Inspection·January 8, 2026

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 interview and record review the facility failed to ensure post fall assessments, to include vital signs, head to toe assessment and fall follow up, were completed for 2 of 3 residents (R1, R2) reviewed for quality of care in the sample of 3.The findings include:1. R1s admission record shows he was admitted on [DATE] with multiple diagnoses including adult failure to thrive, unspecified lack of coordination and weakness. The 11/11/25 annual resident assessment and care screening documents R1 to have severe cognitive impairment.R1s nursing progress notes of 10/8/25 show at 8:28 PM, he experienced a witnessed fall at the bedside. The roommate alerted staff R1 had rolled out of bed onto the floor. R1 reported he fell out of bed. R1 had no further assessments documented related to his fall.The 11/3/25 risk management report shows R1 was found lying on his right side on the ground at bedside. Fall mat in place. R1 reported he rolled over while in bed. The progress notes show no follow up assessments for 11/4/25. The post fall assessment for 11/5/25 includes the vital signs taken on 11/3/25.R1s nursing progress notes for 1/2/26 document he was sitting in bed and fell forward striking his face on the nightstand next to the bed. R1 was sent out to the emergency room and returned at 10:00 AM with sutures to the bridge of his nose. R1 had no further assessments documented for 1/2/26. On 1/3/26 at 2:39 PM, a follow up assessment was documented for the laceration to R1s nose. The progress notes show no further assessments or vital signs related to his fall. On 1/8/26 at 10:00 AM, V6 Registered Nurse (RN) said for resident falls, basically we do neuro checks for everyone. The incident should be documented in the progress notes it should say if the fall was witnessed or unwitnessed, skin assessment, physical assessment, pain assessment, it is all included in the forms we fill out. All falls are followed up every shift for 72 hours. A post fall evaluation form should be completed and that will generate a progress note. She said for the fall on 1/2/26, R1 should have charting for 1/3, 1/4, and 1/5. For the assessment, nursing should be getting a fresh set of vitals. She said it would be the same for 11/3/25, there should be documentation every shift for 3 days.On 1/8/26 at 12:34 PM, V2 Director of Nursing (DON) said the nurses are to follow the post fall tool. This tool includes monitoring every shift for 72 hours. The nurses should be assessing for any new pain or injury, or changes to their mobility. All this information would be charted in the notes.2. R2s admission record shows she was initially admitted to the facility on [DATE] with a history of falling. She had multiple diagnoses including dementia and bipolar disorder. Her 12/9/25 quarterly resident assessment and care screening documents her to have severe cognitive impairment.R2s nursing progress note dated 12/18/25 documents she had an unwitnessed fall in her room on 12/17/25 at 8:45 PM. She stated she fell and hit her face/head on the floor. The notes show she was sent out to the emergency room for evaluation. She returned to the facility and was placed back into bed. The progress notes were reviewed and show no follow up assessment related to this fall during the 72 hours following the incident.On 1/8/26, at 12:34 PM, V2 stated the nurses should have used the post fall too. And it is the DONs responsibility Residents Affected - Few (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: 146152 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 146152 B. Wing A. Building (X3) DATE SURVEY COMPLETED 01/08/2026 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE LA Bella of Rochelle 1021 Caron Road Rochelle, IL 61068 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)