Inspection visit
Health inspection
1 citation recorded
Inspector’s narrative
What the inspector wrote
This survey cited 1 deficiency. The full statement and the facility’s plan of correction follow, verbatim from the federal record.
F 0609
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper
authorities.
Based on interview and record review, the facility failed to report an abuse allegation. This applies to 1 of 3
(R1) residents reviewed for reporting abuse allegations. The findings include:On October 17, 2025, multiple
requests were made for abuse allegations for October 2025 to V1 (Administrator) and V2 (DON/Director of
Nursing), with none provided. On October 17, 2025 at 1:50 PM, R1 said she was in pain a lot and it hurt her
when she was changed, especially when V3 (CNA/Certified Nurse Assistant) would change her. V3 said
she told the staff she was in pain because she felt they pull and hurt her when they change her. R1 said
when V3 changed her, she would lift her leg high up, and when she would say she was in pain, V3 would
apologize. R1 said she told the nurse she did not want V3 to care for her anymore. The EHR (Electronic
Health Record) shows R1 was admitted to the facility with diagnoses including hemiplegia and hemiparesis,
major depressive disorder, seizures, persistent mood (affective) disorder, generalized osteoarthritis,
contracture of the left hand and left ankle, and schizophrenia. R1's MDS (Minimum Data Set) dated
October 2, 2025 showed R1 was cognitively intact and was dependent on staff for showers/bathing. On
October 17, 2025 at 3:46 PM, V3 (CNA) said she was the CNA on duty on October 11, 2025. V3 said she
gave R1 a shower and after the shower, was approached by V9 (Nurse) saying R1 complained about the
care. V3 said she was called by V10 (Psychotropic Nurse/Manager on Duty). V3 said she was sent home
because when someone reports you, they send the staff home because of the investigation. On October
17, 2025 at 4 PM, V10 said he was the manager on call on October 11, 2025. V10 said there was an
incident where the nurse called and said V3 had an issue with R1. V10 said she notified V2 (DON/Director
of Nursing) and she called the consultant, who advised him to suspend the CNA. V10 said they got a
statement from R1, and a body check was completed. V10 said the nurse filled out a grievance form with
R1 and the plan was for management to do a further investigation. V10 said he was not sure what
happened after regarding the investigation. On October 17, 2025 at 3:05 PM, V7 (CNA) said he was the
second assist for R1's shower on October 11, 2025. V7 said he heard V3 was told to leave the shift pending
the investigation. On October 21, 2025 at 9:45 AM, V9 (Nurse) said she was R1's nurse on October 11,
2025. V9 said she was passing medications when she heard R1 crying and when asked what happened,
R1 told her she was given a shower in the shower stretcher and the CNA was rough with her. V9 said she
reported it to the supervisor right away and the supervisor sent her home, and they would start an
investigation. V9 said she was not interviewed by anyone, including V1 (Administrator) or V2 (DON)
regarding the allegation by R1. On October 17, 2025 at 2 PM, V4 (CNA) said she worked on October 11,
2025, and R1 complained to her that V3 put cold water on her and pulled her arms and legs. V4 said she
thinks V3 was trying to wash her face and maneuver her on the shower bed but did not take into account
R1's painful sides. On October 17, 2025 at 2:06 PM, V5 (CNA) said she worked on Saturday, October 11,
2025, and she heard R1 crying and yelling loudly in the shower room. V5 said R1 told her V3 pulled her
arms and legs and put cold water on her face. V5 said she knew the nurse started the investigation. V5 said
(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:
145830
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
145830
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
10/22/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Aperion Care West Chicago
201 West North Avenue
West Chicago, IL 60185
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 0609
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
she gave a statement to the administrator about the incident. On October 21, 2025 at 11:16 AM, V5 said
she wrote a statement about the incident. On October 21, 2025 at 11:11 AM, V6 (CNA) said she wrote a
statement and put it in V1's mailbox, which was what they did when an incident happened. V6 said the
incident should be reported. V6 said she felt the situation was abnormal because of the way R1 was crying
after coming from the shower. V6 said V3 was sent home. On October 17, 2025 at 2:17 PM, V2 (DON) said
she did not work on October 11, 2025, but was called by V10 and notified of the incident. V2 said she was
told R1 received a shower in the shower bed but wanted it in the shower chair. V2 said V10 said R1
complained of pain, and she instructed the nurse to do an assessment to check for bodily injury. V2 said
she contacted the consultant, and a grievance form was written regarding the shower. V2 said V1
(Administrator) was notified and did not respond to the allegation until Monday. V2 said V1 spoke with R1
and interviewed the staff. V2 said to ask V1 for the information regarding the investigation. V2 said if there
was an issue with the staff and residents, their protocol was to suspend the staff and investigate what
happened. V2 said it was not really an abuse investigation. V2 said she had not received any written
statements from the staff. On October 21, 2025 at 2:45 PM, V1 (Administrator) said he was not working on
October 11, 2025 and saw the messages regarding the incident late on Saturday night. V1 said R1 had a
history of pain and complaining about pain. V1 said the staff told him R1 screamed of pain, especially in the
leg, and more recently complained about pain in the abdomen and back. V1 said he was told V3 and V7
were giving R1 a shower and she was screaming about the pain in her leg in the shower. V1 said R1
reported to V9 about the shower and V9 confronted V3 about the incident. V1 said V3 got defensive and
was sent home. V1 said some of the staff complained about V3's care. V1 said he did not recall if the staff
had given written statements, and he did not report this to IDPH (Illinois Department of Public Health). The
facility's Abuse Prevention and Reporting-Illinois policy, revised on October 24, 2022, showed Any
allegation of abuse or any incident that results in serious bodily injury will be reported to the Department of
Public Health immediately, but no more than two hours after the allegation of abuse. Any incident that does
not involve abuse and does not result in serious bodily injury shall be reported within 24 hours. All incidents
will be documented, whether or not abuse, neglect, exploitation, mistreatment or misappropriation of
resident property occurred, was alleged or suspected. Any incident or allegation involving abuse, neglect,
exploitation, mistreatment or misappropriation of resident property will result in an investigation. The
administrator or person designated to act as administrator in the administrator's absence will review the
report. The administrator or designee is then responsible for forwarding a final written report of results of
the investigation and of any corrective action taken to the Department of Public Health within five working
days of the reported incident. When an allegation of abuse, exploitation, neglect, mistreatment, or
misappropriation of resident property has occurred, the resident's representative and the Department of
Public Health's regional office shall be informed by telephone or fax. Public Health shall be informed that an
occurrence of potential abuse, neglect, exploitation, mistreatment, or misappropriation of resident property
has been reported and is being investigated.
Event ID:
Facility ID:
145830
If continuation sheet
Page 2 of 2
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Back to topCitations
1 citation 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.
F609 - The facility must develop and implement written policies and procedures that:
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
FAQ · About this visit
Common questions about this visit
What happened during the October 22, 2025 survey of APERION CARE WEST CHICAGO?
This was a inspection survey of APERION CARE WEST CHICAGO on October 22, 2025. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at APERION CARE WEST CHICAGO on October 22, 2025?
Yes, 1 deficiency was cited, each with a CMS Scope and Severity grade. The first was: "Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities."
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.