Inspection·June 26, 2025

F 0600 Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. Level of Harm - Actual harm Residents Affected - Few **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on observation, interview, and record review, the facility failed to ensure residents remained free from abuse. This failure affects two residents (R1, R2) reviewed for abuse. This failure lead to physical assault by R2, which resulted in R1 sustaining a laceration to the head. Findings include: R1 is a [AGE] year old with diagnosis including but not limited to: Transient Ischemic Attack (TIA), Cerebral Infarction without Residual Deficits, Osteoarthritis, Weakness, Chronic Obstructive Pulmonary Disease, Atherosclerotic Heart Disease, Schizophrenia, and bipolar disorder. R1's BIMS (Brief Interview of Mental Status) dated 4/18/2025 documents a score of 12, which indicates moderately impaired. R1's Abuse Care Plan documents, R1 will remain safe, will be treated with respect, dignity and reside in the facility free of mistreatment. R2 is a [AGE] year-old with a diagnosis including but not limited to: Type 2 Diabetes Mellitus without Complications, Unspecified Convulsions, Other Hypertrophic Cardiomyopathy, Essential Hypertension, Acquired Absence of Other Left Toe(S), Acquired Absence of Other Right Toe (S), Anemia Unspecified, Personal History of Other (Healed) Physical Injury and Trauma. R2's BIMS (Brief Interview of Mental Status) dated 6/16/2025 documents a score of 15, which indicates cognitively intact. During investigation on 6/25/2025 at 2:46 pm, R1 stated It was all on camera, he (R2) slammed me on the floor and made me hit my forehead. It really hurt, look at my head. I have stitches. R1 pulled his hair back from his forehead and stitches were noted to R1's right forehead. On 6/25/2025 at 11:57 am, V7 (NP/ Nurse Practitioner) stated the following, the expectation of resident safety during an altercation is de-escalation and separating the residents involved so that neither resident is able to physically harm the other. If a resident falls and hits their head during a physical altercation, the resident can sustain a skull fracture or intracranial hemorrhage. A head injury can lead to a resident's demise or a decline in the resident's health. On 6/25/2025 at 1:53 pm, V4 (DON/ Director of Nursing) stated the following, If there is a physical altercation between two residents, the expectation is that the residents are immediately separated (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 06/26/2025 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)