Inspection visit
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
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 staff failed to report an allegation of abuse to the
administrator for one of three residents (R1) in a total sample of four.
Residents Affected - Few
Findings include:
On 6.3.2025, at 1:17 PM, V1 (Administrator) said, the incident happened on 5.10.2025. Two residents R1
and R2 got into it. It wasn't initially a reportable incident because no resident was injured and there was no
mental distress of either resident. He (V3) stated CNA-Certified Nursing Assistant) came in and hit him in
the face. R1 did not reference R2.
On 6.3.2025, at 1:32 PM, V3 (CNA-Certified Nursing Assistant) said, I did not hit R1. V3's written statement
of 5.12.2025, documents in part, V3 observed R1 and R2 involved in an altercation, intervened by
separating the residents; V3 reported the incident to the nurse.
On 6.4.2025, at 12:17 PM, V10 (PRSC- Psychiatric Rehabilitation Services Coordinator), said it was
towards the end of my shift (5.10.2025). They called me down to the 3rd floor, because there was an
incident that was going on. By the time I got down there it was over. R1 couldn't tell me what happened. At
first, he didn't want to talk to me. All he would tell me was that there was an altercation between him and
R2. When I came back on Monday (5.12.2025), an investigation was in progress. I reported it to V12 (Social
Service Director). We reported it to V1 on Monday.
On 6.4.2025, at 12:38 PM, V11 (Psych Tech) said, I didn't report it (the altercation between R1 and R2)
because it was over when I got up there.
On 6.4.2025, at 1:24 PM, V12 (Social Service Director) said, I was told about the altercation between R1
and R2 on Monday (5.12.2025). I found out from V1 In the morning meeting (Administrator) that it was a
reportable (incident) for behavior. It should be reported to the abuse coordinator.
On 6.4.2025, at 2:19 PM, via telephone, V9 (CNA-Certified Nursing Assistant) said, I would let the charge
nurse know about any abuse. V8 (RN-Registered Nurse) was the charge nurse that shift. She knew, she
reported it (the incident) to V2 (DON-Director of Nursing).
On 6.4.2025, at 3:05 PM, V2 (DON-Director of Nursing) said, R1 and R2 had a verbal altercation and V3
intervened. It wasn't reported to me that either of the residents hit each other. None of my staff reported
anything to me about the alleged incident of 5.10.2025. I didn't find out about the incident until Monday or
Tuesday. I was never told it was physical contact. Abuse is reported to the administrator immediately. He's
the abuse coordinator. They don't have to report it (abuse) to me, they
(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:
145938
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
145938
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
06/04/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Landmark of Hyde Park Rehabilitation and Nursing C
6125 South Kenwood
Chicago, IL 60637
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
should report it to V1.
Level of Harm - Minimal harm
or potential for actual harm
On 6.4.2025, at 3:27 PM, V13 (Nurse Supervisor) said, honestly, I did not hear anything until V1 questioned
me on 5.12.2025. V1 asked me if I heard about an incident involving V3 and R1. R1 stated that V3 allegedly
punched R1 in the face. If a resident hits another I need to know immediately. If residents have a verbal
altercation, staff should let me know immediately. I would immediately let V1 know.
Residents Affected - Few
Facility incident report (initial of 5.10.2025) documents in part, V3 made contact with resident (R1).
Addendum: It is alleged that residents (R1) and (R2) made contact with each other. Conclusion: V3 did not
make contact with R1. V3 responded to a disagreement between R1 and R2. The allegation was not
substantiated.
Facility incident report (initial of 5.12.2025) documents part, V3 made contact with resident R1.
Facsimile cover sheet documents both initial reports were faxed to the Illinois Department of Public Health
on 5.12.2025
Abuse Prevention Program Policy and Procedure (Revised 3.26.12) documents in part:
-V. Identification of Allegations/Internal Reporting Requirements
Employees are required to immediately report any incident, allegation or suspicion of potential abuse,
neglect, exploitation misappropriation of resident property, mistreatment, or a crime against a resident they
observe, hear about, or suspect to the Administrator if available or an immediate supervisor who must
immediately report it to the Administrator. In the absence of the Administrator, reporting can be made to the
DON.
Supervisors shall immediately inform the Administrator or in the absence of the Administrator, the DON of
all reports of incidents, allegations or suspicion of potential abuse, neglect, exploitation, misappropriation of
property, mistreatment, or crime against a resident.
Procedure: Any alleged violations involving mistreatment, abuse, neglect, exploration (exploitation),
misappropriation of resident property, any injuries of an unknown origin, or reasonable suspicion of a crime
against a resident MUST be reported to the Administrator or Director of Nursing. The Administrator is the
Abuse Coordinator of the facility.
Additionally, the person(s) observing an incident of resident abuse or suspecting resident abuse must
IMMEDIATELY report such incidents to the Charge Nurse who will immediately report the allegation to the
Administrator, regardless of the time lapse since the incident occurred. The Charge Nurse will immediately
report the incident to the Administrator or to the DON during the Administrator's absence.
This report shall be made immediately, but no later than two hours after the allegation is made. If the events
that (cause) the allegation involve abuse or resulted in serious bodily injury, or not less than 24 hours if the
events that cause the allegation do not involve abuse and did not result in serious bodily injury.
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145938
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 June 4, 2025 survey of Landmark of Hyde Park Rehabilitation and Nursing C?
This was a inspection survey of Landmark of Hyde Park Rehabilitation and Nursing C on June 4, 2025. The surveyor cited 1 deficiency, recorded on the federal Form 2567 statement of deficiencies.
Were any deficiencies cited at Landmark of Hyde Park Rehabilitation and Nursing C on June 4, 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.