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Complaint Investigation

Southpoint Nursing & Rehab Center

August 15, 2025 · Chicago, IL · 1010 West 95th Street
Citations 2
CMS Rating 1/5
Beds 228
Provider ID 145914
Healthcare Facility
Southpoint Nursing & Rehab Center
Chicago, IL  ·  View full profile →
Inspection Summary

SOUTHPOINT NURSING & REHAB CENTER in CHICAGO, IL — inspection on August 15, 2025.

Found 2 citations. Severity: Standard violations.

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

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Inspection Findings

FF0550
Resident Rights Deficiencies
Potential for More Than Minimal Harm

said, I was told about it.

The staff member opened the door. V4 was asked if he spoke to R3. V4 replied, I did not talk to R3. V4 said it was the nurse on duty who informed him (V4). V4 again reiterate that he did not talk to R3.

And that he (V4) did not know how R3 felt about the incident. V4 said, I did not know she felt violated during that time. V4 was made aware that there was no privacy curtain to all three (3) shower areas in the shower room. V4 stated that as far as he knows there are curtains.

There is no curtain, the curtain needs to be place because it will help in providing privacy. V4 stated that there were no notes about the incident because he thinks it was just a misunderstanding. V4 stated that there was a grievance documented about what happened but there were no notes or other documentation related to the incident.

On 08/14/2025 at 10:07 AM, with V4 went to the shower room upon entering the door near resident's room the three (3) shower areas do not have privacy curtain. It does not have a pole to place the curtain.

Both left and right shower areas are visible upon opening the door through the hallway. V4 said, You are right there is no privacy curtain. It may be because this shower room is newly renovated. V4 stated that all residents are using the same shower room without privacy curtain.

When door was open will be visually exposed to any person on the hallway.

Then V4 went to other shower room near resident's room.

Inside shower room construction ongoing, power tools on the floor, ceiling taken off, lot of construction materials. V4 stated that this shower room is not being use by resident.

And all residents in this floor male and female uses the shower room without privacy curtain. V4 stated that he will address this concern right away. On 08/14/2025 at 10:21 AM, V2 (Director of Nursing) stated that shower room needs privacy curtain for privacy. V2 stated that she addressed this concern with R3. V2 stated that R3 heard something came to the door and called for help. V2 was asked about any documentation related to incident. V2 replied, That's not an incident to me it is something that needs to be addressed but not an incident. To me I addressed. To my knowledge it affected her, when I explained to her it makes her safe. V2 stated that what happened need to be addressed but not documented. V2 said, everything does not need to be documented. V2 confirmed that V12 (Former Certified Nursing Assistant) was the staff who opened the door with R7.

And V13 (Licensed Practical Nurse) was the nurse on duty during that day whom R3 spoke to about what happened in the shower room. On 08/14/2025 at 12:03 PM V13 (Licensed Practical Nurse) confirmed that the incident happened on Sunday, 07/27/2025. V13 stated that R3 told her that somebody opened the door while she was in the shower. I (V13) went in the shower room, I did see that shower room have no curtain, I did see that. On 08/14/2025 at 1:04 PM V1 (Administrator) was made aware about the privacy curtain. V1 stated that she was told about the problem regarding privacy curtain. V1 said, I understand that part about the privacy curtain that it will help. V1 was made aware that shower room was left unsecure earlier when R3 was able to push open the door without use of the key.

Any person may enter shower room when a resident is performing shower.

And without privacy curtain, person showering is right away visible to any person entering shower room or opening the door.

Requested to facility for policy and procedure related to privacy and/or resident rights. V1 presented part of admission packet which serves as a contract between facility and residents; it reads: Resident have the right of privacy over your persona.

The facility must care for residents in a manner and environment that enhances or promotes your quality of life.

The facility will treat residents with dignity and respect in full recognition of resident's individuality.

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

08/15/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Southpoint Nursing & Rehab Center

1010 West 95th Street Chicago, IL 60643

SUMMARY STATEMENT OF DEFICIENCIES

V13 stated that R3 told her that somebody opened the door while she was in the shower. I (V13) went in the shower room, I did see that shower room have no curtain, I did see that. V13 stated that when she talks to R3 she was initially upset, then she said OK, and she got her pass, and she left. I was under the impression that R3 was okay that why I did not write any notes. On 08/14/2025 at 1:04 PM V1 (Administrator) was made aware that there is no documentation on R3's resident record related to incident.

Concern form by V2 (Director of Nursing) was provided by facility dated 07/29/2025 related to R3 regarding shower room.

Concern form is not documented on R3's resident record or part of R3's resident record.

In-service was also provided by V2 dated 07/29/2025 related to shower room safety.

And does not address concerns related to privacy which is the concern of R3.

Facility ID:

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 SOUTHPOINT NURSING & REHAB CENTER or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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