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Complaint Investigation

Carlton At The Lake, The

Inspection Date: November 21, 2025
Total Violations 2
Facility ID 145679
Location CHICAGO, IL
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Inspection Findings

F-Tag F0607

Freedom from Abuse, Neglect, and Exploitation Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0607 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Many

FORM CMS-2567 (02/99) Previous Versions Obsolete

related to abuse prohibition, neglect, exploitation, misappropriation of property such as: Appropriate interventions to deal with aggressive and/or catastrophic reactions of residents. Abuse identification and recognizing signs of abuse. How staff should report their knowledge related to allegation without fear of reprisal. How to recognize signs of burnout, frustration and stress that may lead to abuse; and to what constitutes abuse, neglect, exploitation, and misappropriation of resident property. Understanding of behavior that increase risk of abuse.

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Printed: 04/13/2026 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

B. Wing

A. Building

(X3) DATE SURVEY COMPLETED

11/21/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

Carlton at the Lake, The

725 West Montrose Avenue Chicago, IL 60613

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)

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F-Tag F0609

Freedom from Abuse, Neglect, and Exploitation Deficiencies
Harm Level: Potential for More Than Minimal Harm

F 0609 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Based on interviews and record reviews, the facility failed to follow their ‘Abuse and Neglect' policy and report an allegation of abuse to the Illinois Department of Public Health (IDPH) for one (Resident R1) out of three residents reviewed for abuse. Findings include: Resident R1's admission Record documents in part diagnosis of anxiety disorder.During interviews with Resident R1 on 11/14/2025 at approximately 9:39 AM and 11:00 AM, Resident R1 stated facility hired security to antagonize and intimidate Resident R1. Resident R1 stated V9 (Security) curls [V9's] lips and mean mugs Resident R1. Resident R1 stated V9 puts hand on the gun in front of Resident R1 to intimidate Resident R1. Resident R1 stated [Resident R1] had to call police a few days ago (11/11/2025) because V9 threatened Resident R1 and held gun. Resident R1 stated a receptionist (later identified as V7) and V12 (Human Resources) were present for the incident. On 11/14/2025 at 10:16 AM, V2 (Assistant Administrator / Abuse Coordinator) stated being aware that Resident R1 called police because Resident R1 alleged that V9 was threatening Resident R1. V2 stated did not report the incident to Illinois Department of Public Health and there is no open reportable related to it. On 11/14/2025 at 11:10 AM, V9 (Security) stated Resident R1 was recording staff without consent. V9 stated when staff reminded Resident R1 of facility policy, Resident R1 got mad and called the police. V9 stated Resident R1 told the 911 dispatchers that V9 pointed the gun to Resident R1. V9 denied pointing a gun to Resident R1 or intimidating Resident R1. V9 stated reporting the incident to V2. On 11/14/2025 at 1:36 PM, V7 (Receptionist) stated Resident R1 called the police and informed the 911 dispatcher that security was threatening Resident R1 with a gun. On 11/18/2025 at 9:47 AM, V12 (Human Resources) stated Resident R1 was recording staff without consent. Staff reminded Resident R1 that Resident R1 cannot record, but Resident R1 got more upset. V12 stated Resident R1 kept pointing to

the no gun sign at the front desk and saying facility wasn't allowed to have security. V12 stated Resident R1 then called police.Facility's Abuse and Neglect policy (last revised 6/26/2025) documents in part: All allegations of abuse will be reported to IDPH immediately not exceeding 2 hours after the initial allegation is received.

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📋 Inspection Summary

CARLTON AT THE LAKE, THE in CHICAGO, IL inspection on recent inspection.

Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.

What this means: Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. All deficiencies must be corrected within required timeframes and are subject to follow-up verification.

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 CARLTON AT THE LAKE, THE or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.
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