Inspection visit
Inspection
2 citations recorded
Inspector’s narrative
What the inspector wrote
This survey cited 2 deficiencies, 1 of them serious (actual harm or immediate jeopardy). The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0687
Provide appropriate foot care.
Level of Harm - Minimal harm
or potential for actual harm
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
observations, interviews, and record review, the facility failed to timely provide foot care treatment and
ensure that residents received follow up visits per physician orders and recommendations for residents at
risk for foot disorders. This failure applied to two (R5, R6) of three reviewed for podiatrist services.
Residents Affected - Few
Findings include:
1.) R5 is a [AGE] year-old resident admitted to the facility on [DATE] with diagnoses including but not limited
to: diabetes, hypertension, depression, and gastroesophageal reflux disease.
(MDS) Minimum Data Set assessment of 4/8/2025 section C the BIMS (Brief Interviewed Mental Status)
score was 15/15 and indicates cognitive intact.
6/4/2025 at 10:20 AM, R5 said, I have not seen a foot doctor for a long time. R5 removed his shoes and
showed the surveyor his toenails. The toenails were long, discolored, and thick. R5 said, I need to see a
foot doctor because I have diabetes and I want my nails cut. I don't want any problems with my feet. I
requested to see a doctor a long time ago, and I am still waiting.
Review of physician orders dated 1/17/2025 read: May see a podiatrist.
Facility provided visit notes from Podiatrist for R5 dated 01/03/24, 03/06/2024, and 08/12/2024. Note dated
08/12/2024 documents .feet at risk PVD (peripheral vascular disease) .follow up visit 9 weeks. There was
no additional information provided by the facility indicating that R5 was seen by the podiatrist after
08/12/2024.
2.) R6 is a [AGE] year-old resident admitted to the facility on [DATE] with diagnoses including but not limited
to: diabetes, hypertension, acute kidney disease, and hyperlipidemia.
(MDS) Minimal data Set assessment of 4/4/2025 section C the BIMS (Brief Interviewed Mental Status)
score was 15/15 and indicates cognitive intact.
6/4/2025 at 10:25 AM R6 removed shoes and showed toenails to the surveyor, which were long thick
discolored nails on both feet. Both big toenails and second toenails were curling up. R6 said, I am a diabetic
and I do not recall the last time I had a podiatrist cut my nails. They are too long and I need them cut. R6
verbalized requesting to see a podiatrist but has not seen one for a long time.
Reviewed physician orders for R6 dated 4/16/2023, which read: May see podiatrist, and Podiatry consult
due to diabetes, annual foot exam dated 10/31/2023.
(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 4
Event ID:
145639
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
145639
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/06/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Chicago Ridge Snf
10602 Southwest Highway
Chicago Ridge, IL 60415
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)
F 0687
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
6/4/2025 at 11:05 AM V5 (Social Service Director) said, for residents that require podiatry services, the only
thing that I do is to add their names to the list and send the list to the podiatrist's office. The podiatrist will
come to the facility and see residents in the units.
6/4/2025 at 2:47 PM V3 (Director of Nursing) said, I expect residents to be seen by the podiatrist as needed
when residents request to be seen. The podiatrist provider will come to the facility once a month and will go
to the units and see residents on the list but will not see all residents at one time. The surveyor requested to
see the list of residents and asked V3 when R5 and R6 were seen last time. V3 responded that only
residents who requested services are on the list. V3 did not provide a list of residents when requested.
Facility provided visit notes from podiatrist for R6 dated 04/01/2024 and 09/24/2024. Note dated 09/24/2024
documents .feet at risk patient is diabetic .follow up visit 9 weeks. There was no additional information
provided by the facility indicating that R6 was seen by the podiatrist after 09/24/2024.
On 6/5/2025 at 10:06 AM V1 (Administrator) provided policy titled, Policy & Procedure Foot Care
Assessment (reviewed date 11/2022), which includes:
Policy
It is the policy of the nursing department to perform an assessment of the resident's feet at the time of
admission, updated quarterly, and when significant changes occur.
Purpose
To identify treatable conditions, prevent infections, provide treatment, and comfort.
Procedure:
8. Follow physician's orders. Refer to a podiatrist if needed.
9. Refer all diabetics to podiatrist for follow-up
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145639
If continuation sheet
Page 2 of 4
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
145639
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/06/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Chicago Ridge Snf
10602 Southwest Highway
Chicago Ridge, IL 60415
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)
F 0689
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to
prevent accidents.
Level of Harm - Actual harm
Residents Affected - Few
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
interview and record review, the facility failed to follow their stated protocol for signing residents out on
community pass by not verifying the identity of the individual who signed out a resident (R11). The facility
did not have an effective supervised community pass protocol in place. This failure applied to one (R11) of
two residents reviewed for community pass and resulted in R11 leaving the facility on pass on 4/30/2025
and not returning. R11 has a significant history of substance abuse disorders and R11's whereabouts are
currently unknown.
Findings include:
R11 is a [AGE] year-old female who originally admitted to the facility on [DATE]. R11 has multiple diagnoses
including but not limited to the following: multiple orbital fractures, nasal bone fracture, psychoactive
substance abuse, opioid dependence, and alcohol abuse.
R11's BIMS (Brief Interview for Mental Status) Score is 15.
Community Survival Skills assessment dated [DATE] shows that R11 is not capable of unsupervised
outside pass privileges at this time. R11's care plan states in part but not limited to the following:
Interventions: A community survival skills assessment will be conducted to reasonably determine the
person's ability to safely and respectfully negotiate within the outside community.
Progress note dated 4/29/2025 states in part that V21 (R11's Friend) will be taking R11 on a day pass on
4/30/2025 from 5PM-7PM.
Pass Request Form states in part but not limited to the following: Pass to begin on 4/30/2025 at 5PM and
end on 4/30/2025 at 7PM and accompanied by V21.
It is to be noted that the ID scanned and attached to the community pass is not the same name/person
listed on the Community Pass Request Form (V21).
On 6/3/2025 at 9:40AM, V7 (Psychosocial Rehabilitation Services Clinician/PRSC) said our process for the
facility is that when a resident needs a supervised pass: the family/friend they are going out with requests
to take them out. We get the name and phone number of this person. We document where they are going,
when they are leaving, and when they will return. When the date and time comes, the visitor takes the pass,
the nurse signs off on it, then the receptionist makes a copy of the ID of the individual taking them out. The
copy of the ID is done to ensure the person taking the resident out on supervised pass is the same
individual listed on the pass request form. We explain the rules to them and to ensure they are safe that
way.
On 6/3/25 at 1:30PM, V22 (R11's Family Member) said R11 is constantly drug seeking. Before she came to
the facility, she was in the hospital due to someone assaulting her. She is unsafe to herself and others when
in the community. I have an order of protection against her for me and my family's safety. R11 is very
manipulative.
On 6/3/25 at 1:50PM, V16 (Licensed Practical Nurse) said I was the nurse on duty on 4/30/2025 when R11
said she had a pass to go out to the grocery store for a couple hours. A friend came and picked
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145639
If continuation sheet
Page 3 of 4
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
145639
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/06/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Chicago Ridge Snf
10602 Southwest Highway
Chicago Ridge, IL 60415
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)
F 0689
her up, I scanned the ID. I then gave the pass and the copy of the ID to the receptionist. After 7PM came
and went, I called to follow up. R11 never came back to the facility, to my knowledge.
Level of Harm - Actual harm
Residents Affected - Few
On 6/3/25 at 3:00PM, V6 (Social Service Aide) said I was the receptionist on 4/30/25 when R11 went out
on pass. However, I was passing out cigarettes and not at the front desk at the time R11 left. The
receptionist usually scans the ID of the person taking the resident out on pass, but I was busy. I never
spoke with the person that took R11 out. The reason we scan the ID is to ensure that the ID matches the
name on the pass request form. This is for the resident's safety, in case of an emergency where we would
have to call the police or if the resident does not come back to the facility.
On 6/4/2025 at 11:45AM, V1 (Administrator) said when a resident has a supervised pass, a pass request
form is filled out listing the name of the person taking the resident out including the date and time the
resident is leaving and when they will return. The person's ID is scanned to ensure that the pass and the ID
match. V1 said when R11 did not return to the facility, we did not notify the police. I do not consider this
elopement.
It is to be noted that facility policy titled Community Pass does not lay out the procedure of the facilities
supervised pass system.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145639
If continuation sheet
Page 4 of 4
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Back to topCitations
2 citations recorded*CMS
What do CMS severity letters mean?
Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.
General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.
Each letter combines severity with scope: how many residents the deficiency affected.
F687 - Foot care
Provide appropriate foot care.
F689 - Accidents
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
FAQ · About this visit
Common questions about this visit
What happened during the June 6, 2025 survey of CHICAGO RIDGE SNF?
This was a inspection survey of CHICAGO RIDGE SNF on June 6, 2025. The surveyor cited 2 deficiencies, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at CHICAGO RIDGE SNF on June 6, 2025?
Yes, 2 deficiencies were cited, each with a CMS Scope and Severity grade. The first was: "Provide appropriate foot care."
What type of survey was this?
This was a inspection survey conducted by state surveyors under federal Centers for Medicare & Medicaid Services (CMS) oversight. Findings are published on CMS Care Compare.
SourceView on CMS Care Compare
Next steps
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Data from CMS Care Compare public records. Dataset last refreshed . If you believe any information is inaccurate, report it here.