1st Quarter Report January-March 2019

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

DOCKET NUMBER: NH 19-C0108

LICENSEE INFO: Alden-Orland Park Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 West Peterson Avenue, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 01/22/2019

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)1)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: Alden Manor Rehab & HCC
FACILITY ADDRESS: 6120 West Ogden
FACILITY CITY, STATE, ZIP: Cicero, IL 60804

DOCKET NUMBER: NH 18-C0539

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 – 11/09/2018

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

DOCKET NUMBER: NH 19-C0101

LICENSEE INFO: Alden Town Manor Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 West Peterson Avenue, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 01/09/2019

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)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: Aldeo Rehab & Health Care Ctr
FACILITY ADDRESS: 304 SW 12^th Street
FACILITY CITY, STATE, ZIP: Aledo, IL 61231

DOCKET NUMBER: NH 18-S0236

LICENSEE INFO: Petersen Health Group, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 05/03/2018

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Ambassador Nsg & Rehab Center
FACILITY ADDRESS: 4900 N. Bernard
FACILITY CITY, STATE, ZIP: Chicago, IL 60625

DOCKET NUMBER: NH 19-C0011

LICENSEE INFO: Ambassador Nursing & Rehabilitation II, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 11/21/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)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 Cairo
FACILITY ADDRESS: 2001 Cedar Street
FACILITY CITY, STATE, ZIP: Cairo, IL 62914

DOCKET NUMBER: NH 19-C0024

LICENSEE INFO: Aperion Care Cairo, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/28/2018

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), 300.1210d)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 $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-C0424

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

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-C0002

LICENSEE INFO: Aperion Care Capitol, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/03/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d)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

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) 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), 300.1010h), 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

Total fines $29,400.00

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

DOCKET NUMBER: NH 19-C0042

LICENSEE INFO: River Crossing Rehab, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/13/2018

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), 300.1220b)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: Aperion Care Litchfield
FACILITY ADDRESS: 1024 East Tyler
FACILITY CITY, STATE, ZIP: Litchfield, IL 62056

DOCKET NUMBER: NH 18-S0344

LICENSEE INFO: Litchfield Care Center, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/03/2018

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

FACILITY NAME: Aperion Care Marseilles
FACILITY ADDRESS: 578 West Commercial Street
FACILITY CITY, STATE, ZIP: Marseilles, IL 61341

DOCKET NUMBER: NH 18-S0272

LICENSEE INFO: Aperion Care Marseilles, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 05/18/2018

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-C0046

LICENSEE INFO: Aperion Care Mascoutah, LLC
LICENSEE ADDRESS: 208 South LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/19/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4), 300.1220b)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

FACILITY NAME: Aperion Care Toluca
FACILITY ADDRESS: 101 E. Via Ghiglieri
FACILITY CITY, STATE, ZIP: Toluca, IL 61369

DOCKET NUMBER: NH 19-C0026

LICENSEE INFO: Aperion Care Toluca, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/30/2018

FACILITY NAME: Arden Courts of Elk Grove
FACILITY ADDRESS: 1940 Nerge Road
FACILITY CITY, STATE, ZIP: Elk Grove, IL 60007

DOCKET NUMBER: NH 19-C0033

LICENSEE INFO: Arden Courts of Elk Grove Village IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/13/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.780a)b)c). 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: 330.780). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.1110a)b)d)f). A fine of $2,200.00

Total Fines $3,300.00

FACILITY NAME: Arden Courts of Shorewood
FACILITY ADDRESS: 700 West Black Road
FACILITY CITY, STATE, ZIP: Shorewood, IL 60404

DOCKET NUMBER: NH 18-C0538

LICENSEE INFO: Alden Courts of Shorewood, Inc.
LICENSEE ADDRESS: 4200 West Peterson Avenue, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 11/19/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4)5), 300.1210c), 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 $2,200.00

FACILITY NAME: Batavia Rehab & Hlth Care Ctr
FACILITY ADDRESS: 520 Fabyan Parkway
FACILITY CITY, STATE, ZIP: Batavia, IL 60510

DOCKET NUMBER: NH 19-C0044

LICENSEE INFO: Peterson Health Operations, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 12/11/2018

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: Beecher Manor Nursing & Rehab
FACILITY ADDRESS: 1201 Dixie Highway
FACILITY CITY, STATE, ZIP: Beecher, IL 60401

DOCKET NUMBER: NH 18-C0269 & NH 18-S0270

LICENSEE INFO: Beecher Manor Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 West Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 05/17/2018

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

FACILITY NAME: Bella Terra Morton Grove
FACILITY ADDRESS: 8425 Waukegan Road
FACILITY CITY, STATE, ZIP: Morton Grove, IL 60053

DOCKET NUMBER: NH 19-C0083

LICENSEE INFO: Morton Grove Living & Rehab Center, LLC
LICENSEE ADDRESS: 801 Adali Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/28/2019

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)3), 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: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Bria of Chicago Heights
FACILITY ADDRESS: 120 West 26^th Street
FACILITY CITY, STATE, ZIP: S. Chicago Heights, IL 60411

DOCKET NUMBER: NH 19-C0073

LICENSEE INFO: MST Health Properties, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 01/02/2019

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)3), 300.1210d)6) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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), 300.1210b6) 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: $29,400.00

FACILITY NAME: Bria of Palos Hills
FACILITY ADDRESS: 10426 South Roberts
FACILITY CITY, STATE, ZIP: Palos Hills, IL 60465

DOCKET NUMBER: NH 19-C0059

LICENSEE INFO: Palos Hills Healthcare, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 12/12/2018

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

FACILITY NAME: Briar Place Nursing
FACILITY ADDRESS: 6800 West Joliet
FACILITY CITY, STATE, ZIP: Indian Head Park, IL 60525

DOCKET NUMBER: NH 18-C0253

LICENSEE INFO: Briar Place Nursing, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 05/15/2018

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

FACILITY NAME: Broadway Terrace
FACILITY ADDRESS: 43 Broadway
FACILITY CITY, STATE, ZIP: Chicago Heights, IL 60411

DOCKET NUMBER: NH 19-C0007

LICENSEE INFO: Pioneer Concepts, Inc.
LICENSEE ADDRESS: 285 S. Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 11/21/2018

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

FACILITY NAME: California Gardens Nursing & Rehab Center
FACILITY ADDRESS: 2829 South California Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60608

DOCKET NUMBER: NH 19-C0094

LICENSEE INFO: California Gardens Corp
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/10/2019

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: California Gardens Nursing & Rehab Center
FACILITY ADDRESS: 2829 South California Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60608

DOCKET NUMBER: NH 19-C0094

LICENSEE INFO: California Gardens Corp
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/10/2019

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

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

DOCKET NUMBER: NH 19-S0013

LICENSEE INFO: Champaign County Board
LICENSEE ADDRESS: 1776 East Washington Street
LICENSEE CITY, STATE, ZIP: Urbana, IL 61802
Survey Date – 11/28/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 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: Champaign County Nursing Home
FACILITY ADDRESS: 500 South Art Bartell Drive
FACILITY CITY, STATE, ZIP: Urbana, IL 61802

DOCKET NUMBER: NH 19-C0057

LICENSEE INFO: Champaign County Board
LICENSEE ADDRESS: 1776 East Washington Street
LICENSEE CITY, STATE, ZIP: Urbana, IL 61802
Survey Date – 12/19/2018

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)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: Champaign Living Center
FACILITY ADDRESS: 309 East Springfield Avenue
FACILITY CITY, STATE, ZIP: Champaign, IL 61820

DOCKET NUMBER: NH 19-C0121

LICENSEE INFO: Paradox Champaign Operator, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 02/04/2019

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)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

Total Fines $50,000.00.

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

DOCKET NUMBER: NH 18-C0542

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 – 11/14/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d)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

FACILITY NAME: Charleston Rehab & Health CC
FACILITY ADDRESS: 716 Eighteenth Street
FACILITY CITY, STATE, ZIP: Charleston, IL 61920

DOCKET NUMBER: NH 19-S0053

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 01/03/2019

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: Chateau Nrsg & Rehab Center
FACILITY ADDRESS: 7050 Madison Street
FACILITY CITY, STATE, ZIP: Willowbrook, IL 60521

DOCKET NUMBER: NH 19-C0052

LICENSEE INFO: Chateau Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 12/24/2018

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 18-S0551

LICENSEE INFO: Diamond Development Co.
LICENSEE ADDRESS: 150 South State Rte 45, P.O. Box 250
LICENSEE CITY, STATE, ZIP: Louisville, IL 62858
Survey Date – 11/21/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.120e)1) and 300.3940a). A fine of $1,100.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.2210)a)2)3)5). A fine of $1,100.00

Total fines $2,200.00

FACILITY NAME: Christian Nursing Home
FACILITY ADDRESS: 1507 7^th Street
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 18-C0131

LICENSEE INFO: Christian Homes, Inc.
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Lincoln, IL 62656
Survey Date – 03/07/2018

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

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

DOCKET NUMBER: NH 19-C0092

LICENSEE INFO: Clark Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 01/17/2019

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

FACILITY NAME: Crossroads Care Ctr - Woodstock
FACILITY ADDRESS: 309 McHenry Avenue
FACILITY CITY, STATE, ZIP: Woodstock, IL 60098

DOCKET NUMBER: NH 19-S0103

LICENSEE INFO: Crossroads Care Center of Woodstock, LLC
LICENSEE ADDRESS: 5750 Old Orchard Road, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 01/31/2019

FACILITY NAME: Dixon Rehab & HCC
FACILITY ADDRESS: 800 Division Street
FACILITY CITY, STATE, ZIP: Dixon, IL 61021

DOCKET NUMBER: NH 18-C0055

LICENSEE INFO: Dixon Manor, LLC
LICENSEE ADDRESS: 412 East Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/31/2018

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

FACILITY NAME: Dixon Rehab & HCC
FACILITY ADDRESS: 800 Division Street
FACILITY CITY, STATE, ZIP: Dixon, IL 61021

DOCKET NUMBER: NH 18-S0520

LICENSEE INFO: Dixon Manor, LLC
LICENSEE ADDRESS: 412 East Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 11/05/2018

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: Dixon Rehab & HCC
FACILITY ADDRESS: 800 Division Street
FACILITY CITY, STATE, ZIP: Dixon, IL 61021

DOCKET NUMBER: NH 19-S0006

LICENSEE INFO: Dixon Manor, LLC
LICENSEE ADDRESS: 412 Lawrence Street
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/06/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c) 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: Eden Village Care Center
FACILITY ADDRESS: 400 South Station Road
FACILITY CITY, STATE, ZIP: Glen Carbon, IL 62034

DOCKET NUMBER: NH 19-C0082

LICENSEE INFO: Eden Retirement Center, Inc.
LICENSEE ADDRESS: 400 South Station Road
LICENSEE CITY, STATE, ZIP: Glen Carbon, IL 62034
Survey Date – 01/22/2019

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a) 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: Forest City Rehab and Nrsg Ctr
FACILITY ADDRESS: 321 Arnold Avenue
FACILITY CITY, STATE, ZIP: Rockford, IL 61108

DOCKET NUMBER: NH 19-S0056

LICENSEE INFO: Forest City Rehab and Nursing Center, LLC
LICENSEE ADDRESS: 4711 Golf Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 12/06/2018

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)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: Friendship Manor Healthcare
FACILITY ADDRESS: 485 South Friendship Drive
FACILITY CITY, STATE, ZIP: Nashville, IL 62263

DOCKET NUMBER: NH 18-C0547

LICENSEE INFO: Friendship Manor Group, LLC
LICENSEE ADDRESS: 485 South Friendship Drive
LICENSEE CITY, STATE, ZIP: Nashville, IL 62263
Survey Date – 11/16/2018

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

DOCKET NUMBER: NH 19-C0019

LICENSEE INFO: Gardenview Manor, LLC
LICENSEE ADDRESS: 5750 Old Orchard Road, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 12/06/2018

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

DOCKET NUMBER: NH 19-C0120

LICENSEE INFO: Generations at Lincoln, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 01/30/2019

FACILITY NAME: Genesis Senior Living, Aledo
FACILITY ADDRESS: 309 NW 9^th Avenue
FACILITY CITY, STATE, ZIP: Aledo, IL 61231

DOCKET NUMBER: NH 18-S0506

LICENSEE INFO: Genesis Senior Living, Aledo
LICENSEE ADDRESS: 409 NW 9th Avenue
LICENSEE CITY, STATE, ZIP: Aledo, IL 61231
Survey Date – 11/05/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.686a)4), 300.686b), 300.686e)2)3), 300.1210b), 300.1210d)1)3, 300.3210a), 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: 300.686, 300.1210b), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Gibson Community Hsp Annex
FACILITY ADDRESS: 430 East 19^th Street
FACILITY CITY, STATE, ZIP: Gibson City, IL 60936

DOCKET NUMBER: NH 19-S0060

LICENSEE INFO: Gibson Area Hospital & Health Services
LICENSEE ADDRESS: 1120 North Melvin Street
LICENSEE CITY, STATE, ZIP: Gibson City, IL 60936
Survey Date – 01/03/2019

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: Glencrest Healthcare & Rehab Center
FACILITY ADDRESS: 2451 West Touhy Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60645

DOCKET NUMBER: NH 19-C0010

LICENSEE INFO: Glencrest Healthcare and Rehabilitation Centre, Ltd
LICENSEE ADDRESS: 191 North Wacker Drive, Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 11/29/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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

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)6) and 300.3240a). A fine of $2,200.00

Total fines $4,400.00

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

DOCKET NUMBER: NH 19-C0106 & NH 19-S0117

LICENSEE INFO: Glenwood Healthcare & Rehab, Inc.
LICENSEE ADDRESS: 5750 Old Orchard Road, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 01/18/2019

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)2)4)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

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

Total fines of $27,200.00

FACILITY NAME: Good Sam Soc. Mt Carroll
FACILITY ADDRESS: 1006 North Lowden
FACILITY CITY, STATE, ZIP: Mount Carroll, IL 61053

DOCKET NUMBER: NH 19-S0038

LICENSEE INFO: Good Samaritan Society – Mount Carroll
LICENSEE ADDRESS: 208 South LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/06/2018

FACILITY NAME: Grove of Skokie, The
FACILITY ADDRESS: 9000 Lavergne Avenue
FACILITY CITY, STATE, ZIP: Skokie, IL 60077

DOCKET NUMBER: NH 18-C0251 & NH 18-S0252

LICENSEE INFO: Skokie Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 05/03/2018

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

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

DOCKET NUMBER: NH 19-C0076

LICENSEE INFO: Helia Healthcare of Belleville, LLC
LICENSEE ADDRESS: 118 West Edwards Street, Suite 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 01/16/2019

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)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: Heritage Health - Springfield
FACILITY ADDRESS: 900 North Rutledge
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 19-C0009

LICENSEE INFO: Rutledge Joint Ventures, LLC
LICENSEE ADDRESS: 202 North Center
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 11/30/2018

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

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

DOCKET NUMBER: NH 19-C0066

LICENSEE INFO: Helia Southbelt Healthcare, LLC
LICENSEE ADDRESS: 118 W. Edwards Street, Suite 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 01/04/2019

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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: Integrity HC of Alton
FACILITY ADDRESS: 3523 Wickenhauser
FACILITY CITY, STATE, ZIP: Alton, IL 62002

DOCKET NUMBER: NH 19-S0065

LICENSEE INFO: Alton Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 2015 North Main Street, Ste 111
LICENSEE CITY, STATE, ZIP: Carbondale, IL 62901
Survey Date – 12/20/2018

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

DOCKET NUMBER: NH 18-S0546

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 – 11/02/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) 350.1210, 350.1235)3) and 350.3240a). A fine of $12,500.00

FACILITY NAME: Iona Glos SLC
FACILITY ADDRESS: 50 South Fairbank Street
FACILITY CITY, STATE, ZIP: Addison, IL 60101

DOCKET NUMBER: NH 19-C0098

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 – 01/17/2019

Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.1210, 350.1230b)7) and 350.3240a). A fine of $12,500.00

FACILITY NAME: Jennings Terrace
FACILITY ADDRESS: 275 South LaSalle
FACILITY CITY, STATE, ZIP: Aurora, IL 60505

DOCKET NUMBER: NH 19-C0055

LICENSEE INFO: Jennings Terrace
LICENSEE ADDRESS: 1320 North Route 59
LICENSEE CITY, STATE, ZIP: Naperville, IL 60563
Survey Date – 01/15/2019

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.790a). 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: 330.790). A fine of $2,200.00

FACILITY NAME: Landmark of Des Plaines Rehab
FACILITY ADDRESS: 9300 Ballard Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60016

DOCKET NUMBER: NH 19-C0062

LICENSEE INFO: Landmark of Des Plaines Rehabilitation Center, LLC
LICENSEE ADDRESS: 5683 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659
Survey Date – 12/27/2018

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a)b)c) 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: Lexington of Schaumburg
FACILITY ADDRESS: 675 South Roselle Road
FACILITY CITY, STATE, ZIP: Schaumburg, IL 60193

DOCKET NUMBER: NH 19-S0099

LICENSEE INFO: Lexington Health Care Center of Schaumburg, Inc.
LICENSEE ADDRESS: 665 West North Avenue
LICENSEE CITY, STATE, ZIP: Lombard, IL 60148
Survey Date – 01/24/2019

FACILITY NAME: Lexington of Wheeling
FACILITY ADDRESS: 730 West Hintz Road
FACILITY CITY, STATE, ZIP: Wheeling, IL 60090

DOCKET NUMBER: NH 18-S0532

LICENSEE INFO: Lexington Health Care Center of Wheeling, Inc.
LICENSEE ADDRESS: 665 West North Avenue
LICENSEE CITY, STATE, ZIP: Lombard, IL 60148
Survey Date – 11/19/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)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: Marigold Rehabilitation HCC
FACILITY ADDRESS: 275 East Carl Sandburg Drive
FACILITY CITY, STATE, ZIP: Galesburg, IL 61401

DOCKET NUMBER: NH 19-C0047

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 01/03/2019

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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: Midway Neurological Rehab
FACILITY ADDRESS: 8540 South Harlem Avenue
FACILITY CITY, STATE, ZIP: Bridgeview, IL 60455

DOCKET NUMBER: NH 19-C0048

LICENSEE INFO: Midway Neurological and Rehabilitation Center, L.L.C.
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 12/12/2018

Type A 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 $25,000.00

FACILITY NAME: Midway Neurological Rehab Ctr
FACILITY ADDRESS: 8540 South Harlem Avenue
FACILITY CITY, STATE, ZIP: Bridgeview, IL 60455

DOCKET NUMBER: NH 19-C0105

LICENSEE INFO: Midway Neurological and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 01/04/2019

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), 300.1220b)2), 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: Miller Health Care Center
FACILITY ADDRESS: 1601 Butterfield Trail
FACILITY CITY, STATE, ZIP: Kankakee, IL 60901

DOCKET NUMBER: NH 19-S0104

LICENSEE INFO: Riverside Senior Living Center
LICENSEE ADDRESS: 350 North Wall Street
LICENSEE CITY, STATE, ZIP: Kankakee, IL 60901
Survey Date – 01/17/2019

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.610c)2), 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 $2,200.00

FACILITY NAME: Niles Nrsg & Rehab Center
FACILITY ADDRESS: 9777 Greenwood Avenue
FACILITY CITY, STATE, ZIP: Niles, IL 60714

DOCKET NUMBER: NH 18-C0218

LICENSEE INFO: Niles Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 04/16/2018

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

FACILITY NAME: Niles Nursing & Rehab Center
FACILITY ADDRESS: 9777 Greenwood Avenue
FACILITY CITY, STATE, ZIP: Niles, IL 60714

DOCKET NUMBER: NH 18-C0545

LICENSEE INFO: Niles Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 11/27/2018

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: Nokomis Rehab & Health Care C
FACILITY ADDRESS: 505 Stevens Street
FACILITY CITY, STATE, ZIP: Nokomis, IL 62075

DOCKET NUMBER: NH 19-C0020

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 11/28/2018

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

Total fines $4,400.00

FACILITY NAME: Nokomis Rehab & Health Care C
FACILITY ADDRESS: 505 Stevens Street
FACILITY CITY, STATE, ZIP: Nokomis, IL 62075

DOCKET NUMBER: NH 19-S0089

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 01/18/2019

FACILITY NAME: Northwoods Care Centre
FACILITY ADDRESS: 2250 Pearl Street
FACILITY CITY, STATE, ZIP: Belvidere, IL 61008

DOCKET NUMBER: NH 19-S0027

LICENSEE INFO: Symphony Northwoods, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/14/2018

FACILITY NAME: Oak Lawn Respiratory & Rehab
FACILITY ADDRESS: 9525 South Mayfield
FACILITY CITY, STATE, ZIP: Oaklawn, IL 60453

DOCKET NUMBER: NH 19-C0039

LICENSEE INFO: Oak Lawn Respiratory and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 12/07/2018

FACILITY NAME: PA Peterson at the Citadel
FACILITY ADDRESS: 1311 Parkview Avenue
FACILITY CITY, STATE, ZIP: Rockford, IL 61107

DOCKET NUMBER: NH 18-C0536

LICENSEE INFO: P A Peterson at the Citadel, LLC
LICENSEE ADDRESS: 55 West Monroe Street, Ste 2400
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 11/13/2018

FACILITY NAME: Parc at Joliet, The
FACILITY ADDRESS: 222 North Hammes Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60435

DOCKET NUMBER: NH 18-C0153

LICENSEE INFO: The Parc of Joliet, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 03/15/2018

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

FACILITY NAME: Parker Nursing and Rehab Ctr
FACILITY ADDRESS: 516 West Frechs Street
FACILITY CITY, STATE, ZIP: Streator, IL 61364

DOCKET NUMBER: NH 19-S0081

LICENSEE INFO: Parker Rehab and Nursing Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 01/17/2019

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b)3), , 300.1210c), 300.1210d)3)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)5 and 300.3240a). A fine of $2,200.00

FACILITY NAME: Parkview Home - Freeport
FACILITY ADDRESS: 1234 South Park Boulevard
FACILITY CITY, STATE, ZIP: Freeport, IL 61032

DOCKET NUMBER: NH 19-S0041

LICENSEE INFO: Parkview Home of Freeport, Illinois, Inc.
LICENSEE ADDRESS: 1234 South Park Boulevard
LICENSEE CITY, STATE, ZIP: Freeport, IL 61032
Survey Date – 01/03/2019

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

FACILITY NAME: Parkview Home - Freeport
FACILITY ADDRESS: 1234 South Park Blvd
FACILITY CITY, STATE, ZIP: Freeport, IL 61032

DOCKET NUMBER: NH 19-C0067

LICENSEE INFO: Parkview Home of Freeport, Illinois, Inc.
LICENSEE ADDRESS: 1234 South Park Boulevard
LICENSEE CITY, STATE, ZIP: Freeport, IL 61032
Survey Date – 01/17/2019

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

FACILITY NAME: Pearl Pavilion
FACILITY ADDRESS: 900 South Kiwanis Drive
FACILITY CITY, STATE, ZIP: Freeport, IL 61032

DOCKET NUMBER: NH 19-C0064

LICENSEE INFO: Pearl Pavilion, LLC
LICENSEE ADDRESS: 4711 Golf Road, Suite 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 12/19/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1220b)2), 300.3240a), 300.3240d)and 300.3240e). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.3240a), 300.3240d) and 300.3240e). A fine of $2,200.

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)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 fine $4,400.00

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

DOCKET NUMBER: NH 19-C0021

LICENSEE INFO: UDI #10, LLC
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 12/04/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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: Pine Acres Rehab & Living Center
FACILITY ADDRESS: 1212 South Second Street
FACILITY CITY, STATE, ZIP: DeKalb, IL 60115

DOCKET NUMBER: NH 18-C0533

LICENSEE INFO: Pine Acres Rehab & Living Center, LLC
LICENSEE ADDRESS: 191 N. Wacker Drive, Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 11/21/2018

FACILITY NAME: Presence Villa Scalabrini N & R
FACILITY ADDRESS: 480 North Wolf Road
FACILITY CITY, STATE, ZIP: Northlake, IL 60146

DOCKET NUMBER: NH 19-S0100

LICENSEE INFO: Presence Senior Services - Chicagoland
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/17/2019

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

DOCKET NUMBER: NH 19-C0061

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 – 12/11/2018

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

DOCKET NUMBER: NH 18-C0045

LICENSEE INFO: Bravo Care of Alton, Inc.
LICENSEE ADDRESS: 412 East Lawrence Avenue
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/14/2017

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

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

DOCKET NUMBER: NH 18-C0241

LICENSEE INFO: Bravo Care of Alton, Inc.
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 04/26/2018

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

FACILITY NAME: Rosewood Care Ctr of Elgin
FACILITY ADDRESS: 2355 Royal Boulevard
FACILITY CITY, STATE, ZIP: Elgin, IL 60123

DOCKET NUMBER: NH 19-C0001

LICENSEE INFO: Bravo Care of Elgin, Inc.
LICENSEE ADDRESS: 412 East Lawrence Street
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 11/15/2018

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), 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: Rosewood Care Center Galesburg
FACILITY ADDRESS: 1250 West Carl Sandburg Drive
FACILITY CITY, STATE, ZIP: Galesburg, IL 61401

DOCKET NUMBER: NH 17-S0331

LICENSEE INFO: Bravo Care of Galesburg, Inc.
LICENSEE ADDRESS: 412 East Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 06/16/2017

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 18-C0329

LICENSEE INFO: Bravo Care of Inverness, Inc.
LICENSEE ADDRESS: 412 East Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 06/28/2018

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

FACILITY NAME: Rosewood Care Ctr Inverness
FACILITY ADDRESS: 1800 Colonial Parkway
FACILITY CITY, STATE, ZIP: Inverness, IL 60067

DOCKET NUMBER: NH 19-C0116

LICENSEE INFO: Bravo Care of Inverness, Inc.
LICENSEE ADDRESS: 412 East Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/30/2019

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

DOCKET NUMBER: NH 18-C0113

LICENSEE INFO: Rosewood Care Center of Moline
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 02/22/2018

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

FACILITY NAME: Rosewood Care Ctr Northbrook
FACILITY ADDRESS: 4101 Lake Cook Road
FACILITY CITY, STATE, ZIP: Northbrook, IL 60062

DOCKET NUMBER: NH 18-S0202

LICENSEE INFO: Bravo Care of Northbrook, Inc.
LICENSEE ADDRESS: 412 East Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 04/05/2018

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 17-S0251 & NH 17-C0252

LICENSEE INFO: Bravo Care of Peoria, Inc.
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 04/13/2017

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

FACILITY NAME: Saline Care Nursing & Rehab
FACILITY ADDRESS: 120 South Land Street, P.O. Box 468
FACILITY CITY, STATE, ZIP: Harrisburg, IL 62946

DOCKET NUMBER: NH 19-S0123

LICENSEE INFO: Saline Care Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 215 East Locust Street
LICENSEE CITY, STATE, ZIP: Harrisburg, IL 62946
Survey Date – 02/15/2019

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)6), 300.2210a), 300.2210b)2). and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: Sandwich Rehab & HCC
FACILITY ADDRESS: 902 East Arnold Street
FACILITY CITY, STATE, ZIP: Sandwich, IL 60548

DOCKET NUMBER: NH 18-C0535

LICENSEE INFO: Petersen Health Business, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 11/16/2018

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)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 $2,200.00

FACILITY NAME: Sauk Valley Senior Living
FACILITY ADDRESS: 1000 Dixon Avenue
FACILITY CITY, STATE, ZIP: Rock Falls, IL 61071

DOCKET NUMBER: NH 18-S0540

LICENSEE INFO: Midwest Health Operations, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 11/09/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1220b)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

FACILITY NAME: Sauk Valley Senior Living
FACILITY ADDRESS: 1000 Dixon Avenue
FACILITY CITY, STATE, ZIP: Rock Falls, IL 61071

DOCKET NUMBER: NH 19-C0008

LICENSEE INFO: Midwest Health Operations, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 11/28/2018

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), 300.1220b)8) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Sauk Valley Senior Living
FACILITY ADDRESS: 1000 Dixon Avenue
FACILITY CITY, STATE, ZIP: Rock Falls, IL 61071

DOCKET NUMBER: NH 19-C0037

LICENSEE INFO: Midwest Health Operations, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 12/10/2018

FACILITY NAME: Southgate Health Care Center
FACILITY ADDRESS: 900 East Ninth Street, P.O. Box 843
FACILITY CITY, STATE, ZIP: Metropolis, IL 62960

DOCKET NUMBER: NH 19-C0107

LICENSEE INFO: Southgate Health Care, Inc.
LICENSEE ADDRESS: 900 East 9^th Street
LICENSEE CITY, STATE, ZIP: Metropolis, IL 62960
Survey Date – 02/05/2019

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) 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: Southpoint Nrsg & Rehab Ctr
FACILITY ADDRESS: 1010 West 95^th Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60643

DOCKET NUMBER: NH 19-C0072

LICENSEE INFO: Southpoint Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 01/08/2019

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)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: St. Anthony’s Nrsg & Rehab Center
FACILITY ADDRESS: 767 30^th Street
FACILITY CITY, STATE, ZIP: Rock Island, IL 61201

DOCKET NUMBER: NH 19-S0043

LICENSEE INFO: St. Anthony’s Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 150 N. Riverside Place, Suite 3000
LICENSEE CITY, STATE, ZIP: Chicago, IL 60601
Survey Date – 12/13/2018

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) 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: Stephenson Nursing Center
FACILITY ADDRESS: 2946 S. Walnut Road
FACILITY CITY, STATE, ZIP: Freeport, IL 61032

DOCKET NUMBER: NH 19-S0025

LICENSEE INFO: Stephenson County Board of Supervisors
LICENSEE ADDRESS: 50 W. Douglas Street, Suite 1002
LICENSEE CITY, STATE, ZIP: Freeport, IL 61032
Survey Date – 12/14/2018

FACILITY NAME: Symphony at Aria
FACILITY ADDRESS: 4600 North Frontage Road
FACILITY CITY, STATE, ZIP: Hillside, IL 60162

DOCKET NUMBER: NH 19-C0004

LICENSEE INFO: Symphony Aria, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 11/21/2018

FACILITY NAME: Symphony of Bronzeville
FACILITY ADDRESS: 3400 South Indiana
FACILITY CITY, STATE, ZIP: Chicago, IL 60616

DOCKET NUMBER: NH 19-C0068

LICENSEE INFO: Symphony Bronzeville Park, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/28/2018

FACILITY NAME: Symphony of Chicago West
FACILITY ADDRESS: 5130 West Jackson Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60644

DOCKET NUMBER: NH 19-C0012

LICENSEE INFO: Symphony Jackson Square, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/06/2018

FACILITY NAME: Thomas Herbstritt House
FACILITY ADDRESS: 4003 N RT 1 & 17 P.O. Box 260
FACILITY CITY, STATE, ZIP: Momence, IL 60954

DOCKET NUMBER: NH 19-S0029

LICENSEE INFO: Good Shepherd Manor, Inc.
LICENSEE ADDRESS: 4129 N. RTE 1 & 17, P.O. Box 260
LICENSEE CITY, STATE, ZIP: Momence, IL 60954
Survey Date – 11/21/2018

Type B violation for violating one or more of the following sections of the Code: 350.510e), 350.620a), 350.700a), 350.1210b), 350.1220h)j)k), 350.1230b), 350.1230e) and 350.3240a). A fine of $550.00

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

DOCKET NUMBER: NH 19-S0097

LICENSEE INFO: Tower Hill Rehabilitation, LLC
LICENSEE ADDRESS: 7434 Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 01/11/2019

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)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: University Nsg & Rehab Center
FACILITY ADDRESS: 1095 University Drive
FACILITY CITY, STATE, ZIP: Edwardsville, IL 62025

DOCKET NUMBER: NH 19-S0109 & NH 19-C0110

LICENSEE INFO: University Care Center, LLC
LICENSEE ADDRESS: 111 North Ottawa Street
LICENSEE CITY, STATE, ZIP: Joliet, IL 60432
Survey Date – 02/05/2019

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

DOCKET NUMBER: NH 19-S0091

LICENSEE INFO: Uptown Health Center, LLC
LICENSEE ADDRESS: 5215 Old Orchard Road, Ste 960
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 01/17/2019

FACILITY NAME: Villa at South Holland, The
FACILITY ADDRESS: 16300 Wausau Street
FACILITY CITY, STATE, ZIP: South Holland, IL 60473

DOCKET NUMBER: NH 18-C0529

LICENSEE INFO: The Villa at South Holland, LLC
LICENSEE ADDRESS: 191 North Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 11/13/2018

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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: 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Villa at South Holland, The
FACILITY ADDRESS: 16300 Wausau Street
FACILITY CITY, STATE, ZIP: South Holland, IL 60473

DOCKET NUMBER: NH 19-C0115

LICENSEE INFO: The Villa at South Holland, LLC
LICENSEE ADDRESS: 191 North Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 01/25/2019

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210d)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: Walker Nursing Home
FACILITY ADDRESS: 530 East Beardstown Street
FACILITY CITY, STATE, ZIP: Virginia, IL 62691

DOCKET NUMBER: NH 19-S0005

LICENSEE INFO: Walker Nursing Home, Inc.
LICENSEE ADDRESS: 2319 W. Jefferson Street
LICENSEE CITY, STATE, ZIP: Springfield, IL 62706
Survey Date – 12/05/2018

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

DOCKET NUMBER: NH 19-C0032

LICENSEE INFO: Lincolnshire Living & Rehab Center, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/06/2018

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

DOCKET NUMBER: NH 19-C0040

LICENSEE INFO: Warren Barr North Shore, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/20/2018

FACILITY NAME: Warren Barr South Loop
FACILITY ADDRESS: 1725 South Wabash Ave
FACILITY CITY, STATE, ZIP: Chicago, IL 60616

DOCKET NUMBER: NH 19-C0017

LICENSEE INFO: South Loop Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 11/13/2019

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 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: Winchester House
FACILITY ADDRESS: 1125 North Milwaukee Avenue
FACILITY CITY, STATE, ZIP: Libertyville, IL 60048

DOCKET NUMBER: NH 18-S0127

LICENSEE INFO: Transitional Care of Lake County, LLC
LICENSEE ADDRESS: 1 N. LaSalle Street, Ste 1350
LICENSEE CITY, STATE, ZIP: Chicago, IL 60602
Survey Date – 02/22/2018

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

1st Quarter Report January-March 2019

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1st Quarter Report January-March 2019

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