Quarterly Report April - June 2015

The Illinois Department of Public Health has initiated action, as indicated, against the following facilities which have been determined to be in violation of the Nursing Home Care Act, or has recommended decertification to the Director of the Department of Healthcare and Family Service, or the Secretary of the United States Department of Health and Human Services for violations in relation to patient care, pursuant to Titles XVIII and XIX of the Federal Social Security Act.

FACILITY NAME: Aperion Care Plum Grove
FACILITY ADDRESS: 24 S. Plum Grove Road
FACILITY CITY, STATE, ZIP: Palatine, IL 60067
DOCKET NUMBER: NH 14-S-400 and NH 14-C-403
LICENSEE INFO: Aperion Care Inc.
LICENSEE ADDRESS: 8131 N. Monticello Ave.
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and Notice of Conditional License Withdrawn.
 
FACILITY NAME: Covenant Health Care Center - Batavia
FACILITY ADDRESS: 831 N. Batavia Ave.
FACILITY CITY, STATE, ZIP: Batavia, IL 60510
DOCKET NUMBER: NH 13-C-549
LICENSEE INFO: Covenant Health Care Center, Inc.
LICENSEE ADDRESS: 801 Adlai Stevenson Dr.
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and Notice of Conditional License Withdrawn.
 
FACILITY NAME: Centralia Manor
FACILITY ADDRESS: 1910 East McCord, Route 161 East
FACILITY CITY, STATE, ZIP: Centralia, IL 62801
DOCKET NUMBER: NH 15-C0130
LICENSEE INFO: UDI #8 L.L.C.
LICENSEE ADDRESS: 285 S. Farnham St.
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 2-23-15  
Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6) and 300.3240a) The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210b),300.1210d)6) and 300.3240a). For a total fine of $25,000.00
 
FACILITY NAME: Mcallister Nursing and Rehab
FACILITY ADDRESS: 18300 S. Lavergne
FACILITY CITY, STATE, ZIP: Tinley Park, IL 60477
DOCKET NUMBER: NH 15-C0131
LICENSEE INFO: Mcallister Nursing and Rehab, LLC
LICENSEE ADDRESS: 9100 Karlov Ave.
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 2-28-15  
Type A violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b)5), 300.1210d)6) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b),300.1210d)6) and 300.3240a). For a total fine of $25,000.00
 
FACILITY NAME: Windmill Nursing Pavilion
FACILITY ADDRESS: 16000 South Wabash Ave.
FACILITY CITY, STATE, ZIP: South Holland, IL 60473
DOCKET NUMBER: NH 15-C0136
LICENSEE INFO: Windmill Nursing Pavilion, Ltd
LICENSEE ADDRESS: 191 N. Wacker Dr., Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 3-9-15  
Type B violation for violating one or more sections: 300.690a),300.690b) and 300.690c).
 
FACILITY NAME: Oak Lawn Respiratory and Rehab
FACILITY ADDRESS: 9525 S. Mayfield Ave.
FACILITY CITY, STATE, ZIP: Oaklawn, IL 60453
DOCKET NUMBER: NH 15-S0134
LICENSEE INFO: Oak Lawn Respiratory and Rehabilitation Center, LLC
LICENSEE ADDRESS: 9525 S. Mayfield Ave.
LICENSEE CITY, STATE, ZIP: Oak Lawn, IL 60453
Survey Date – 2-27-15  
Type B violation for violating one or more sections: 300.615e).
 
FACILITY NAME: Imboden Creek Living Center
FACILITY ADDRESS: 180 W. Imboden Dr.
FACILITY CITY, STATE, ZIP: Decatur, IL 62521
DOCKET NUMBER: NH 14-C0402
LICENSEE INFO: Living Center Inc
LICENSEE ADDRESS: 20 Southside Country Club Road
LICENSEE CITY, STATE, ZIP: Decatur, IL 62521
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Grove of Skokie Living and Rehabilitation Center
FACILITY ADDRESS: 900 N. Lavergne Ave.
FACILITY CITY, STATE, ZIP: Skokie, IL 60077
DOCKET NUMBER: NH 14-C357
LICENSEE INFO: Meyer Magence
LICENSEE ADDRESS: 4711 Golf Road, Suite 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Highland Health Care Center
FACILITY ADDRESS: 1450 26th St.
FACILITY CITY, STATE, ZIP: Highland, IL 62249
DOCKET NUMBER: NH 15-C0142
LICENSEE INFO: Covenant Care Midwest Inc.
LICENSEE ADDRESS: 208 South LaSalle, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 3-6-15  
Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)5 and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a. For a total fine of $2,200.00
 
FACILITY NAME: The British Home
FACILITY ADDRESS: 8700 W. 31st St.
FACILITY CITY, STATE, ZIP: Brookfield, IL 60511
DOCKET NUMBER: NH 15-S0141
LICENSEE INFO: The British Home for Retired Men and Women
LICENSEE ADDRESS: 31st St. & McCormick Ave.
LICENSEE CITY, STATE, ZIP: Brookfield, IL 60513
Survey Date – 2-27-15  
Type B violation for violating one or more sections: 300.615
 
FACILITY NAME: Crossroads Care Center Woodstock
FACILITY ADDRESS: 309 McHenry Ave.
FACILITY CITY, STATE, ZIP: Woodstock, IL 60098
DOCKET NUMBER: NH 15-C0145
LICENSEE INFO: Crossroads Care Center of Woodstock LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 3-2-15  
Type B violation for violating one or more sections: 300.610a), 300.1010h) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.00
 
FACILITY NAME: Thornton Heights Terrace
FACILITY ADDRESS: 160 West 10th St.
FACILITY CITY, STATE, ZIP: Chicago Heights, IL 60411
DOCKET NUMBER: NH 15-C0047
LICENSEE INFO: Thorton Heights Terrace, LTD
LICENSEE ADDRESS: 465 Central Ave., Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Care Center of Abingdon
FACILITY ADDRESS: 801 West Martin St.
FACILITY CITY, STATE, ZIP: Abingdon, IL 61410
DOCKET NUMBER: NH 14-C0270
LICENSEE INFO: UDI #6 L.L.C.
LICENSEE ADDRESS: 285 S. Farnham St.
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Jackson Square Skilled Nursing & Living
FACILITY ADDRESS: 5130 West Jackson Boulevard
FACILITY CITY, STATE, ZIP: Chicago, IL 60644
DOCKET NUMBER: NH 15-S0140
LICENSEE INFO: Jackson Corp
LICENSEE ADDRESS: 191 N. Wacker Dr., Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 2-20-15  
Type A violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)3), 300.1210d)6) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210b), 300.1210d)6) and 300.3240a). For a total fine of $25,000.00
 
FACILITY NAME: Aspen Rehab & Health Care
FACILITY ADDRESS: 1403 9th Ave.
FACILITY CITY, STATE, ZIP: Silvis, IL 61282
DOCKET NUMBER: NH 15-C0139
LICENSEE INFO: Petersen Health & Wellness, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 2-11-15  
Type A violation for violating one or more sections: 300.610a), 300.690b), 300690c), 300.1210b), 300.3240a), 300.3240d) and 300.3240f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210b) and 300.3240a). For a total fine of $2,200.00
 
FACILITY NAME: Oak Lawn Respiratory & Rehab
FACILITY ADDRESS: 9525 S. Mayfield Ave.
FACILITY CITY, STATE, ZIP: Oaklawn, IL 60453
DOCKET NUMBER: NH 15-C0135
LICENSEE INFO: Oak Lawn Respiratory & Rehab
LICENSEE ADDRESS: 9525 S. Mayfield Ave.
LICENSEE CITY, STATE, ZIP: Oaklawn, IL 60453
Survey Date – 2-17-15  
Type A violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210c), 300.1210d)6), 300.1220b)2), 300.1220b)6), 300.1220b)8) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210b), 300.1210d)6) and 300.3240a). For a total fine of $25,000.00
 
FACILITY NAME: Oak Lawn Respiratory & Rehab
FACILITY ADDRESS: 9525 S. Mayfield Ave.
FACILITY CITY, STATE, ZIP: Oak Lawn, IL 60453
DOCKET NUMBER: NH 15-C0149
LICENSEE INFO: Oak Lawn Respiratory & Rehab
LICENSEE ADDRESS: 9525 S. Mayfield Ave.
LICENSEE CITY, STATE, ZIP: Oak Lawn, IL 60453
Survey Date – 3-4-15  
Type B violation for violating one or more sections: 300.1210d)2) and 300.1210d)6).
 
FACILITY NAME: Manor Care of Oak Lawn West
FACILITY ADDRESS: 6300 W. 95th St.
FACILITY CITY, STATE, ZIP: Oak Lawn, IL 60453
DOCKET NUMBER: NH 14-S0265
LICENSEE INFO: Manor Care of Oak Lawn West
LICENSEE ADDRESS: 208 S. LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Arden Courts at Manorcare - S. Holland
FACILITY ADDRESS: 2045 E. 170th St.
FACILITY CITY, STATE, ZIP: South Holland, IL 60473
DOCKET NUMBER: NH 15-S0154
LICENSEE INFO: Manorcare Health Services, INC
LICENSEE ADDRESS: 208 S. LaSalle St.
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 4-1-15  
Type B violation for violating one or more sections: 330.710A)C)3)A) and 330.4240A)
 
FACILITY NAME: Providence Palos Heights
FACILITY ADDRESS: 13259 S. Central Ave.
FACILITY CITY, STATE, ZIP: Palos Heights, IL 60463
DOCKET NUMBER: NH 15-S0147 and 15-C0159
LICENSEE INFO: Providence Operations, LLC
LICENSEE ADDRESS: 18601 N. Creek Dr., Suite A
LICENSEE CITY, STATE, ZIP: Tinley Park, IL 60477
Survey Date – 3-4-15  
Type B violation for violating one or more sections: 300.610A), 300.1010H), 300.1210B), 300.1210D)6) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Wauconda Healthcare and Rehab
FACILITY ADDRESS: 176 Thomas Court
FACILITY CITY, STATE, ZIP: Wauconda, IL 60084
DOCKET NUMBER: NH 15-C0160
LICENSEE INFO: Wauconda Healthcare and Rehab
LICENSEE ADDRESS: 176 Thomas Court
LICENSEE CITY, STATE, ZIP: Waukonda, IL 60084
Survey Date – 2-19-15  
Type B violation for violating one or more sections: 300.1010H), 300.1210B) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Villa at Evergreen Park
FACILITY ADDRESS: 10124 S. Kedzie Ave.
FACILITY CITY, STATE, ZIP: Evergreen Park, IL 60805
DOCKET NUMBER: NH 15-S0155
LICENSEE INFO: Evergreen Living & Rehab Center, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Dr.
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 2-25-15  
Type B violation for violating one or more sections: 300.610A), 300.1210D)6) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Holy Family Villa
FACILITY ADDRESS: 12220 S. Will Cook Road
FACILITY CITY, STATE, ZIP: Palos Park, IL 60464
DOCKET NUMBER: NH 15-S0153
LICENSEE INFO: Holy Family Villa
LICENSEE ADDRESS: 721 N. LaSalle St.
LICENSEE CITY, STATE, ZIP: Chicago, IL 60654
Survey Date – 2-25-15  
Type B violation for violating one or more sections: 300.610A), 300.1210D)6) and 300.3240A) The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210D)6) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Heather Health Care Center
FACILITY ADDRESS: 15600 South Honore Ave.
FACILITY CITY, STATE, ZIP: Harvey, IL 60426
DOCKET NUMBER: NH 15-C0161
LICENSEE INFO: Heather Health Care Center Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave., Suite 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 3-12-15  
Type B violation for violating one or more sections: 300.690B)C), 300.1010H), 300.1210A), 300.1210B), 300.1210C), 300.1210D)2)3) and 300.3240A).
 
FACILITY NAME: Tillers Nursing & Rehab Center
FACILITY ADDRESS: 4390 Route 71
FACILITY CITY, STATE, ZIP: Oswego, IL 60543
DOCKET NUMBER: NH 14-S-0397
LICENSEE INFO: Tillers Nursing and Rehabilitation, Inc
LICENSEE ADDRESS: 190 S. LaSalle St., Suite 3700
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603-3433
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Rochelle Health Care
FACILITY ADDRESS: 900 N. 3rd St.
FACILITY CITY, STATE, ZIP: Rochelle, IL 61068
DOCKET NUMBER: NH 13-C0343
LICENSEE INFO: Petersen HealthCare Inc
LICENSEE ADDRESS: 830 West Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: St. Anthony's Nursing & Rehab Center
FACILITY ADDRESS: 767 30th St.
FACILITY CITY, STATE, ZIP: Rock Island, IL 61201
DOCKET NUMBER: NH 15-C0157
LICENSEE INFO: St. Anthony's Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 330 N. Wabash #1700
LICENSEE CITY, STATE, ZIP: Chicago, IL 60611
Survey Date – 2-25-15  
Type A violation for violating one or more sections: 300.610A), 300.1210B), 300.1220B)6), 300.3240A) and 300.3240E). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.3240A) and 300.3240E). For a total fine of $25,000.00.
 
FACILITY NAME: Ballard Respiratory and Rehab
FACILITY ADDRESS: 9300 Ballard Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60016
DOCKET NUMBER: NH 15-S0156
LICENSEE INFO: Ballard Respiratory and Rehabilitation Center, LLC
LICENSEE ADDRESS: 55 W. Monroe ST., Suite 2400
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 3-17-15  
Type A violation for violating one or more sections: 300.610A), 300.670A), 300.670C)1), 300.670C)2), 300.670D), 300.670E), 300.1210B), 300.1210D)6) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.1210D6) and 300.6240A). For a total fine of $25,000.00.
 
FACILITY NAME: Park Place of Belvidere
FACILITY ADDRESS: 1701 5th Ave.
FACILITY CITY, STATE, ZIP: Belvidere, IL 61008
DOCKET NUMBER: NH 15-C0151
LICENSEE INFO: The Gardens of Belvidere, LLC
LICENSEE ADDRESS: 8170 McCormick Blvd., #124
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 3-3-15  
Type A violation for violating one or more sections: 300.610A), 300.1210A), 300.1210B), 300.1210D)6), 300.1220B)3) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.1210D)6) and 300.3240A). For a total fine of 25,000.00
 
FACILITY NAME: Prairie View Cr Center - Lewiston
FACILITY ADDRESS: 175 East Sycamore
FACILITY CITY, STATE, ZIP: Lewiston, IL 61542
DOCKET NUMBER: NH 14-C-0450
LICENSEE INFO: Prarie View Care Center of Lewiston, Inc
LICENSEE ADDRESS: 5750 Old Orchard Road, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Timbercreek Rehab & Health Care Center
FACILITY ADDRESS: 220 State St.
FACILITY CITY, STATE, ZIP: Pekin, IL 61554
DOCKET NUMBER: NH 15-S0162
LICENSEE INFO: Petersen Health Operations, L.L.C
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 2-23-15  
Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210C), 300.1210D)6), 300.1220B)3), 300.1230B), 300.1230D), 300.1230D)2), 300.1230E), 300.1230F), 300.1230H), 300.1230I), 300.1230J01), 300.1230J)5), 300.1230K)1), 300.1230K)2), 300.1230K)3),300.1230K)4), 300.1230K)5)and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B), 300.1210D)6), 300.1230B)D)E)F)H)I)J)1)5)K)1)2)3)4)5) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Timbercreek Rehab & Health Care Center
FACILITY ADDRESS: 220 State St.
FACILITY CITY, STATE, ZIP: Pekin, IL 61554
DOCKET NUMBER: NH 15-C0163
LICENSEE INFO: Petersen Health Operations, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 3-5-15  
Type B violation for violating one or more sections: 300.610A, 300.1210D)6), 300.2210A), 300.2210B_2) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210D)6) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Kensington Place Nrsg & Rehab
FACILITY ADDRESS: 3405 S. Michigan Ave.
FACILITY CITY, STATE, ZIP: Chicago, IL 60616
DOCKET NUMBER: NH 15-S0173
LICENSEE INFO: Kensington Place Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 8170 McCormick Blvd., Suite 219
LICENSEE CITY, STATE, ZIP: Skokie, IL 60079
Survey Date – 3-20-15  
Type B violation for violating one or more sections: 300.610A), 300.1010H), 300.1210D)3), 300.1210D)6) and 300..3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210D)6) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Lena Living Center
FACILITY ADDRESS: 1010 S. Logan St.
FACILITY CITY, STATE, ZIP: Lena, IL 61048
DOCKET NUMBER: NH 15-S0165
LICENSEE INFO: Lena Living Center, L.L.C.
LICENSEE ADDRESS: One IBM Plaza, Suite 3000
LICENSEE CITY, STATE, ZIP: Chicago, IL 60611
Survey Date – 3-5-15  
Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210C), 300.1210D)5), 300.1220B)2) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.1210D)5) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Midwest Rehab & Respiratory
FACILITY ADDRESS: 727 N. 17th St.
FACILITY CITY, STATE, ZIP: Belleville, IL 62226
DOCKET NUMBER: NH 15-C0174
LICENSEE INFO: Midwest Rehabilitation & Respiratory Center, LLC
LICENSEE ADDRESS: 8170 McCormick Blvd, Suite 219
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 4-29-15  
Type AA violation for violating one or more sections: 300.610A), 300.1210B), 300.1210C), 300.1210D)6) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B),200.1210)6) and 300.3240A). For a total fine of $50,000.00
 
FACILITY NAME: Spring Valley Nursing
FACILITY ADDRESS: 1300 N. Greenwood St.
FACILITY CITY, STATE, ZIP: Spring Valley, IL 61362
DOCKET NUMBER: NH 15-C0166
LICENSEE INFO: Spring Valley Nursing Center – A Limited Partnership
LICENSEE ADDRESS: 1300 N Green St
LICENSEE CITY, STATE, ZIP: Spring Valley, IL 61362
Survey Date – 3-25-15  
Type AA violation for violating one or more sections: 300.610A), 300.1010H), 300.1210B) and 300.3240A. The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B and 300.3240A). For a total fine of $50,000.00
 
FACILITY NAME: Warren Barr North Shore
FACILITY ADDRESS: 2773 Skokie Valley Road
FACILITY CITY, STATE, ZIP: Highland Park, IL 60035
DOCKET NUMBER: NH 15-S0172
LICENSEE INFO: Warren Barr North Shore, LLC
LICENSEE ADDRESS: 7040 N Ridgeway Ave.
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 4-9-15  
Type C violation for violating one or more sections: 300.1210A), 3001210A)4) and 300.1210B)3).
 
FACILITY NAME: South Elgin Rehab & HCC
FACILITY ADDRESS: 746 West Spring St.
FACILITY CITY, STATE, ZIP: South Elgin, IL 60177
DOCKET NUMBER: NH 15-C0169
LICENSEE INFO: Petersen Health Properties, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 3-30-15  
Type B violation for violating one or more sections: 300.610A), 30031210B), 300.1220B)3), 300.3220F) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Wabash Christian Retirement
FACILITY ADDRESS: 216 College Boulevard
FACILITY CITY, STATE, ZIP: Carmi, IL 62821
DOCKET NUMBER: NH 15-C0175
LICENSEE INFO: Christian Homes Inc,
LICENSEE ADDRESS: 200 N. Postville Dr.
LICENSEE CITY, STATE, ZIP: Lincoln, IL 62656
Survey Date – 4-7-15  
Type B violation for violating one or more sections: 300.1210B), 300.1210D)6) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: The Villa at South Holland
FACILITY ADDRESS: 16300 Wausau St.
FACILITY CITY, STATE, ZIP: South Holland, IL 60473
DOCKET NUMBER: NH 15-C0176
LICENSEE INFO: The Villa At South Holland, LLC
LICENSEE ADDRESS: 191 N Wacker Dr, Suite 1800
LICENSEE CITY, STATE, ZIP: South Holland, IL 60473
Survey Date – 3-18-15  
Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210C), 300.1210D)6) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Concordia Village Care Center
FACILITY ADDRESS: 4101 West Iles Ave.
FACILITY CITY, STATE, ZIP: Springfield, IL 62711
DOCKET NUMBER: NH 15-C0170
LICENSEE INFO: Lutheran Senior Services
LICENSEE ADDRESS: 1150 Hanley Industrial Court
LICENSEE CITY, STATE, ZIP: St. Louis, MO 63144
Survey Date – 3-17-15  
Type A violation for violating one or more sections: 300.610A), 300.1010H), 300.1210D)6) and 300.3240A) . The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210D)6) and 300.3240A). For a total fine of $25,000.00
 
FACILITY NAME: Atrium Health Care Center
FACILITY ADDRESS: 1425 West Estes Ave.
FACILITY CITY, STATE, ZIP: Chicago, IL 60626
DOCKET NUMBER: NH 15-S0168
LICENSEE INFO: Atrium Health Care center, LTD
LICENSEE ADDRESS: 191 N. Wacker Dr., Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 3-26-15  
Type B violation for violating one or more sections: 300.610A), 300.1010H), 300.1210A), 300.1210B), 300.1210D)3), 300.1210D)5), 300.1220B)3) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B),300.1210D)5) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Gibson Community Hospital Annex
FACILITY ADDRESS: 430 E. 19th
FACILITY CITY, STATE, ZIP: Gibson City, IL 60936
DOCKET NUMBER: NH- 15-S0171
LICENSEE INFO: Gibson Area Hospital & Health Services
LICENSEE ADDRESS: 1120 N. Melvin St.
LICENSEE CITY, STATE, ZIP: Gibson City, IL 60936
Survey Date – 4-8-15  
Type B violation for violating one or more sections: 300.1210A)5), 300.615F) and 300.615). There was no fine.
 
FACILITY NAME: Meadowbrook Manor-Naperville
FACILITY ADDRESS: 720 Raymond Dr.
FACILITY CITY, STATE, ZIP: Naperville, IL 61108
DOCKET NUMBER: NH 13-S0546
LICENSEE INFO: Butterfield Health Care II, Inc
LICENSEE ADDRESS: 161 N. Clark St., Suite 4200
LICENSEE CITY, STATE, ZIP: Chicago, IL 60601
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Heritage Health-Carlinville
FACILITY ADDRESS: 1200 University Ave.
FACILITY CITY, STATE, ZIP: Carlinville, IL 62626
DOCKET NUMBER: NH 14-S0303
LICENSEE INFO: Heritage Manor-Carlinville, LLC
LICENSEE ADDRESS: 202 N. Center
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Tillers Nursing & Rehab Center
FACILITY ADDRESS: 4390 Route 71
FACILITY CITY, STATE, ZIP: Oswego, IL 60543
DOCKET NUMBER: NH 14-S-0397
LICENSEE INFO: Tillers Nursing and Rehabilitation Center, Inc.
LICENSEE ADDRESS: 4390 Route 71
LICENSEE CITY, STATE, ZIP: Oswego, IL 60543
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Rochelle Health Care Center
FACILITY ADDRESS: 900 N. 3rd St.
FACILITY CITY, STATE, ZIP: Rochelle, IL 61068
DOCKET NUMBER: NH 13-C0343
LICENSEE INFO: Petersen HealthCare, Inc.
LICENSEE ADDRESS: 830 West Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Gardenview Manor
FACILITY ADDRESS: 14792 Catlin- Tilton Road
FACILITY CITY, STATE, ZIP: Danville, IL 61834
DOCKET NUMBER: NH 15-S0177
LICENSEE INFO: Gardenview Manor, LLC
LICENSEE ADDRESS: 5750 Old Orchard Road, Suite 420
LICENSEE CITY, STATE, ZIP: Danville, IL 61834
Survey Date – 03-12-15  
Type B violation for violating one or more sections: 300.610A), 300.1210A), 300.1210D)6), 300.1220B)3) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210D)6) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Alton Rehab and Nursing Center
FACILITY ADDRESS: 3523 Wickenhauser
FACILITY CITY, STATE, ZIP: Alton, IL 62002
DOCKET NUMBER: NH 15-S0179
LICENSEE INFO: Alton Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 8170 McCormick Blvd, Suite 219
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 3-13-15  
Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210D)6) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Alden Trails
FACILITY ADDRESS: 273 Army Trail Road
FACILITY CITY, STATE, ZIP: Bloomingdale, IL 60108
DOCKET NUMBER: NH 15-C0180
LICENSEE INFO: Alden Trails, Inc.
LICENSEE ADDRESS: 4200 W Peterson Ave, Suite 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 4-3-15  
Type B violation for violating one or more sections: 350.620A), 350.1230D)1), 350.1230D)2), 350.11230D)3 and 350.3240A) . For a total fine of $550.00
 
FACILITY NAME: Iroquois Resident Home, The
FACILITY ADDRESS: 200 Fairman Ave.
FACILITY CITY, STATE, ZIP: Wateska, IL 60970
DOCKET NUMBER: NH 15-S0182
LICENSEE INFO: The Iroquois Memorial Hospital and Resident Home
LICENSEE ADDRESS: 200 Fairman Ave.
LICENSEE CITY, STATE, ZIP: Wateska, IL 60970
Survey Date – 4-15-15  
No fine given.
 
FACILITY NAME: Belmont Village Oak Park
FACILITY ADDRESS: 1035 Madison St.
FACILITY CITY, STATE, ZIP: Oak Park, IL 60302
DOCKET NUMBER: NH 15-S0183
LICENSEE INFO: Belmont Village Oak Park Leasing, L.L.C.
LICENSEE ADDRESS: 208 South LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 3-17-15  
No fine given.
 
FACILITY NAME: Bloomington Rehabilitation and HCC
FACILITY ADDRESS: 1925 S. Main St.
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701
DOCKET NUMBER: NH 15-C0185
LICENSEE INFO: Petersen Health Operations, L.L.C.
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 4-15-15  
Type C violation for violating one or more sections: 300.610A), 300.1010H), 300.1210B), 300.1210D)2), 300.1210D)5) and 300.3240A). No fine given.
 
FACILITY NAME: Glencrest Healthcr & Rehab Centre
FACILITY ADDRESS: 2451 W. Touhy Ave.
FACILITY CITY, STATE, ZIP: Chicago, Il 60645
DOCKET NUMBER: NH 15-C0181
LICENSEE INFO: Glencrest Healthcare and Rehabilitation Centre, LTD
LICENSEE ADDRESS: 191 N. Wacker Dr., Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 4-9-15  
Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210D)6)300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Heddington Oaks
FACILITY ADDRESS: 2223 W. Heading Ave.
FACILITY CITY, STATE, ZIP: Peoria, IL 61064
DOCKET NUMBER: NH 15-C0186
LICENSEE INFO: Peoria County Board
LICENSEE ADDRESS: 324 Main St., Room 502
LICENSEE CITY, STATE, ZIP: Peoria, IL 61602
Survey Date – 3-25-15  
Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210D)1), 300.1210D)2), 300.162A), 300.1620C), 300.3220F) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: St. Anthony's Nursing & Rehab Center
FACILITY ADDRESS: 767 30th St.
FACILITY CITY, STATE, ZIP: Rock Island, IL 61201
DOCKET NUMBER: NH 15-C0190
LICENSEE INFO: St. Anthony's Nursing and Rehabilitation Center L.L.C
LICENSEE ADDRESS: 330 N. Wabash, #1700
LICENSEE CITY, STATE, ZIP: Chicago, IL 60611
Survey Date – 4-1-15  
Type B violation for violating one or more sections: 300.610A), 300.1210D)6), 300.1220B), 300.3100J) and 300.3100K). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210D)6). For a total fine of $2,200.00
 
FACILITY NAME: Aledo Health Rehab & Health Care Center
FACILITY ADDRESS: 304 SW 12th St.
FACILITY CITY, STATE, ZIP: Aldo, IL 61231
DOCKET NUMBER: NH 15-S0194
LICENSEE INFO: Midwest Health Operations LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 4-9-15  
Type B violation for violating one or more sections: No fine given.
 
FACILITY NAME: Bement Health Care Center
FACILITY ADDRESS: 601 N. Morgan
FACILITY CITY, STATE, ZIP: Bement, IL 61813
DOCKET NUMBER: NH 15-S0195
LICENSEE INFO: Petersen Health Quality, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 4-16-15  
Type B violation for violating one or more sections: No fine given.
 
FACILITY NAME: Mason Point
FACILITY ADDRESS: One Masonic Way
FACILITY CITY, STATE, ZIP: Sullivan, IL 61951
DOCKET NUMBER: NH 15-S0196
LICENSEE INFO: Petersen Health Care VII, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 3-26-15  
Type B violation for violating one or more sections: No fine given.
 
FACILITY NAME: Arba Care Center of Colfax
FACILITY ADDRESS: 402 S. Harrison
FACILITY CITY, STATE, ZIP: Colfax, IL 61728
DOCKET NUMBER: NH 15-S0198
LICENSEE INFO: Arba Care center of Colfax, LLC
LICENSEE ADDRESS: 134 N. McLean Blvd
LICENSEE CITY, STATE, ZIP: Elgin, IL 60123
Survey Date – 4-29-15  
Type B violation for violating one or more sections: 300.670C), 300.670K)1), 300.670K)2) and 300.670K)3). No fine given.
 
FACILITY NAME: Symphony of Lincoln
FACILITY ADDRESS: 2202 N. Kickapoo St.
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656
DOCKET NUMBER: NH 15-C0199
LICENSEE INFO: Symphony Maple Ridge, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Dr.
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 3-19-15  
Type B violation for violating one or more sections: 300.1210B)1), 300.1210D)1), 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Rivershores Health & Rehab Center
FACILITY ADDRESS: 578 West Commercial St.
FACILITY CITY, STATE, ZIP: Marseilles, IL 60712
DOCKET NUMBER: NH 15-C0191
LICENSEE INFO: Rivershores Healthcare and Rehabilitation Center, LLC
LICENSEE ADDRESS: 4600 West Touhy Ave, Suite 200
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 4-13-15  
Type A violation for violating one or more sections: 300.1210B), 300.1210C), 300.1210D)6) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B),300.1210D)6) and 300.3240A). For a total fine of $25,000.00
 
FACILITY NAME: Carthage Terrace
FACILITY ADDRESS: 1205 N. Center St.
FACILITY CITY, STATE, ZIP: Carthage, IL 62321
DOCKET NUMBER: NH 15-C0200
LICENSEE INFO: Community Living Options, INC
LICENSEE ADDRESS: 285 S. Farnham St.
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 3-18-15  
Type B violation for violating one or more sections: 350.620A), 350.1210), 350.1230D)2) and 350.3240A). For a total fine of $550.00
 
FACILITY NAME: Estates of Hyde Park 
FACILITY ADDRESS: 4505 S. Drexel Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60653
DOCKET NUMBER: NH 15-S0201
LICENSEE INFO: The Estates of Hyde Park, LLC
LICENSEE ADDRESS: 4711 Golf Road Suite 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 4-15-15  
Type B violation for violating one or more sections: 300.3130) and 300.3130)C). No fine.
 
FACILITY NAME: Belhaven Nursing & Rehab Center
FACILITY ADDRESS: 11401 South Oakley Ave.
FACILITY CITY, STATE, ZIP: Chicago, IL 60643
DOCKET NUMBER: NH 15-S0202
LICENSEE INFO: Belhaven Nursing & Rehab Center
LICENSEE ADDRESS: 150 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 4-22-15  
Type B violation for violating one or more sections: 300.615) and 300.625). No fine.
 
FACILITY NAME: Manor Court of Princeton
FACILITY ADDRESS: 140 N. Sixth St.
FACILITY CITY, STATE, ZIP: Princeton, IL 61356
DOCKET NUMBER: NH 15-S0203
LICENSEE INFO: Residential Alternatives of Illinois, Inc.
LICENSEE ADDRESS: 285 S. Farnham St.
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 4-3-15  
Type B violation for violating one or more sections: 300.1210B), 300.1210D)6) and 300.1220B)3), 300.3240S). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.1210D)60 and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Midwest Rehab & Respiratory
FACILITY ADDRESS: 727 N. 17th St.
FACILITY CITY, STATE, ZIP: Belleville, IL 62226
DOCKET NUMBER: NH-15-C0189
LICENSEE INFO: Midwest Rehabilitation & Respiratory Center, LLC
LICENSEE ADDRESS: 8170 McCormick Blvd., Suite 219
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 3-26-15  
Type A violation for violating one or more sections: 300.610A), 300.1210B), 300.1620C) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B) and 300.3240A). For a total fine of $25,000.00
 
FACILITY NAME: Pleasant Meadows Senior Living
FACILITY ADDRESS: 400 West Washington
FACILITY CITY, STATE, ZIP: Chrisman, IL 61924
DOCKET NUMBER: NH 15-C0204
LICENSEE INFO: Pleasant Meadows Senior Living, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 4-8-15  
Type B violation for violating one or more sections: 300.610A), 300.1010H), 300.1210B), 300.1210D)3), 300.1210D)5), 300.1220B)2) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.1210D)5) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Arba Care Center of Bloomington
FACILITY ADDRESS: 1509 N Calhoun St.
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701
DOCKET NUMBER: NH 15-C0205
LICENSEE INFO: Arba Care Center of Bloomington, LLC
LICENSEE ADDRESS: 134 N McLean Blvd
LICENSEE CITY, STATE, ZIP: Elgin, IL 60123
Survey Date – 3-31-15  
Type B violation for violating one or more sections: 300.1210B), 300.1210D)1), 300.1620A) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B) and 300.3240A). For a total fine of $2,200.00
 
FACILITY NAME: Manorcare of Palos Heights East
FACILITY ADDRESS: 7850 W. College Dr.
FACILITY CITY, STATE, ZIP: Palos Heights, IL 60463
DOCKET NUMBER: NH 15-C0208
LICENSEE INFO: Manor Care of Palos Heights IL, LLC
LICENSEE ADDRESS: 208 S LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date -4-16-15  
Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210D)6), 300.1220B)3) and 300.3240A). No fine given
 
FACILITY NAME: Pleasant View Rehab & HCC
FACILITY ADDRESS: 500 N. Jackson St.
FACILITY CITY, STATE, ZIP: Morrison, IL 61270
DOCKET NUMBER: NH 15-S0211
LICENSEE INFO: Petersen Health Business, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 4-17-15  
Type 2-B violation for violating one or more sections: 300.610A), 300.1010H), 300.1210B), 300.1210D)3), 300.1210D)5),300.1210D)6), 300.1220B)3) and 300.3240A) . The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.1210D)5), and 300.3240A). For a total fine of $4,400.00
 
FACILITY NAME: Arden Courts of Palos Heights
FACILITY ADDRESS: 7880 W College Dr.
FACILITY CITY, STATE, ZIP: Palos Heights, IL 60463
DOCKET NUMBER: NH 15-S0214
LICENSEE INFO: Arden Courts of Palos Heights IL, LLC
LICENSEE ADDRESS: 208 S LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 4-29-15  
Type B violation for violating one or more sections: No fine given.
 
FACILITY NAME: Covenant Health Cr Center-Northbrook
FACILITY ADDRESS: 2155 Pfingsten Road
FACILITY CITY, STATE, ZIP: Northbrook, Il 60062
DOCKET NUMBER: NH 15-S0215
LICENSEE INFO: Covenant Health Care Center, Inc
LICENSEE ADDRESS: 2155 Pfingsten Road
LICENSEE CITY, STATE, ZIP: Northbrook, IL 60062
Survey Date – 4-23-15  
Type B violation for violating one or more sections: 300.3100D)2). No fine given.
 
FACILITY NAME: Danish Home, The
FACILITY ADDRESS: 5656 N. Newcastle Ave.
FACILITY CITY, STATE, ZIP: Chicago, IL 60631
DOCKET NUMBER: NH 15-C0218
LICENSEE INFO: The Society for the Danish Old Peoples' Home
LICENSEE ADDRESS: 5656 N. Newcastle Ave.
LICENSEE CITY, STATE, ZIP: Chicago, IL 60631
Survey Date – 3/27/15  
Type B violation for violating one or more sections: 300.610A), 300.1210A), 300.1210B), 300.1210D)6), 300.1220B)3) and 300.3240A). No fine given
 
FACILITY NAME: Hancock County Sheltered Care
FACILITY ADDRESS: 97 Main St., P.O. Box 157
FACILITY CITY, STATE, ZIP: Augusta, IL 62311
DOCKET NUMBER: NH 15-S0236
LICENSEE INFO: Hancock County Board
LICENSEE ADDRESS: Hancock County Courthouse
LICENSEE CITY, STATE, ZIP: Carthage, IL 62321
Survey Date – 5/7/15  
Type B violation for violating one or more sections: 330.785c)1)2)3)d), 330.11251)c)1)2), 330.1160a)b)c)d), 330.1530a)b)c), and 330.2000. No fine given.
 
FACILITY NAME: Alden Terrace of McHenry Rehab
FACILITY ADDRESS: 803 Royal Dr.
FACILITY CITY, STATE, ZIP: McHenry, IL 60050
DOCKET NUMBER: NH 15-S0247
LICENSEE INFO: Alden Terrace of McHenry Rehab and HCC, Inc
LICENSEE ADDRESS: 4200 W. Petersen Ave., Suite 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 4/23/15  
Type B violation for violating one or more sections: 300.615e). No fine given.
 
FACILITY NAME: Brookdale Hoffman Estates
FACILITY ADDRESS: 2150 West Golf Road
FACILITY CITY, STATE, ZIP: Hoffman Estates, IL 60169
DOCKET NUMBER: NH 15-S0237
LICENSEE INFO: S-H OPCO Hoffman Estates, LLC
LICENSEE ADDRESS: 208 S. LaSalle St, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 5/21/15  
Type B violation for violating one or more sections: 330.790a)b)c)1)2)3)4), 330.710A)B)C), and 330.1520a). No fine given.
 
FACILITY NAME: Westminster Place
FACILITY ADDRESS: 3200 Grant St.
FACILITY CITY, STATE, ZIP: Evanston, IL 60201
DOCKET NUMBER: NH 15-S0226
LICENSEE INFO: Presbyterian Homes
LICENSEE ADDRESS: 3200 Grant St.
LICENSEE CITY, STATE, ZIP: Evanston, IL 60201
Survey Date – 4/14/15  
Type B violation for violating one or more sections: 300.1620a). No fine given.
 
FACILITY NAME: Alden Village Health Facility
FACILITY ADDRESS: 267 East Lake St.
FACILITY CITY, STATE, ZIP: Bloomingdale, IL 60108
DOCKET NUMBER: NH 15-S0227
LICENSEE INFO: Alden Village Health Facility for Children/Young Adults
LICENSEE ADDRESS: 4200 W. Petersen Ave., Suite 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 4/3/15  
Type B violation for violating one or more sections: 350.620a), 350.1210, 350.1230d)2), and 350.3240a). No fine given.
 
FACILITY NAME: Palm Terrace of Mattoon
FACILITY ADDRESS: 1000 Palm Ave
FACILITY CITY, STATE, ZIP: Mattoon, IL 61938
DOCKET NUMBER: NH 15-C0213
LICENSEE INFO: Petersen Management Company, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 4/15/15  
Type B violation for violating one or more sections: 300.1210b), 300.1210d)2), 300.1210d)3), 300.1220b)2), 300.1220b)3), 300.1220b)7), and 300.3240a).. The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a).. For a total fine of $2,200.
 
FACILITY NAME: Arden Courts of Hazel Crest
FACILITY ADDRESS: 3701 West 183rd St.
FACILITY CITY, STATE, ZIP: Hazel Crest, IL 60429
DOCKET NUMBER: NH 15-C0228
LICENSEE INFO: Arden Courts of Hazel Crest IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 5/12/15  
Type B violation for violating one or more sections: 330.710a). No Fine Given.
 
FACILITY NAME: Arba Care of Toluca
FACILITY ADDRESS: 101 East Via Ghiglieri
FACILITY CITY, STATE, ZIP: Toluca, IL 61369
DOCKET NUMBER: NH 15-S0223
LICENSEE INFO: Arba Care Center of Toluca, LLC
LICENSEE ADDRESS: 134 N. McLean Blvd.
LICENSEE CITY, STATE, ZIP: Elgin, IL 60123
Survey Date – 4/30/15  
Type B violation for violating one or more sections: 300.4060a). No fine given.
 
FACILITY NAME: Renaissance Care Center
FACILITY ADDRESS: 1675 east Ash St.
FACILITY CITY, STATE, ZIP: Canton, IL 61520
DOCKET NUMBER: NH 15-C0224
LICENSEE INFO: Renaissance Care Center, Inc.
LICENSEE ADDRESS: 5750 Old Orchard Rd, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 4/21/15  
Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210c), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.
 
FACILITY NAME: Regency Rehab Center
FACILITY ADDRESS: 6631 Milwaukee Ave.
FACILITY CITY, STATE, ZIP: Niles, IL 60714
DOCKET NUMBER: NH 15-S0231
LICENSEE INFO: Regency Rehab Center, LLC
LICENSEE ADDRESS: 6840 N. Lincoln Ave.
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 4-15-15  
Type B violation for violating one or more sections: 300.1610a)1), 300.1620a), 300.1630C, 300.1640a)1)2), 300.2040b)e)f), 300.2070b), 300.2100, 750.120a), 750.151a), 75054a)1), 750820e)2), and 750830h)3)
 
FACILITY NAME: Colonial Manor
FACILITY ADDRESS: 620 Warrington Ave.
FACILITY CITY, STATE, ZIP: Danville, IL 61832
DOCKET NUMBER: NH 15-S0233
LICENSEE INFO: Heritage Manor- Danville, LLC
LICENSEE ADDRESS: 202 N. Center St
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 4/2/15  
Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b)5), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.
 
FACILITY NAME: Flora Gardens Care Center
FACILITY ADDRESS: 701 Shadwell Ave.
FACILITY CITY, STATE, ZIP: Flora, IL 62839
DOCKET NUMBER: NH 15-C0219
LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 4/22/15  
Type B violation for violating one or more sections: 300.610a), 300.690a), 300.1210b), 300.3240a), 300.3240d), and 300.3240e). . The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.690a), 300.1210b), 300.3240a), 300.3240d), and 300.3240e). For a total fine of $2,200.
 
FACILITY NAME: Jerseyville Manor
FACILITY ADDRESS: 1251 N. State St.
FACILITY CITY, STATE, ZIP: Jerseyville, IL 62052
DOCKET NUMBER: NH 15-S0232
LICENSEE INFO: UDI #11, LLC
LICENSEE ADDRESS: 285 S. Farnham St.
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 4/17/15  
Type B violation for violating one or more sections: 300.1210b)1)
 
FACILITY NAME: H & S Care Center
FACILITY ADDRESS: 310 Third St., P.O. Box 376
FACILITY CITY, STATE, ZIP: Tamms, IL 62988
DOCKET NUMBER: NH 15-C0234
LICENSEE INFO: Tweedy Inc.
LICENSEE ADDRESS: 101 W Market St, PO Box I
LICENSEE CITY, STATE, ZIP: Jonesboro, IL 62952
Survey Date – 5-5-15  
Type A violation for violating one or more sections: 330.720e)3), 300.1110d), 330.1710f), and 330.4240f). For a total fine of $12,500.
 
FACILITY NAME: Arden Courts of Hazel Crest
FACILITY ADDRESS: 3701 West 183rd St.
FACILITY CITY, STATE, ZIP: Hazel Crest, IL 60429
DOCKET NUMBER: NH 15-C0228
LICENSEE INFO: Arden Courts of Hazel Crest IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 5-12-15  
Type C violation for violating one or more sections: 330.710a)
 
FACILITY NAME: Hancock County Sheltered Care
FACILITY ADDRESS: 97 Main St., PO Box 157
FACILITY CITY, STATE, ZIP: Augusta, IL 62311
DOCKET NUMBER: NH 15-S0236
LICENSEE INFO: Hancock County Board
LICENSEE ADDRESS: Hancock County Courthouse
LICENSEE CITY, STATE, ZIP:  
Survey Date – 5-7-15  
Type B violation for violating one or more sections: 330.785, 330.1160, 330.1530, 330.2000
 
FACILITY NAME: Brookdale Hoffman Estates
FACILITY ADDRESS: 2150 West Golf Road
FACILITY CITY, STATE, ZIP: Hoffman Estates, IL 60194
DOCKET NUMBER: NH 15-S0237
LICENSEE INFO: S-H OPCO Hoffman Estates, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Suite. 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 5-21-15  
Type B violation for violating one or more sections: 330.792, 330.710, 330.1520
 
FACILITY NAME: Sunnymere
FACILITY ADDRESS: 925 Sixth Ave.
FACILITY CITY, STATE, ZIP: Aurora, IL 60505
DOCKET NUMBER: NH 15-S0238
LICENSEE INFO: Sunnymere
LICENSEE ADDRESS: 407 W. Galena, PO Box 1625
LICENSEE CITY, STATE, ZIP: Aurora, IL 60507
Survey Date – 4-30-15  
Type B violation for violating one or more sections: 330.710a), 330.790a) b) c), 330.1155, 330.1530,
 
FACILITY NAME: Ottawa Pavilion
FACILITY ADDRESS: 800 East Center St.
FACILITY CITY, STATE, ZIP: Ottawa, IL 61350
DOCKET NUMBER: NH 15-C0239
LICENSEE INFO: Ottawa Pavilion, LTD.
LICENSEE ADDRESS: 191 N. Wacker Dr., Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60636
Survey Date – 4-23-15  
Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.3240a), 300.1210, 300.1210, 300.3240, The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) 300.1210d)6) and300.3240a), for a total fine of $2.200.
 
FACILITY NAME: Moorings Health Center, The
FACILITY ADDRESS: 761 Old Barn Lane
FACILITY CITY, STATE, ZIP: Arlington Heights, IL 60005
DOCKET NUMBER: NH 15-S0241
LICENSEE INFO: Presbyterian Homes
LICENSEE ADDRESS: 3200 Grant St.
LICENSEE CITY, STATE, ZIP: Evanston, IL 60201
Survey Date – 5-14-15  
Type B violation for violating one or more sections: 300.696a)c)2, 300.1210b)4)d)4), 300.7060a),
 
FACILITY NAME: Jacksonville Skilled Nursing & Rehab
FACILITY ADDRESS: 1517 West Walnut St.
FACILITY CITY, STATE, ZIP: Jacksonville, IL 62650
DOCKET NUMBER: NH 15-S0243
LICENSEE INFO: Covenant Care Jacksonville, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 4-24-15  
Type B violation for violating one or more sections: 300.610a), 300.1210b), 3001210d)5), 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). For a total fine of $2,200
 
FACILITY NAME: Carlinville Rehab & HCC
FACILITY ADDRESS: 751 N. Oak St.
FACILITY CITY, STATE, ZIP: Carlinville, IL 62626
DOCKET NUMBER: NH 15-C0244
LICENSEE INFO: Carlinville Rehabilitation and Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 4-26-15  
Type B violation for violating one or more sections: 300.610a), 300.1210b), 3001210d)6), 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). For a total fine of $2,200
 
FACILITY NAME: Alden Terrace of McHenry Rehab
FACILITY ADDRESS: 803 Royal Dr.
FACILITY CITY, STATE, ZIP: McHenry, IL 60050
DOCKET NUMBER: NH 15-S0247
LICENSEE INFO: Alden Terrace of McHenry Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave., Suite 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 4-23-15  
Type B violation for violating one or more sections: 300.615e),300.7000,
 
FACILITY NAME: Piper City Rehab & Living Center
FACILITY ADDRESS: 600 Maple St.
FACILITY CITY, STATE, ZIP: Piper City, IL 60959
DOCKET NUMBER: NH 15-C0245
LICENSEE INFO: Midwest Health Operations, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 4-23-15  
Type B violation for violating one or more sections: 300.1210a), 300.1210b)5), 300.1210d)6), 300.3240a), the fine was doubled in the instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b)5), 300.1210d)6), and 300.3240a). For a total fine of $2,200.
 
FACILITY NAME: Heartland of Moline
FACILITY ADDRESS: 833 Sixteenth Ave.
FACILITY CITY, STATE, ZIP: Moline, IL 61265
DOCKET NUMBER: NH 15-C0240
LICENSEE INFO: Heartland of Moline IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 4-18-15  
Type B violation for violating one or more sections: 300.1010h), 300.1210b), 300.1210d)5), 300.3240a), The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $2,200
 
FACILITY NAME: Capitol Healthcare and Rehab Center
FACILITY ADDRESS: 555 West Carpenter
FACILITY CITY, STATE, ZIP: Springfield, IL 62702
DOCKET NUMBER: NH 15-C0246
LICENSEE INFO: Capitol Healthcare and Rehabilitation Center, LLC
LICENSEE ADDRESS: 4600 West Touhy Ave, Suite 200
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 4-20-15  
Type B violation for violating one or more sections: 300.610a), 300.696a), 300.1010h), 300.1210b), 300.1210d)2)3)5), 300.3240a), the fine was doubled in this instance in accordance with 300.282i) and j), of the code due to the violations of the sections of the code with a high risk designation: 300.696a), 300.1210b), and 300.3240a). For a total fine of $2,200
 
FACILITY NAME: Arcola Health Care Center
FACILITY ADDRESS: 422 E. Fourth St., P.O. Box 70
FACILITY CITY, STATE, ZIP: Arcola, IL 61910
DOCKET NUMBER: NH 15-S0249
LICENSEE INFO: Petersen Health Care, Inc.
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 5-28-15  
Type B violation for violating one or more sections: 300.615, 300.1230b), 300.1230d)1)2), 300.1230j)5), 300.1230k), 300.1650a), 300.1650b), 300.1650c)
 
FACILITY NAME: Terrace Nursing Home, The
FACILITY ADDRESS: 1615 Sunset Ave.
FACILITY CITY, STATE, ZIP: Waukegan, IL 60087
DOCKET NUMBER: NH 15-S0252
LICENSEE INFO: TN Care, LLC
LICENSEE ADDRESS: 1S443 Summitt Ave., Suite 204
LICENSEE CITY, STATE, ZIP: Oakbrook Terrace, IL 60181
Survey Date – 4-9-15  
Type B violation for violating one or more sections: 300.615e)
 
FACILITY NAME: Lexington of Wheeling
FACILITY ADDRESS: 730 West Hintz Road
FACILITY CITY, STATE, ZIP: Wheeling, IL 60090
DOCKET NUMBER: NH 15-C0253
LICENSEE INFO: Lexington Health Care Center of Wheeling, Inc.
LICENSEE ADDRESS: 665 W. North Ave.
LICENSEE CITY, STATE, ZIP: Lombard, IL 60148
Survey Date – 5-8-2015  
Type B violation for violating one or more sections: 300.1010h), 3001210b), 300.1210d)5), 300.3240a), the fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). For a total fine of $2,200.
 
FACILITY NAME: Heritage Health-Robinson
FACILITY ADDRESS: 600 East Robinwood Dr.
FACILITY CITY, STATE, ZIP: Robinson, IL 62454
DOCKET NUMBER: NH 15-C0251
LICENSEE INFO: Heritage Manor – Robinson, LLC
LICENSEE ADDRESS: 202 N. Center St.
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 5-5-2015  
Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210c), 300.1210d)6), 300.3240a), the fine was doubled in this instance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). For a total fine of $2,200.
 
FACILITY NAME: Meadowbrook Manor - LaGrange
FACILITY ADDRESS: 339 9th Ave.
FACILITY CITY, STATE, ZIP: LaGrange, IL 60525
DOCKET NUMBER: NH 15-S0248
LICENSEE INFO: Butterfield Health Care VII, L.L.C.
LICENSEE ADDRESS: 161 N. Clark St., Suite 4200
LICENSEE CITY, STATE, ZIP: Chicago, IL 60601
Survey Date – 5-14-2015  
Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)6), 300.3240a), the fine was doubled in the instance in accordance with 300.282i) and j) of the Code due to the violation of sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). For a total fine of $2,200.
 
FACILITY NAME: Our Lady of Angels Retirement Home
FACILITY ADDRESS: 1201 Wyoming Ave.
FACILITY CITY, STATE, ZIP: Joliet, IL 60435
DOCKET NUMBER: NH 15-C0250
LICENSEE INFO: Our Lady of Angels Retirement Home
LICENSEE ADDRESS: 2601 Black Road, 2nd Floor
LICENSEE CITY, STATE, ZIP: Joliet, IL 60435
Survey Date – 5-8-2015  
Type A violation for violating one or more sections: 300.610a), 300.1010i), 300.1210a), 300.1210b)5), 300.1210d)6), 300.1220b)3), 300.3240a), the was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b)5), 300.1210d)6) and 300.3240a). For a total fine of
 
FACILITY NAME: Pavilion of Waukegan
FACILITY ADDRESS: 2217 Washington St.
FACILITY CITY, STATE, ZIP: Waukegan, IL 60085
DOCKET NUMBER: NH 15-S0255
LICENSEE INFO: Pavilion of Waukegan, LLC
LICENSEE ADDRESS: 5750 Old Orchard Road, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 5-21-2015  
Type B violation for violating one or more sections: 300.615e), 300.3060a)4, 300.2010, 300.2100
 
FACILITY NAME: Eastern Star Home
FACILITY ADDRESS: 9890 Star Lane, P.O. Box 317
FACILITY CITY, STATE, ZIP: Macon, IL 62544
DOCKET NUMBER: NH 15-S0256
LICENSEE INFO: Grand Chapter Order of the Eastern Star of the State of
LICENSEE ADDRESS: 9894 Star Lane, PO Box 317
LICENSEE CITY, STATE, ZIP: Macon, IL 62544
Survey Date – 6-2-2015  
Type B violation for violating one or more sections: 300.1210d)6)
 
FACILITY NAME: DuPage Convalescent Center
FACILITY ADDRESS: 400 N. County Farm Road, P.O. Box 708
FACILITY CITY, STATE, ZIP: Wheaton, IL 60187
DOCKET NUMBER: NH 15-C0265
LICENSEE INFO: DuPage County Board of Supervisors
LICENSEE ADDRESS: 421 County Farm Road
LICENSEE CITY, STATE, ZIP: Wheaton, IL 60187
Survey Date – 4-27-2015  
Type B violation for violating one or more sections: 300.690, 300.1030.
 
FACILITY NAME: Heritage Health-Dwight
FACILITY ADDRESS: 300 East Mazon Ave.
FACILITY CITY, STATE, ZIP: Dwight, IL 60420
DOCKET NUMBER: NH 15-S0266
LICENSEE INFO: Heritage Manor – Dwight, LLC
LICENSEE ADDRESS: 115 West Jefferson, Suite 4004
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 5-21-2015  
Type B violation for violating one or more sections: 300.615, 300.615e), 300.615f).
 
FACILITY NAME: Manor Court of Peru
FACILITY ADDRESS: 3230 Becker Dr.
FACILITY CITY, STATE, ZIP: Peru, IL 61354
DOCKET NUMBER: NH 15-S0254
LICENSEE INFO: Residential Alternatives of Illinois, Inc.
LICENSEE ADDRESS: 285 S. Farnham St.
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 5-14-2015  
Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.2040b), 300.2040e), 300.2040g), 300.3240a), The fine was doubled in this instance in accordance with 300.282i), and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a), for a total fine of $2,200.
 
FACILITY NAME: Sharon Health Care Elms
FACILITY ADDRESS: 3611 North Rochelle
FACILITY CITY, STATE, ZIP: Peoria, IL 61604
DOCKET NUMBER: NH 15-C0259
LICENSEE INFO: Sharon Health Care Elms, Inc.
LICENSEE ADDRESS: 4654 Central Ave., Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 5-19-2015  
Type B violation for violating one or more sections: 300.610a), 300.1010h), 3001210b), 300.1210d)6), 300.3240a), The fine was doubled in two separate instances in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a), for a total fine of $4,400.
 
FACILITY NAME: Alden Alma Nelson Manor
FACILITY ADDRESS: 550 South Mulford Ave.
FACILITY CITY, STATE, ZIP: Rockford, IL 61108
DOCKET NUMBER: NH 15-C0264
LICENSEE INFO: Alden – Alma Nelson Manor
LICENSEE ADDRESS: 550 South Mulford Ave.
LICENSEE CITY, STATE, ZIP: Rockford, IL 61108
Survey Date – 5-5-2015  
Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)3), 300.1210d)5), 300.1210d)6), 300.3240a), The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the section of the Code with a high risk designation: 300.121b), 300.1210d)5), 300.1210d)6) and 300.3240a), for a total fine of $2,200.
 
FACILITY NAME: Imperial Grove Pavilion, The
FACILITY ADDRESS: 1366 West Fullerton Ave.
FACILITY CITY, STATE, ZIP: Chicago, Il 60614
DOCKET NUMBER: NH 15-S0267
  15-C0268
LICENSEE INFO: Claridge Imperial LTD
LICENSEE ADDRESS: 191 North Wacker Dr, Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 5-6-2015  
Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the section of the Code with high risk designation: 300.1210b), and 300.1210d)6), for a total fine of $2,200.
 
FACILITY NAME: Lutheran Home, The
FACILITY ADDRESS: 6901 N. Galena Road
FACILITY CITY, STATE, ZIP: Peoria, IL 61614
DOCKET NUMBER: NH 15-C0269
LICENSEE INFO: Lutheran Hillside Village
LICENSEE ADDRESS: 6901 N. Galena Road
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 5-20-2015  
Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.3240a), the fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a), for a total fine of $2,200.
 
FACILITY NAME: Jerseyville Nursing & Rehab Center
FACILITY ADDRESS: 1001 S. State St.
FACILITY CITY, STATE, ZIP: Jerseyville, IL 62052
DOCKET NUMBER: NH 15-S0270
LICENSEE INFO: Helia Healthcare of Jerseyville, LLC
LICENSEE ADDRESS: 600 South Second St.
LICENSEE CITY, STATE, ZIP: Springfield, IL 62701
Survey Date – 6-4-2015  
Administrative Warning for violating one or more sections: 300.2930
 
FACILITY NAME: Helia Healthcare of Benton
FACILITY ADDRESS: 1310 Mark Franklin Louis St.
FACILITY CITY, STATE, ZIP: Benton, IL 62812
DOCKET NUMBER: NH 15-S0271
LICENSEE INFO: Helia Healthcare of Benton, LLC
LICENSEE ADDRESS: 600 South Second St., Suite 103
LICENSEE CITY, STATE, ZIP: Springfield, IL 62812
Survey Date – 5-29-2015  
Type B violation for violating one or more sections: 300.615e), 300.1230a)1)2)3), 300.1230b)5)
 
FACILITY NAME: ManorCare of South Holland
FACILITY ADDRESS: 2145 East 170th St.
FACILITY CITY, STATE, ZIP: South Holland, IL 60473
DOCKET NUMBER: NH 15-S0274
LICENSEE INFO: ManorCare of South Holland IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 5-14-2015  
Type B violation for violating one or more sections: 300.610a), 300.1210a)b), 300.1210d)6, 300.3240a), the fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the section of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a), for a total fine of $2,200.00.
 
FACILITY NAME: Heartland of Canton
FACILITY ADDRESS: 2081 N. Main St.
FACILITY CITY, STATE, ZIP: Canton, IL 61520
DOCKET NUMBER: NH 15-C0272
LICENSEE INFO: Heartland of Canton IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 6-3-2015  
Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)6), 300.3240a), the fine was doubled in this instance in accordance with 300.282i) and j) of the Code to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a), for a total fine of $2,200.00.
 
FACILITY NAME: Centralia Manor
FACILITY ADDRESS: 1910 East McCord St., Route 161 East
FACILITY CITY, STATE, ZIP: Centralia, IL 62801
DOCKET NUMBER: NH 15-C0130
LICENSEE INFO: UDI #8, L.C.C.
LICENSEE ADDRESS: 285 S. Farnham St.
LICENSEE CITY, STATE, ZIP: Galesburg, Illinois 61401
Survey Date – 2-23-2015  
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Highland Health Care Center
FACILITY ADDRESS: 1450 26th St.
FACILITY CITY, STATE, ZIP: Highland, IL 62249
DOCKET NUMBER: NH 14-S0524
LICENSEE INFO: Covenant Care Midwest, Inc.
LICENSEE ADDRESS: 208 South LaSalle, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11-5-2014  
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Brother James Court
FACILITY ADDRESS: 2508 St. James Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62707
DOCKET NUMBER: NH 14-S0412
LICENSEE INFO: Brother James Court
LICENSEE ADDRESS: 1214 S 8th St.
LICENSEE CITY, STATE, ZIP: Springfield, Illinois 62703
Survey Date – 8-21-2014  
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Chester Rehab & Nursing Center
FACILITY ADDRESS: 770 State St.
FACILITY CITY, STATE, ZIP: Chester, IL 62233
DOCKET NUMBER: NH 15-C0278
LICENSEE INFO: Chester Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 8170 N. McCormick Blvd, Suite 219
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 5-6-2015  
Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.3240a), the fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a), for a total fine of $2,200
 
FACILITY NAME: Rochelle Rehab & Health Care Center
FACILITY ADDRESS: 900 N. 3rd St.
FACILITY CITY, STATE, ZIP: Rochelle, IL 61068
DOCKET NUMBER: NH 15-S0276
LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 6-3-2015  
Type B violation for violating one or more sections: 300.510a), 300.615b)e)f), 300.1210b)1)2)3)4)5).
 
FACILITY NAME: A Merkle C Knipprath Nursing Home
FACILITY ADDRESS: 1190 E 2900 North Road
FACILITY CITY, STATE, ZIP: Clifton, IL 60927
DOCKET NUMBER: NH 15-S0279
LICENSEE INFO: Arther Merkle – Clara Knipprath Nursing Home
LICENSEE ADDRESS: 9223 West Saint Francis Road
LICENSEE CITY, STATE, ZIP: Frankfurt, IL 60423
Survey Date – 5-8-2015  
Type B violation for violating one or more sections: 300.670k1)2)3), 300.2620d).
 
FACILITY NAME: Arden Courts of Hazel Crest
FACILITY ADDRESS: 3701 West 183rd St.
FACILITY CITY, STATE, ZIP: Hazel Crest, IL 60429
DOCKET NUMBER: NH 14-S0473
NH 14-C0474
LICENSEE INFO: Arden Courts of Hazel Crest IL, LLC
LICENSEE ADDRESS: 208 South LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10-23-2014  
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Waterfront Terrace
FACILITY ADDRESS: 7750 South Shore Dr.
FACILITY CITY, STATE, ZIP: Chicago, IL 60649
DOCKET NUMBER: NH 15-C-0037
LICENSEE INFO: Waterfront Terrace, Inc.
LICENSEE ADDRESS: 191 N. Wacker Dr., Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 12-17-2014  
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Sandwich Rehabilitation & HCC
FACILITY ADDRESS: 902 E. Arnold St.
FACILITY CITY, STATE, ZIP: Sandwich, IL 60548
DOCKET NUMBER: NH 14-C-0326
LICENSEE INFO: Peterson Health Operations, LLC
LICENSEE ADDRESS: 830 West Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 7-9-2014  
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Alden Town Manor Rehab & HCC
FACILITY ADDRESS: 6120 West Ogden
FACILITY CITY, STATE, ZIP: Cicero, IL 60804
DOCKET NUMBER: NH 15-C-0011
LICENSEE INFO: Alden – Town Manor Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave., Suite 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 12-12-2014  
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Neighbors Rehabilitation Center
FACILITY ADDRESS: 811 West 2nd St.
FACILITY CITY, STATE, ZIP: Byron, IL 61010
DOCKET NUMBER: NH 14-C162
LICENSEE INFO: Neighbors Rehabilitation Center, LLC
LICENSEE ADDRESS: 6840 N Lincoln Ave.
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 2-26-2014  
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Villa Health Care East
FACILITY ADDRESS: 100 Marian Parkway, PO Box 109
FACILITY CITY, STATE, ZIP: Sherman, IL 62684
DOCKET NUMBER: NH 14-S0322
LICENSEE INFO: Villa Health Care, Inc.
LICENSEE ADDRESS: 313 Saratoga Chase
LICENSEE CITY, STATE, ZIP: Sherman, IL 62684
Survey Date – 7-11-2014  
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Arden Courts of Northbrook
FACILITY ADDRESS: 3240 Milwaukee Ave.
FACILITY CITY, STATE, ZIP: Northbrook, IL 60062
DOCKET NUMBER: NH 14-S0429
LICENSEE INFO: Arden Courts of Northbrook IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 8-27-14  
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Alden Alma Nelson Manor
FACILITY ADDRESS: 550 South Mulford Ave.
FACILITY CITY, STATE, ZIP: Rockford, IL 61108
DOCKET NUMBER: NH 14-C0231
LICENSEE INFO: Alden-Alma Nelson Manor, Inc
LICENSEE ADDRESS: 4200 West Peterson
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 5-12-14  
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.
 
FACILITY NAME: Capitol Healthcare and Rehab Center
FACILITY ADDRESS: 555 West Carpenter
FACILITY CITY, STATE, ZIP: Springfield, IL 62702
DOCKET NUMBER: 15-C0246
LICENSEE INFO: Capitol Healthcare and Rehab Center, LLC
LICENSEE ADDRESS: 4600 West Touhy Ave, Suite 200
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 4-20-15  
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.1010h), 300.1210b), 300.1210d)2)3)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.696a), 300.1210b) and 300.3240a).
 
FACILITY NAME: Cahokia Nursing & Rehab Center
FACILITY ADDRESS: 2 Annabelle Court
FACILITY CITY, STATE, ZIP: Cahokia, IL 62206
DOCKET NUMBER: 15-C0277
LICENSEE INFO: Cahokia Nursing & Rehabilitation Center, Inc
LICENSEE ADDRESS: 7434 N. Skokie Boulevard
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 5-6-15  
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.1010h), 300.1210b), 300.1210d)2)3)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.696a), 300.1210b) and 300.3240a).
 
FACILITY NAME: Meadows Mennonite Home
FACILITY ADDRESS: 24588 Church St.
FACILITY CITY, STATE, ZIP: Chenoa, IL 61726
DOCKET NUMBER: 15-C0132
LICENSEE INFO: Meadows Mennonite Retirement Community Association, Inc.
LICENSEE ADDRESS: 24588 Church St.
LICENSEE CITY, STATE, ZIP: Chenoa, IL 61726
Survey Date – 3-17-15  
Type B violation of an occurrence for violating one or more of the following sections of the Code:300.690b, 300.690c).