Health inspection·January 8, 2026

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. Based on interview and record review, facility staff (V3 and V5, Certified Nursing Assistants, and V6 Registered Nurse) failed to report allegations of observed and known potential abuse in the required immediate, not more than 24 hour, time frame. This failure has the potential to affect three residents (R2, R3, and R4) out of twelve reviewed for abuse on the sample list of thirteen.Findings include:1. The facility Investigation Report with an initial date of 11/10/25 documents an allegation of V4, Certified Nursing Assistant, hitting R2 with a positioning cushion and stating, I hate you, which was allegedly witnessed by V3, Certified Nursing Assistant. This report documented an investigation detail that the alleged event occurred on 10/27/25. R2 was not interviewable due to severe cognitive impairments. On 1/6/26 at 2:16 PM, V4 stated the alleged incident did not happen. V4 denied having any personal problems with V3. On 1/6/26 at 3:40 PM, V1, Administrator, stated this alleged incident occurred on 10/27/25 according to the staff schedules when V3 and V4 had worked together. V1 confirmed V3 was a new employee at that time and had participated in the new employee training about abuse reporting prior to working any shifts at the facility. On 1/8/26 at 9:55 AM, V3 stated she had witnessed the incident as alleged on 10/27/25 but had not reported the incident until about a week later. V3 stated she was concerned being a new employee and didn't want to experience any backlash from other employees for reporting. V3 denied having any personal problems with V4. On 1/8/26 at 12:49 PM, V2, Director of Nursing, stated V3 did report the allegation to herself in the presence of V13, Business Office Manager, on 11/10/25. V2 confirmed the staffing schedules determined the alleged incident had to have occurred on 10/27/25. V2 stated there had been a previous situation between V3 and V4 when each of the employees felt like the other one was not helping during provisions of resident care and V2 had to implement a verbal intervention about working together as a team. V3's Training Acknowledgement Form dated and signed by V3 on 10/17/25 documents it is the team member responsibility to report immediately to your supervisor any signs of abuse or neglect. This form further documents alleged violations involving mistreatment, neglect or abuse, including injuries of unknown origin, and misappropriation of resident property are to be reported to the facility administrator. This form further documents the employee must report any occurrences of mistreatment observed, heard about, or suspected, no matter what the situation or perpetrator, immediately. 2. The facility Investigation Report with an initial date of 12/1/25 documents an allegation of a resident to resident verbal altercation occurred on 11/29/25 between R3 and R4 wherein R3 threatened to beat R4. On 1/7/26 at 11:25 AM, R3 and R4 stated they get along fine, but confirmed each other that they had arguments in the past because both of them are straight honest and tell it like it is. On 1/6/26 at 3:40 PM, V1, Administrator, stated there had been two staff witnesses to the altercation between R3 and R4, but neither of them had reported the incident to V1. V1 stated the two staff members were V5, Certified Nursing Assistant, and V6, Registered Nurse, a former employee. V1 stated she had learned of the incident because V6 had made a progress note in the electronic medical record (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: 146117 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 146117 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/08/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Casey Rehab and Nursing 100 N.E. 15th Casey, IL 62420 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)