Ambassador Nursing & Rehab Center
Inspection Findings
F-Tag F0609
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. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on interviews and record review, the facility failed to report an allegation of resident abuse within two hours of notification. This failure affected one resident (Resident R1) reviewed for Reporting of Alleged Violation. Findings include:Resident R1 is [AGE] year old with diagnosis including but not limited to: spinal stenosis, morbid obesity, other abnormalities of gait and mobility, low back pain and heart failure.Resident R2 is [AGE] year old with diagnosis including but not limited to: depression, insomnia, aphasia, hypertensive heart disease without heart failure and facial weakness.On 9/10/25 at 10:30 am, V2 (DON) stated the following, We transferred Resident R1 to a sister facility because he alleged that Resident R2 hurt his arm. The incident was unwitnessed and occurred on 7/29/25.
V25 (MDS Nurse) was the MOD (Manager on Duty) on that day and completed an incident report of the incident between Resident R1 and Resident R2. Resident R1 had an in-house X-ray done because he complained of pain to his arm, but there were no injuries noted via X-ray and no redness. All abuse allegations are handled by V1, however in his absence I am able to send an abuse incident to IDPH. All alleged abuse incidents must be reported within 2 hours of the incident.On 9/10/25 at 10:45 am, V25 (MDS Nurse) stated the following, Resident R1 had stated that he was in an altercation with Resident R2 a little after 7:00 am. I was the MOD that morning, which is why I completed an incident report. The information was given directly from Resident R1 since the incident was unwitnessed. The Administrator was notified by me immediately via telephone. I always notify the Administrator about any allegations regarding abuse immediately.On 9/10/25 at 10:56 am, V1 (Administrator) stated the following, With abuse allegations, we are to report abuse within two hours of the incident. Abuse can be physical, verbal, mental, financial, seclusion and more. Abuse can also be resident to resident, staff to resident, family member to resident, etc. All allegations are reported to me immediately.Facility Census Report dated 9/8/25 documents a total of 172 current residents.Facility Incident Report dated 7/29/25 at 7:36 am documents, Resident R1 alleged that another resident (Resident R2) made contact with him while he was in bed.Facility email transmittal dated 7/29/25 documents, IDPH Incident Report involving Resident R1 was reported at 10:22 am.Facility policy titled Abuse Prevention Program documents, this report (abuse report) should be made immediately, but no longer than two hours after the allegation is made.
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
Event ID:
AMBASSADOR NURSING & REHAB CENTER in CHICAGO, IL inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in CHICAGO, IL, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from AMBASSADOR NURSING & REHAB CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.