Health inspection·April 16, 2025

F 0607 Develop and implement policies and procedures to prevent abuse, neglect, and theft. Level of Harm - Minimal harm or potential for actual harm Based on interview, and record review, the facility failed to follow their policy of requesting a fingerprint-based background check within 72 hours of receiving the residents' name based criminal history background check for two of two residents (R9, R10) reviewed for Abuse Prevention. Residents Affected - Few Findings include: On 04/14/2025 at 12:05pm during the Identified Offender Program review with V9 (Business Office Manager) observed R9's (03/26/2025) name based Criminal History Report's result: HIT and R10's (04/03/2025) name based Criminal History Report's result: HIT. This surveyor requested to see R9's and R10's fingerprinting consent, schedule, receipt, result and risk assessment. V9 stated (V3 - Social Service Director) is responsible for scheduling the fingerprinting of the residents. On 04/14/2025 at 1:24pm, V3 presented this surveyor R9's and R10's unsigned and undated 'Nursing Home Resident Applicant Fingerprinting Consent Forms'. V3 stated when I get the CHIRP result with HIT that is the only time we order for fingerprinting of our residents. I inform (Fingerprint Service Provider) via email. (Fingerprint Service Provider) can only do so many. They were here on 3/21/2025. I am not sure when I emailed (Fingerprint Service Provider) for their (R9 and R10) fingerprinting. Maybe on 4/8/2025. If the CHIRP came out with a 'hit', the expectation is to schedule the fingerprinting within 72 hours. V3 stated I will find out for you the purpose of scheduling the fingerprinting within 72 hours. On 04/14/2025 at 2:19pm inside V3's office, V3 checked the email she sent out to (Fingerprint Service Provider) and stated I don't have it in my email. I did not send an email to (Fingerprint Service Provider) to schedule the fingerprinting of (R9). For (R10), I emailed (Fingerprint Service Provider) on 04/08/2025. I know I am behind in scheduling their fingerprinting. On 04/14/2025 at 2:37pm, this surveyor presented V1 (Administrator) the CHIRP results of R9 and R10 and inquired when the facility should schedule the fingerprinting of these residents. V1 stated R9's fingerprinting should have been scheduled on 03/29/2025 and R10's fingerprinting should have been scheduled on 04/06/2025. On 04/14/2025 at 2:40pm, this surveyor presented V1 the facility provided Identified Offender Policy and Procedure and inquired if facility follows its policy of requesting a fingerprint-based background check within 72 hours. V1 stated No. On 04/15/2025 at 12:22pm, V1 (Administrator) stated burglary is a qualifying offense that necessitate for us to schedule fingerprinting within 72 hours. Prostitution Class 4 is also a qualifying offense. (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 2 Event ID: 145479 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 145479 B. Wing A. Building (X3) DATE SURVEY COMPLETED 04/16/2025 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Atrium Health Care Center 1425 West Estes Avenue Chicago, IL 60626 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)