01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-04-11 | 10 | 2024-04-11 | 7 |
| Cycle 2 | 2023-05-10 | 7 | 2023-05-10 | 1 |
| Cycle 3 | 2022-06-16 | 5 | 2022-06-16 | 0 |
CMS CCN 1452942026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Prairie Village Healthcare Ctr
1024 West Walnut · Jacksonville, IL 62650 · Morgan County
Certified beds126CMS provider file
Recent citation rows30current CMS citation release
Penalty rows3current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
30 rows in the current release
2 rows carry G–L scope/severity codes; 1 carry J–L. 5 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-04-23 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2026-05-15 · complaint2026-04-23 · HEALTHF0690Severity J · isolated immediate jeopardy
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2026-05-15 · complaint2026-04-23 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2026-05-15 · complaint2026-04-23 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2026-05-15 · complaint2026-04-23 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2026-05-15 · complaint2025-10-24 · HEALTHF0687Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate foot care.
Correction field: Deficient, Provider has date of correction · 2025-11-26 · complaint2025-10-24 · HEALTHF0842Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2025-11-26 · complaint2025-06-30 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2025-07-09 · complaint2025-06-30 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2025-07-09 · complaint2024-04-11 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2024-05-112024-04-11 · HEALTHF0686Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2024-04-222024-04-11 · HEALTHF0727Severity F · widespread; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Correction field: Deficient, Provider has date of correction · 2024-04-222024-04-11 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-04-222024-04-11 · FIREK0133Severity E · pattern; potential for more than minimal harm
Construction Deficiencies
Install a two-hour-resistant firewall separation.
Correction field: Deficient, Provider has date of correction · 2024-05-112024-04-11 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2024-05-162024-04-11 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Waiver has been granted · 2024-07-172024-04-11 · FIREK0711Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Provide a written emergency evacuation plan.
Correction field: Deficient, Provider has date of correction · 2024-05-112024-04-11 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2024-05-112024-04-11 · FIREK0918Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Correction field: Deficient, Provider has date of correction · 2024-05-112023-05-10 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2023-05-262023-05-10 · HEALTHF0727Severity F · widespread; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Correction field: Deficient, Provider has date of correction · 2023-05-262023-05-10 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2023-05-262023-05-10 · HEALTHF0882Severity F · widespread; potential for more than minimal harm
Infection Control Deficiencies
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Correction field: Deficient, Provider has date of correction · 2023-05-262023-05-10 · HEALTHF0883Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Correction field: Deficient, Provider has date of correction · 2023-05-2603 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2026-04-23 | Fine | $131,684 | 0 |
| 2026-04-23 | Payment Denial | $0 | 8 |
| 2025-05-15 | Payment Denial | $0 | 26 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- RAY, SHERWINIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST50% · since 12/31/2020
- ROTHNER, ERICIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST33% · since 12/31/2020
- ARONIN, DAVIDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2015
- RAY, SHERWINIndividual · CORPORATE OFFICERNOT APPLICABLE · since 01/01/2015
- EXTENDED CARE CLINICAL LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2015
- EXTENDED CARE CONSULTING LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2015
- ROTH & CO, LLPOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2015
- DIXON, WILLIAMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2015
- SPRINGER, JERRIIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/01/2015
- ATIED ASSOCIATES LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 12/15/2024
- EXTENDED CARE CLINICAL LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/13/2025
- EXTENDED CARE CONSULTING LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/13/2025
- ROTH & CO, LLPOrganization · ADP OF THE SNFNOT APPLICABLE · since 02/13/2025
- DIXON, WILLIAMIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2015
- RAY, SHERWINIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2015
- ROTHNER, ERICIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/11/2025
- SPRINGER, JERRIIndividual · ADP OF THE SNFNOT APPLICABLE · since 12/01/2015
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.84per resident day
RN hours0.57per resident day
Weekend nurse hours2.91per resident day
Staff turnover65.2%CMS reported field