Inspection·January 14, 2026

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 treatment and supports for daily living safely. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to ensure resident rooms and equipment were clean and in good repair for two of three residents (R8 and R25) reviewed for homelike environment in the sample list of 41. Findings include:1) R25's minimum data set (MDS) dated [DATE] documents R25 is cognitively intact.On [DATE] at 8:45 AM, R25 stated she is embarrassed by how her room looks, stating, is this what I'm supposed to live with? The wall behind R25 was noted have cracked, fading paint and large nails placed in various spots. R25 stated she hangs pictures and a tee shirt to distract visitors from the condition of the walls. R25 stated she has expressed to staff about how bad her room looks. R25 stated she was ashamed when the doctor came in for a visit. R25 stated she spoke with her roommate stating, have we died, and this is where we ended up. R25 stated she is worried about her ceiling tiles being asbestos since they are so old.On [DATE] at 12:05 PM, R25's room and bathroom were observed with V2 Director of Nursing (DON). There were visible cracked areas on the walls with peeling of paint. There was visible dark debris in the light covers of the ceiling and the lighting in the room was very dim. Dark and rust color debris was present on the back of the toilet riser in the crease behind the toilet seat and in the ridge along the back of the seat. There was a string-like substance hanging from the ceiling corners in the bathroom of R25's room. On [DATE] at 12:05 PM, V16 Plant Operations Manager stated she is going to work on the painting of the walls in the building when they hire another driver for transportation. V16 stated V16 has had to fill in for transportation of the residents to appointments since there isn't a regular transportation driver. V16 reported she used to work maintenance, and she paints the rooms herself. V16 stated she has been too busy with transportation and hasn't had a chance to check if the other areas are being cleaned by housekeeping staff since she is also the supervisor of housekeeping. V16 confirmed there is no dated plan of action to do inside repairs at this time.On [DATE] at 9:00 AM, V2 DON stated repairs on the roof were started last spring and they are waiting to do inside repairs until after they get the roof completed. On [DATE] at 9:25 AM, V1 Administrator stated repairs are in process. V1 confirmed the roof is being done in sections and the inside will be done afterwards. The undated Maintenance Policy of the facility documents to ensure a safe, accessible, effective, and efficient environment of care that is consistent with its mission, services, law, and regulations. To ensure that the building (interior and exterior), grounds, and equipment are maintained in a safe operable manner.2) R8's minimum data set (MDS) dated [DATE] documents R8 is cognitively intact.On [DATE] at 10:41 AM V16 Plant Operations Manager stated that on [DATE] she received a call from the facility to go back to the dialysis unit, pick up R8's wheelchair, and take it to the carwash to clean it. V16 stated after arriving, she witnessed an approximately six inch around area of a hard, dark substance on the backrest of R8's wheelchair that she believed to be feces. V16 stated she took the chair to the carwash, as directed by V2, and cleaned the (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 2 Event ID: 146037 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 146037 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/14/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Pleasant Meadows Senior Living 400 West Washington Chrisman, IL 61924 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)