Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

Nexus at Columbia

COLUMBIA, IL · 119 certified beds · Last Life Safety survey October 25, 2024

CMS Certification Number 145717 · first certified February 1992

Ownership

Independently operated (no chain recorded by CMS) · For profit - Limited Liability company

No change of ownership on CMS record since January 1, 2016, when the records begin.

25
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
4
Tags cited more than once
Across separate surveys
13
Inspection & testing records
Of the citations on file

Position within IL

25 citations — more than 74% of the 666 certified nursing homes in IL. Compared within IL rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 5 citations; the earlier surveys in the window averaged 10. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Well past the typical window (September 2025 to December 2025), and past the point by which nine in ten IL facilities have been surveyed. This facility’s last Life Safety survey was October 2024. Facilities in IL are typically surveyed 11–13 months after the last one (median 12), measured over 759 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

4 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

8 of the 25 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

7 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 25 Life Safety citations above. The Physical Environment Index

  • F-0921 Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
  • F-0880 Provide and implement an infection prevention and control program.
  • F-0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

How that compares

Citations on file over three years

Compared with the median facility in IL, and nationally. Surveyors differ markedly between states, so the IL figure is the meaningful one.

This facility25IL median15National median11
Citations on file over three years, compared
MeasureCitations
This facility25
Median facility in IL15
Median facility nationally11

Survey history

Citations at each Life Safety survey
132022-1172023-0952024-10
Citations at each Life Safety survey
Survey dateCitations
November 18, 202213
September 1, 20237
October 25, 20245

Most-cited tags

Most-cited tags at this facility
K-03533K-05212K-09232K-03242E-00041K-07121E-00351K-02931
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0353Inspect, test, and maintain automatic sprinkler systems.32024-10-25
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.22024-10-25
K-0923Have proper medical gas storage and administration areas.22024-10-25
K-0324Provide properly protected cooking facilities.22023-09-01
E-0004Develop and maintain an Emergency Preparedness Program (EP).12022-11-18
K-0712Have simulated fire drills held at unexpected times.12022-11-18
E-0035Provide family notifications of emergency plan.12022-11-18
K-0293Have properly located and lighted "Exit" signs.12022-11-18

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 9
  • Emergency Preparedness Deficiencies 8
  • Gas, Vacuum, and Electrical Systems Deficiencies 4
  • Services Deficiencies 2
  • Other 2
Citations by CMS category
CategoryCitations
Smoke Deficiencies9
Emergency Preparedness Deficiencies8
Gas, Vacuum, and Electrical Systems Deficiencies4
Services Deficiencies2
Egress Deficiencies1
Miscellaneous Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

October 25, 2024 — 5 citations

Citations issued on October 25, 2024
TagWhat the surveyor checksStatus
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (January 24, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (December 22, 2024)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (January 7, 2025)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (November 27, 2024)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (November 30, 2024)

September 1, 2023 — 7 citations

Citations issued on September 1, 2023
TagWhat the surveyor checksStatus
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (September 11, 2023)
K-0324Provide properly protected cooking facilities.Waiver has been granted (October 5, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Waiver has been granted (March 4, 2024)
K-0354Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.Deficient, Provider has date of correction (September 11, 2023)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (September 11, 2023)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (September 21, 2023)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (September 11, 2023)

November 18, 2022 — 13 citations

Citations issued on November 18, 2022
TagWhat the surveyor checksStatus
E-0004Develop and maintain an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (November 19, 2022)
E-0006Conduct risk assessment and an All-Hazards approach.Deficient, Provider has date of correction (November 19, 2022)
E-0013Develop Emergency Preparedness policies and procedures.Deficient, Provider has date of correction (November 19, 2022)
E-0029Develop a communication plan.Deficient, Provider has date of correction (November 19, 2022)
E-0035Provide family notifications of emergency plan.Deficient, Provider has date of correction (November 19, 2022)
E-0036Establish emergency prep training and testing.Deficient, Provider has date of correction (November 19, 2022)
E-0037Establish staff and initial training requirements.Deficient, Provider has date of correction (November 23, 2022)
E-0041Implement emergency and standby power systems.Deficient, Provider has date of correction (November 28, 2022)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (November 19, 2022)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (November 23, 2022)
K-0353Inspect, test, and maintain automatic sprinkler systems.Waiver has been granted (March 4, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (November 19, 2022)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (December 6, 2022)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.