4th Quarter Report October-December 2018

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 Services, 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: Admiral at the Lake, The
FACILITY ADDRESS: 933 West Foster Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 18-C0479

LICENSEE INFO: The Admiral at the Lake
LICENSEE ADDRESS: 933 West Foster Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60640
Survey Date – 10/11/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b) and 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 sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Alden Terrace of McHenry Rehab
FACILITY ADDRESS: 803 Royal Drive
FACILITY CITY, STATE, ZIP: McHenry, IL 60050

DOCKET NUMBER: NH 18-C0512

LICENSEE INFO: Alden Terrace of McHenry Rehabilitation and Health Care Ctr. Inc.
LICENSEE ADDRESS: 4200 W. Peterson Avenue, Suite 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 10/15/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.3210a), 300.3210o), 300.3240a), 300.3300j) and 300.3300k) . 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: 300.3240a). A fine of $25,000.00

FACILITY NAME: Alden Town Manor Rehab & HCC
FACILITY ADDRESS: 6120 West Ogden
FACILITY CITY, STATE, ZIP: Cicero, IL 60804

DOCKET NUMBER: NH 18-C0423

LICENSEE INFO: Alden Town Manor Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Avenue, Suite 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 08/02/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), 300.1210c), and 300.1210d)3). 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). A fine of $2,200.00

Total fine of $27,200.00

FACILITY NAME: Alhambra Care Center
FACILITY ADDRESS: 417 East Main Street, Box 310
FACILITY CITY, STATE, ZIP: Alhambra, IL 62001

DOCKET NUMBER: NH 18-S0499

LICENSEE INFO: Alhambra Care Center, Inc.
LICENSEE ADDRESS: 11501 Brother Lane, P.O. Box 41
LICENSEE CITY, STATE, ZIP: Highland, IL 62249
Survey Date – 10/10/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Alpine Fireside Health Center
FACILITY ADDRESS: 3650 North Alpine Road
FACILITY CITY, STATE, ZIP: Rockford, IL 61114

DOCKET NUMBER: NH 18-C0492

LICENSEE INFO: Alpine Fireside Health Center, LTD
LICENSEE ADDRESS: 3650 N. Alpine Road
LICENSEE CITY, STATE, ZIP: Rockford, IL 61114
Survey Date – 10/18/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 330.1110a) and 330.4220f). A fine of $12,500.00

FACILITY NAME: Aperion Care of Bloomington
FACILITY ADDRESS: 1509 Calhoun Street
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701

DOCKET NUMBER: NH 18-S0491

LICENSEE INFO: Aperion Care Bloomington, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/01/2018

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b) and 300.3240a). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $500.00

FACILITY NAME: Aperion Care Capitol
FACILITY ADDRESS: 555 West Carpenter Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 18-C0110

LICENSEE INFO: Aperion Care Capitol, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 03/07/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Aperion Care Capitol
FACILITY ADDRESS: 555 West Carpenter Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 18-C0200 & NH 18-C0201

LICENSEE INFO: Aperion Care Capitol, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 04/20/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Aperion Care Capitol
FACILITY ADDRESS: 555 West Carpenter Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 18-C0424

LICENSEE INFO: Aperion Care Capitol, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/08/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)2), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Aperion Care Capitol
FACILITY ADDRESS: 555 West Carpenter Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 18-C0468

LICENSEE INFO: Aperion Care Capitol, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/25/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Aperion Care Capitol
FACILITY ADDRESS: 555 West Carpenter Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 18-C0505

LICENSEE INFO: Aperion Care Capitol, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/30/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)1), 300.1210b), 300.1210d)2)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 sections of the Code with a high risk designation: 300.1210b), 300.696 and 300.3240a). A fine of $2,200.00

Total fine of $4,400.00

FACILITY NAME: Aperion Care Galesburg
FACILITY ADDRESS: 1145 Frank Street
FACILITY CITY, STATE, ZIP: Galesburg, IL 61401

DOCKET NUMBER: NH 18-C0314

LICENSEE INFO: River Crossing Rehab, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 06/14/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Aperion Care Mascoutah
FACILITY ADDRESS: 901 North Tenth Street
FACILITY CITY, STATE, ZIP: Mascoutah, IL 62258

DOCKET NUMBER: NH 18-C0394

LICENSEE INFO: Aperion Care Mascoutah, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/04/2018

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.1230k) and 300.1230l)1) This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.1230). A fine of $500.00

FACILITY NAME: Aperion Care Morton Terrace
FACILITY ADDRESS: 191 East Queenwood Road
FACILITY CITY, STATE, ZIP: Morton, IL 61550

DOCKET NUMBER: NH 18-C0389

LICENSEE INFO: Aperion Care Morton Terrace, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/11/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1)2)3)5), 300.1610a)1), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Aperion Care Morton Terrace
FACILITY ADDRESS: 191 East Queenwood Road
FACILITY CITY, STATE, ZIP: Morton, IL 61550

DOCKET NUMBER: NH 18-C0401

LICENSEE INFO: Aperion Care Morton
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/16/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Aperion Care Morton Villa
FACILITY ADDRESS: 190 East Queenwood Road
FACILITY CITY, STATE, ZIP: Morton, IL 61550

DOCKET NUMBER: NH 18-C0109

LICENSEE INFO: Aperion Care Morton Villa, LLC
LICENSEE ADDRESS: 208 S. LaSalle St, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 03/13/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Aperion Care Wilmington
FACILITY ADDRESS: 555 West Kahler
FACILITY CITY, STATE, ZIP: Wilmington, IL 60481

DOCKET NUMBER: NH 18-C0305

LICENSEE INFO: Island City Rehabilitation Center, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 06/22/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Arista Healthcare
FACILITY ADDRESS: 1136 North Mill Street
FACILITY CITY, STATE, ZIP: Naperville, IL 60563

DOCKET NUMBER: NH 18-S0449

LICENSEE INFO: Arista Healthcare, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/20/2018

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b) and 300.1210d2)3)5). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5). A fine of $500.00

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.1210d)1) and 300.1610a)1). No fine

Total fine of $500.00

FACILITY NAME: Arthur Home, The
FACILITY ADDRESS: 423 South Eberhardt Drive
FACILITY CITY, STATE, ZIP: Arthur, IL 61911

DOCKET NUMBER: NH 17-S0106

LICENSEE INFO: Community Retirement, Inc.
LICENSEE ADDRESS: 423 South Eberhardt Drive
LICENSEE CITY, STATE, ZIP: Arthur, IL 61911
Survey Date – 01/10/2017

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Avanti Wellness & Rehab
FACILITY ADDRESS: 6840 West Touhy Avenue
FACILITY CITY, STATE, ZIP: Niles, IL 60714

DOCKET NUMBER: NH 18-C0486

LICENSEE INFO: Forest Villa Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 7257 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 09/26/2018

FACILITY NAME: Avanti Wellness & Rehab
FACILITY ADDRESS: 6840 West Touhy Avenue
FACILITY CITY, STATE, ZIP: Niles, IL 60714

DOCKET NUMBER: NH 18-C0498

LICENSEE INFO: Forest Villa Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 7257 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/10/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Beacon Health Center
FACILITY ADDRESS: 4538 North Beacon
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 18-C0405

LICENSEE INFO: Beacon Health Center, LLC
LICENSEE ADDRESS: 5215 Old Orchard Road, Ste 960
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 08/17/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)3)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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Beacon Health Center
FACILITY ADDRESS: 4538 North Beacon
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 18-C0524

LICENSEE INFO: Beacon Health Center, LLC
LICENSEE ADDRESS: 5215 Old Orchard Road, Ste 960
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 11/02/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Bria of Geneva
FACILITY ADDRESS: 1101 East State Street
FACILITY CITY, STATE, ZIP: Geneva, IL 60134

DOCKET NUMBER: NH 18-C0476

LICENSEE INFO: Geneva Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 4711 Golf Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 09/27/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)4), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Brookdale Plaza Lisle SNF
FACILITY ADDRESS: 1800 Robin Lane
FACILITY CITY, STATE, ZIP: Lisle, IL 60532

DOCKET NUMBER: NH 18-S0412

LICENSEE INFO: Brookdale Living Communities of Illinois, DNC, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/30/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210d)2), 300.1210d)3), 300.1210d)5), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Cedar Ridge Health Rehab Center
FACILITY ADDRESS: One Perryman Street
FACILITY CITY, STATE, ZIP: Lebanon, IL 62254

DOCKET NUMBER: NH 18-S0047

LICENSEE INFO: Covenant Care Midwest, Inc.
LICENSEE ADDRESS: 2015 West Main Street, #111
LICENSEE CITY, STATE, ZIP: Carbondale, IL 62901
Survey Date – 01/05/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Center Home Hispanic Elderly
FACILITY ADDRESS: 1401 North California
FACILITY CITY, STATE, ZIP: Chicago, IL 60622

DOCKET NUMBER: NH 18-S0509 & NH 18-C0510

LICENSEE INFO: Center Home Hispanic Elderly, LLC
LICENSEE ADDRESS: 191 North Wacker Drive, Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/17/2018

FACILITY NAME: Champaign County Nursing Home
FACILITY ADDRESS: 500 S. Art Bartell Drive
FACILITY CITY, STATE, ZIP: Urbana, IL 61802

DOCKET NUMBER: NH 18-C0500 & NH 18-S0501

LICENSEE INFO: Champaign County Board
LICENSEE ADDRESS: 1776 E. Washington Street
LICENSEE CITY, STATE, ZIP: Urbana, IL 61802
Survey Date – 10/04/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210c), 300.1210d)1)2)3), 300.1620a), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Champaign Urbana Nrsg & Rehab
FACILITY ADDRESS: 302 Burwash Avenue
FACILITY CITY, STATE, ZIP: Savoy, IL 61874

DOCKET NUMBER: NH 18-S0452

LICENSEE INFO: Champaign Urbana Nursing and Rehab, LP
LICENSEE ADDRESS: 5750 Old Orchard Road, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/12/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Church Creek
FACILITY ADDRESS: 1200 West Central Road
FACILITY CITY, STATE, ZIP: Arlington Heights, IL 60005

DOCKET NUMBER: NH 18-S0407

LICENSEE INFO: SNH SE Tenant TRS, Inc.
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/09/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Total fine of $2,200.00

FACILITY NAME: Citadel Estates Hazel Crest
FACILITY ADDRESS: 3701 West 183^rd Street
FACILITY CITY, STATE, ZIP: Hazel Crest, IL 60429

DOCKET NUMBER: NH 18-S0447

LICENSEE INFO: Citadel Estates – Hazel Crest, LLC
LICENSEE ADDRESS: 191 N. Wacker Drive, Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 09/06/2018

Type C violation of an occurrence for violating one or more of the following sections of the Code: 330.790c)1), 330.1155a)2)3)4)b)d) and 330.1510a)1)2). This instance in accordance with 330.282f) i) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 330.790). A fine of $500.00

FACILITY NAME: Clark Manor CNV Center
FACILITY ADDRESS: 7433 North Clark Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60626

DOCKET NUMBER: NH 18-C0418

LICENSEE INFO: Clark Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 08/03/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Clinton Manor Living Center
FACILITY ADDRESS: 111 East Illinois Street
FACILITY CITY, STATE, ZIP: New Baden, IL 62266

DOCKET NUMBER: NH 18-C0444

LICENSEE INFO: Southern Illinois Living Center, Inc.
LICENSEE ADDRESS: 1 West Old State Capitol Plaza, #600
LICENSEE CITY, STATE, ZIP: Springfield, IL 62701
Survey Date – 09/27/2018

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.661. This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.661). A fine of $500.00

FACILITY NAME: Danville Care Center
FACILITY ADDRESS: 1701 North Bowman
FACILITY CITY, STATE, ZIP: Danville, IL 61832

DOCKET NUMBER: NH 18-C0480

LICENSEE INFO: Danville Care Center, LTD
LICENSEE ADDRESS: 5750 Old Orchard Road, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 10/02/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Eldorado Rehab & Healthcare
FACILITY ADDRESS: 1001 A. Jefferson Street
FACILITY CITY, STATE, ZIP: Eldorado, IL 62930

DOCKET NUMBER: NH 18-C0454

LICENSEE INFO: Eldorado Rehab & Healthcare, LLC
LICENSEE ADDRESS: 105 S. Commercial Street, Suite 1
LICENSEE CITY, STATE, ZIP: Harrisburg, IL 62946
Survey Date – 09/12/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d)2), 300.1210d)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Evenglow Lodge
FACILITY ADDRESS: 215 East Washington
FACILITY CITY, STATE, ZIP: Pontiac, IL 61764

DOCKET NUMBER: NH 18-S0481

LICENSEE INFO: Evenglow Lodge
LICENSEE ADDRESS: 109 North Mill Street
LICENSEE CITY, STATE, ZIP: Pontiac, IL 61764
Survey Date – 09/20/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010b), 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 sections of the Code with a high risk designation: 300.3240a). A fine of $25,000.00

FACILITY NAME: Forest City Rehab & Nrsg Ctr
FACILITY ADDRESS: 321 Arnold Avenue
FACILITY CITY, STATE, ZIP: Rockford, IL 61108

DOCKET NUMBER: NH 17-C0333 & NH 17-S0394 & NH 17-C0395

LICENSEE INFO: Forest City Rehab and Nursing Center, LLC
LICENSEE ADDRESS: 4711 Golf Road, Suite 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 06/06/2017

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Franciscan Village
FACILITY ADDRESS: 1270 Franciscan Drive
FACILITY CITY, STATE, ZIP: Lemont, IL 60439

DOCKET NUMBER: NH 18-S0461

LICENSEE INFO: Franciscan Communities, Inc.
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/31/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Friendship Skilled Nursing & Rehab
FACILITY ADDRESS: 826 North High Street
FACILITY CITY, STATE, ZIP: Carlinville, IL 62626

DOCKET NUMBER: NH 18-C0397

LICENSEE INFO: Covenant Care Midwest, Inc.
LICENSEE ADDRESS: 2015 W. Main Street, #111
LICENSEE CITY, STATE, ZIP: Carbondale, IL 62901
Survey Date – 08/14/2018

FACILITY NAME: Generations at Applewood
FACILITY ADDRESS: 21020 Kostner Avenue
FACILITY CITY, STATE, ZIP: Matteson, IL 60443

DOCKET NUMBER: NH 18-C0451

LICENSEE INFO: Generations at Applewood, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 09/05/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $25,000.00

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)1), 300.1210d)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

Total fine of $50,000.00

FACILITY NAME: Generations at Lincoln
FACILITY ADDRESS: 2202 North Kickapoo
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 18- C0503

LICENSEE INFO: Generations at Lincoln, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/17/2018

FACILITY NAME: Generations at Lincoln
FACILITY ADDRESS: 2202 North Kickapoo
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 18-S0518 & NH 18-C0519

LICENSEE INFO: Generations at Lincoln, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/29/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1)2)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: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)1)2), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Total fine of $4,400.00

FACILITY NAME: Generations at McKinley Place
FACILITY ADDRESS: 2530 North Monroe
FACILITY CITY, STATE, ZIP: Decatur, IL 62526

DOCKET NUMBER: NH 18-S0383

LICENSEE INFO: Generations at McKinley Place, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 08/01/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h) and 300.1210)d)2). A fine of $1,100.00

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.1210d)6). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.1210d)6). A fine of $500.00.

Administrative Warning for violating the following sections of the Code: 300.2210b)1)2). No fine

Total fine of $1,600.00

FACILITY NAME: Glenlake Terrace Nursing & Reh
FACILITY ADDRESS: 2222 West 14^th Street
FACILITY CITY, STATE, ZIP: Waukegan, IL 60085

DOCKET NUMBER: NH 18-S0119

LICENSEE INFO: Pinnacle, Inc
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 03/08/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Glenshire Nursing & Rehab Ctre
FACILITY ADDRESS: 22660 South Cicero Avenue
FACILITY CITY, STATE, ZIP: Richton Park, IL 60471

DOCKET NUMBER: NH 18-C0009

LICENSEE INFO: Glenshire Nursing and Rehabilitation Centre, Ltd
LICENSEE ADDRESS: 191 North Wacker Drive, Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 11/09/2017

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Glenshire Nursing & Rehab Ctre
FACILITY ADDRESS: 22660 South Cicero Avenue
FACILITY CITY, STATE, ZIP: Richton Park, IL 60471

DOCKET NUMBER: NH 18-C0495

LICENSEE INFO: Glenshire Nursing and Rehabilitation Center, LTD
LICENSEE ADDRESS: 191 North Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/12/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Granite Nursing & Rehab Center
FACILITY ADDRESS: 3500 Century Drive
FACILITY CITY, STATE, ZIP: Granite City, IL 62040

DOCKET NUMBER: NH 18-C0515

LICENSEE INFO: Granite Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 901 S. Second Street, Suite 201
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 10/23/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)2), 300.1210d)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)3), 300.1210d)2), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Total fine of $29,400.00

FACILITY NAME: Havana Health Care Center
FACILITY ADDRESS: 609 North Harpham Street
FACILITY CITY, STATE, ZIP: Havana, IL 62644

DOCKET NUMBER: NH 18-C0359

LICENSEE INFO: Petersen Health Quality LLC
LICENSEE ADDRESS: 830 Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/13/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Heartland Manor Nursing Center
FACILITY ADDRESS: 410 Northwest Third, P.O. Box 10
FACILITY CITY, STATE, ZIP: Casey, IL 62420

DOCKET NUMBER: NH 17-S0578

LICENSEE INFO: Heartland Manor Nursing Center
LICENSEE ADDRESS: 410 Northwest Third, P.O. Box 10
LICENSEE CITY, STATE, ZIP: Casey, IL 62420
Survey Date – 10/27/2017

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Heartland of Galesburg
FACILITY ADDRESS: 280 East Losey Street
FACILITY CITY, STATE, ZIP: Galesburg, IL 61401

DOCKET NUMBER: NH 18-S0455

LICENSEE INFO: Heartland of Galesburg, IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/29/2018

FACILITY NAME: Heartland of Riverview
FACILITY ADDRESS: 500 Centennial Drive
FACILITY CITY, STATE, ZIP: East Peoria, IL 61611

DOCKET NUMBER: NH 18-S0470

LICENSEE INFO: Heartland Riverview of East Peoria, IL (SNF) LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/21/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Helia Healthcare of Belleville
FACILITY ADDRESS: 40 North 64^th Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62223

DOCKET NUMBER: NH 18-C0382 & NH 18-S0386

LICENSEE INFO: Helia Healthcare of Belleville, LLC
LICENSEE ADDRESS: 118 West Edwards Street, Suite 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 07/30/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $2,200.00.

Total fines $4,400.00

FACILITY NAME: Helia Southbelt Healthcare
FACILITY ADDRESS: 101 South Belt West
FACILITY CITY, STATE, ZIP: Belleville, IL 62220

DOCKET NUMBER: NH 18-S0413

LICENSEE INFO: Helia Southbelt Healthcare, LLC
LICENSEE ADDRESS: 118 West Edwards Street, Suite 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 08/28/2018

Total fine of $2,200.00

FACILITY NAME: Heritage Health Mendota
FACILITY ADDRESS: 1201 First Avenue
FACILITY CITY, STATE, ZIP: Mendota, IL 61342

DOCKET NUMBER: NH 18-S0432

LICENSEE INFO: Heritage Manor Mendota, LLC
LICENSEE ADDRESS: 115 West Jefferson Street, Ste 400
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 08/10/2018

FACILITY NAME: Hillcrest Retirement Village
FACILITY ADDRESS: 1740 North Circuit Drive
FACILITY CITY, STATE, ZIP: Round Lake Beach, IL 60073

DOCKET NUMBER: NH 18-C0410

LICENSEE INFO: Hillcrest Retirement Village, LTD
LICENSEE ADDRESS: 30 S. Wacker Drive, Suite 2600
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 08/28/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)4), 300.1210c), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Holy Family Villa
FACILITY ADDRESS: 12220 South Will Cook Road
FACILITY CITY, STATE, ZIP: Palos Park, IL 60464

DOCKET NUMBER: NH 18-C0485

LICENSEE INFO: Holy Family Villa
LICENSEE ADDRESS: 721 N. LaSalle Street
LICENSEE CITY, STATE, ZIP: Chicago, IL 60654
Survey Date – 10/05/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)5) 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Holy Family Villa
FACILITY ADDRESS: 12220 South Will Cook Road
FACILITY CITY, STATE, ZIP: Palos Park, IL 60464

DOCKET NUMBER: NH 18-C0530

LICENSEE INFO: Holy Family Villa
LICENSEE ADDRESS: 721 N. LaSalle Street
LICENSEE CITY, STATE, ZIP: Chicago, IL 60654
Survey Date – 10/23/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $25,000.00

FACILITY NAME: IL Veterans’ Home at Quincy
FACILITY ADDRESS: 1707 North 12^th Street
FACILITY CITY, STATE, ZIP: Quincy, IL 62301

DOCKET NUMBER: NH 17-S0501

LICENSEE INFO: Illinois Department of Veteran’s Affairs
LICENSEE ADDRESS: 833 South Spring Street, Box 19432
LICENSEE CITY, STATE, ZIP: Springfield, IL 62794
Survey Date – 10/12/2017

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Integrity HC of Columbia
FACILITY ADDRESS: 253 Bradington Drive
FACILITY CITY, STATE, ZIP: Columbia, IL 62236

DOCKET NUMBER: NH 18-S0389

LICENSEE INFO: Columbia Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 2015 West Main Street. Suite 111
LICENSEE CITY, STATE, ZIP: Carbondale, IL 62901
Survey Date – 08/07/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), 300.1210d)2), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $2,200.00

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.625b),300.625c)1)2), 300.625f)1)2) and 300.325j). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.625b), 300.625c) and 300.625j). A fine of $500.00

Total fine of $2,700.00

FACILITY NAME: Integrity HC of Columbia
FACILITY ADDRESS: 253 Bradington Drive
FACILITY CITY, STATE, ZIP: Columbia, IL 62236

DOCKET NUMBER: NH 18-C0489

LICENSEE INFO: Columbia Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 2015 West Main Street, Suite 111
LICENSEE CITY, STATE, ZIP: Carbondale, IL 62901
Survey Date – 10/16/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), 300.1210d)6), 300.2900d)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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), 300.2900d)2) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Integrity HC of Wood River
FACILITY ADDRESS: 393 Edwardsville Road
FACILITY CITY, STATE, ZIP: Wood River, IL 62095

DOCKET NUMBER: NH 17-C0469

LICENSEE INFO: Wood River Healthcare & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2015 West Main, Suite 111
LICENSEE CITY, STATE, ZIP: Carbondale, IL 62901
Survey Date – 09/14/2017

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Integrity HC of Wood River
FACILITY ADDRESS: 393 Edwardsville Road
FACILITY CITY, STATE, ZIP: Wood River, IL 62095

DOCKET NUMBER: NH 18-S0507

LICENSEE INFO: Wood River Healthcare & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2015 West Main Street, Ste 111
LICENSEE CITY, STATE, ZIP: Carbondale, IL 62901
Survey Date – 10/03/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)2), 300.1210d)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4), 300.1210d)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Total fine of $4,400.00

FACILITY NAME: Leroy Manor
FACILITY ADDRESS: 509 South Buck, P.O. Box 149
FACILITY CITY, STATE, ZIP: LeRoy, IL 61752

DOCKET NUMBER: NH 18-S0355

LICENSEE INFO: UDI #4, L.L.C.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 08/09/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Lewis Memorial Christian Village
FACILITY ADDRESS: 3400 West Washington
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 18-C0472

LICENSEE INFO: Lewis Memorial Christian Village
LICENSEE ADDRESS: 208 South LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/18/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Lieberman Ctr for Health & Rehab
FACILITY ADDRESS: 9700 Gross Point Road
FACILITY CITY, STATE, ZIP: Skokie, IL 60076

DOCKET NUMBER: NH 18-C0465

LICENSEE INFO: Council for Jewish Elderly
LICENSEE ADDRESS: 3003 West Touhy Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645
Survey Date – 09/20/2018

FACILITY NAME: Little Village Nrsg & Rhb Ctr
FACILITY ADDRESS: 2320 South Lawndale Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60623

DOCKET NUMBER: NH 18-C0541 & NH 18-S0552

LICENSEE INFO: Little Village Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 5750 Old Orchard Road, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 11/08/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1)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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Lynwood Terrace
FACILITY ADDRESS: 2317 East 207^th Street
FACILITY CITY, STATE, ZIP: Lynwood, IL 60411

DOCKET NUMBER: NH 18-S0422

LICENSEE INFO: Pioneer Concepts, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 08/16/2018

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.700a), 350.810a), 350.810c)1)2)3), 350.1230b)3)6)7), 350.1230e) and 350.3240a). A fine of $550.00

FACILITY NAME: Manor Court of Clinton
FACILITY ADDRESS: 1 Park Lane West
FACILITY CITY, STATE, ZIP: Clinton, IL 61727

DOCKET NUMBER: NH 18-C0435

LICENSEE INFO: Residential Alternatives of Illinois, Inc.
LICENSEE ADDRESS: 285 S. Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 10/03/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)5), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Manor Court of Peoria
FACILITY ADDRESS: 6900 North Stalworth Drive
FACILITY CITY, STATE, ZIP: Peoria, IL 61615

DOCKET NUMBER: NH 18-C0419

LICENSEE INFO: Residential Alternatives of Illinois, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 08/24/2018

FACILITY NAME: Manorcare of South Holland
FACILITY ADDRESS: 2145 East 170^th Street
FACILITY CITY, STATE, ZIP: South Holland, IL 60473

DOCKET NUMBER: NH 18-S0478

LICENSEE INFO: Manor Care of South Holland IL, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/21/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), 300.1210d)3), 300.1210d)5), 3001220b)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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Meadowbrook Manor Naperville
FACILITY ADDRESS: 720 Raymond Drive
FACILITY CITY, STATE, ZIP: Naperville, IL 60563

DOCKET NUMBER: NH 18-S0523

LICENSEE INFO: Butterfield Health Care II, Inc.
LICENSEE ADDRESS: 150 North Riverside Plaza, Ste 3000
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 11/01/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Mosaic of Lakeshore, The
FACILITY ADDRESS: 7200 North Sheridan Road
FACILITY CITY, STATE, ZIP: Chicago, IL 60626

DOCKET NUMBER: NH 18-C0494

LICENSEE INFO: Lake Shore Healthcare & Rehabilitation Centre, LLC
LICENSEE ADDRESS: 4600 W. Touhy Avenue #200
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/05/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.1210d)6), 300.1220b)3), 300.3240a) and 300.2900d)2). 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). A fine of $25,000.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1), 300.1210d)2), 300.1210d)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Total fine of $27,200.00

FACILITY NAME: Newman Rehab & Health Care Ctr
FACILITY ADDRESS: 418 S. Memorial Park Road
FACILITY CITY, STATE, ZIP: Newman, IL 61942

DOCKET NUMBER: NH 18-C0402

LICENSEE INFO: Petersen Health & Wellness, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/14/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210d)3)4)A), 300.1210d)5), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Oakridge Healthcare Center
FACILITY ADDRESS: 323 Oakridge Avenue
FACILITY CITY, STATE, ZIP: Hillside, IL 60162

DOCKET NUMBER: NH 18-C0521

LICENSEE INFO: Oakridge Healthcare Center, LLC
LICENSEE ADDRESS: 2202 Main Street. Suite 180
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 11/01/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Oregon Living and Rehabilitation Center
FACILITY ADDRESS: 811 South 10^th Street
FACILITY CITY, STATE, ZIP: Oregon, IL 61061

DOCKET NUMBER: NH 18-C0404

LICENSEE INFO: Oregon Living & Rehabilitation Center, LLC
LICENSEE ADDRESS: 7434 Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 08/14/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.610c)2), 300.1210a), 300.1210b)5), 300.1210c) and 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 sections of the Code with a high risk designation: 300.1210b. A fine of $2,200.00

FACILITY NAME: Oregon Living and Rehabilitation Center
FACILITY ADDRESS: 811 South 10^th Street
FACILITY CITY, STATE, ZIP: Oregon, IL 61061

DOCKET NUMBER: NH 18-S0440

LICENSEE INFO: Oregon Living & Rehabilitation Center, LLC
LICENSEE ADDRESS: 7434 Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 08/28/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)2)4)5), 300.1210d)2)3), 300.1420, 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)5), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

Total fine of $4,400.00

FACILITY NAME: Park Place Pana
FACILITY ADDRESS: 205 Park Avenue
FACILITY CITY, STATE, ZIP: Pana, IL 62557

DOCKET NUMBER: NH 18-S0464

LICENSEE INFO: Progressive Housing, Inc.
LICENSEE ADDRESS: 20180 Governors Drive, Suite 300
LICENSEE CITY, STATE, ZIP: Olympia Fields, IL 60461
Survey Date – 10/11/2018

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1210b), 350.1220e), 350.1220i), 350.1220j), 350.1420a), 350.1430a) and 350.3240a). A fine of $550.00

FACILITY NAME: Park View Rehab Center
FACILITY ADDRESS: 5888 North Ridge
FACILITY CITY, STATE, ZIP: Chicago, IL 60660

DOCKET NUMBER: NH 18-C0522

LICENSEE INFO: Park View Rehab Center, LLC
LICENSEE ADDRESS: 191 North Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/30/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)6), 300.3240a) 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Pekin Manor
FACILITY ADDRESS: 1520 El Camino Drive
FACILITY CITY, STATE, ZIP: Pekin, IL 61554

DOCKET NUMBER: NH 18-S0409

LICENSEE INFO: UDI #10, LLC
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 08/22/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Total fine of $4,400.00

FACILITY NAME: Piper City Rehab & Living Ctr
FACILITY ADDRESS: 600 South Maple Street, P.O. Box 68
FACILITY CITY, STATE, ZIP: Piper City, IL 60959

DOCKET NUMBER: NH 18-S0406

LICENSEE INFO: Midwest Health Operations, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/13/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.3130c)3)4. A fine $1,100.00

FACILITY NAME: Prairie Crossing Lvg & Rehab
FACILITY ADDRESS: 409 West Comanche Avenue
FACILITY CITY, STATE, ZIP: Shabbona, IL 60550

DOCKET NUMBER: NH 18-C0438

LICENSEE INFO: Prairie Crossing Living & Rehabilitation Center, LLC
LICENSEE ADDRESS: 7434 Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/12/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.810a), 300.1210b), 300.1230d)1) 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: 300.1210b), 300.1230d)1) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Presence St. Joseph Center
FACILITY ADDRESS: 659 East Jefferson Street
FACILITY CITY, STATE, ZIP: Freeport, IL 61032

DOCKET NUMBER: NH 18-S0504

LICENSEE INFO: Presence Life Connections
LICENSEE ADDRESS: 18927 Hickory Creek Drive, Ste 300
LICENSEE CITY, STATE, ZIP: Mokena, IL 60448
Survey Date – 10/24/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210d)1)2)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Presence St. Joseph Center
FACILITY ADDRESS: 659 East Jefferson Street
FACILITY CITY, STATE, ZIP: Freeport, IL 61032

DOCKET NUMBER: NH 18-S0525

LICENSEE INFO: Presence Life Connections
LICENSEE ADDRESS: 18927 Hickory Creek Drive, Ste 300
LICENSEE CITY, STATE, ZIP: Mokena, IL 60448
Survey Date – 11/02/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b)5), 300.1210c), 300.1210d)3)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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Presence Villa Franciscan
FACILITY ADDRESS: 210 North Springfield Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60435

DOCKET NUMBER: NH 18-C0467

LICENSEE INFO: Presence Life Connections
LICENSEE ADDRESS: 18927 Hickory Creek Drive, Ste 300
LICENSEE CITY, STATE, ZIP: Mokena, IL 60448
Survey Date – 09/21/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)2), 300.1210d)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Presence Villa Franciscan
FACILITY ADDRESS: 210 North Springfield Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60435

DOCKET NUMBER: NH 18-S0488

LICENSEE INFO: Presence Life Connections
LICENSEE ADDRESS: 18927 Hickory Creek Drive, Ste 300
LICENSEE CITY, STATE, ZIP: Mokena, IL 60448
Survey Date – 10/26/2018

FACILITY NAME: Regency Care of Sterling
FACILITY ADDRESS: 612 West St. Mary’s Street
FACILITY CITY, STATE, ZIP: Sterling, IL 61081

DOCKET NUMBER: NH 18-C0408

LICENSEE INFO: Sterling SNF Management, LLC
LICENSEE ADDRESS: 1315 West Lawrence Avenue
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 08/21/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.3240a), 300.3240c) 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: River North of Bradley H & R
FACILITY ADDRESS: 650 North Kinzie
FACILITY CITY, STATE, ZIP: Bradley, IL 60915

DOCKET NUMBER: NH 18-S0544

LICENSEE INFO: River North of Bradley Health and Rehabilitation Center, LLC
LICENSEE ADDRESS: 191 North Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/24/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)2)5) and 300.1210d)2)5)6) . 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 300.1210d)6). A fine of $25,000.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1610a)1). A fine of $1,100.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1620a). A fine of $1,100.00

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.615f)j). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.615f). A fine of $500.00

Total fine of $27,700.00

FACILITY NAME: Rochelle Rehab & Healthcare Center
FACILITY ADDRESS: 900 North Third Street
FACILITY CITY, STATE, ZIP: Rochelle, IL 61068

DOCKET NUMBER: NH 18-C0384

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/07/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)3), 300.1210a), 300.1210d)5), 300.1220b)2)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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $25,000.00.

FACILITY NAME: Rolling Hills Manor
FACILITY ADDRESS: 3615 16^th Street
FACILITY CITY, STATE, ZIP: Zion, IL 60099

DOCKET NUMBER: NH 18-S0403

LICENSEE INFO: Slovak American Charitable Association
LICENSEE ADDRESS: 3521 16^th Street
LICENSEE CITY, STATE, ZIP: Zion, IL 60099
Survey Date – 08/14/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Rosewood Care Center of Alton
FACILITY ADDRESS: 3490 Humbert Road
FACILITY CITY, STATE, ZIP: Alton, IL 62002

DOCKET NUMBER: NH 18-C0433

LICENSEE INFO: Bravo Care of Alton, Inc.
LICENSEE ADDRESS: 412 East Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/06/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b)4), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Rosewood Care Center of Moline
FACILITY ADDRESS: 7300 34^th Avenue
FACILITY CITY, STATE, ZIP: Moline, IL 61265

DOCKET NUMBER: NH 18-C0484

LICENSEE INFO: Bravo Care of Moline, Inc.
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/03/2018

FACILITY NAME: Schultz House
FACILITY ADDRESS: 340 Bryan Avenue
FACILITY CITY, STATE, ZIP: Danville, IL 61832

DOCKET NUMBER: NH 18-C0427

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 08/17/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) 350.1060e), 350.1210, 350.1230b)d)1) and 350.3240a). A fine of $6,250.00

FACILITY NAME: Springs at Crystal Lake, The
FACILITY ADDRESS: 1000 East Brighton
FACILITY CITY, STATE, ZIP: Crystal Lake, IL 60012

DOCKET NUMBER: NH 18-C0445

LICENSEE INFO: The Springs at Crystal Lake, LLC
LICENSEE ADDRESS: 191 N. Wacker Drive, Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/01/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210d)3)4)A)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: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $25,000.00

FACILITY NAME: St. James Wellness Rehab Villas
FACILITY ADDRESS: 1251 East Richton Road
FACILITY CITY, STATE, ZIP: Crete, IL 60417

DOCKET NUMBER: NH 18-C0223

LICENSEE INFO: St. James Wellness Rehab Villas, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 04/23/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: St. Vincent’s Home
FACILITY ADDRESS: 1440 North 10^th Street
FACILITY CITY, STATE, ZIP: Quincy, IL 62301

DOCKET NUMBER: NH 18-C0392 & NH 18-S0393

LICENSEE INFO: St. Vincent’s Home, Inc.
LICENSEE ADDRESS: 1 W. Old State Capitol Plaza, Suite 600, Box 2117
LICENSEE CITY, STATE, ZIP: Springfield, IL 62705
Survey Date – 08/09/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.3240a) and 300.3240b). 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) and 300.3240a). A fine of $2,200.00

FACILITY NAME: St. Vincent’s Home
FACILITY ADDRESS: 1440 North 10^th Street
FACILITY CITY, STATE, ZIP: Quincy, IL 62301

DOCKET NUMBER: NH 18-C0534

LICENSEE INFO: St. Vincent’s Home, Inc.
LICENSEE ADDRESS: 1 West Old State Capitol Plaza, Suite 600, Box 2117
LICENSEE CITY, STATE, ZIP: Springfield, IL 62705
Survey Date – 11/01/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1) 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: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Sunset Home
FACILITY ADDRESS: 418 Washington Street
FACILITY CITY, STATE, ZIP: Quincy, IL 62301

DOCKET NUMBER: NH 18-S0497

LICENSEE INFO: Sunset Home
LICENSEE ADDRESS: 625 Vermont Street
LICENSEE CITY, STATE, ZIP: Quincy, IL 62301
Survey Date – 10/04/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Swansea Rehab Health Care
FACILITY ADDRESS: 1405 North Second Street
FACILITY CITY, STATE, ZIP: Swansea, IL 62226

DOCKET NUMBER: NH 18-C0466

LICENSEE INFO: Petersen Health Care II, Inc.
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/12/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)3)4)5), 3300.1210d)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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1230)l)1)2)3)4)5)6). 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: 300.1230. A fine of $2,200.00

Total fine of $4,400.00

FACILITY NAME: Swansea Rehab Health Care
FACILITY ADDRESS: 1405 North Second Street
FACILITY CITY, STATE, ZIP: Swansea, IL 62226

DOCKET NUMBER: NH 18-C0469

LICENSEE INFO: Petersen Health Care II, Inc.
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/24/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b)3), 300.1210d)2)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Timbercreek Rehab & Hlth C Center
FACILITY ADDRESS: 2220 State Street
FACILITY CITY, STATE, ZIP: Pekin, IL 61554

DOCKET NUMBER: NH 18-S0417

LICENSEE INFO: Petersen Health Operations, L.L.C.
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/16/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)2) and 300.1220b)3). 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). A fine of $25,000.00

Total fine of $27,200.00

FACILITY NAME: Tower Hill Healthcare Center
FACILITY ADDRESS: 759 Kane Street
FACILITY CITY, STATE, ZIP: South Elgin, IL 60177

DOCKET NUMBER: NH 18-C0471

LICENSEE INFO: Tower Hill Rehabilitation, LLC
LICENSEE ADDRESS: 7434 Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/17/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b), 300.1210c), 300.1210d)5) and 300.1220b)3). 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) and 300.1210d)5). A fine of $2,200.00

FACILITY NAME: Tower Hill Healthcare Center
FACILITY ADDRESS: 759 Kane Street
FACILITY CITY, STATE, ZIP: South Elgin, IL 60177

DOCKET NUMBER: NH 18-C0511

LICENSEE INFO: Tower Hill Rehabilitation, LLC
LICENSEE ADDRESS: 7434 Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 10/25/2018

FACILITY NAME: United Methodist Village, The
FACILITY ADDRESS: 1616 Cedar
FACILITY CITY, STATE, ZIP: Lawrenceville, IL 62439

DOCKET NUMBER: NH 18-C0425

LICENSEE INFO: The United Methodist Village, Inc.
LICENSEE ADDRESS: 190 S. LaSalle Street, Suite 3700
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 08/02/2018

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b) 300.3240a), 300.3300d), 300.3300e)1)2)3)4)5), 300.3300g), 300.3300j), 300.3300k) and 300.3300y). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.690, 300.1210b) and 300.3240a). A fine of $500.00

FACILITY NAME: United Methodist Village North Campus
FACILITY ADDRESS: 2101 James Street
FACILITY CITY, STATE, ZIP: Lawrenceville, IL 62439

DOCKET NUMBER: NH 18- C0411

LICENSEE INFO: Village Health Care Management, LLC
LICENSEE ADDRESS: 190 South LaSalle Street, Suite 3700
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 08/29/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.510e), 300.695b)4), 300.695c)3)5), 300.695)e), 300.3210a), 300.3210f), 300.3210g), 300.3210o), 300.3240a), 300.3260g) and 300.3260o). 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: 300.3240a). A fine of $2,200.00

FACILITY NAME: Uptown Health Center
FACILITY ADDRESS: 4920 North Kenmore
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 18-C0513

LICENSEE INFO: Uptown Health Center, LLC
LICENSEE ADDRESS: 5215 Old Orchard Road, Suite 960
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 10/18/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.1210d)4)B)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: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $25,000.00

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210c), 300.1210d)6), 300.3240a) and 300.3240d). 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), 300.3240a) and 300.3240d). A fine of $25,000.00

Total fine of $50,000.00

FACILITY NAME: Veracare Burbank
FACILITY ADDRESS: 5400 West 87^th Street
FACILITY CITY, STATE, ZIP: Burbank, IL 60459

DOCKET NUMBER: NH 17-C0075

LICENSEE INFO: Veracare Bremtwood, LLC
LICENSEE ADDRESS: 6312 North Central Park Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659
Survey Date – 01/19/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Veracare Burbank
FACILITY ADDRESS: 5400 West 87^th Street
FACILITY CITY, STATE, ZIP: Burbank, IL 60459

DOCKET NUMBER: NH 17-C0440

LICENSEE INFO: Veracare Bremtwood, LLC
LICENSEE ADDRESS: 6312 North Central Park Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659
Survey Date – 09/01/2017

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Village at Victory Lakes, The
FACILITY ADDRESS: 1055 East Grand Avenue
FACILITY CITY, STATE, ZIP: Lindenhurst, IL 60046

DOCKET NUMBER: NH 18-S0430

LICENSEE INFO: Franciscan Communities, Inc.
LICENSEE ADDRESS: 208 South LaSalle Street. Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, Il 60604
Survey Date – 08/16/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Warren Barr Lincolnshire
FACILITY ADDRESS: 150 Jamestown Lane
FACILITY CITY, STATE, ZIP: Lincolnshire, IL 60069

DOCKET NUMBER: NH 18-S0431

LICENSEE INFO: Lincolnshire Living & Rehab Center, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/06/2018

FACILITY NAME: West Suburban Nsg & Rehab Center
FACILITY ADDRESS: 311 Edgewater Drive
FACILITY CITY, STATE, ZIP: Bloomingdale, IL 60108

DOCKET NUMBER: NH 18-C0415

LICENSEE INFO: West Suburban Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 08/09/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)2), 300.1210d)3), 300.1210d)5) and 300.1220b). 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). A fine of $2,200.00.

FACILITY NAME: West Suburban Nsg & Rehab Center
FACILITY ADDRESS: 311 Edgewater Drive
FACILITY CITY, STATE, ZIP: Bloomingdale, IL 60108

DOCKET NUMBER: NH 18-C0490

LICENSEE INFO: West Suburban Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 10/09/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1035)3)4), 300.1210b), 300.1210d)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Westminister Village
FACILITY ADDRESS: 2025 East Lincoln Street
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701

DOCKET NUMBER: NH 18-C0460

LICENSEE INFO: Westminister Village, Inc.
LICENSEE ADDRESS: 2025 E. Lincoln Street
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 10/03/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b) and 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 sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: White Hall Nursing & Rehab Center
FACILITY ADDRESS: 620 West Bridgeport Street
FACILITY CITY, STATE, ZIP: White Hall, IL 62092

DOCKET NUMBER: NH 18-C0398

LICENSEE INFO: White Hall Nursing and Rehabilitation Center
LICENSEE ADDRESS: 901 S. 2^nd Street, Suite 201
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 08/09/2018

FACILITY NAME: White Hall Nursing & Rehab Center
FACILITY ADDRESS: 620 West Bridgeport Street
FACILITY CITY, STATE, ZIP: White Hall, IL 62092

DOCKET NUMBER: NH 18-S0531

LICENSEE INFO: White Hall Nursing and Rehabilitation Center
LICENSEE ADDRESS: 901 S. 2^nd Street, Suite 201
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 10/25/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)6), 300.1220)b)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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Willow Crest Nursing Pavilion
FACILITY ADDRESS: 515 North Main
FACILITY CITY, STATE, ZIP: Sandwich, IL 60548

DOCKET NUMBER: NH 18-C0416

LICENSEE INFO: Willow Crest Nursing Pavilion, LTD
LICENSEE ADDRESS: 191 North Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 08/08/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.1210d)1), 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: 300.1210b) and 300.3240a). A fine of $25,000.00.

Total fine of $27,200.00.

FACILITY NAME: Willow Rose Rehab & Health
FACILITY ADDRESS: 410 Fletcher
FACILITY CITY, STATE, ZIP: Jerseyville, IL 62052

DOCKET NUMBER: NH 18-C0458 & NH 18-S0459

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/25/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)4) 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: 300.1210b) and 300.3240a). A fine of $2.200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). A fine of $2,200.00

Total fine of $6,600.00

FACILITY NAME: Woodbridge Nursing Pavilion
FACILITY ADDRESS: 2242 North Kedzie
FACILITY CITY, STATE, ZIP: Chicago, IL 60647

DOCKET NUMBER: NH 18-C0516

LICENSEE INFO: Woodbridge Nursing Pavilion, LTD
LICENSEE ADDRESS: 191 North Wacker Drive, Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/18/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)6, 300.3240a)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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.00

4th Quarter Report October-December 2018

RESOURCES

QUICKLINKS

4th Quarter Report October-December 2018

Footer

RESOURCES

QUICKLINKS