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2019 2nd Quarterly Report

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: Accolade Healthcare of Pontiac

FACILITY ADDRESS: 300 West Lowell
FACILITY CITY, STATE, ZIP: Pontiac, IL 61764

DOCKET NUMBER: NH 18-S0151

LICENSEE INFO: Accolade Healthcare of Pontiac, LLC
LICENSEE ADDRESS: 1900 E. Golf Rd, Ste 950A
LICENSEE CITY, STATE, ZIP: Schaumburg, IL 60173

Survey Date – 03/21/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Alden Courts of Waterford

FACILITY ADDRESS: 1991 Randi Drive
FACILITY CITY, STATE, ZIP: Aurora, IL 60504

DOCKET NUMBER: NH 19-C0202

LICENSEE INFO: Alden Courts of Waterford, LLC
LICENSEE ADDRESS: 4200 West Peterson Avenue, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646

Survey Date – 04/17/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.710a), 300.710c)2)3)A)C)F), and 330.4240a). The fine was doubled in this instance in accordance with 330.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 330.4240a). A fine of $2,200.00.

FACILITY NAME: Alden Estates of Northmoor

FACILITY ADDRESS: 5831 North Northwest Highway
FACILITY CITY, STATE, ZIP: Chicago, IL 60631

DOCKET NUMBER: NH 19-C0254

LICENSEE INFO: Alden Northmoor Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 West Peterson Avenue, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645

Survey Date – 04/23/2019
Type A 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)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: Alden Estates of Orland Park

FACILITY ADDRESS: 16450 South 97^th Avenue
FACILITY CITY, STATE, ZIP: Orland Park, IL 60462

DOCKET NUMBER:NH 18-C0197

LICENSEE INFO: Alden-Orland Park Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Avenue, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646

Survey Date – 04/10/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Alden Long Grove Rehab & HCC

FACILITY ADDRESS: Box 2308, RFD Old Hicks Road
FACILITY CITY, STATE, ZIP: Long Grove, IL 60047

DOCKET NUMBER: NH 19-C0194

LICENSEE INFO: Alden Long Grove Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 West Peterson Avenue, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646

Survey Date – 03/14/2019
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)6), 300.3100d)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), 300.3100d)2), and 300.3240a). A fine of $25,000.00

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

FACILITY NAME: Aperion Care Bloomington

FACILITY ADDRESS: 1509 North Calhoun Street
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701

DOCKET NUMBER: NH 19-C0249

LICENSEE INFO: Aperion Care Bloomington, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 04/02/2019
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

FACILITY NAME: Aperion Care Capitol

FACILITY ADDRESS: 555 West Carpenter Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 18-S0365

LICENSEE INFO: Aperion Care Capitol, LLC
LICENSEE ADDRESS: 2018 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 07/16/2018
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-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
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-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
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 19-S0223

LICENSEE INFO: Aperion Care Capitol, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 04/12/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), 300.1210d)2)3)5), 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 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: 300.1210a), 300.1210b)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 $4,400.00

FACILITY NAME: Aperion Care Capitol

FACILITY ADDRESS: 555 West Carpenter Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 19-C0281

LICENSEE INFO: Aperion Care Capitol, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 05/02/2019
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: Aperion Care Forest Park

FACILITY ADDRESS: 8200 West Roosevelt Road
FACILITY CITY, STATE, ZIP: Forest Park, IL 60130

DOCKET NUMBER: NH 19-C0288

LICENSEE INFO: Berkshire Nursing & Rehab Center, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 05/02/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00.

FACILITY NAME: Aperion Care Galesburg

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

DOCKET NUMBER: NH 19-S0146

LICENSEE INFO: River Crossing Rehab, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 02/22/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Aperion Care Jacksonville

FACILITY ADDRESS: 1021 North Church Street
FACILITY CITY, STATE, ZIP: Jacksonville, IL 62650

DOCKET NUMBER: NH 19-C0186

LICENSEE INFO: North Church Nursing & Rehab Center, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 03/19/2019
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 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 $25,000.00

FACILITY NAME: Aperion Care Mascoutah

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

DOCKET NUMBER: NH 19-C0046

LICENSEE INFO: Aperion Care Mascoutah, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 12/19/2018
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 19-S0136

LICENSEE INFO: Aperion Care Mascoutah, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 02/27/2019
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)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 of Moline

FACILITY ADDRESS: 430 South 30^th Avenue
FACILITY CITY, STATE, ZIP: East Moline, IL 61244

DOCKET NUMBER: NH 19-C0265

LICENSEE INFO: Riverwood Rehab, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 04/30/2019
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), 300.1210d)3)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: 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
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Aperion Care Oak Lawn

FACILITY ADDRESS: 9401 South Ridgeland Avenue
FACILITY CITY, STATE, ZIP: Oak Lawn, IL 60453

DOCKET NUMBER: NH 19-C0233

LICENSEE INFO: Concord Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 04/09/2019
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)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: Asbury Gardens Nsg & Rehab

FACILITY ADDRESS: 212 Airport Road
FACILITY CITY, STATE, ZIP: North Aurora, IL 60542

DOCKET NUMBER: NH 19-C0163

LICENSEE INFO: Asbury Pavilion Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 8170 McCormick Blvd, Ste 104
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076

Survey Date – 03/14/2019
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)2)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: Avantara of Elgin

FACILITY ADDRESS: 1950 Larkin Avenue
FACILITY CITY, STATE, ZIP: Elgin, IL 60123

DOCKET NUMBER: NH 19-C0157

LICENSEE INFO: Elgin Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076

Survey Date – 03/28/2019
Type A 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 $25,000.00

FACILITY NAME: Batavia Rehab & Health Care C

FACILITY ADDRESS: 520 Fabyan Parkway
FACILITY CITY, STATE, ZIP: Batavia, IL 60510

DOCKET NUMBER: NH 19-C0154

LICENSEE INFO: Petersen Health Operations, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 03/18/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210a), 300.1210b), 300.1210c), 300.1210d)1)2)3)4)A), 300.1220b)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), 300.1210d)6) and 300.3240a). A fine of $2,200.00.

FACILITY NAME: Bloomington Rehabilitation & HCC

FACILITY ADDRESS: 1925 South Main Street
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701

DOCKET NUMBER: NH 19-C0226

LICENSEE INFO: Petersen Health Operations, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 03/29/2019
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: Bridge Care Suites, The

FACILITY ADDRESS: 3089 Old Jacksonville Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62704

DOCKET NUMBER: NH 18-C0195

LICENSEE INFO: OJCC, LLC
LICENSEE ADDRESS: 208 S. LaSalle St, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 04/05/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Bridgeview Health Care Center

FACILITY ADDRESS: 8100 South Harlem Avenue
FACILITY CITY, STATE, ZIP: Bridgeview, IL 60455

DOCKET NUMBER: NH 19-C0190

LICENSEE INFO: Bridgeview Health Care Center, LTD
LICENSEE ADDRESS: 191 North Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 03/22/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.3240a)b) 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: 300.3240a) and 300.3240d). A fine of $2,200.00.

FACILITY NAME: Brother James Court

FACILITY ADDRESS: 2508 St. James Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62707

DOCKET NUMBER: NH 19-C0155

LICENSEE INFO: Brother James Court
LICENSEE ADDRESS: 1215 S. 4^th Street
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 03/11/2019
Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) 350.1210, 350.1220j), 350.1230d)1) and 350.3240a). A fine of $10,.000.00

FACILITY NAME: Caseyville Nursing & Rehab Ctr

FACILITY ADDRESS: 601 West Lincoln Avenue
FACILITY CITY, STATE, ZIP: Caseyville, IL 62232

DOCKET NUMBER: NH 18-C0362

LICENSEE INFO: Caseyville Nursing & Rehabilitation Center, Inc.
LICENSEE ADDRESS: 7434 N. Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 07/18/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Caseyville Nursing & Rehab Ctr

FACILITY ADDRESS: 601 West Lincoln Avenue
FACILITY CITY, STATE, ZIP: Caseyville, IL 62232

DOCKET NUMBER: NH 19-S0269

LICENSEE INFO: Caseyville Nursing & Rehabilitation Center, Inc.
LICENSEE ADDRESS: 7434 North Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 04/23/2019
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: Central Nursing Home

FACILITY ADDRESS: 2450 North Central Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60639

DOCKET NUMBER: NH 19-C0271

LICENSEE INFO: Central Nursing Home, LLC
LICENSEE ADDRESS: 150 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162

Survey Date – 04/26/2019
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: Chestnut Corner S C

FACILITY ADDRESS: 905 West Chestnut Street, P.O. Box 250
FACILITY CITY, STATE, ZIP: Louisville, IL 62858

DOCKET NUMBER: NH 19-S0111

LICENSEE INFO: Diamond Development Co
LICENSEE ADDRESS: 150 South State, Rte 45, Box 250
LICENSEE CITY, STATE, ZIP: Louisville, IL 62858

Survey Date – 02/27/2019
Type Repeat B violation of an occurrence of failing to satisfactorily comply with an accepted plan of correction for one or more of the following sections of the Code: 330.120e)1) and 330.3940a). $10,153.00

FACILITY NAME: Claridge Healthcare Center

FACILITY ADDRESS: 700 Jenkisson
FACILITY CITY, STATE, ZIP: Lake Bluff, IL 60044

DOCKET NUMBER: NH 19-S0240

LICENSEE INFO: Claridge Operations, LLC
LICENSEE ADDRESS: 325 North Wells, 9^th Floor
LICENSEE CITY, STATE, ZIP: Chicago, IL 60610

Survey Date – 04/24/2019
Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1030a)1)2), 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 $50,000.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.690a), 300.690b), and 300.690c). 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: 300.690. A fine of $2,200.00.

Total Fine $52,200.00

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

FACILITY NAME: Cumberland Rehab & Health CC

FACILITY ADDRESS: 300 North Marietta Street
FACILITY CITY, STATE, ZIP: Greenup, IL 62428

DOCKET NUMBER: NH 19-S0141

LICENSEE INFO: Peterson Health Network, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 03/07/2019
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

FACILITY NAME: Eden Village Care Center

FACILITY ADDRESS: 400 South Station Road
FACILITY CITY, STATE, ZIP: Glen Carbon, IL 62034

DOCKET NUMBER: NH 19-C0119

LICENSEE INFO: Eden Retirement Center, Inc.
LICENSEE ADDRESS: 400 South Station Road
LICENSEE CITY, STATE, ZIP: Glen Carbon, IL 62034

Survey Date – 02/14/2019
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)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Eden Village Care Center

FACILITY ADDRESS: 400 South Station Road
FACILITY CITY, STATE, ZIP: Glen Carbon, IL 62034

DOCKET NUMBER: NH 19-S0189

LICENSEE INFO: Eden Retirement Center, Inc.
LICENSEE ADDRESS: 400 South Station Road
LICENSEE CITY, STATE, ZIP: Glen Carbon, IL 62034

Survey Date – 03/22/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)4)5) 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 $2,200.00.

FACILITY NAME: Edwardsville Nsg & Rehab Ctr

FACILITY ADDRESS: 401 St. Mary Drive
FACILITY CITY, STATE, ZIP: Edwardsville, IL 62025

DOCKET NUMBER: NH 19-S0259

LICENSEE INFO: Edwardsville Care Center, LLC
LICENSEE ADDRESS: 111 North Ottawa Street
LICENSEE CITY, STATE, ZIP: Joliet, IL 60432

Survey Date – 04/25/2019
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)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 $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)2), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00.

Total fines $4,400.00

FACILITY NAME: Fair Oaks Rehab & HCC

FACILITY ADDRESS: 1515 Blackhawk
FACILITY CITY, STATE, ZIP: South Beloit, IL 61080

DOCKET NUMBER: NH 18- C0189

LICENSEE INFO: Fair Oaks Rehabilitation and Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 04/11/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Fairmont Care

FACILITY ADDRESS: 5061 North Pulaski Road
FACILITY CITY, STATE, ZIP: Chicago, IL 60630

DOCKET NUMBER: NH 19-C0246

LICENSEE INFO: Fairmont Care Center, Inc.
LICENSEE ADDRESS: 5061 North Pulaski Road
LICENSEE CITY, STATE, ZIP: Chicago, IL 60630

Survey Date – 04/17/2019
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), 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: Foster Health & Rehab Center

FACILITY ADDRESS: 2840 West Foster Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60625

DOCKET NUMBER: NH 19-C0126

LICENSEE INFO: Foster Health & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2835 West North Shore Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645

Survey Date – 02/15/2019
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), 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) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Gardenview Manor

FACILITY ADDRESS: 14792 Catlin Tilton Road
FACILITY CITY, STATE, ZIP: Danville, IL 61834

DOCKET NUMBER: NH 19-C0195

LICENSEE INFO: Gardenview Manor, LLC
LICENSEE ADDRESS: 5750 Old Orchard Road, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 03/14/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 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: Generations at Elmwood Park

FACILITY ADDRESS: 7733 West Grand Avenue
FACILITY CITY, STATE, ZIP: Elmwood Park, IL 60707

DOCKET NUMBER: NH 18-S0024

LICENSEE INFO: Generations at Elmwood Park, Inc.
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712

Survey Date – 12/08/2017
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Generations at Lincoln

FACILITY ADDRESS: 2202 North Kickapoo Street
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 19-C0147

LICENSEE INFO: Generations at Lincoln, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712

Survey Date – 02/13/2019
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: Generations at Lincoln

FACILITY ADDRESS: 2202 North Kickapoo Street
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 19-C0292

LICENSEE INFO: Generations at Lincoln, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712

Survey Date – 05/01/2019
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.

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.620g)h), 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 fines $4,400.00

FACILITY NAME: Generations at Rock Island

FACILITY ADDRESS: 2545 24^th Street
FACILITY CITY, STATE, ZIP: Rock Island, IL 61201

DOCKET NUMBER: NH 19-C0187

LICENSEE INFO: Generations at Rock Island, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712

Survey Date – 03/20/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 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: Generations at Rock Island

FACILITY ADDRESS: 2545 24^th Street
FACILITY CITY, STATE, ZIP: Rock Island, IL 61201

DOCKET NUMBER: NH 19-C0227

LICENSEE INFO: Generations at Rock Island, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712

Survey Date – 03/28/2019
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)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: Gilman Healthcare Center

FACILITY ADDRESS: 1390 South Crescent Street
FACILITY CITY, STATE, ZIP: Gilman, IL 60938

DOCKET NUMBER: NH 19-C0203

LICENSEE INFO: Gilman Health Center, LLC
LICENSEE ADDRESS: 4711 Golf Rd, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076

Survey Date – 03/27/2019
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)2), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Glenwood Healthcare & Rehab

FACILITY ADDRESS: 19330 South Cottage Grove
FACILITY CITY, STATE, ZIP: Glenwood, IL 60425

DOCKET NUMBER: NH 19-C0208

LICENSEE INFO: Glenwood Healthcare & Rehab, Inc.
LICENSEE ADDRESS: 5750 Old Orchard Road, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 04/09/2019
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: Golfview Development Center

FACILITY ADDRESS: 9555 West Golf Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60016

DOCKET NUMBER: NH 19-C0138

LICENSEE INFO: Golfview Development Center, Inc.
LICENSEE ADDRESS: 111 Wacker Drive, 44^th FL
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 02/04/2019
Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) 350.1210d)1)2), 350.3240a) and 350.3240c). A fine of $12,500.00

FACILITY NAME: Good Samaritan Home

FACILITY ADDRESS: 2130 Harrison Street
FACILITY CITY, STATE, ZIP: Quincy, IL 62301

DOCKET NUMBER: NH 19-S0130

LICENSEE INFO: The Good Samaritan Home of Quincy
LICENSEE ADDRESS: 2130 Harrison Street
LICENSEE CITY, STATE, ZIP: Quincy, IL 62301

Survey Date – 02/26/2019
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), 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: Granite Nsg & Rehab Center

FACILITY ADDRESS: 3500 Century Drive
FACILITY CITY, STATE, ZIP: Granite City, IL 62040

DOCKET NUMBER: NH 19-C0201

LICENSEE INFO: Granite Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 901 South 2^nd Street, Ste 201
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704

Survey Date – 04/09/2019
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: Greentree of Bradley Rehab

FACILITY ADDRESS: 650 North Kinzie
FACILITY CITY, STATE, ZIP: Bradley, IL 60915

DOCKET NUMBER: NH 19-S0206

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 – 03/13/2019
Type Repeat B violation of an occurrence for violating one or more of the following sections of the Code: 300.1610a)1). A fine of $2,200.00.

FACILITY NAME: Greentree of Bradley Rehab

FACILITY ADDRESS: 650 North Kinzie
FACILITY CITY, STATE, ZIP: Bradley, IL 60915

DOCKET NUMBER: NH 19-C0264

LICENSEE INFO: River North of Bradley Health & Rehabilitation Center, LLC
LICENSEE ADDRESS: 191 North Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 04/10/2019
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)1)2), 300.1210d)6), 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)6) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Greenville Nursing & Rehab

FACILITY ADDRESS: 400 East Hillview Avenue
FACILITY CITY, STATE, ZIP: Greenville, IL 62246

DOCKET NUMBER: NH 19-S0295

LICENSEE INFO: Greenville Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 215 East Locust Street
LICENSEE CITY, STATE, ZIP: Harrisburg, IL 62946

Survey Date – 05/09/2019
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), 300.1210d)3)4)A) 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: Grove of Berwyn, The

FACILITY ADDRESS: 3601 South Harlem Avenue
FACILITY CITY, STATE, ZIP: Berwyn. IL 60402

DOCKET NUMBER: NH 19-S0234

LICENSEE INFO: Berwyn Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076

Survey Date – 04/25/2019
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)3)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: Grove of Evanston L & R, The

FACILITY ADDRESS: 500 Asbury Avenue
FACILITY CITY, STATE, ZIP: Evanston, IL 60202

DOCKET NUMBER: NH 19-C0168

LICENSEE INFO: Evanston Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 03/15/2019
Type B 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 $2,200.00.

FACILITY NAME: Grove of LaGrange Park

FACILITY ADDRESS: 701 North LaGrange Road
FACILITY CITY, STATE, ZIP: LaGrange Park, IL 60526

DOCKET NUMBER: NH 19-S0239

LICENSEE INFO: Lagrange Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 04/18/2019
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), 300.1220b)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: Harbor House

FACILITY ADDRESS: 760 McHenry Road
FACILITY CITY, STATE, ZIP: Wheeling, IL 60090

DOCKET NUMBER: NH 19-S0164

LICENSEE INFO: Harbor Healthcare, LLC
LICENSEE ADDRESS: 120 South Riverside Plz, Ste 1200
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 03/07/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.720b). A fine of $1,100.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.1120a). A fine of $1,100.00

Total Fine $2,200.00

FACILITY NAME: Havana Health Care Center

FACILITY ADDRESS: 609 North Harpham Street
FACILITY CITY, STATE, ZIP: Havana, IL 62644

DOCKET NUMBER: NH 19-S0242

LICENSEE INFO: Petersen Health Quality, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 05/09/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 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.

FACILITY NAME: Heartland Nursing & Rehab

FACILITY ADDRESS: 410 Northwest Third Street
FACILITY CITY, STATE, ZIP: Casey, IL 62420

DOCKET NUMBER: NH 19-S0166

LICENSEE INFO: Heartland Nursing & Rehabilitation, LLC
LICENSEE ADDRESS: 215 East Locust Street
LICENSEE CITY, STATE, ZIP: Harrisburg, IL 62946

Survey Date – 03/20/2019
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: Heartland of Galesburg

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

DOCKET NUMBER: NH 19-S0297

LICENSEE INFO: Heartland of Galesburg IL, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 05/07/2019
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: Helia Healthcare of Belleville

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

DOCKET NUMBER: NH 19-C0237

LICENSEE INFO: Helia Healthcare of Belleville, LLC
LICENSEE ADDRESS: 118 West Edwards Street, Ste 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704

Survey Date – 04/01/2019
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)3), 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 $25,000.00

FACILITY NAME: Henderson County Ret Center

FACILITY ADDRESS: 604 Oakwood Drive
FACILITY CITY, STATE, ZIP: Stronghurst, IL 61480

DOCKET NUMBER: NH 19-C0228

LICENSEE INFO: Henderson County Retirement Center, Inc.
LICENSEE ADDRESS: 110 South Broadway
LICENSEE CITY, STATE, ZIP: Stronghurst, IL 61480

Survey Date – 04/18/2019
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)3)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: Heritage Health Gillespie

FACILITY ADDRESS: 7588 Staunton Road
FACILITY CITY, STATE, ZIP: Gillespie, IL 62033

DOCKET NUMBER: NH 19-S0241

LICENSEE INFO: Heritage Manor Gillespie, LLC
LICENSEE ADDRESS: 115 West Jefferson Street, Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701

Survey Date – 04/15/2019
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: Heritage Health Jacksonville

FACILITY ADDRESS: 873 Grove Street
FACILITY CITY, STATE, ZIP: Jacksonville, IL 62650

DOCKET NUMBER: NH 19-C0170

LICENSEE INFO: Barton W Stone Jacksonville, LLC
LICENSEE ADDRESS: 115 W Jefferson St, Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701

Survey Date – 03/11/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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: Heritage Health Mendota

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

DOCKET NUMBER: NH 19-S0167

LICENSEE INFO: Heritage Manor Mendota, LLC
LICENSEE ADDRESS: 115 W Jefferson St, Ste 400
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701

Survey Date – 03/01/2019
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: Heritage Health Normal

FACILITY ADDRESS: 509 North Adelaide
FACILITY CITY, STATE, ZIP: Normal, IL 61761

DOCKET NUMBER: NH 18-C0060

LICENSEE INFO: Heritage Manor – Normal, LLC
LICENSEE ADDRESS: 115 West Jefferson Street, Suite 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701

Survey Date – 01/12/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Heritage Health - Pana

FACILITY ADDRESS: 1000 East Sixth Street Road
FACILITY CITY, STATE, ZIP: Pana, IL 62557

DOCKET NUMBER: NH 18-S0072

LICENSEE INFO: Heritage Manor – Pana, LLC
LICENSEE ADDRESS: 115 West Jefferson Street, Suite 4004
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701

Survey Date – 01/19/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Heritage Health Peru

FACILITY ADDRESS: 1301 21^st Street
FACILITY CITY, STATE, ZIP: Peru, IL 61354

DOCKET NUMBER: NH 19-S0197

LICENSEE INFO: Heritage Manor Peru LLC
LICENSEE ADDRESS: 115 West Jefferson, Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701

Survey Date – 03/21/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4)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: Heritage Health Staunton

FACILITY ADDRESS: 215 West Pennsylvania Avenue
FACILITY CITY, STATE, ZIP: Staunton, IL 62088

DOCKET NUMBER: NH 18-S0162

LICENSEE INFO: Heritage Manor Staunton
LICENSEE ADDRESS: 115 West Jefferson St, Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701

Survey Date – 03/02/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Integrity HC of Belleville

FACILITY ADDRESS: 727 North 17^th Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62226

DOCKET NUMBER: NH 19-S0161

LICENSEE INFO: Belleville Behavioral Health & Nursing Center, LLC
LICENSEE ADDRESS: 2015 West Main Street, Ste 111
LICENSEE CITY, STATE, ZIP: Carbondale, IL 62901

Survey Date – 03/01/2019
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

FACILITY NAME: Integrity HC of Columbia

FACILITY ADDRESS: 253 Bradington Drive
FACILITY CITY, STATE, ZIP: Columbia, IL 62236

DOCKET NUMBER: NH 19-C0134

LICENSEE INFO: Columbia Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 2015 West Main Street, Ste 111
LICENSEE CITY, STATE, ZIP: Carbondale, IL 62901

Survey Date – 02/13/2019
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.3210o) 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: Iona Glos SLC

FACILITY ADDRESS: 50 South Fairbank Street
FACILITY CITY, STATE, ZIP: Addison, IL 60101

DOCKET NUMBER: NH 19-S0204

LICENSEE INFO: Ray Graham Association for People with Disabilities
LICENSEE ADDRESS: 901 Warrenville Road, Ste 500
LICENSEE CITY, STATE, ZIP: Lisle, IL 60532

Survey Date – 03/20/2019
Type AA violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) 350.1210 and 350.3240a). A fine of $25,000.00

FACILITY NAME: Jacksonville Skld Nur & Rehab

FACILITY ADDRESS: 1517 West Walnut
FACILITY CITY, STATE, ZIP: Jacksonville, IL 62650

DOCKET NUMBER: NH 19-C0135

LICENSEE INFO: Covenant Care Jacksonville, LLC
LICENSEE ADDRESS: 2015 West Main Street, #111
LICENSEE CITY, STATE, ZIP: Carbondale, IL 62901

Survey Date – 02/20/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4)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: Lakeview Rehab & Nrsg Center

FACILITY ADDRESS: 735 West Diversey
FACILITY CITY, STATE, ZIP: Chicago, IL 60614

DOCKET NUMBER: NH 19-C0212

LICENSEE INFO: Lakeview Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162

Survey Date – 03/22/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1230f)1)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: 300.1230).
A fine of $2,200.00.

FACILITY NAME: Lakewood Nrsg & Rehab Center

FACILITY ADDRESS: 14716 South Eastern Avenue
FACILITY CITY, STATE, ZIP: Plainfield, IL 60544

DOCKET NUMBER: NH 19-C0215

LICENSEE INFO: Lakewood Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202

Survey Date – 04/08/2019
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: Lebanon Care Center

FACILITY ADDRESS: 1201 North Alton
FACILITY CITY, STATE, ZIP: Lebanon, IL 62254

DOCKET NUMBER: NH 19-S0114

LICENSEE INFO: Petersen Health Group, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 02/08/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1220b)2), 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 sections of the Code with a high risk designation: 300.1210b), 300.3240a) and 300.3240e) A fine of $2,200.00.

FACILITY NAME: Lebanon Care Center

FACILITY ADDRESS: 1201 North Alton
FACILITY CITY, STATE, ZIP: Lebanon, IL 62254

DOCKET NUMBER: NH 19-C0193

LICENSEE INFO: Petersen Health Group, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 04/04/2019
Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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 $50,000.00

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

FACILITY NAME: Lexington of Orland Park

FACILITY ADDRESS: 14601 South John Humphrey Drive
FACILITY CITY, STATE, ZIP: Orland Park, IL 60462

DOCKET NUMBER: NH 19-C0261

LICENSEE INFO: Lexington health Care Center of Orland Park, Inc.
LICENSEE ADDRESS: 665 West North Avenue
LICENSEE CITY, STATE, ZIP: Lombard, IL 60148

Survey Date – 04/12/2019
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)2), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Lexington of Orland Park

FACILITY ADDRESS: 14601 S. John Humphrey Drive
FACILITY CITY, STATE, ZIP: Orland Park, IL 60462

DOCKET NUMBER: NH 19-S0262

LICENSEE INFO: Lexington Health Care Center of Orland Park, Inc.
LICENSEE ADDRESS: 665 W. North Avenue
LICENSEE CITY, STATE, ZIP: Lombard, IL 60148

Survey Date – 05/09/2019
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: Lexington of Streamwood

FACILITY ADDRESS: 815 East Irving Park Road
FACILITY CITY, STATE, ZIP: Streamwood, IL 60107

DOCKET NUMBER: NH 19-C0127

LICENSEE INFO: Lexington Health Care Center of Streamwood, Inc.
LICENSEE ADDRESS: 665 West North Avenue
LICENSEE CITY, STATE, ZIP: Lombard, IL 60148

Survey Date – 02/07/2019
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) 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: Loft Rehab & Nursing of Canton

FACILITY ADDRESS: 2081 North Main Street
FACILITY CITY, STATE, ZIP: Canton, IL 61520

DOCKET NUMBER: NH 19-S0140

LICENSEE INFO: The Loft Rehabilitation and Nursing of Canton, LLC
LICENSEE ADDRESS: 55 West Monroe Street, Ste 2400
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603

Survey Date – 03/06/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)4). 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)4). A fine of $2,200.00

FACILITY NAME: Loft Rehabilitation & Nursing

FACILITY ADDRESS: 700 North Main Street
FACILITY CITY, STATE, ZIP: Eureka, IL 61530

DOCKET NUMBER: NH 19-S0247

LICENSEE INFO: The Loft Rehabilitation & Nursing, LLC
LICENSEE ADDRESS: 191 North Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 04/11/2019
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)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: Magnolia Manor Shelter Care HM

FACILITY ADDRESS: 1100 Grant
FACILITY CITY, STATE, ZIP: Eldorado, IL 62930

DOCKET NUMBER: NH 19-C0124

LICENSEE INFO: John W. Zink
LICENSEE ADDRESS: 150 South Route 45, P.O. Box 250
LICENSEE CITY, STATE, ZIP: Louisville, IL 62858

Survey Date – 02/20/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.4240a)b)c)d)e)f). The fine was doubled in this instance in accordance with 330.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 330.4240a), 330.4240d), and 330.4240e). A fine of $2,200.00

FACILITY NAME: Manor Court of Freeport

FACILITY ADDRESS: 2170 West Navajo Drive
FACILITY CITY, STATE, ZIP: Freeport, IL 61032

DOCKET NUMBER: NH 19-C0179

LICENSEE INFO: Residential Alternatives of Illinois, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401

Survey Date – 03/12/2019
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), 300.3240a), and300.3240e). 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 300.32040e). A fine of $2,200.00

FACILITY NAME: Manorcare of Arlington Heights

FACILITY ADDRESS: 715 West Central Road
FACILITY CITY, STATE, ZIP: Arlington Heights, IL 60005

DOCKET NUMBER: NH 19-C0185

LICENSEE INFO: Manorcare Health Services, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60005

Survey Date – 03/13/2019
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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 $25,000.00

FACILITY NAME: Manorcare of Homewood

FACILITY ADDRESS: 940 Maple Avenue
FACILITY CITY, STATE, ZIP: Homewood, IL 60430

DOCKET NUMBER: NH 19-C0224

LICENSEE INFO: Manor Care of Homewood, IL, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 04/03/2019
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)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: Manorcare of Libertyville

FACILITY ADDRESS: 1500 South Milwaukee Avenue
FACILITY CITY, STATE, ZIP: Libertyville, IL 60048

DOCKET NUMBER: NH 19-S0282

LICENSEE INFO: Manor Care of Libertyville, IL, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 04/25/2019
Type B 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 $2,200.00.

FACILITY NAME: Mattoon Rehab & HCC

FACILITY ADDRESS: 2121 South 9^th Street
FACILITY CITY, STATE, ZIP: Mattoon, IL 61938

DOCKET NUMBER: NH 19-C0296

LICENSEE INFO: Mattoon Manor, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 05/09/2019
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: Meadowbrook Manor LaGrange

FACILITY ADDRESS: 339 9^th Avenue
FACILITY CITY, STATE, ZIP: LaGrange, IL 60525

DOCKET NUMBER: NH 19-S0238

LICENSEE INFO: Butterfield Health Care VII, LLC
LICENSEE ADDRESS: 150 North Riverside Plaza, Ste 3000
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 04/04/2019
Type A 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 $25,000.00

FACILITY NAME: Meadow Manor Skld Nur & Rehab

FACILITY ADDRESS: 800 McAdam Drive
FACILITY CITY, STATE, ZIP: Taylorville, IL 62568

DOCKET NUMBER: NH 19-S0131

LICENSEE INFO: Covenant Care Meadow Manor, LLC
LICENSEE ADDRESS: 2015 West Main Street, Ste 111
LICENSEE CITY, STATE, ZIP: Carbondale, IL 62901

Survey Date – 02/*05/2019
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)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.

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) and 300.1220b)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). A fine of $2,200.00
Total Fines $4,400.00

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

FACILITY NAME: Mendota Lutheran Home

FACILITY ADDRESS: 500 Sixth Street
FACILITY CITY, STATE, ZIP: Mendota, IL 61342

DOCKET NUMBER: NH 19-S0142

LICENSEE INFO: Mendota Lutheran Home
LICENSEE ADDRESS: 1316 Meridan Street
LICENSEE CITY, STATE, ZIP: Mendota, IL 61342

Survey Date – 02/20/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1220d)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: Mendota Lutheran Home

FACILITY ADDRESS: 500 Sixth Street
FACILITY CITY, STATE, ZIP: Mendota, IL 61342

DOCKET NUMBER: NH 19-S0257

LICENSEE INFO: Mendota Lutheran Home
LICENSEE ADDRESS: 1316 Meridan Street
LICENSEE CITY, STATE, ZIP: Mendota, IL 61342

Survey Date – 04/18/2019
Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210c), 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 $50,000.00

FACILITY NAME: Mercy Rehab and Care Center

FACILITY ADDRESS: 100 Rosewood Village Drive
FACILITY CITY, STATE, ZIP: Swansea, IL 62226

DOCKET NUMBER: NH 18-S0354

LICENSEE INFO: Mercy Rehab and Care Center, Inc.
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 07/12/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Montgomery Nursing & Rehab Ctr

FACILITY ADDRESS: State Route 127, P.O. Box 309
FACILITY CITY, STATE, ZIP: Hillsboro, IL 62049

DOCKET NUMBER: NH 19-C0177

LICENSEE INFO: Helia Healthcare of Hillsboro, LLC
LICENSEE ADDRESS: 118 West Edwards Street, Ste 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704

Survey Date – 03/21/2019
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: Moorings of Arlington Heights

FACILITY ADDRESS: 761 Old Barn Lane
FACILITY CITY, STATE, ZIP: Arlington Hts, IL 60005

DOCKET NUMBER: NH 19-C0213
NH 19-S0214

LICENSEE INFO: The Moorings of Arlington Heights, LLC
LICENSEE ADDRESS: 8707 Skokie Blvd, Ste 400
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 03/21/2019
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), 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 A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210c), 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

Total Fine $50,000.00

FACILITY NAME: Oak Park Oasis

FACILITY ADDRESS: 625 North Harlem
FACILITY CITY, STATE, ZIP: Oak Park, IL 60302

DOCKET NUMBER: NH 19-S0248

LICENSEE INFO: Oak Park Oasis, LLC
LICENSEE ADDRESS: 4711 Gold Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076

Survey Date – 05/01/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1620a), 300.1640a), and 300.1810g). A fine $1,100.00

FACILITY NAME: Palm Terrace of Mattoon

FACILITY ADDRESS: 1000 Palm Avenue
FACILITY CITY, STATE, ZIP: Mattoon, IL 61938

DOCKET NUMBER: NH 19-C0129

LICENSEE INFO: Petersen Management Company, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 02/27/2019
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), 300.1620a), 300.1630b), 300.1630c), 3000.3220f) 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: Pearl of the Rolling Meadows, The

FACILITY ADDRESS: 4225 Kirchoff Road
FACILITY CITY, STATE, ZIP: Rolling Meadows, IL 60008

DOCKET NUMBER: NH 19-C0144

LICENSEE INFO: Pearl of Rolling Meadows, LLC
LICENSEE ADDRESS: 4711 Golf Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076

Survey Date – 02/26/2019
Type A 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 $25,000.00

FACILITY NAME: Pekin Manor

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

DOCKET NUMBER: NH 19-C0169

LICENSEE INFO: UDI #10, LLC
LICENSEE ADDRESS: 285 South Farnharm Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401

Survey Date – 03/07/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)2), 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: Presence Cor Mariae Center

FACILITY ADDRESS: 3330 Maria Linden Drive
FACILITY CITY, STATE, ZIP: Rockford, IL 61114

DOCKET NUMBER: NH 19-C0196

LICENSEE INFO: Presence Life Connections
LICENSEE ADDRESS: 18927 Hickory Creek Drive, Suite 300
LICENSEE CITY, STATE, ZIP: Mokena, IL 60448

Survey Date – 03/26/2019
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: Presence St. Anne Center

FACILITY ADDRESS: 4405 Hillcrest Road
FACILITY CITY, STATE, ZIP: Rockford, IL 61107

DOCKET NUMBER: NH 19-S0160

LICENSEE INFO: Presence Life Connections
LICENSEE ADDRESS: 18927 Hickory Creek Drive, Ste 300
LICENSEE CITY, STATE, ZIP: Mokena, IL 60448

Survey Date – 03/21/2019
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1030a)1), 300.1210d)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: 300.3240a). A fine of $25,000.00

FACILITY NAME: Presence St. Anne Center

FACILITY ADDRESS: 4405 Highcrest Road
FACILITY CITY, STATE, ZIP: Rockford, IL 61107

DOCKET NUMBER: NH 19-S0231
NH 19-C0232

LICENSEE INFO: Presence Life Connections
LICENSEE ADDRESS: 18927 Hickory Creek Drive, Ste 300
LICENSEE CITY, STATE, ZIP: Mokena, IL 60448

Survey Date – 04/25/2019
Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210c), 300.1210d)6), 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)6) and 300.3240a). A fine of $50.000.00

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

Total Fine $52,200.00

FACILITY NAME: Regency Care

FACILITY ADDRESS: 2120 W. Washington Street
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 18-S0179

LICENSEE INFO: Rutledge – Regency Operations, LLC
LICENSEE ADDRESS: 202 N. Center Street
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701

Survey Date – 04/13/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

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

FACILITY NAME: Rosewood Care Center Inverness

FACILITY ADDRESS: 1800 Colonial Parkway
FACILITY CITY, STATE, ZIP: Inverness, IL 60067

DOCKET NUMBER: NH 19-S0205

LICENSEE INFO: Bravo Care of Inverness, Inc.
LICENSEE ADDRESS: 412 East Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 03/01/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4), 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: Rosewood Care Center of Joliet

FACILITY ADDRESS: 3401 Hennepin Drive
FACILITY CITY, STATE, ZIP: Joliet, IL 60431

DOCKET NUMBER: NH 19-C0221

LICENSEE INFO: Bravo Care of Joliet, Inc.
LICENSEE ADDRESS: 412 East Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 03/22/2019
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: 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
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Rosewood Care Center of Peoria

FACILITY ADDRESS: 1500 W. Northmoor Road
FACILITY CITY, STATE, ZIP: Peoria, IL 61614

DOCKET NUMBER: NH 18-C0115

LICENSEE INFO: Bravo Care of Peoria, Inc.
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 03/08/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Rosewood Care Center of Peoria

FACILITY ADDRESS: 1500 West Northmoor Road
FACILITY CITY, STATE, ZIP: Peoria, IL 61614

DOCKET NUMBER: NH 19-S0143

LICENSEE INFO: Bravo Care of Peoria, Inc.
LICENSEE ADDRESS: 412 East Lawrence Street
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 02/21/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a) and 300.1210b). 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: Rosewood Care Center of Peoria

FACILITY ADDRESS: 1500 West Northmoor Road
FACILITY CITY, STATE, ZIP: Peoria, IL 61614

DOCKET NUMBER: NH 19-C0150

LICENSEE INFO: Bravo Care of Peoria, Inc.
LICENSEE ADDRESS: 412 East Lawrence Street
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 03/06/2019
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), 300.1620a) 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: South Holland Manor Hlth & Rhb

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

DOCKET NUMBER: NH 19-C0211

LICENSEE INFO: South Holland Manor HRC, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202

Survey Date – 03/28/2019
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210c), ge300.1210d)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: South Suburban Rehab Center

FACILITY ADDRESS: 19000 South Halsted Street
FACILITY CITY, STATE, ZIP: Homewood, IL 60430

DOCKET NUMBER: NH 19-C0302

LICENSEE INFO: South Suburban Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 West Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202

Survey Date – 05/07/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 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.

FACILITY NAME: Stephenson Nursing Center

FACILITY ADDRESS: 2946 South Walnut Road
FACILITY CITY, STATE, ZIP: Freeport, IL 61032

DOCKET NUMBER: NH 19-S0235

LICENSEE INFO: Stephenson County Board of Supervisors
LICENSEE ADDRESS: 50 West Douglas Street, Ste 1002
LICENSEE CITY, STATE, ZIP: Freeport, IL 61032

Survey Date – 04/25/2019
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.682b), 300.690c), 300.1210b), 300.3240a), 300.3240b), 300.3240c), 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 sections of the Code with a high risk designation: 300.690), 300.1210b), 300.3240a), 300.3240d) and 300.3240e). A fine of $25,000.00

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

FACILITY NAME: Sunset Home

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

DOCKET NUMBER: NH 19-C0184

LICENSEE INFO: Sunset Home
LICENSEE ADDRESS: 625 Vermont Street
LICENSEE CITY, STATE, ZIP: Quincy, IL 62301

Survey Date – 03/19/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 $2,200.00.

FACILITY NAME: Symphony at Aria

FACILITY ADDRESS: 4600 North Frontage Road
FACILITY CITY, STATE, ZIP: Hillside, IL 60162

DOCKET NUMBER: NH 19-C0225

LICENSEE INFO: Symphony Aria, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 03/27/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00.

FACILITY NAME: Symphony at Midway

FACILITY ADDRESS: 4437 South Cicero
FACILITY CITY, STATE, ZIP: Chicago, IL 60632

DOCKET NUMBER: NH 19-C0153

LICENSEE INFO: Symphony Midway, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 02/20/2019
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

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)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 Fines $27,200.00

FACILITY NAME: Symphony Evanston Healthcare

FACILITY ADDRESS: 820 Foster Street
FACILITY CITY, STATE, ZIP: Evanston, IL 60201

DOCKET NUMBER: NH 19-S0191
NH 19-C0192

LICENSEE INFO: Symphony of Evanston Healthcare, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 03/22/2019
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: Symphony of Buffalo Grove

FACILITY ADDRESS: 150 North Weiland
FACILITY CITY, STATE, ZIP: Buffalo Grove, IL 60089

DOCKET NUMBER: NH 19-S0174

LICENSEE INFO: Symphony Buffalo Grove, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 03/20/2019
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)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: Symphony of Crestwood

FACILITY ADDRESS: 14255 South Cicero Avenue
FACILITY CITY, STATE, ZIP: Crestwood, IL 60445

DOCKET NUMBER: NH 19-C0149

LICENSEE INFO: Symphony Crestwood, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 02/21/2019
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: Tanner Place

FACILITY ADDRESS: 321 Chestnut Street
FACILITY CITY, STATE, ZIP: Paris, IL 61944

DOCKET NUMBER: NH 19-C0165

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401

Survey Date – 03/06/2019
Type B violation for violating one or more of the following sections of the Code: 350.1210) and 350.3240a)b). A fine of $550.00.

Type B violation for violating one or more of the following sections of the Code: 350.620a) and 350.3240b)d)f). A fine of $550.00

Total Fine $1,100.00

FACILITY NAME: Timbercreek Rehab & Hlth C Ctr

FACILITY ADDRESS: 2220 State Street
FACILITY CITY, STATE, ZIP: Pekin, IL 61554

DOCKET NUMBER: NH 19-C0230

LICENSEE INFO: Petersen Health Operations, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 04/11/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 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: Uptown Health Center

FACILITY ADDRESS: 4920 North Kenmore
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 18-C0336

LICENSEE INFO: Uptown Health Center, LLC
LICENSEE ADDRESS: 5215 Old Orchard Road, Suite 960
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 07/27/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Walker Nursing Home

FACILITY ADDRESS: 530 East Beardstown Street
FACILITY CITY, STATE, ZIP: Virginia, IL 62691

DOCKET NUMBER: NH 19-S0263

LICENSEE INFO: Walker Nursing Home, Inc.
LICENSEE ADDRESS: 2319 West Jefferson Street
LICENSEE CITY, STATE, ZIP: Springfield, IL 62702

Survey Date – 05/07/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)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: Warren Barr Lincolnshire

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

DOCKET NUMBER: NH 18-S0229

LICENSEE INFO: Lincolnshire Living & Rehab Center, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 04/19/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Warren Barr North Shore

FACILITY ADDRESS: 2773 Skokie Valley Road
FACILITY CITY, STATE, ZIP: Highland Park, IL 60035

DOCKET NUMBER: NH 19-S0217

LICENSEE INFO: Warren Barr North Shore, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 04/17/2019
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: Warren Barr North Shore

FACILITY ADDRESS: 2773 Skokie Valley Road
FACILITY CITY, STATE, ZIP: Highland Park, IL 60035

DOCKET NUMBER: NH 19-C0220

LICENSEE INFO: Warren Barr North Shore, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 04/23/2019
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)4)A)B)6), 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), 300.1210d)6), 300.1230) and 300.3240a).
A fine of $2,200.00.

FACILITY NAME: Westminster Village

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

DOCKET NUMBER: NH 18-C0460

LICENSEE INFO: Westminster Village, Inc.
LICENSEE ADDRESS: 2025 E. Lincoln Street
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701

Survey Date – 10/03/2018
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Willows Health Center

FACILITY ADDRESS: 4054 Albright Lane
FACILITY CITY, STATE, ZIP: Rockford, IL 61103

DOCKET NUMBER: NH 19-C0125

LICENSEE INFO: Willows Health Center
LICENSEE ADDRESS: 4141 North Rockton Avenue
LICENSEE CITY, STATE, ZIP: Rockford, IL

Survey Date – 03/05/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.4240a) The fine was doubled in this instance in accordance with 330.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 330.4240a). A fine of $2,200.00

FACILITY NAME: Winning Wheels

FACILITY ADDRESS: 701 East 3^rd Street
FACILITY CITY, STATE, ZIP: Prophetstown, IL 61277

DOCKET NUMBER: NH 19-C0145

LICENSEE INFO: Winning Wheels, Inc.
LICENSEE ADDRESS: 701 East Third Street
LICENSEE CITY, STATE, ZIP: Prophetstown, IL 61277

Survey Date – 02/26/2019
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), 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) and 300.3240a). A fine $2,200.00

FACILITY NAME: Woodbridge Nursing Pavilion

FACILITY ADDRESS: 2242 North Kedzie
FACILITY CITY, STATE, ZIP: Chicago, IL 60647

DOCKET NUMBER: NH 19-C0250

LICENSEE INFO: Woodbridge Nursing Pavilion, LLC
LICENSEE ADDRESS: 191 North Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 04/30/2019
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.