Goldwater Care Peoria Heights
On Medicare Special Focus status, a serious quality warning. Visit in person and ask tough questions before deciding.
based on 32 Google reviews

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Quality Concerns Identified
Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.
- Low overall rating (1/5 stars)
- Low staffing rating (1/5 stars)
- High staff turnover (62%)
- High RN turnover (80%)
Bottom 25% in IL · Critically understaffed (RN) · Worst in GOLDWATER CARE chain · $181,422 in fines
What this means for your family
While some families report positive rehabilitation outcomes, the recent trend of negative reviews regarding basic hygiene and administrative responsiveness is concerning. We strongly recommend conducting an unannounced visit and specifically observing how quickly staff respond to call lights before making a decision.
Google Reviews
Google Reviews
32 reviews on Google“Goldwater Care Peoria Heights receives highly polarized feedback, with some families praising the homey atmosphere and dedicated staff, while others report severe neglect and administrative failures. Recent reviews highlight significant concerns regarding resident hygiene, slow response times for basic needs, and high staff turnover under current management.”
Quality Themes
Tap a score for detailsStrengths
- Clean, well-maintained building
- Homey, welcoming atmosphere
- Effective rehabilitation outcomes
- Specific staff members praised for dedication
Concerns
- Neglect of basic hygiene and resident needs (soiled diapers, lack of showers) (mentioned by 3 reviewers)
- Inattentive or unresponsive staff/reception (mentioned by 3 reviewers)
- High staff turnover and understaffing issues (mentioned by 3 reviewers)
- Administrative incompetence or poor management (mentioned by 3 reviewers)
Rating Trends
Tap a year to see what changed
Distribution · 33 analyzed
How They Respond to Reviews
Questions for Your Tour
- 1Given the recent feedback regarding staffing levels, how does the current management team ensure that residents receive consistent support with daily hygiene and personal care needs?
- 2With the facility currently working to improve its CMS quality ratings, what specific steps is leadership taking to enhance communication and responsiveness with family members?
- 3How does the team manage staff turnover to ensure that my loved one consistently interacts with familiar faces who understand their unique care preferences?
- 4Can you walk me through the daily routine for residents, and how do you ensure that those who need extra assistance with showers or grooming are prioritized?
- 5In the event of a medical change or emergency, what is your protocol for notifying family members, and how quickly can we expect a response from the nursing staff?
- 6I’ve heard positive things about the rehabilitation outcomes here; how do you integrate those successful therapy practices into the overall daily care plan for long-term residents?
Personalized based on this facility's data
Key Review Excerpts
“My mother came in to this facility not being able to walk or really even sit correctly. I am so excited that she can now walk and enjoy life how she needs to.”
“I’ve been on a bedpan for 2 and 1/2 hours without getting help literally with lite on . Have not had a wash rag to wash my face or oral care since I’ve been here. Have went 3 weeks without a shower.”
“In just around 5 months of the new administration the census has plummeted from around 70 to the low 30s. The once great and family feeling environment has gone so stale.”
Staffing
Staffing Hours
per resident/day · Medicare 2026Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 17 measures
5
measures
7
measures
5
measures
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents whose bladder or bowel control got worse
Residents on antipsychotic medication
Residents whose walking got worse
Residents on anti-anxiety or sleep medication
Residents vaccinated for the flu
Short-stay residents vaccinated for the flu
Short-stay residents vaccinated for pneumonia
Short-stay residents newly given antipsychotics
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
Families have filed multiple reports triggering 42 deficiencies, with ongoing problems in medication management, nursing staffing, and pressure ulcer prevention. The facility has had 122 total deficiencies across 17 surveys, with issues in abuse prevention, safety hazards, and infection control recurring repeatedly throughout recent years. While deficiencies show correction dates, the pattern of repeated violations in critical care areas suggests persistent operational challenges that families should carefully consider.
Feb 28, 2026Complaint1
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Feb 13, 2026Complaint19
Administration Deficiencies
Administer the facility in a manner that enables it to use its resources effectively and efficiently.
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies
Provide safe, appropriate pain management for a resident who requires such services.
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Quality of Life and Care Deficiencies
Provide activities to meet all resident's needs.
Nursing and Physician Services Deficiencies
Observe each nurse aide's job performance and give regular training.
Administration Deficiencies
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Administration Deficiencies
Conduct mandatory training, for all staff, on the facility’s Quality Assurance and Performance Improvement Program.
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Resident Rights Deficiencies
Notify each resident of certain balances and convey resident funds upon discharge, eviction, or death.
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies
Provide enough food/fluids to maintain a resident's health.
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Administration Deficiencies
Provide or obtain laboratory tests/services when ordered and promptly tell the ordering practitioner of the results.
Administration Deficiencies
Provide or obtain x-rays/tests when ordered and promptly tell the ordering practitioner of the results.
Dec 7, 2025Complaint2
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Aug 6, 2025Complaint2
Resident Rights Deficiencies
Honor the resident's right to organize and participate in resident/family groups in the facility.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Dec 7, 2024Complaint1
Resident Rights Deficiencies
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.
Oct 1, 2024Routine19
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Administration Deficiencies
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Infection Control Deficiencies
Implement a program that monitors antibiotic use.
Emergency Preparedness Deficiencies
Address subsistence needs for staff and patients.
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Smoke Deficiencies
Properly select, install, inspect, or maintain portable fire extinguishes.
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Egress Deficiencies
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Smoke Deficiencies
Provide properly protected cooking facilities.
Resident Rights Deficiencies
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Egress Deficiencies
Have exits that are accessible at all times.
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Smoke Deficiencies
Install an approved automatic sprinkler system.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure operating rooms are properly protected and written records are maintained and available for inspection.
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Federal Penalties
Fine
Nov 30, 2023
$181,422
Payment Denial
Nov 30, 2023
111-day denial
Ownership & Operations
Who Operates This Facility
Goldwater Care Peoria Heights
for profit
Chain Affiliation
Goldwater Care
11 facilities nationwide
Chain avg rating: 1.4/5 · Rank 6 of 11 (Worst)
Ownership & Management
Owners
Katzenstein, Meir
Owner
Tversky, Aaron
Owner
Berkowitz, David
Individual is an Owner, Partner or Trustee of Any Adp of the Snf
Meystel, Yosef
Individual is an Owner, Partner or Trustee of Any Adp of the Snf
Key personnel
Contact
Get in Touch
Contact this facility directly and verify the details that matter most to your family.
References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
32 reviews from families & visitors
Official Website
Visit goldwatercare.com
Medicare data downloads
Original nursing home datasets
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