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Inspection visit

Health inspection

SUNNY ACRES NURSING HOMECMS #1460681 citation on this visit
1 citation recorded

Inspector’s narrative

What the inspector wrote

This survey cited 1 deficiency, 1 of them serious (actual harm or immediate jeopardy). The full statement and the facility’s plan of correction follow, verbatim from the federal record.

F 0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Level of Harm - Actual harm Residents Affected - Few Note: The nursing home is disputing this citation. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review the facility failed to provide adequate supervision to prevent verbal and physical resident-to-resident abuse for two of four residents (R1 and R2) reviewed for abuse in the sample of seven. These findings resulted in R1 physically assaulting R2 causing R2 pain, a laceration to the left cheek, and two large hematomas to the bilateral shins which required emergency room services.Findings include:The facility's Abuse Prohibition Policy, dated 1/29/2026, documents Abuse and Neglect Prohibited: 1. All residents have the right to be free from verbal, sexual, physical, mental abuse, corporal punishment, involuntary seclusion, neglect, misappropriation of property, and exploitation. Abuse is the willful infliction of injury, unreasonable confinement, intimidation, or punishment with resulting in physical harm, pain, or mental anguish. Abuse includes deprivation by an individual, including a caretaker, of goods or services that are necessary to attain or maintain physical, mental, or psychosocial well-being. Physical Abuse means the infliction of injury on a resident that occurs other than by accidental means and that requires medical attention. Physical abuse may include, but it is not limited to such acts as hitting, slapping, kicking, hair pulling, and pinching. Verbal Abuse means the use of oral, written, or gestured language that includes disparaging and derogatory terms to a resident or within his or her hearing or seeing distance, regardless of the resident's age, ability to comprehend, or disability. R1's admission Record documents R1 is an [AGE] year-old admitted to the facility on [DATE] with diagnoses of Alzheimer's Disease, Dementia with Agitation, Major Depressive Disorder, and Anxiety Disorder.R1's MDS (Minimum Data Set) Assessment documents R1 is moderately cognitively impaired and has behaviors every one to three days.R1's current Care Plan documents R1 has behaviors of yelling out, being demanding, making inappropriate sexual comments, touching on staff, and most recently (2/13/26) having physical behavioral symptoms.R2's admission Record documents R2 is an [AGE] year-old that was admitted to the facility on [DATE] with diagnoses of Osteoarthritis, Cardiomyopathy, Aortic Aneurysm, Hypertensive Heart Disease with Heart Failures, and Idiopathic Peripheral Autonomic Neuropathy.R2's MDS assessment dated [DATE] documents R2 is cognitively intact and self-propels in a wheelchair.R1 and R2's Final Abuse Report dated 2/12/26 and signed by V1 (Administrator-In-Training) documents that on 2/7/26 at 8:45 PM R1 and R2 had a verbal altercation while in the bathroom that turned into a physical altercation when R1 hit R2 in the face and R1's walker hit R2's leg. This same Abuse Report documents R2 was sent to the hospital for treatment of left cheek abrasion and lower leg bruising.R1's Progress Notes dated 2/7/26 at 10:22 PM document R1 had a physical altercation with another resident (R2).R2's Emergency Department Notes dated 2/7/25 at 8:30 PM document, Chief Complaint: (R2) arrives via EMS (Emergency Medical Services) from (the facility) for assault by another resident (R1). (R2) arrives with abrasion to left side of face and bilateral hematomas to shins from being hit with (R1's) walker multiple times. (R2) punched in head then struck by walker in shins. Left temporal pain and (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: 146068 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 146068 B. Wing A. Building (X3) DATE SURVEY COMPLETED 02/28/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Sunny Acres Nursing Home 19130 Sunny Acres Road Petersburg, IL 62675 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 0600 Level of Harm - Actual harm Residents Affected - Few Note: The nursing home is disputing this citation. FORM CMS-2567 (02/99) Previous Versions Obsolete Tramadol 50 mg (milligrams) administered for pain.R1 and R2's Police Report dated 2/7/26 and signed by V4 (Police Officer) documents, Offense: Battery. Offender: (R1). On 2/7/26 (V4) was dispatched to (the facility) for a battery report. The incident took place at (the facility). I spoke to (V7/RN/Registered Nurse). (V7) explained that (R2) and (R1) had gotten into a verbal and physical altercation inside the common bathroom (R2) and (R1) shared. (V7) said both (R2) and (R1) are separated now. (V7) stated that (R2) needed to go to the hospital to get his injuries checked after I was done speaking with (R2). (V7) briefly explained the situation to me, stating that both (R1) and (R2) were arguing and (R1) struck (R2) in the face with (R1's) fists and struck (R2) in the face several times, and hit (R2) with (R1's) walker. (R2) was unable to provide a written statement and wanted to go to the hospital to be checked out. I requested dispatch to send EMS to my location for transport to (ED/Emergency Department). I took photographs of the injuries too (R2). I then went to speak to (R1) inside (R1's) room. I asked (R1) what happened tonight. (R1) stated that he beat (R2) up because (R2) had called (R1) a Son of a bi**h. (R1) stated that he hit (R2) several times and may have hit (R2) with the walker. I photographed (R1's) hands and (R1's) right hand did appear to possibly have some bruising and (R1) stated it hurt. I asked (V7) if any staff witnessed the incident. (V7) stated (Certified Nursing Assistant/CNA/V3) did. (V3's) statement is attached to the report.The Police Report Photos printed 2/9/26 were observed. In the photos R2 had a laceration to the left upper cheek and a softball sized, dark purple hematoma to the right lower leg, and R1 had reddish discoloration to the top of his right hand and end of his right fingers.On 2/27/26 at 9:30 AM R2 was sitting in his room in a wheelchair. R2 had a 2-inch by 2-inch dressing with brownish drainage covering an open area to the top of the left shin. R2 had a baseball sized dark red hematoma to the right shin. R2 stated, Several weeks ago I had a friend visiting me and (R1) was in the bathroom singing a song repeatedly, It's bare a** time. What (R1) was singing was embarrassing and (R1) does it just to aggravate me. I went into the bathroom and told (R1), Shut the h**l up you son of a bi**h! (R1) took his walker and slammed it into my legs over and over and when I grabbed ahold of the walker to get (R1) to stop, (R1) started to punch me in the face. Both of my shins are really swollen and sore and my cheek got busted open. It hurt really badly, and I asked to go to the hospital to make sure my cheek wasn't broken. I definitely felt abused and should not have to deal with (R1). My shins are still swollen and are painful every day.On 2/27/26 at 2:12 PM V3 (CNA) stated, On 2/7/26 around 8:30 at night I heard someone yelling help. I went into (R2's) room and (R2) was in the doorway of the bathroom and (R1) was in the bathroom. I saw (R1) punching (R2) in the chin with closed fists. I yelled at (R1) to stop, and (R1) had ahold of (R2's) wheelchair. I removed (R1's) hands from (R2's) wheelchair and separated (R1) and (R2). (R2) had a bloody mouth and a soft-ball sized bruise to the right shin. (R2's) left cheek was busted open. (R2) told me that (R1) was singing its bare a** time, so (R2) yelled at (R1) and called (R1) a son of a bi**h. (R2) stated (R1) hit him multiple times in the face and hitting (R2) in the shins with (R1's) walker. (R2) was hurting and wanted to go to the hospital. Event ID: Facility ID: 146068 If continuation sheet 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.

  • 0600SeriousS&S Gactual harm

    F600 - Freedom from Abuse, Neglect, and Exploitation

    Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.

FAQ · About this visit

Common questions about this visit

What happened during the February 28, 2026 survey of SUNNY ACRES NURSING HOME?

This was a inspection survey of SUNNY ACRES NURSING HOME on February 28, 2026. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.

Were any deficiencies cited at SUNNY ACRES NURSING HOME on February 28, 2026?

Yes, 1 deficiency was cited, each with a CMS Scope and Severity grade. The first was: "Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect b..."

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.

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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.