Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

CLARK MANOR

CHICAGO, IL · 267 certified beds · Last Life Safety survey May 17, 2024

CMS Certification Number 145507 · first certified August 1984

Ownership

Operated by LEGACY HEALTHCARE · For profit - Corporation

No change of ownership on CMS record since January 1, 2016, when the records begin.

20
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
6
Tags cited more than once
Across separate surveys
9
Inspection & testing records
Of the citations on file

Position within IL

20 citations — more than 64% of the 666 certified nursing homes in IL. Compared within IL rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 6 citations; the earlier surveys in the window averaged 7. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Well past the typical window (April 2025 to June 2025), and past the point by which nine in ten IL facilities have been surveyed. This facility’s last Life Safety survey was May 2024. Facilities in IL are typically surveyed 11–13 months after the last one (median 12), measured over 759 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

3 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Physical environment (health survey)

4 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 20 Life Safety citations above. The Physical Environment Index

  • F-0925 Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.
  • F-0880 Provide and implement an infection prevention and control program.
  • F-0908 Keep all essential equipment working safely.

How that compares

Citations on file over three years

Compared with the median facility in IL, and nationally. Surveyors differ markedly between states, so the IL figure is the meaningful one.

This facility20IL median15National median11
Citations on file over three years, compared
MeasureCitations
This facility20
Median facility in IL15
Median facility nationally11

Survey history

Citations at each Life Safety survey
82022-0962023-0662024-05
Citations at each Life Safety survey
Survey dateCitations
September 21, 20228
June 2, 20236
May 17, 20246

Most-cited tags

Most-cited tags at this facility
K-03113K-03533K-03452K-09202K-03242K-03212K-03511K-03721
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0311Have an enclosure around a vertical opening shaft.32024-05-17
K-0353Inspect, test, and maintain automatic sprinkler systems.32024-05-17
K-0345Have approved installation, maintenance and testing program for fire alarm systems.22024-05-17
K-0920Ensure proper usage of power strips and extension cords.22023-06-02
K-0324Provide properly protected cooking facilities.22024-05-17
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.22023-06-02
K-0351Install an approved automatic sprinkler system.12023-06-02
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.12024-05-17

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 16
  • Gas, Vacuum, and Electrical Systems Deficiencies 3
  • Egress Deficiencies 1
Citations by CMS category
CategoryCitations
Smoke Deficiencies16
Gas, Vacuum, and Electrical Systems Deficiencies3
Egress Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

May 17, 2024 — 6 citations

Citations issued on May 17, 2024
TagWhat the surveyor checksStatus
K-0311Have an enclosure around a vertical opening shaft.Fire Safety Evaluation Survey
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (June 14, 2024)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (June 14, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (June 27, 2024)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (June 14, 2024)
K-0374Install smoke barrier doors that can resist smoke for at least 20 minutes.Deficient, Provider has date of correction (June 14, 2024)

June 2, 2023 — 6 citations

Citations issued on June 2, 2023
TagWhat the surveyor checksStatus
K-0311Have an enclosure around a vertical opening shaft.Fire Safety Evaluation Survey
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (June 30, 2023)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (June 30, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (June 30, 2023)
K-0911Meet requirements for the installation and maintenance of electrical systems.Deficient, Provider has date of correction (June 30, 2023)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (June 30, 2023)

September 21, 2022 — 8 citations

Citations issued on September 21, 2022
TagWhat the surveyor checksStatus
K-0222Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.Deficient, Provider has date of correction (September 22, 2022)
K-0311Have an enclosure around a vertical opening shaft.Fire Safety Evaluation Survey
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (October 12, 2022)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (October 14, 2022)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (October 14, 2022)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (October 12, 2022)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (October 14, 2022)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (October 14, 2022)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.