Peterson Park Health Care Ctr
Inspection Findings
F-Tag F0925
F 0925
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Level of Harm - Minimal harm or potential for actual harm
Based on observation, interview, and record review, the facility failed to provide and maintain an effective pest control program. These failures have the potential to affect 174 resident's residing in the facility.
Findings Include: On 11/25/2025 at 9:53 AM, surveyor observed Resident R159 laying on his bed free of pain. Resident R159 is alert and oriented to person, place or time. Resident R159 stated he has seen roaches today in the bathroom.
Surveyors open the bathroom door and observe one small roach on the ground. Resident R159 stated he has not seen an exterminator from the pest control company come in to spray medication to get rid of the roaches.
On 11/25/2025 at 10:04 AM, Surveyor observed Resident R70 sitting on the edge of the bed. Resident R70 appears to be comfortable and free of pain. Resident R70 is alert and oriented to person, place and time. Resident R70 stated he has seen roaches in his bathroom, dresser, and nightstand. Resident R70 opened his dresser, and there was live activity present of three different size roaches: small, medium and large. The roaches scattered away when the dresser door was opened. Resident R70 stated this is nothing, I see them all the time everywhere. Resident R70 stated he has not seen an exterminator from the pest control company come in to spray medication. On 11/25/2025 at 10:32 AM, surveyor observed Resident R19 sitting on the edge of the bed while reading a magazine. Resident R19 is alert to person, place and time, with occasional forgetfulness. Resident R19 stated she has seen roaches in her bathroom. Resident R19 stated when I saw the roach in my bathroom I stepped on it, then I called the nurse. Resident R19 continued by stating the nurse then called the housekeeper, and she cleaned up the dead roach from the floor. Resident R19 stated I don't recall seeing an exterminator come in to get rid of the roaches. On 11/25/2025 at 12:00 PM, surveyor observed activity of a small roach in the conference room table while it landed on the table. On 11/25/2025 at 9:48 AM, V17 (Maintenance Director) stated he has seen roaches in the past typically in the hallways but has seen improvement since the facility hired an exterminator. V17 stated the exterminator comes to the facility two times per month, and during that time he will let the exterminator know where he last seen any activity of roaches. Policy titled Pest Control documents in part it is the facility's policy to ensure that there is an effective pest control process in the building. If there is a suspicion or actual problem with pests, the facility will contact a pest control company to inspect presence of a pest control problem. If a pest problem or infestation is identified, the pest control company will treat the problem. It is the discretion of the pest control company if follow-up treatment or inspection is needed.
Residents Affected - Many
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:
PETERSON PARK HEALTH CARE CTR 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 PETERSON PARK HEALTH CARE CTR or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.