Inspection visit
Health 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 0925
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
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 maintain an effective bed bug control program to ensure the
facility was free of bed bugs. This has the potential to affect all 36 residents residing in the facility.
Residents Affected - Many
The findings included:
The facility Midnight Census Report dated 4/30/2025 documented 36 residents living in the facility.
On 4/30/2025 at 9:00 AM, R2 stated, she had been the first person to find a bed bug in her room around
3/19/2025. R2 stated, that she seen the bug on the floor by her bed and she smashed it with her foot. R2
stated, she did notify a staff member but is unable to remember whom, but they did take the bug for
evidence. R2's Minimum Data Set (MDS) dated [DATE] documented a brief interview for mental status
(BIMS) of 15 which indicated she is cognitively intact.
On 4/30/2025 at 8:10 AM, V3 (Housekeeping/Laundry Supervisor) stated, there had been a bug found in
R2's room located on the B-Hall on 3/19/2025. V3 stated, the pest control company came in and treated. V3
stated V13 (Pest Control Technician) did advise them to not use any wet liquids to clean beds, mattress,
beside tables, etc. for 2-3 months because it can remove the treatment. V3 stated, her staff had been made
aware and are using dry towels to clean. V3 stated, she is not aware of any facility policy for bed bugs and
had not been educated by the facility on bed bugs.
On 4/30/2025 at 8:47 AM, V4 (Certified Nurse Assistant/CNA Supervisor) stated, she had not been
educated on bed bugs by the facility. V4 stated, the first bed bug inspection documentation started on
4/29/2025 which had been completed by her and V10 (Maintenance/Transportation).
On 4/30/2025 at 8:52 AM, V5 (CNA) stated, she is aware that there had been a bed bug reported in the
facility but does not know who found it first. V5 stated, she is not aware if the facility completed an
inspection or monitoring of the other rooms for bed bugs when R2 and R3's rooms were treated on
3/19/2025. V5 stated, she had not received any education on bed bugs by the facility.
On 4/30/3025 at 9:03 AM, V6 (CNA) stated, she is aware that there had been reports of bed bugs in the
facility. V6 stated, she had not been educated by the facility on bed bugs and is not aware of any monitoring
of rooms for bed bugs after 3/19/2025.
On 4/30/2025 at 9:10 AM, V7 (Licensed Practical Nurse/LPN) stated, she is not aware of any monitoring for
bed bugs in the facility after the first report of a bug on 3/19/2025 in R2's room. V7 stated, she had not
received any education from the facility on bed bugs. V7 stated, she had observed a bug in a medicine cup
on 4/25/2025 that was found by V8 (LPN) in the laundry room.
(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:
146092
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
146092
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
05/01/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Integrity Hc of Herrin
1900 North Park Avenue
Herrin, IL 62948
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 0925
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
On 4/30/2025 at 9:22 AM, V1(Administrator) stated, there had been a previous employee that turned in a
report to her about a bed bug being found and sent her a picture around 3/18/2025. V1 stated, there had
been a confirmation with the local pest company of the bed bug. V1 stated she and V3 had been notified,
by V13 (Pest Control Technician) not to use any wet liquids to clean beds, mattress, beside tables, etc. for
2-3 months because it can remove the treatment. V1 stated, there had been 2 more reports (4/21/2025 and
4/25/2025) of bugs seen in the facility. V1 stated, she did start a monthly inspection log for bed bugs for all
rooms and offices to be monitored that included walls, ceilings, frames/bed boards, mattress, nightstand,
base boards, chairs/wheelchairs and initialed by V4 (CNA Supervisor) and V10 (Maintenance) that took
effect on 4/29/2025. V1 stated, no education had been given to employees on bed bugs.
On 4/30/2025 at 10:03 AM, V9 (Housekeeping) stated, she had been notified by V3 that a bug had been
found in a room. V9 stated, she had not been working at the time of the first reported bug in March 2025. V9
stated, around 4/21/2025 it had been reported that a bug had been seen in R4's room but not sure who
reported it. V9 stated, they were instructed by the pest control company not to use any wipes or liquid
cleaning on the mattresses, bed rails, headboards, etc. of rooms that had been treated until the pest
company gives the go ahead for them to return to normal cleaning routine. V9 stated, she had been wiping
down 2 of the rooms that had been treated (A-7 &A-9) on 4/25/2025 with bleach because she did not know
that they had been treated. V9 stated, she thought the only rooms not cleaned with liquid or wipes were A6
& A8.
On 5/1/2025 at 9:46 AM, V8 (LPN) stated, she had been working on 3/19/2025 when R2 came to her and
notified her that there had been a bug in her room that she smashed with her foot. V8 stated, she did collect
the specimen and give it to the previous maintenance employee who did notify V1 (Administrator) and gave
the specimen to the local pest control company for confirmation. V8 stated, she had also been working on
4/25/2025 when another bug had been found in the laundry room. V8 stated, she did collect the bug in a
specimen cup and notified V1.
On 5/1/2025 at 10:49 AM, V13 (Pest Control Technician) stated, he had been the technician to come out
and treat the facility on 4/25/2025 and 4/28/2025. V13 stated, he did not confirm a bug on the 4/25/2025
visit. V13 stated, he treated all six rooms (A6-A9 initial, B15-B16 and follow up). V13 stated, he did return
on 4/28/2025 were he confirmed 2 bed bugs with V2 (Business Office Manager). V13 stated, V2 showed
him a bug in a medicine cup that he confirmed and then also one she had removed off a shoulder and
placed in tape that he confirmed as well. V13 stated, he did advise V3 and V1 not to clean any of the beds,
bed rails, etc. with any liquid cleaning supplies or wipes because it will remove the chemical treatment. V13
stated, he did tell V3 and V1 that they could vacuum mattress if needed.
A statement of the summary of services from the contracted pest control company dated 3/19/2025
documents services of .Targeted Pest: Bed Bug. Device of Application: Resident Room. Equipment Used:
Compressed Sprayer. Recommendations: Other Areas: Pipes extending through wall allowing pest access.
Please fill in gaps between pipes and wall to prevent pest entry. Severity: Medium. Status: New. Date
11-4-2024. Site: Patient Room. Pest: Bed Bug. Infestation: 1.
A statement of the summary of services from the contracted pest control company dated 4/25/2025
documents services of .Targeted Pest: Bed Bug. Device of Application: Resident Room. Equipment Used:
Compressed Sprayer.
A statement of services from the contracted pest control company dated 4/28/2025 documented
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
146092
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
146092
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
05/01/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Integrity Hc of Herrin
1900 North Park Avenue
Herrin, IL 62948
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 0925
services of: Target Pest Bed Bugs. Areas: Laundry Room.
Level of Harm - Minimal harm
or potential for actual harm
There was no documentation provided by the facility for education given to staff, monitoring/inspections of
rooms, or recommended areas being inspected after confirmation of bed bugs on 3/19/2025.
Residents Affected - Many
The facility Bed Bugs, Preventing and Managing Infestations of policy revised August 2015 documented in
part, Purpose, staff will employ infection control strategies to prevent and manage infestations of bed bugs
(cimex lectularius). Preparation, Staff should be trained to recognize bed bugs and bed bug infestation and
know what their specific roles will be should an infestation occur. Monitoring and Investigation, 1.
Thoroughly screen newly admitted residents, as well as those who returning from a stay away from the
facility .3. Regularly inspect mattresses, box springs, bed frames, and headboards following current
published guidelines for inspection and identification. Documented under Evaluation and Continued
Monitoring, 1. After treatment methods have been applied it is important to follow up by monitoring for
subsequent infestations. Even if eradication of adult bed bugs was successful, eggs may have survived and
hatched . 5. Monitor for bed bugs on a regular basis. 6. Seal cracks and crevices to remove hiding places.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
146092
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.
F925 - Maintain an effective pest control program so that the facility is free of
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
FAQ · About this visit
Common questions about this visit
What happened during the May 1, 2025 survey of INTEGRITY HC OF HERRIN?
This was a inspection survey of INTEGRITY HC OF HERRIN on May 1, 2025. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at INTEGRITY HC OF HERRIN on May 1, 2025?
Yes, 1 deficiency was cited, each with a CMS Scope and Severity grade. The first was: "Make sure there is a pest control program to prevent/deal with mice, insects, or other pests."
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.