SPRINGFIELD, IL – The Illinois Department of Public Health has fined Royal Heights Nursing and Rehabilitation Center $25,000 Statement of Violation for three violations of the state Nursing Home Care Act. The 234-bed skilled care facility is located at 900 Royal Heights Road in Belleville.

The first violation was the result of a complaint investigation in which Department surveyors learned the facility failed to provide adequate supervision to prevent a resident from leaving the facility unsupervised. A confused resident was found by the employees of a local ambulance company as he walked along a four-lane highway. The resident was taken to a local hospital, where he was admitted with pneumonia.

Following the incident, it was determined that the resident left the facility through a laundry room door, which was not locked, alarmed or supervised at the time of the incident. Facility administration told investigators that the problem was immediately corrected.

The second violation resulted from the facility's failure to monitor a resident who had struck her head on a wall after being shoved by another resident. An employee related the incident to a nurse, who performed an assessment and determined the resident sustained no apparent injuries. The resident's condition deteriorated over the next several days, but her physician was not notified of the changes. When the physician was notified, he told staff to monitor the resident and to report any changes. However, facility staff failed to report subsequent changes to the physician until a few days later. The physician then ordered staff to transport the woman to a hospital, where she died of a brain hemorrhage three days later and 12 days after striking her head.

The facility also failed to investigate the abusive behavior of the resident who shoved the woman or to evaluate his need for therapy. After the incident, staff counseled the resident about his anger, but did not investigate the incident as abuse.

Royal Heights Nursing and Rehabilitation Center did not request a hearing on these two violations.

The third violation resulted from the facility's failure to ensure that staff immediately report incidents of abuse. An employee discovered a resident with a swollen and purple eye and notified a supervisor of the injury. However, another employee, who witnessed a nurse's aide striking the resident, did not report the incident until questioned about the resident's injury. The witness, who also heard the nurse's aide say that she hoped she did not break the resident's jaw, said she did not report the incident because she was afraid of retaliation by staff. The nurse's aide was arrested on a charge of aggravated battery.

Royal Heights did request a hearing on this violation. A hearing date has not been scheduled.

In March, the Department announced that it had fined Royal Heights $30,000 for failure to meet the needs of its residents and had given notice that it intends to revoke the facility's license. Also, in August 2002, Royal Heights was fined $5,000 for failing to prevent abuse of a resident by a staff member. Both actions are still pending.

In addition to the state actions against Royal Heights Nursing and Rehabilitation Center, the federal Centers for Medicare and Medicaid Services suspended facility participation in the Medicaid and Medicare program on Oct. 7, 2002, due to lack of supervision, inadequate programming for residents with mental illnesses and insufficient interventions to prevent sexual and physical abuse of residents.