01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2024-05-17 | 11 | 2024-05-17 | 6 |
| Cycle 2 | 2023-06-02 | 11 | 2023-06-02 | 6 |
| Cycle 3 | 2022-09-21 | 12 | 2022-09-21 | 8 |
CMS CCN 1455072026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Clark Manor
7433 North Clark Street · Chicago, IL 60626 · Cook County
Certified beds267CMS provider file
Recent citation rows54current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
54 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 13 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-12-24 · HEALTHF0607Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Correction field: Deficient, Provider has date of correction · 2026-01-19 · complaint2025-07-01 · HEALTHF0925Severity E · pattern; potential for more than minimal harm
Environmental Deficiencies
Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
Correction field: Deficient, Provider has date of correction · 2025-08-07 · complaint2025-06-12 · HEALTHF0600Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2025-07-07 · complaint2025-03-13 · HEALTHF0600Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2025-03-27 · complaint2025-02-28 · HEALTHF0604Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Correction field: Deficient, Provider has date of correction · 2025-03-21 · complaint2024-08-26 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-09-25 · complaint2024-05-17 · HEALTHF0550Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · HEALTHF0558Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · HEALTHF0645Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
PASARR screening for Mental disorders or Intellectual Disabilities
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · HEALTHF0686Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · HEALTHF0693Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · HEALTHF0725Severity F · widespread; potential for more than minimal harm
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · HEALTHF0755Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · HEALTHF0814Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · FIREK0311Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have an enclosure around a vertical opening shaft.
Correction field: Fire Safety Evaluation Survey2024-05-17 · FIREK0324Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Provide properly protected cooking facilities.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · FIREK0353Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-06-272024-05-17 · FIREK0372Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-05-17 · FIREK0374Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Correction field: Deficient, Provider has date of correction · 2024-06-142024-03-27 · HEALTHF0600Severity G · isolated actual harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2024-04-18 · complaint2023-11-03 · HEALTHF0600Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Correction field: Deficient, Provider has date of correction · 2023-11-23 · complaint03 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2025-04-17 | Payment Denial | $0 | 21 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- DOROS GENERATION TRUST U/A/D 1/3/12Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST50% · since 01/01/2017
- GPN FAMILY TRUST U/A/D 4/28/08Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST50% · since 01/01/2017
- FORBRIGHT BANKOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 08/22/2022
- ROGERS PROPERTY HOLDINGS LLCOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 08/30/2016
- SHABAT, MENACHEMIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 01/01/2017
- FORBRIGHT BANKOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/22/2022
- LEGACY HEALTHCARE FINANCIAL SERVICES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/30/2016
- FREITAG, ROBERTIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 06/19/2017
- GUPTA, VIVEKIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/30/2016
- SHABAT, MENACHEMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 01/01/2017
- DOROS GENERATION TRUST U/A/D 1/3/12Organization · ADP OF THE SNFNOT APPLICABLE · since 08/30/2016
- GPN FAMILY TRUST U/A/D 4/28/08Organization · ADP OF THE SNFNOT APPLICABLE · since 08/30/2016
- LEGACY HEALTHCARE FINANCIAL SERVICES LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 11/13/2025
- MILLER COOPER & CO, LTDOrganization · ADP OF THE SNFNOT APPLICABLE · since 01/01/2024
- ROGERS PROPERTY HOLDINGS LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 08/30/2016
- FREITAG, ROBERTIndividual · ADP OF THE SNFNOT APPLICABLE · since 06/19/2017
- GUPTA, VIVEKIndividual · ADP OF THE SNFNOT APPLICABLE · since 08/30/2016
- SHABAT, MENACHEMIndividual · ADP OF THE SNFNOT APPLICABLE · since 01/01/2017
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours2.53per resident day
RN hours0.70per resident day
Weekend nurse hours2.37per resident day
Staff turnover14.8%CMS reported field
06 / LOCAL RECORDS
Open the Chicago ledger →Other published facilities nearby
Admiral At The Lake, The36 beds · CMS overall 4/541 citation rowsAlden Estates Of Northmoor198 beds · CMS overall 4/558 citation rowsAlden Lakeland Rehab & Hcc300 beds · CMS overall 1/5121 citation rowsAlden Lincoln Rehab & H C Ctr96 beds · CMS overall 3/562 citation rowsAliya On 87Th210 beds · CMS overall 2/584 citation rowsAll American Vlge Nrsg & Rhb144 beds · CMS overall 1/541 citation rowsAlta Rehab At Fairmont186 beds · CMS overall 2/5101 citation rowsAmbassador Nursing & Rehab Center190 beds · CMS overall 2/571 citation rows