The home failed to ensure residents received food prepared in a form that met their individual needs. Cited July 2024 — isolated incident, immediate jeopardy to residents.
View the original federal record
F-Tag 805 — 42 CFR §483.60 — S/S: J
Nursing home report
SANDWICH LIVING & REHAB CENTER
SANDWICH, IL · Medicare-certified · 63 beds
Needs attention
For-profitChain member
1 of 5 overall
Sandwich Living & Rehab Center in Sandwich, IL has a 1-star overall rating, with 1-star health inspections and quality measures and 2-star staffing. Reported nurse staffing is 3.86 hours per resident per day, below the 4.1 federal benchmark, and the facility has had $126,398 in fines in the last 24 months plus a recent federal penalty.
Facility ratings
Health inspections
Staffing
3.8648 hrs/resident/day
Quality measures
Last inspection: March 4, 2026Penalties, last 24 months: $126,398recent federal penalty
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 3.8648.
Staffing detail
- Registered nurses
- 0.75
- Licensed practical nurses
- 0.61
- Nurse aides
- 2.50
- Weekend nursing
- 3.25
Hours per resident per day.
Total staff turnover: 55%
Registered nurse turnover: 86%
Resident outcomes
How often residents experience these outcomes, with the direction over the past year.
Long-stay residents on antipsychotic medication
33.3%Steady
Residents with a fall causing major injury
3.3%Improving
Residents with pressure ulcers (bedsores)
4.6%Improving
Residents with a urinary tract infection
1.1%Improving
Residents who lost too much weight
3.1%Steady
Residents who were physically restrained
0%Steady
Residents needing more help with daily activities
22%Steady
Residents whose ability to walk got worse
28.1%Steady
Show all measures
Long-stay residents on antianxiety or sleep medication
30.8%Steady
Residents with a long-term catheter
1.5%Steady
Residents with new or worsening incontinence
28.9%Steady
Residents with depressive symptoms
36.6%Worsening
Long-stay residents given the seasonal flu vaccine
85.2%Steady
Long-stay residents given the pneumonia vaccine
81.1%Improving
Short-stay residents given the pneumonia vaccine
66.2%Steady
What the inspectors found
The nursing home failed to keep the area free of hazards and provide enough supervision to prevent accidents. Cited December 2023 — isolated incident, immediate jeopardy to residents.
View the original federal record
F-Tag 689 — 42 CFR §483.25(d) — S/S: J
The nursing home failed to protect residents from abuse and neglect by others. Cited December 2023 — isolated incident, immediate jeopardy to residents.
View the original federal record
F-Tag 600 — 42 CFR §483.12 — S/S: J
The nursing home failed to provide proper pressure ulcer care and failed to prevent new pressure sores from developing. Cited December 2024 — isolated incident, actual harm.
View the original federal record
F-Tag 686 — 42 CFR §483.25(b) — S/S: G
The home failed to provide enough food and fluids to keep residents healthy. Cited December 2024 — isolated incident, actual harm.
View the original federal record
F-Tag 692 — 42 CFR §483.25(g) — S/S: G
Recent history
- STAFFING
Reported nurse staffing was below the federal recommendation of 4.1 hours per resident per day.
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
- PENALTY
A federal payment denial was recorded.
- INSPECTION
Health inspection found 2 health deficiencies.
See what inspectors found
- PENALTY
A federal payment denial was recorded.
- PENALTY
A federal fine of $74,159 was recorded.
- INSPECTION
Health inspection found 9 health deficiencies.
See what inspectors found
- PENALTY
A federal payment denial was recorded.
- PENALTY
A federal fine of $35,438 was recorded.
- PENALTY
A federal fine of $16,801 was recorded.
Penalties & enforcement
On record with Medicare: 5 fines · $285,025 in total fines · 5 payment denials.
- 14 days
Medicare/Medicaid payment denial
Feb 5, 2026
- 35 days
Medicare/Medicaid payment denial
Dec 5, 2024
- $74,159
Federal fine
Dec 5, 2024
- 75 days
Medicare/Medicaid payment denial
Jul 3, 2024
- $35,438
Federal fine
Jul 3, 2024
- $16,801
Federal fine
Jul 3, 2024
- $39,998
Federal fine
Jan 19, 2024
- 64 days
Medicare/Medicaid payment denial
Sep 14, 2023
Operator & ownership
- Ownership
- For profit - Limited Liability company
- Chain
- Part of LINEAGE HEALTHCARE · 5 homes · 1.8 stars avg
- Occupancy
- 28 residents on an average day (44% of 63 beds)
- Resident voice
- Resident council
- Medicare history
- Certified for 17 years
Things at a nursing home change — inspections, staffing, ownership, news.
Source: Centers for Medicare & Medicaid Services — public records, updated monthly. GoodStanding presents official records with plain-language summaries. Always visit a facility in person.