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Willow Crest Nursing Pavilion Abuse and Neglect Attorneys
Families often entrust caregivers in nursing homes to provide their loved one the highest level of services in a safe, compassionate environment. Unfortunately, there are serious indicators of abuse, neglect or mistreatment occurring in nursing facilities nationwide.
The Illinois Nursing Home Law Center lawyers work aggressively on behalf of our clients to hold those responsible for causing harm both legally and financially accountable. If your loved one was injured while residing in a DeKalb County, Kendall County, or LaSalle County nursing facility, contact our Chicago nursing home abuse attorneys today. Let us use the law to ensure your family is adequately compensated for your damages.
Willow Crest Nursing Pavilion
This long-term care (LTC) home is a 113-certified bed Center providing cares and services to residents of Sandwich and DeKalb, Kendall, and LaSalle counties, Illinois. The Medicare/Medicaid-participating "for profit" facility is located at:
515 North Main
Sandwich, Illinois, 60548
(815) 786-8426
In addition to providing around-the-clock skilled nursing care, Willow Crest Nursing Pavilion offers other services that include:
- Rehabilitation therapy
- Physical, occupational and speech therapies
- Cardiac care
- Hospice
- Respiratory care
- Pain management
- Cognitive rehab
- Post-acute care
- Social work services
- Personalized nutritional services
Financial Penalties and Violations
The federal government and the state of Illinois routinely monitor every nursing facility to identify serious violations of established rules and regulations. These agencies can levy monetary fines or deny payments through Medicare when problems are found. Typically, these violations result in penalties when investigators identify severe problems that harmed or could have harmed a resident.
Over the last three years, the nursing regulatory agencies imposed a monetary fine of $4550 against Willow Crest Nursing Pavilion on April 19, 2016, due to substandard care. Also, Medicare denied two payments for services rendered on February 16, 2018, and April 19, 2016.
The nursing facility received fifteen formally filed complaints and self-reported six serious issues that all resulted in citations. Additional information about penalties and fines can be reviewed on the Illinois Department of Public Health Nursing Home Reporting Website concerning this nursing facility.
Sandwich Illinois Nursing Home Safety Concerns

A list of filed complaints, dangerous hazards, health violations, safety concerns, incident inquiries, and opened investigations on statewide long-term care homes can be reviewed on database sites including the Illinois Department of Public Health and Medicare.gov. Many families use this data to determine the best facility to place a loved one who requires the highest level of skilled health care and hygiene assistance.
According to Medicare, this facility maintains an overall rating of one out of five stars, including one out of five stars concerning health inspections, one out of five stars for staffing issues and three out of five stars for quality measures. The DeKalb, Kendall, and LaSalle counties neglect attorneys at Nursing Home Law Center have found serious deficiencies and safety concerns at Willow Crest Nursing Pavilion that include:
- Failure to Provide Every Resident an Environment Free of Accident Hazards and Provide Adequate Supervision to Prevent Avoidable Accidents
- Failure to Provide and Implement an Infection Protection and Control Program
- Failure to Protect Every Resident from All Forms of Abuse Including Physical Abuse, Mental Abuse, Sexual Assault, Physical Punishment and Neglect by Anybody
- Failure to Develop and Implement Policies and Procedures for Pneumonia Vaccinations
- Failure to Ensure Residents Receive Proper Treatment to Prevent New Bedsores or Heal Existing Pressure Sores
In a summary statement of deficiencies dated March 16, 2018, the state investigators documented that the facility had failed to “safely transfer a resident using a mechanical lift.” The deficient practice by the nursing staff involved one of twenty-three residents “reviewed for safety.”
The state surveyors observed two Certified Nursing Assistants (CNAs) placing “a mechanical lift sling under [a resident].” One CNA “attached the sling to the mechanical lift and without locking the wheels on the lift then raised [the resident] into the air.” The CNA “then pulled the mechanical lift back and turned the lift toward [the resident’s] wheelchair.”
At that time, the legs of the mechanical lift “were widened to accommodate the wheelchair, and [the resident] was moved over the wheelchair. Without locking the wheels of the wheelchair or the mechanical lift, [the CNA began lowering the resident] into his wheelchair.” The other CNA “was attempting to aid [the resident] into his wheelchair with one hand and was trying to stabilize the wheelchair with the other.” The first CNA “had her foot on the leg of the mechanical lift and tried to keep the lift from moving.”
The surveyors interviewed the Director of Nursing who said that “the wheels should be locked in the wheelchair when transferring, so the resident’s wheelchair does not move from under the resident.” The Director said that “the mechanical lift should also be locked and not use a foot to stabilize the machine.”
The investigators reviewed the facility’s policy for transferring residents and ensuring their safety that reads in part:
“While transferring residents with a mechanical lift device, at least two staff members are needed to transfer a resident when using the lift device. The first members should position the destination chair next to the bed and will not get in the way of the lift. The second staff member should support the resident’s head as needed. Be sure to check all the brakes.”
In a summary statement of deficiencies dated March 16, 2018, a state investigator noted the nursing home's failure to “establish an infection control program that prevents, identifies, tracks and trends infections.” The nursing home also “failed to ensure isolation practices were implemented correctly and failed to ensure a soiled bedpan was not left on the floor.”
The nursing home also “failed to change soiled gloves in a manner to prevent cross-contamination. This applies to all residents in the facility.”
The investigative team interviewed the Assistant Director of Nursing who said that “she is the Infection Prevention Nurse.” The Assistant Director “said to obtain infection information, I review all telephone orders, shift reports, and new antibiotic orders and pharmacy antibiotic logs.”
The Assistant Director of Nursing said that two residents “were influenza positive. I do not know why they are not on my infection tracking log.” A review of the facility’s Infection Control Policy from 2014 reads in part:
“An effective infection control program may include identifying recent human and environmental context of each resident (room move/roommate contact).”
The investigators stated that the facility’s infection tracking logs, antibiotic usage logs, and immunization logs have numerous blanks reflecting incomplete data collection.”
In a separate summary statement of deficiencies dated April 16, 2017, the state investigative team noted that “the facility failed to prevent cross-contamination by removing gloves and washing hands after providing perineal care. The facility also failed to dispose of soiled linen in a manner to prevent cross-contamination.” This failure “applies to three of sixteen residents reviewed for infection control.”
After observing nurses providing care to residents, the team interviewed the Assistant Director of Nursing who said that “the staff should wash their hands and changed her gloves when going from dirty to clean tasks.” The Director also said that “dirty linens should be placed in a plastic bag and never in a resident’s bed.”
The investigators reviewed the facility’s policy titled: Hand Washing and Hand Hygiene from 2014 that reads in part:
“Employees must wash their hands for at least fifteen seconds using anti-microbial soap and water under the following conditions – before and after resident contact; after removing gloves.”
In a summary statement of deficiencies dated August a 2018, the state surveyor said “the facility neglected to follow their bowel program. The facility neglected to file their intake and output procedure and their Urinary Catheter Care Plan for a resident with an indwelling urinary drainage catheter [and other medical conditions].” The surveyor said that the failures “resulted in a resident not having a bowel movement for six days and being sent to the intensive care unit.”
Observations were made by the surveyors of a resident “lying in bed in the intensive care unit of a local hospital. An intravenous line was inserted into [the resident’s] right arm with antibiotics being infused into [the resident].”
The resident’s Hospital ICU Registered Nurse (RN) said that when the resident “was admitted to the hospital, she was very sick.” The RN said that the resident’s “urine in her catheter bag was very dark, and she was lethargic.” The nurse said that the resident “was not draining stool because she had a bowel obstruction [and] was dehydrated.” The resident was “receiving two different antibiotics due” to her medical condition.
During an interview with the Willow Crest Nursing Pavilion’s Director of Nursing, it was revealed that the resident “did not have a bowel movement for six days.” The Director said that the resident’s “meals, snack, and food consumption forms were not filled out correctly either.” The Director of Nursing said that “the staff that initiated the facility’s bowel protocol, they may have been able to prevent [the resident’s] bowel obstruction.”
In a summary statement of deficiencies dated March 16, 2018, the state surveyors noted that the nursing home “failed to ensure residents were screened for pneumonia immunization status and failed to provide pneumococcal immunizations when indicated.” This failure applies to “three of twenty-three residents reviewed for immunizations.”
The investigators reviewed the electronic health records of residents at the facility. In one incident, “there was no pneumonia vaccine history or refusal [to take the vaccine] documented under the immunizations area.” A separate resident’s electronic health record “shows “there is no pneumonia vaccine history or refusal documented [in their] immunization area.” These failures continued through for other residents at the facility.”
The survey team interviewed the Immunization Nurse who said “after residents are admitted, I asked them for their immunization history. If it is not known, I call their doctor office and chart this information in our electronic health record under immunization area. Flu, pneumonia and TB history is obtained, and vaccinations are then updated if needed.”
The Immunization Nurse said “my official tracking tool is in the electronic health record, not on paper forms in the hard chart. It is important to have a current immunization status because we want to make sure the residents are vaccinated from TB, influenza, and pneumonia. I do not want to immunize a resident who is already vaccinated.”
The Immunization Nurse turned to the Assistant Director of Nursing and asked:” does everyone have a pneumonia vaccine?” The nurse said that “a resident could possibly get pneumonia if they are not vaccinated.” The investigative team reviewed the facility’s policy titled: Pneumonia Vaccine from 2008 that reads in part:
Before “or upon admission, residents will be assessed for eligibility to receive the pneumococcal vaccine, and when indicated, will be offered the vaccine within thirty days of admission unless medically contraindicated or the resident has already been vaccinated. Assessments of pneumococcal vaccination status will be conducted within five working days of the resident’s admission if not conducted [before] admission.”
“For residents who received the vaccine, the date of the vaccination, lot number, expiration date, the person administering, and the site of vaccination will be documented in the resident’s medical record.”
In a summary statement of deficiencies dated August a 2018, a state surveyor documented that the facility had failed to “identify areas of pressure on a resident [before the deterioration of] deep tissue injuries. The facility failed to follow their policy and procedure for dressing changes.” One incident involved a resident who shows she is “at high risk for developing pressure injury.”
Injured or Abused While Residing at Willow Crest Nursing Pavilion? We Can Help
Do you believe that your loved one suffered abuse or mistreatment while living at Willow Crest Nursing Pavilion? If so, contact the Illinois nursing home abuse lawyers at Nursing Home Law Center at (800) 926-7565 today. Our network of attorneys fights aggressively on behalf of DeKalb, Kendall, and LaSalle counties victims of mistreatment living in long-term facilities including nursing homes in Sandwich. Contact us now to schedule a free case review to discuss how to obtain justice and resolve a financial compensation claim.
Our dedicated lawyers can work on your behalf to file and resolve your claim for compensation against all those that caused your loved one’s harm, injury, or premature death. We accept all cases of wrongful death, nursing home abuse, and personal injury through a contingency fee arrangement. This agreement will postpone the need to make a payment for our legal services until after our attorneys have resolved your case through a jury trial award or negotiated out of court settlement.
Our network of attorneys offers every client a “No Win/No-Fee” Guarantee, meaning if we are unable to resolve your case successfully, you owe us nothing. Let our network of attorneys start working on your case today to ensure your family receives the financial compensation they deserve for your harm. All information you share with our law offices will remain confidential.