F 0557
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Honor the resident's right to be treated with respect and dignity and to retain and use personal
possessions.
Based on interview and record review, the facility failed to implement their policy to inventory the belongings
of one (R4) resident of eight reviewed for personal property.Findings include:2/11/26 at 2:00 PM, V2
(Director of Nursing) stated there is no inventory list for R4s belongings.2/13/26 at 11:26 AM, V10 (Certified
Nursing Assistant) stated for new admissions, a staff member, usually a CNA (Certified Nursing Assistant),
is supposed to record their belongings. There's a form we use to log what the resident has. So, we know
what the resident has/come in with. The CNA gives the form to the nurse after filling it out. I believe the
resident is supposed to sign the form. We don't log new items that are brought in after admission. We insure
there is no contraband. When discharged the belongings should be bagged up by the CNA and taken to a
storage area by housekeeping.2/13/26 at 12:42 PM, V1 (Administrator) stated they are supposed to be
doing inventory sheets. Everything the resident comes in with is supposed to be noted on the inventory
sheet. The sheet is supposed to be uploaded to the system. The purpose is to keep track of what the
resident comes in with. To ensure what they have is what they should have in the facility. We do not have an
inventory sheet for R4. I am not aware if anyone has come to retrieve R4s belongings. Belongings are
packed up when residents go out and put into a storage area then given back when they come back. If they
don't come back, the belongings are held for 30 days as we reach out to the family for instruction on what to
do with the belongings.2/13/26 at 1:37 PM, V1 (Administrator) located/verified a bag of R4s personal
belongings, including a Bible, on the third floor with no name, still in the facility and had not been returned
to R4.Facility policy Resident Personal Clothes and Belongings Handling, no date, documents in part:
Purpose: To ensure that all clothing/personal belongings are identified/labeled/stored/laundered
appropriately. Procedure: (Upon admission and annually the following will be done) Personal belongings are
to be listed as well, such as TV/recliner/bookcase etc. The CNA (Certified Nursing Assistant) submits the
list of the resident's clothing/belongings to the charge nurse. This list becomes part of the chart.
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 3
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
02/17/2026
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 0600
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment,
and neglect by anybody.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
interview and record review, the facility failed to assert the rights of the residents and prevent and protect
residents from resident-to-resident abuse. This failure affects two of three residents (R1, R2) reviewed for
abuse. Findings include: R1 is no longer in the facility and was reviewed as a closed record. R1's Facesheet
documents that R1 has diagnoses not limited to: Schizoaffective disorder, bipolar disorder, current episode
manic without psychotic features, cocaine abuse, anxiety disorder, other asthma, depression,
schizophrenia, other psychoactive substance abuse, insomnia, adult failure to thrive.R1's progress notes
document:10/31/2025 at 10:55AM Resident was physically aggressive towards peer unprovoked. Resident
immediately separated and placed on 1:1. Refused PRN (as needed). Order received from psych
(psychiatric) team to petition for further psych evaluation. all notifications made.10/31/2025 at 11:07AM
Resident is exhibiting aggressive behaviors with increased agitation and is unable to be redirected. NP
(Nurse Practitioner) notified, and an order was received to send resident to hospital for psych
evaluation.10/31/2025 at 12:28PM Resident left facility in stable condition with ambulance via stretcher on a
petition to hospital for psych evaluation. All belongings secured, family and staff notified. Will follow up as
needed.R1's aggression assessment dated [DATE] documents that R1 is at moderate risk for aggression,
Resident has demonstrated the need for re-evaluating services due to recent behavior.R1's care plan
documents in part, R1 presents with signs & symptoms of persistent anger towards self & others related to:
Feeling abandoned by support system (which may include family members, friends, physician, God &
religion, etc.)., Psychotic symptoms (i.e., delusions, hallucinations, paranoia).R2's progress
notes:10/31/2025 at 10:58AM, Resident received physical contact from peer. Residents were immediately
separated. Head to toe assessment completed. No visible bruises or injuries noted. Denies pain and
discomfort. MD and family made aware. Vital signs stable. All notifications made.On 02/10/2026 at
12:20PM, R2 observed lying in bed in a supine position with an electric wheelchair next to his bed. R2
states this incident occurred so long ago that he does not recall what happened. R2 states R1 was his
girlfriend, and she is no longer in the facility.R2's care plan documents in part, R2 will remain safe, will be
treated with respect, dignity and reside in the facility free of mistreatment (i.e., abuse/neglect) through next
review. Provide a safe environment, free from judgment, especially during the investigation. Provide
emotional support to the resident.On 02/10/2026 at 1:22PM, V3 (Nursing Supervisor/RN) states, he is not
sure exactly what happened, but he was made aware that R1 hit R2. V3 states R2 is someone that he built
a rapport with and talks to frequently. V3 states R2 told him that R1 hit him but R2 did not hit R1 back. V3
states R2 did not complain of pain and stated that he was fine. V3 states he did not speak with R1
regarding the incident, but he has seen R1 upset and aggressive on previous occasions. V3 states he
would often calm R1 down by offering her to take a cigarette smoke break because this is the only thing
that seemed to calm R1 down when she was not redirectable. V3 states he has even seen R1 become
aggressive and verbally abusive towards her own mother. V3 states he would hear R1 curse, get loud, and
tell R1's mother I don't want to speak to you, you put me here. On 02/10/2026 at 1:36PM, V1
(Administrator) states she has been the abuse coordinator at the facility since 09/29/2025. V1 states on
10/31/2025, she and other staff members were in a morning meeting, and everyone heard a noise and
came running out of the room to see what was happening. V1 states she observed that R1 was having a
behavioral episode. V1 states she was trying to tell R1 to calm down and then R1 slapped R2 across the
back of his head right in front of V1. V1 states she then told R1 now I have to send you out to the hospital
and R1 said I don't care send me out. V1 states R1 and R2 were
(continued on next page)
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Event ID:
Facility ID:
145938
If continuation sheet
Page 2 of 3
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
02/17/2026
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 0600
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
separated until 911 came and took R1 out to the hospital. V1 states a body assessment was performed for
R2 and R2 did not have any bruising or complain of pain. V1 states she observed that R1 did not hit R2
willfully and R1 was just having an episode. V1 states it was not a willful intent to hurt or harm R2. V1 states
she also informed R1 that R1 could not return back to the facility.Facility Reported Incident dated
10/31/2025 documents that the facility reported that R1 made physical contact with R2.Facility policy dated
01/2019 titled Abuse Prevention Program documents in part, It is the policy of this facility to prohibit and
prevent resident abuse, neglect, exploitation, mistreatment, and misappropriation of resident property and a
crime against a resident in the facility. Abuse: The willful infliction of injury, unreasonable confinement,
intimidation, or punishment with resulting physical harm or pain or mental anguish or deprivation by an
individual,.Willful, as used in this definition of abuse, means the individual must have acted deliberately, not
that the individual must have intended to inflict injury or harm. Physical abuse: Hitting, slapping, pinching,
kicking, etc.
Event ID:
Facility ID:
145938
If continuation sheet
Page 3 of 3