01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-09-04 | 9 | 2024-07-11 | 3 |
| Cycle 2 | 2024-07-11 | 8 | 2023-08-16 | 2 |
| Cycle 3 | 2023-08-16 | 13 | 2022-08-05 | 10 |
CMS CCN 1456992026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
The Pearl Of Fox River Valley
1950 Larkin Avenue · Elgin, IL 60123 · Kane County
Certified beds112CMS provider file
Recent citation rows45current 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
45 rows in the current release
3 rows carry G–L scope/severity codes; 1 carry J–L. 9 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-09-04 · 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 · 2025-09-052025-09-04 · HEALTHF0554Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Allow residents to self-administer drugs if determined clinically appropriate.
Correction field: Deficient, Provider has date of correction · 2025-09-052025-09-04 · 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 · 2025-09-052025-09-04 · 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 · 2025-09-052025-09-04 · 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 · 2025-09-052025-09-04 · HEALTHF0690Severity E · pattern; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2025-09-052025-09-04 · 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 · 2025-09-052025-09-04 · 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 · 2025-09-052025-09-04 · HEALTHF0880Severity D · isolated; 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 · 2025-09-052024-11-21 · HEALTHF0756Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Correction field: Deficient, Provider has date of correction · 2024-11-27 · complaint2024-11-21 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2024-11-27 · complaint2024-07-11 · HEALTHF0585Severity E · pattern; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Correction field: Deficient, Provider has date of correction · 2024-07-192024-07-11 · HEALTHF0684Severity E · pattern; 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 · 2024-07-192024-07-11 · HEALTHF0686Severity D · isolated; 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 · 2024-07-192024-07-11 · HEALTHF0689Severity G · isolated actual 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 · 2024-07-19 · complaint2024-07-11 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Correction field: Deficient, Provider has date of correction · 2024-07-192024-07-11 · HEALTHF0805Severity E · pattern; 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 · 2024-07-192024-07-11 · FIREK0345Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Correction field: Waiver has been granted · 2024-08-082024-07-11 · FIREK0363Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install corridor and hallway doors that block smoke.
Correction field: Deficient, Provider has date of correction · 2024-07-222024-07-11 · FIREK0920Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Correction field: Deficient, Provider has date of correction · 2024-07-222023-12-16 · 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 · 2023-12-18 · complaint2023-11-30 · HEALTHF0600Severity J · isolated immediate jeopardy
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 · 2023-12-01 · complaint2023-11-30 · HEALTHF0609Severity G · isolated actual harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Correction field: Deficient, Provider has date of correction · 2023-12-01 · complaint2023-11-30 · HEALTHF0610Severity D · isolated; potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Correction field: Deficient, Provider has date of correction · 2023-12-01 · 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 |
|---|---|---|---|
| 2024-07-11 | Fine | $10,033 | 0 |
| 2023-11-22 | Fine | $132,415 | 0 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- DOROS GENERATION TRUST U/A/D 1/3/12Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST43% · since 10/01/2018
- GPN FAMILY TRUST U/A/D 4/28/08Organization · 5% OR GREATER DIRECT OWNERSHIP INTEREST43% · since 10/01/2018
- OAKWAY OPERATIONS LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST15% · since 10/01/2018
- CIBC BANK USAOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 10/01/2018
- LARKIN AVE PROPERTY HOLDINGS, LLCOrganization · 5% OR GREATER SECURITY INTERESTNOT APPLICABLE · since 10/01/2018
- SHABAT, MENACHEMIndividual · MANAGING CONTROL - GOVERNING BODYNOT APPLICABLE · since 10/01/2018
- CIBC BANK USAOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2018
- LEGACY HEALTHCARE FINANCIAL SERVICES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2018
- AVELINO, JESSICAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 08/02/2021
- SHABAT, MENACHEMIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2018
- SHAH, ASADIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 10/01/2018
- DOROS GENERATION TRUST U/A/D 1/3/12Organization · ADP OF THE SNFNOT APPLICABLE · since 10/01/2018
- GPN FAMILY TRUST U/A/D 4/28/08Organization · ADP OF THE SNFNOT APPLICABLE · since 10/01/2018
- LARKIN AVE PROPERTY HOLDINGS, LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 10/01/2018
- LEGACY HEALTHCARE FINANCIAL SERVICES LLCOrganization · ADP OF THE SNFNOT APPLICABLE · since 11/11/2025
- MILLER COOPER & CO, LTDOrganization · ADP OF THE SNFNOT APPLICABLE · since 01/01/2024
- AVELINO, JESSICAIndividual · ADP OF THE SNFNOT APPLICABLE · since 08/02/2021
- SHABAT, MENACHEMIndividual · ADP OF THE SNFNOT APPLICABLE · since 10/01/2018
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 hours3.48per resident day
RN hours1.21per resident day
Weekend nurse hours3.23per resident day
Staff turnover48.5%CMS reported field
06 / LOCAL RECORDS
Open the Elgin ledger →Other published facilities nearby
Aperion Care Elgin101 beds · CMS overall 3/550 citation rowsAperion Care Fox River94 beds · CMS overall 5/550 citation rowsAvondale Estates Of Elgin120 beds · CMS overall 5/525 citation rowsCrescent Care Of Elgin88 beds · CMS overall 4/526 citation rowsHighland Oaks24 beds · CMS overall 5/522 citation rowsPearl Of Elgin, The139 beds · CMS overall 4/553 citation rowsRiver View Rehab Center203 beds · CMS overall 2/567 citation rows