated she continued working until 6:00 PM which was the end of her shift. V6 stated when she got home she decided to test and it was positive. V6 stated the facility tested her the next day to confirm the positive test and it was also positive. On 9/25/23 at 1:09 PM, V10 CNA stated she tested positive for COVID-19 on 9/17/23. V10 stated she worked on Saturday (9/16/23) and felt like she had a head cold. V10 stated she had a runny nose, cough, and was sneezing. V10 stated on Sunday (9/17/23) she felt like she had a head cold times ten. V10 stated she was tested on [DATE] before work and was positive for COVID-19. On 9/27/23 at 12:00 PM, V1 Administrator stated V6 and V10 worked on the Memphis hallway when symptomatic with COVID-19. V1 stated the staff are expected to report all symptoms of illness. V1 stated V6 and V10 should have reported their symptoms to someone so that they could be tested. The facility's CNA group assignments documents R6 and R10 worked on the Memphis hallway on 9/16/23 from 6:00 AM to 6:00 PM. The facility's census sheet dated 9/25/23 provided by V16 Owner/Administrator documents R6, R7, R8, R9, R10, R11, R12, and R13 reside on the Memphis hallway. The facility's undated COVID Positive Resident list provided by V3 documents 42 residents have tested positive for COVID-19. This log documents R6 tested positive on 9/16/23, R8 on 9/21/23, R9 on Page 1 of 2 145930 145930 09/27/2023 Goldwater Pontiac Nursing Home 1225 South Ewing Drive Pontiac, IL 61764
F 0880 9/21/23, R10 on 9/20/23, R11 on 9/18/23, R12 on 9/23/23, and R13 on 9/17/23. Level of Harm - Minimal harm or potential for actual harm The facility's COVID Testing policy with a revision dated 5/12/23 documents that staff with signs and symptoms of COVID-19 must be tested and are expected to be restricted from the facility. This policy also documents anyone even with mild symptoms of COVID-19 regardless of their vaccination status should receive a viral test for COVID-19 as soon as possible. Residents Affected - Some 145930 Page 2 of 2

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Citations

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.

  • 0880GeneralS&S Epotential for harm

    F880 - Infection Control

    Provide and implement an infection prevention and control program.

FAQ · About this visit

Common questions about this visit

What happened during the September 27, 2023 survey of GOLDWATER PONTIAC NURSING HOME?

This was a inspection survey of GOLDWATER PONTIAC NURSING HOME on September 27, 2023. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.

Were any deficiencies cited at GOLDWATER PONTIAC NURSING HOME on September 27, 2023?

Yes, 1 deficiency was cited, each with a CMS Scope and Severity grade. The first was: "Provide and implement an infection prevention and control program."

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

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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.