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

THE PEARL OF DOWNERS GROVE

DOWNERS GROVE, IL · 145 certified beds · Last Life Safety survey April 14, 2025

CMS Certification Number 145657 · first certified August 1989

Ownership

Operated by PEARL HEALTHCARE · For profit - Corporation

  • New ownershipOwnership changed April 10, 2025 (change of ownership)from DOWNERS GROVE SNF OPERATIONS LLC
30
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
6
Tags cited more than once
Across separate surveys
17
Inspection & testing records
Of the citations on file

Position within IL

30 citations — more than 82% 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 5 citations; the earlier surveys in the window averaged 12.5. 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 (March 2026 to May 2026), and past the point by which nine in ten IL facilities have been surveyed. This facility’s last Life Safety survey was April 2025. 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

Get an email about THE PEARL OF DOWNERS GROVE

One email when it happens. No account; stop it any time with one click.

Which alerts

5 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.

Emergency preparedness

9 of the 30 citations on file are Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

9 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 30 Life Safety citations above. The Physical Environment Index

  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0880 Provide and implement an infection prevention and control program.
  • F-0584 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.

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 facility30IL median15National median11
Citations on file over three years, compared
MeasureCitations
This facility30
Median facility in IL15
Median facility nationally11

Survey history

Citations at each Life Safety survey
152023-03102024-0252025-04
Citations at each Life Safety survey
Survey dateCitations
March 1, 202315
February 2, 202410
April 14, 20255

Most-cited tags

Most-cited tags at this facility
K-09183K-03533K-02913K-07123K-02932K-03452E-00411K-01331
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0918Have generator or other power source capable of supplying service within 10 seconds.32025-04-14
K-0353Inspect, test, and maintain automatic sprinkler systems.32025-04-14
K-0291Install emergency lighting that can last at least 1 1/2 hours.32025-04-14
K-0712Have simulated fire drills held at unexpected times.32025-04-14
K-0293Have properly located and lighted "Exit" signs.22024-02-02
K-0345Have approved installation, maintenance and testing program for fire alarm systems.22024-02-02
E-0041Implement emergency and standby power systems.12023-03-01
K-0133Install a two-hour-resistant firewall separation.12023-03-01

What the citations cover

Citations by CMS category
  • Emergency Preparedness Deficiencies 9
  • Smoke Deficiencies 6
  • Egress Deficiencies 6
  • Miscellaneous Deficiencies 4
  • Other 5
Citations by CMS category
CategoryCitations
Emergency Preparedness Deficiencies9
Smoke Deficiencies6
Egress Deficiencies6
Miscellaneous Deficiencies4
Gas, Vacuum, and Electrical Systems Deficiencies3
Services Deficiencies1
Construction Deficiencies1

Every citation on file

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

April 14, 2025 — 5 citations

Citations issued on April 14, 2025
TagWhat the surveyor checksStatus
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (April 28, 2025)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (April 29, 2025)
K-0521Ensure heating and ventilation systems that have been properly installed according to the manufacturer's instructions.Deficient, Provider has date of correction (April 29, 2025)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (April 28, 2025)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (April 29, 2025)

February 2, 2024 — 10 citations

Citations issued on February 2, 2024
TagWhat the surveyor checksStatus
E-0037Establish staff and initial training requirements.Deficient, Provider has date of correction (March 12, 2024)
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (March 12, 2024)
K-0211Keep aisles, corridors, and exits free of obstruction in case of emergency.Deficient, Provider has date of correction (March 12, 2024)
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (February 22, 2024)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (February 22, 2024)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (March 23, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (March 12, 2024)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (February 22, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (February 28, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (February 23, 2024)

March 1, 2023 — 15 citations

Citations issued on March 1, 2023
TagWhat the surveyor checksStatus
E-0004Develop and maintain an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (April 14, 2023)
E-0013Develop Emergency Preparedness policies and procedures.Deficient, Provider has date of correction (April 14, 2023)
E-0015Address subsistence needs for staff and patients.Deficient, Provider has date of correction (April 14, 2023)
E-0022Establish policies and procedures for sheltering.Deficient, Provider has date of correction (April 14, 2023)
E-0029Develop a communication plan.Deficient, Provider has date of correction (April 14, 2023)
E-0036Establish emergency prep training and testing.Deficient, Provider has date of correction (April 14, 2023)
E-0041Implement emergency and standby power systems.Deficient, Provider has date of correction (April 14, 2023)
K-0133Install a two-hour-resistant firewall separation.Deficient, Provider has date of correction (April 14, 2023)
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (April 14, 2023)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (April 14, 2023)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (May 12, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (April 14, 2023)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (April 14, 2023)
K-0761To conduct inspection, testing and maintenance of fire doors by qualified individuals.Deficient, Provider has date of correction (April 14, 2023)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (April 14, 2023)

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