Inspection visit
Inspection
15 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 15 deficiencies. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0550
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or
her rights.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, interview, and record review the facility failed to ensure a resident was provided catheter care
in a dignified manner for 1 of 1 residents (R1) reviewed for catheters in the sample of 13.
The findings include:
On 6/05/24 at 1:28 PM, V7 (CNA- Certified Nursing Aide) and V8 (Restorative Aide) entered R1's room to
provide catheter care. R1's roommate was seated in her wheelchair, watching TV. V7 explained that she
was going to provide catheter care to R1 and pulled the privacy curtain between R1's side of the room and
the roommate's side. R1's room had 3 windows on the opposite side of her bed. Each window had it's own
blind. The center window had the blinds closed, but the left and right window blinds were open. There was a
clear view to the sidewalk, street, and diagonal street parking from R1's window. V7 and V8 removed R1's
linens and exposed her perineum and lower body. V7 provided catheter care to R1. During this care, a white
sedan pulled into the diagonal parking, facing R1's room. A male exited the car and walked down the
sidewalk, passed R1's open blinds. R1's body was fully exposed from the waist down. V7 completed
catheter care and R1 decided to get up for the afternoon activity. V7 and V8 turned R1 side to side placing
an incontinence brief and dressing her. V7 and V8 used a total, mechanical lift to transfer R1 from the bed
to her wheelchair. R1's left and right window blinds remained open throughout. R1 said she's used to the
CNAs seeing her because she needs help, but wouldn't want anyone to be able to see her private parts.
R1's Facesheet dated 6/5/24 showed diagnoses to include, but no limited to: morbid obesity, chronic
ischemic heart disease, diabetes, acute on chronic respiratory failure, mild protein-calorie malnutrition,
neuromuscular dysfunction of bladder, history of colon cancer, intervertebral disc degeneration (lumbar
region), Barrett's Esophagus, cataracts, major depressive disorder, dyshidrosis, seborrheic dermatitis,
peripheral vascular disease, psoriasis vulgaris, and gout.
R1's facility assessment dated [DATE] showed she had severe cognitive impairment and required
substantial/maximal assistance from staff for personal hygiene, toilet use, and rolling side to side in bed.
On 6/6/24 at 8:21 AM, V9 (CNA) said it's important to close the privacy curtains and window blinds, during
catheter care. V9 said it's for the resident's privacy and dignity.
On 6/6/24 at 9:56 AM, V6 (RN - Registered Nurse) said R1 has had the catheter for a long time. V6 said the
privacy curtain and blinds should be pulled during resident care, so no one can see inside.
(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 7
Event ID:
146147
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
146147
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/06/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Allure of Stockton
501 Front Street
Stockton, IL 61085
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 0550
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
The facility's Catheter Car Policy reviewed 2/1/22 showed, It is the policy of this facility to ensure that
resident's with indwelling catheters receive appropriate catheter care and maintain their dignity and privacy
when indwelling catheters are in use . Compliance Guidelines: .3. Provide privacy by closing the door,
closing the blinds/curtains, pulling the room dividing curtain, etc .
The facility's Resident Rights Policy reviewed 2/1/22 showed, The facility will inform the resident both orally
and in writing, in a language that the resident understands, of his or her rights and all rules and regulations
governing resident conduct and responsibilities during the stay in the facility . 10. The facility will ensure that
all direct care and indirect care staff members, including contractors and volunteers, are educated on the
rights of residents and the responsibility of the facility to properly care for it's residents . Resident rights. The
resident has the right to a dignified existence, self-determination, and communication with and access to
persons and services inside and outside the facility. 4. Respect and dignity. The resident has a right to be
treated with respect and dignity .
Event ID:
Facility ID:
146147
If continuation sheet
Page 2 of 7
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
146147
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/06/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Allure of Stockton
501 Front Street
Stockton, IL 61085
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 0684
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
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 to complete assessments including wound
measurements for a resident with a reoccurring wound. This applies to one of two residents (R6) reviewed
for non-pressure wounds in the sample of 13.
Residents Affected - Few
The findings include:
The facility face sheet for R6 shows diagnoses to include heart disease, hemiplegia, obesity, chronic kidney
disease and mild protein-calorie malnutrition. The facility assessment dated [DATE] for R6 shows him to be
cognitively intact and is dependent on staff for all activities of daily living.
The weekly skin assessments for R6 dated 5/14/24, 5/21/24 and 5/28/24 shows scar tissue open to left
buttock. No measurements or other assessment of the wound observed in the record.
On 6/5/24 at 9:56 AM, R6 was observed lying in bed receiving incontinence care by the staff. A small
opening was observed on R6's left lower buttock near his leg. The area that was open was surrounded by a
darker red color skin. No drainage was observed at the open area.
On 6/5/24 at 1:41 PM, (V2) Assistant Director of Nursing said she is responsible for the weekly wound
assessments. V2 said R6's wound to his left buttock has been opening often, but heals quickly. R6 was
seen by the wound care physician before, but is currently not being seen. V2 said the area is the same area
and the Physician determined it to be an area of trauma. V2 said the staff are trying to figure out why the
area is re-opening so frequently. V2 said when a resident is seen by the wound care physician, the weekly
measurements are documented with that assessment. V2 said the weekly wound assessments she uses
does not have a place for wound measurements and she relies on the Certified Nursing Assistants to let
her know if the wounds are getting bigger or smaller. V2 said it's important to monitor the wounds weekly for
improvement and to see if the current wound treatment is working or needs to be changed.
The facility policy with a revision date of 2/1/22 for wound treatment management shows 5. treatment
decisions will be based on: b.) characteristics of the wound 2)size-including shape, depth, and presence of
tunneling and/or undermining The effectiveness of treatments will be monitored through ongoing
assessments of the wound .
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
146147
If continuation sheet
Page 3 of 7
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
146147
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/06/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Allure of Stockton
501 Front Street
Stockton, IL 61085
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 0690
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate
catheter care, and appropriate care to prevent urinary tract infections.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, interview, and record review the facility failed to ensure a resident had an anchoring device for
an indwelling catheter for 1 of 1 residents (R1) reviewed for catheters in the sample of 13.
The findings include:
On 6/5/24 at 1:28 PM, V7 (CNA - Certified Nursing Aide) and V8 (Restorative Aide) entered R1's room to
provide catheter care. V7 and V8 pulled R1's blankets down and moved her gown to expose R1's perineum
and lower legs. R1 had a silicone, indwelling catheter in place. The catheter was not anchored to her leg.
The catheter tubing ran along R1's right leg, curled on the bed, then extended to the catheter bag that was
hooked on the bed-frame. R1's right and left thigh did not have any tape or evidence of a securing device
being in place. R1's bedding did not contain a catheter anchoring device. V7 (CNA) provided catheter care,
then R1 decided she wanted to get dressed for the day and participate in an activity. V7 and V8 rolled R1
side to side while applying an incontinence brief, dressing R1, and transferring R1 to the wheelchair with a
mechanical, total lift. R1's catheter was not anchored to her leg.
R1's Facesheet dated 6/5/24 showed diagnoses to include, but no limited to: morbid obesity, chronic
ischemic heart disease, diabetes, acute on chronic respiratory failure, mild protein-calorie malnutrition,
neuromuscular dysfunction of bladder, history of colon cancer, intervertebral disc degeneration (lumbar
region), Barrett's Esophagus, cataracts, major depressive disorder, dyshidrosis, seborrheic dermatitis,
peripheral vascular disease, psoriasis vulgaris, and gout.
R1's facility assessment dated [DATE] showed she had severe cognitive impairment and required
substantial/maximal assistance from staff for personal hygiene, toilet use, and rolling side to side in bed.
R1's Progress Note dated 5/7/24 showed the CNA reported to the nurse that R1's indwelling catheter was
out with the balloon intact.
On 6/6/24 at 8:21 AM, V9 (CNA) said the facility has white adhesive dressing that hold the resident
catheters in place. V9 stated, They are nice and they keep the catheter from pulling. I think they are
supposed to be used when a resident has a catheter.
On 6/6/24 at 9:56 AM, V6 (RN - Registered Nurse) said R1 has had the catheter for a long time. V6 said in
May R1's catheter had dislodged, with the balloon intact. V6 said she wasn't sure why that happened. The
surveyor asked why R1 didn't have a catheter anchoring device in place. V6 said R1's catheter should have
an anchoring device to keep the catheter for dislodging.
The facility's Catheter Car Policy reviewed 2/1/22 showed, It is the policy of this facility to ensure that
resident's with indwelling catheters receive appropriate catheter care and maintain their dignity and privacy
when indwelling catheters are in use .
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
146147
If continuation sheet
Page 4 of 7
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
146147
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/06/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Allure of Stockton
501 Front Street
Stockton, IL 61085
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 0761
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Many
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted
professional principles; and all drugs and biologicals must be stored in locked compartments, separately
locked, compartments for controlled drugs.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observation, interview, and record review the facility failed to ensure an opened vial of Tuberculin was
labeled with an open date. This has the potential to affect all the residents residing in the facility.
The findings include:
The facility's CMS form 671 dated [DATE] showed there were 22 residents residing in the facility.
On [DATE] at 10:40 AM, V6 (RN - Registered Nurse) used a key to open the black, medication refrigerator,
in the facility's only medication room. On the top shelf of the refrigerator was a sealed, clear plastic bag with
3 unopened vials of Tuberculin inside. To the left of this bag was an opened vial of Tuberculin, with
approximately 1/3 of the fluid remaining in the vial. This vial was not labeled with an open date. The
surveyor asked V6 what this vial was used for. V6 stated, We use that to do the TB tests on all new
admissions and then once a year for our long-term residents. That vial should have an open date on it. It's
not labeled, so I will need to throw it away. V6 said the open dates are important, so the nurse knows when
the medication had expired. V6 stated, I think those vials are only good for 30 days. V6 said she did not
know when the vial had been opened.
The facility's Labeling of Medication and Biologicals Policy reviewed [DATE] showed, All medications and
biologicals used in the facility will be labeled in accordance with current state and federal regulations to
facilitate consideration of precautions and safe administration of medications . 8. Labels for multi-use vials
must include: a. The date the vial was initially opened or accessed (needle punctured); b. All opened or
accessed vials should be discarded within 28 days unless the manufacturer specifies a different (shorter or
longer) date for that opened vial. c. Unopened or accessed (needle-punctured) vials should be discarded
according to the manufacturer's expiration date .
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
146147
If continuation sheet
Page 5 of 7
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
146147
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/06/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Allure of Stockton
501 Front Street
Stockton, IL 61085
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 0812
Level of Harm - Minimal harm
or potential for actual harm
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve
food in accordance with professional standards.
Based on observation, interview, and record review the facility failed to clean ceiling fans above the food
service area and failed to clean and defrost a freezer. This applies to all residents in the facility.
Residents Affected - Many
The findings include:
The Centers for Medicare and Medicaid (CMS) 671 dated 6/4/24 shows there are 22 residents in the
facility.
On 6/4/24 at 9:21 AM, the freezer in the dry storage room was observed with large amounts of frost present
throughout the entire freezer. The food within the freezer was covered with frost crystals.
On 6/4/24 at 11:45 AM, the kitchen staff were observed preparing the lunch trays for the residents. Above
the food service area were two working ceiling fans covered with a black substance.
The cleaning schedule and procedures check list shows the freezers should be defrosted if ice build up is
present. The list also shows to clean ceilings and light fixtures during non-food production hours, clean free
from dust and debris.
On 6/06/24 at 9:10 AM, (V3) (food service supervisor) said it's important to keep the work areas clean to
prevent contamination of the food and the freezer should be defrosted to keep the freezer temperature
maintained and to prevent the food from getting freezer burnt.
The facility policy for sanitation inspection with a revision date of 2/1/22 shows it is the policy of this facility
to conduct inspections to ensure food service areas are clean, sanitary and in compliance with applicable
state and federal regulations. 1.All food service areas shall be kept clean, sanitary 4. sanitation inspections
will be conducted in the following manner: a) daily-food service staff shall inspect refrigerators. coolers,
freezers, storage area temperatures and dishwasher temperatures daily. b) weekly the dietary manager
shall inspect all food service areas weekly to ensure the areas are clean and comply with sanitation and
food service regulations.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
146147
If continuation sheet
Page 6 of 7
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
146147
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/06/2024
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Allure of Stockton
501 Front Street
Stockton, IL 61085
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 0851
Level of Harm - Minimal harm
or potential for actual harm
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and
other verifiable and auditable data.
Based on interview and record review the facility failed to submit required payroll based journal (PBJ) data.
This effects all residents in the facility.
Residents Affected - Many
The findings include:
The Centers for Medicare and Medicaid (CMS) 671 dated 6/4/24 shows there are 22 residents in the
facility.
The [NAME] Report 1705D for the fiscal year quarter 1 2024 shows the facility triggered for failed to have
licensed nursing coverage 24 hours a day and one star staffing rating.
The facility was able to produce time card records showing a nurse was on duty for all infraction dates of
10/1/23, 10/4/23, 10/5/23, 10/9/23, 10/10/23, 10/13/23, 10/14/23, 10/15/23, 10/19/23, 10/28/23, 10/29/23,
11/11/23, 11/15/23, 11/23/23, 11/24/23, 11/25/23, 12/9/23 and 12/23/23.
On 6/05/24 at 11:38 AM, (V4) (Office Assistant) said she receives the spreadsheet from (V5) (Vice
President of Operations) and she fills in all the staff hours of the social services, activities, dietary,
management staff, and any outside agency staff and returns the spread sheet to V5. V4 said she does not
understand why the information did not show up correctly in the PBJ data report.
On 6/05/24 at 2:45 PM, V5 he does not understand why the PBJ data is not correct. V5 said he has
numerous ways to track the data and have it input into the system.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
146147
If continuation sheet
Page 7 of 7
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Back to topCitations
15 citations 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.
F550 - Resident Rights
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
F684 - Quality of care
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
F690 - Incontinence
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
F761 - Labeling of Drugs and Biologicals
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
F812 - Food safety requirements
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
F851 - Mandatory submission of staffing information based on payroll data in a
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
- 0004GeneralS&S Fpotential for harm
Develop and maintain an Emergency Preparedness Program (EP).
- 0039GeneralS&S Fpotential for harm
Conduct testing and exercise requirements.
- 0223GeneralS&S Epotential for harm
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
- 0271GeneralS&S Epotential for harm
Have exits that are accessible at all times.
- 0345GeneralS&S Fpotential for harm
Have approved installation, maintenance and testing program for fire alarm systems.
- 0351GeneralS&S Fpotential for harm
Install an approved automatic sprinkler system.
- 0355GeneralS&S Epotential for harm
Properly select, install, inspect, or maintain portable fire extinguishes.
- 0363GeneralS&S Epotential for harm
Install corridor and hallway doors that block smoke.
F916 - Have a floor at or above grade level
Have a battery powered remote alarm panel in a location accessible by operating personnel.
FAQ · About this visit
Common questions about this visit
What happened during the June 6, 2024 survey of ALLURE OF STOCKTON?
This was a inspection survey of ALLURE OF STOCKTON on June 6, 2024. The surveyor cited 15 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at ALLURE OF STOCKTON on June 6, 2024?
Yes, 15 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her right..."
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.