01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-11-15 | 10 | 2024-11-15 | 1 |
| Cycle 2 | 2023-09-29 | 6 | 2023-09-29 | 8 |
| Cycle 3 | 2022-10-07 | 12 | 2022-10-07 | 6 |
CMS CCN 1459532026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Prairieview Lutheran Home
403 North Fourth Street · Danforth, IL 60930 · Iroquois County
Certified beds90CMS provider file
Recent citation rows43current CMS citation release
Penalty rows7current 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
43 rows in the current release
5 rows carry G–L scope/severity codes; 1 carry J–L. 6 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-12-02 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-12-19 · complaint2025-12-02 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2025-12-19 · complaint2025-11-05 · HEALTHF0610Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2025-11-21 · complaint2025-11-05 · HEALTHF0684Severity J · isolated immediate jeopardy
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 · 2025-11-21 · complaint2025-11-05 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-11-21 · complaint2025-11-05 · HEALTHF0711Severity E · pattern; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Ensure the resident's doctor reviews the resident's care, writes, signs and dates progress notes and orders, at each required visit.
Correction field: Deficient, Provider has date of correction · 2025-11-22 · complaint2025-11-05 · HEALTHF0944Severity F · widespread; potential for more than minimal harm
Administration Deficiencies
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Correction field: Deficient, Provider has date of correction · 2025-11-28 · complaint2025-06-11 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-06-24 · complaint2025-05-14 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2025-06-05 · complaint2025-05-14 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-06-24 · complaint2025-02-11 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2025-03-05 · complaint2024-11-15 · HEALTHF0692Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Correction field: Deficient, Provider has date of correction · 2024-12-102024-11-15 · HEALTHF0697Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2024-12-102024-11-15 · HEALTHF0842Severity E · pattern; 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 · 2024-12-102024-11-15 · 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 · 2024-12-302024-07-30 · HEALTHF0602Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from the wrongful use of the resident's belongings or money.
Correction field: Deficient, Provider has date of correction · 2024-08-20 · complaint2024-07-30 · 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 · 2024-08-20 · complaint2024-04-26 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2024-07-10 · complaint2023-09-29 · 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 · 2023-11-302023-09-29 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2023-10-122023-09-29 · 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 · 2023-10-122023-09-29 · 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 · 2023-10-302023-09-29 · FIREK0291Severity F · widespread; potential for more than minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2023-10-302023-09-29 · 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 · 2023-10-1503 / 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 |
|---|---|---|---|
| 2025-12-02 | Fine | $22,335 | 0 |
| 2025-12-02 | Fine | $22,335 | 0 |
| 2025-11-05 | Fine | $36,000 | 0 |
| 2025-11-05 | Payment Denial | $0 | 1 |
| 2025-05-14 | Fine | $8,372 | 0 |
| 2025-05-14 | Payment Denial | $0 | 15 |
| 2024-04-26 | Payment Denial | $0 | 89 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- BENNER, DOUGIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2020
- BOHLMANN, CHARLESIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/01/2022
- HENRICHS, JERRYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2022
- JENKINS, PATRICKIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 02/01/2022
- KOLBERG, MARCIEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/01/2022
- MUNSTERMAN, JODYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2022
- RITZMA, KRISTINEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2022
- WITHEFT, JUDYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/01/2023
- PETERSEN, JEFFREYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 12/01/2021
- MOPARTHI, VENKETAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2025
- PETERSEN, JEFFREYIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 12/01/2024
- KOLBERG, MARCIEIndividual · ADP OF THE SNFNOT APPLICABLE · since 05/01/2022
- MOPARTHI, VENKETAIndividual · ADP OF THE SNFNOT APPLICABLE · since 02/24/2025
- PETERSEN, JEFFREYIndividual · ADP OF THE SNFNOT APPLICABLE · since 12/01/2021
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 hours4.82per resident day
RN hours0.72per resident day
Weekend nurse hours4.38per resident day
Staff turnover34.5%CMS reported field
06 / LOCAL RECORDS
Open the Illinois ledger →Other published facilities nearby
No second facility in the same city met the directory rule.