01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-11-29 | 5 | 2024-09-20 | 1 |
| Cycle 2 | 2024-09-20 | 11 | 2023-10-19 | 0 |
| Cycle 3 | 2023-10-19 | 17 | 2022-11-03 | 0 |
CMS CCN 1458382026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Peterson Park Health Care Ctr
6141 North Pulaski Road · Chicago, IL 60646 · Cook County
Certified beds196CMS provider file
Recent citation rows34current CMS citation release
Penalty rows2current 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
34 rows in the current release
2 rows carry G–L scope/severity codes; 1 carry J–L. 6 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-01-30 · 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 · 2026-01-31 · complaint2025-11-29 · HEALTHF0641Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2025-12-022025-11-29 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2025-12-022025-11-29 · HEALTHF0805Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Correction field: Deficient, Provider has date of correction · 2025-12-012025-11-29 · HEALTHF0925Severity F · widespread; 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 · 2025-12-01 · complaint2025-03-25 · 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 · 2025-04-02 · complaint2024-09-20 · FIREE0004Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2024-09-202024-09-20 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Correction field: Deficient, Provider has date of correction · 2024-09-212024-09-20 · HEALTHF0689Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2024-09-212024-09-20 · HEALTHF0693Severity E · pattern; 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 · 2024-09-212024-09-20 · HEALTHF0694Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide for the safe, appropriate administration of IV fluids for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2024-09-212024-09-20 · HEALTHF0761Severity E · pattern; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Correction field: Deficient, Provider has date of correction · 2024-09-212024-09-20 · HEALTHF0803Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Correction field: Deficient, Provider has date of correction · 2024-09-212024-09-20 · 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 · 2024-09-212024-09-20 · HEALTHF0813Severity D · isolated; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Have a policy regarding use and storage of foods brought to residents by family and other visitors.
Correction field: Deficient, Provider has date of correction · 2024-09-212024-09-20 · HEALTHF0880Severity F · widespread; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-09-212024-09-20 · HEALTHF0919Severity D · isolated; potential for more than minimal harm
Environmental Deficiencies
Make sure that a working call system is available in each resident's bathroom and bathing area.
Correction field: Deficient, Provider has date of correction · 2024-09-212024-05-20 · HEALTHF0836Severity E · pattern; potential for more than minimal harm
Administration Deficiencies
Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.
Correction field: Deficient, Provider has date of correction · 2024-05-22 · complaint2024-03-18 · HEALTHF0557Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to be treated with respect and dignity and to retain and use personal possessions.
Correction field: Deficient, Provider has date of correction · 2024-03-20 · complaint2024-03-18 · 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 · 2024-03-20 · complaint2023-10-19 · HEALTHF0550Severity D · isolated; 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 · 2023-10-202023-10-19 · HEALTHF0584Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Correction field: Deficient, Provider has date of correction · 2023-10-202023-10-19 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2023-10-202023-10-19 · HEALTHF0687Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate foot care.
Correction field: Deficient, Provider has date of correction · 2023-10-2003 / 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 |
|---|---|---|---|
| 2023-09-22 | Fine | $13,042 | 0 |
| 2023-09-22 | Payment Denial | $0 | 6 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- PPA LTDOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST5% · since 11/29/2011
- RAJCHENBACH, CHAIMIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST5% · since 11/29/2011
- SHABAT, MENACHEMIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST9% · since 11/29/2011
- SHABAT, RONALDIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST69% · since 11/29/2011
- ESTERSOHN, STEVENIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 01/17/2022
- SHABAT, MENACHEMIndividual · CORPORATE OFFICERNOT APPLICABLE · since 11/29/2011
- SHABAT, AHUVAIndividual · GENERAL PARTNERSHIP INTERESTNOT APPLICABLE · since 11/29/2011
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 hours3.42per resident day
RN hours0.75per resident day
Weekend nurse hours3.33per resident day
Staff turnover37.1%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