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2020 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 20-S0102

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

Survey Date – 01/16/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Accolade HC of Pontiac

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

DOCKET NUMBER: NH 20-C0176

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

Survey Date – 02/20/2020
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: Aperion Care Capitol

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

DOCKET NUMBER: NH 20-S0148

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

Survey Date – 03/06/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)4), 300.1210d)2)3), 300.1620a), 300.1630b), 300.2040c), 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: 300.610a), 300.686a)1), 300.686e)1), 300.1210b), 300.1210d)1)2)6), 300.1630e), 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: 300.686), 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: 300.1010h), 300.1210b), 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
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
Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b)4), 300.1210d)3), and 300.3240a). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $500.00
Total Fine: $54,900.00

FACILITY NAME: Aperion Care Fairfield

FACILITY ADDRESS: 305 Northwest 11^th Street
FACILITY CITY, STATE, ZIP: Fairfield, IL 62837

DOCKET NUMBER: NH 20-C0159

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

Survey Date – 02/27/2020
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)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 Forest Park

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

DOCKET NUMBER: NH 19-C0305

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

Survey Date – 05/23/2019
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn

FACILITY NAME: Aperion Care West Ridge

FACILITY ADDRESS: 6450 North Ridge Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60626

DOCKET NUMBER: NH 20-S0124
NH 20-C0125

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

Survey Date – 02/07/2020
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: Austin Oasis, The

FACILITY ADDRESS: 901 South Austin Boulevard
FACILITY CITY, STATE, ZIP: Chicago, IL 60644

DOCKET NUMBER: NH 20-C0170

LICENSEE INFO: The Austin Oasis, LLC
LICENSEE ADDRESS: 4711 Golf Road, Suite 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076

Survey Date – 03/06/2020
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 300.3240a). 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: Avantara of Elgin

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

DOCKET NUMBER: NH 19-S0258

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

Survey Date – 05/15/2019
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn

FACILITY NAME: Bement Health Care Center

FACILITY ADDRESS: 601 North Morgan
FACILITY CITY, STATE, ZIP: Bement, IL 61813

DOCKET NUMBER: NH 20-S0113

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

Survey Date – 01/24/2020
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: Briar Place Nursing

FACILITY ADDRESS: 6800 West Joliet
FACILITY CITY, STATE, ZIP: Indian Head Park, IL 60525

DOCKET NUMBER: NH 20-C0167

LICENSEE INFO: Briar Place Nursing, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 02/28/2020
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: Brookdale Prospect Heights

FACILITY ADDRESS: 700 East Euclid Avenue
FACILITY CITY, STATE, ZIP: Prospect Heights, IL 60070

DOCKET NUMBER: NH 20-S0141

LICENSEE INFO: S-H OPCO Prospect Heights, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 01/31/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.710a)3)A). A fine of $1,100.00
Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.720b). A fine of $1,100.00
Total Fines $2,200.00

FACILITY NAME: Carlyle Healthcare Center

FACILITY ADDRESS: 501 Clinton Street
FACILITY CITY, STATE, ZIP: Carlyle, IL 62231

DOCKET NUMBER: NH 20-S0107

LICENSEE INFO: Carlyle Healthcare Center, Inc.
LICENSEE ADDRESS: 1 W. Old State Capitol, Suite 600
LICENSEE CITY, STATE, ZIP: Springfield, IL 62701

Survey Date – 01/24/2020
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: Casey Health Care Center

FACILITY ADDRESS: 100 N. E. 15^th
FACILITY CITY, STATE, ZIP: Casey, IL 62420

DOCKET NUMBER: NH 20-S0165

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

Survey Date – 02/07/2020
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) 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: Centennial Rehab & Healthcare

FACILITY ADDRESS: 7300 34^th Avenue
FACILITY CITY, STATE, ZIP: Moline, IL 61265

DOCKET NUMBER: NH 20-S0114

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

Survey Date – 01/30/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.661. The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.661. A fine of $2,200.00

FACILITY NAME: Champaign Rehab Center

FACILITY ADDRESS: 1915 South Mattis Avenue
FACILITY CITY, STATE, ZIP: Champaign, IL 61821

DOCKET NUMBER: NH 20-S0132

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

Survey Date – 01/29/2020
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: Chicago Ridge Nursing Center

FACILITY ADDRESS: 10602 Southwest Highway
FACILITY CITY, STATE, ZIP: Chicago Ridge, IL 60415

DOCKET NUMBER: NH 20-C0089

LICENSEE INFO: BM of Chicago Ridge, LLC
LICENSEE ADDRESS: 6500 N. Hamlin
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712

Survey Date – 01/17/2020
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: Cornerstone Rehab and HC

FACILITY ADDRESS: 5533 North Galena Road
FACILITY CITY, STATE, ZIP: Peoria Heights, IL 61616

DOCKET NUMBER: NH 20-C0154

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

Survey Date – 02/26/2020
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: Danish Home

FACILITY ADDRESS: 5656 North Newcastle Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60631

DOCKET NUMBER: NH 20-C0087

LICENSEE INFO: The Society for the Danish Old Peoples Home
LICENSEE ADDRESS: 5656 North Newcastle Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60631

Survey Date – 01/31/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1240a), 300.1240d), and 300.1240e). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1240). A fine of $2,200.00

FACILITY NAME: DuPage Care Center

FACILITY ADDRESS: 400 North County Farm Road
FACILITY CITY, STATE, ZIP: Wheaton, IL 60187

DOCKET NUMBER: NH 20-C0076

LICENSEE INFO: Du Page County Board
LICENSEE ADDRESS: 421 County Farm Road
LICENSEE CITY, STATE, ZIP: Wheaton, IL 60187

Survey Date: 01/16/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.690b)c), 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: 300.690), 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 20-C0085

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

Survey Date – 01/13/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210c), 300.1210d)2)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Elevate Care Niles

FACILITY ADDRESS: 8333 West Golf Road
FACILITY CITY, STATE, ZIP: Niles, IL 60714

DOCKET NUMBER: NH 20-S0097

LICENSEE INFO: Elevate Care Niles, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

FACILITY NAME: Elevate Care Northbrook

FACILITY ADDRESS: 270 Skokie Blvd
FACILITY CITY, STATE, ZIP: Northbrook, IL 60062

DOCKET NUMBER: NH 20-C0151

LICENSEE INFO: Elevate Care Northbrook, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 02/18/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)5), 300.1210d)6), 300.3240a), and 300.3240d). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.3240d)5), 300.1210d)6), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Elevate Care Waukegan

FACILITY ADDRESS: 2222 14^th Street
FACILITY CITY, STATE, ZIP: Waukegan, IL 60085

DOCKET NUMBER: NH 20-C0160

LICENSEE INFO: Elevate Care Waukegan, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 03/03/2020
Type B 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 $2,200.00

FACILITY NAME: Forest City Rehab & Nrsg Ctr

FACILITY ADDRESS: 321 Arnold Avenue
FACILITY CITY, STATE, ZIP: Rockford, IL 61108

DOCKET NUMBER: NH 20-S0108

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 – 01/10/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.615e)j), 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: 300.615e), 300.1210b), 300.1210d)6) and 300.3240a). A fine of $25,000.00
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 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 $25,000.00
Total Fine: $50,000.00

FACILITY NAME: Gardenview Manor

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

DOCKET NUMBER: NH 20-C0082

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

Survey Date – 01/08/2020
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), 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), 300.1210d)6) and 300.3240a).
A fine of $25,000.00

FACILITY NAME: Good Samaritan Home

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

DOCKET NUMBER: NH 19-C0386

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

Survey Date – 06/20/2019
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn

FACILITY NAME: Grosse Pointe Manor
FACILITY ADDRESS: 6601 West Touhy
FACILITY CITY, STATE, ZIP: Niles, IL 60714

DOCKET NUMBER: NH 20-S0136
NH 20-C0137

LICENSEE INFO: Grosse Pointe Manor, LLC
LICENSEE ADDRESS: 191 North Wacker Drive, Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 02/06/2020
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: Grove at the Lake

FACILITY ADDRESS: 2534 Elim Avenue
FACILITY CITY, STATE, ZIP: Zion, IL 60099

DOCKET NUMBER: NH 20-C0120

LICENSEE INFO: Grove at the Lake Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 02/06/2020
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 Berwyn, The

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

DOCKET NUMBER: NH 20-C0181

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

Survey Date – 03/11/2020
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)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: Grove of St. Charles

FACILITY ADDRESS: 611 Allen Lane
FACILITY CITY, STATE, ZIP: St. Charles. IL 60174

DOCKET NUMBER: NH 20-S0168

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

Survey Date – 03/03/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 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: Heddington Oaks

FACILITY ADDRESS: 2223 West Heading Avenue
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 20-C0105

LICENSEE INFO: Peoria County Board
LICENSEE ADDRESS: 324 Main Street, Room 502
LICENSEE CITY, STATE, ZIP: Peoria, IL 61602

Survey Date – 01/21/2020
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: Hidden Valley

FACILITY ADDRESS: 204 South Pecon Street, P.O. Box G
FACILITY CITY, STATE, ZIP: Jonesboro, IL 62952

DOCKET NUMBER: NH 19-C0403

LICENSEE INFO: Tweedy, Inc.
LICENSEE ADDRESS: 101 West Market Street, P.O. Box 1
LICENSEE CITY, STATE, ZIP: Jonesboro, IL 62952

Survey Date – 08/02/2019
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn

FACILITY NAME: Heritage Health Mt Zion

FACILITY ADDRESS: 1225 Woodland Drive
FACILITY CITY, STATE, ZIP: Mt. Zion, IL 62549

DOCKET NUMBER: NH 20-C0119

LICENSEE INFO: Heritage Health Mt Zion, LLC
LICENSEE ADDRESS: 115 W Jefferson Street, Suite 400
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701

Survey Date – 02/11/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)3), 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: Heritage Health Staunton

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

DOCKET NUMBER: NH 20-S0153

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

Survey Date – 02/26/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1060c), 300.1060d), 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: Imboden Creek Living Center

FACILITY ADDRESS: 180 West Imboden
FACILITY CITY, STATE, ZIP: Decatur, IL 62521

DOCKET NUMBER: NH 19-S0370

LICENSEE INFO: Living Center, Inc.
LICENSEE ADDRESS: 20 South Side Country Club
LICENSEE CITY, STATE, ZIP: Decatur, IL 62521

Survey Date – 06/26/2019
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn

FACILITY NAME: Jerseyville Nsg & Rehab Center

FACILITY ADDRESS: 1001 South State Street
FACILITY CITY, STATE, ZIP: Jerseyville, IL 62052

DOCKET NUMBER: NH 20-S0146

LICENSEE INFO: Helia Healthcare of Jerseyville, LLC
LICENSEE ADDRESS: 118 W. Edwards Street, Suite 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704

Survey Date – 03/03/2020
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 300.3240a). 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), 300.1060c), 300.1060d), 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: Lakeview Rehab & Nursing Center

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

DOCKET NUMBER: NH 20-C0131

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

Survey Date – 01/23/2020
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
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
Total Fine: $4,400.00

FACILITY NAME: Lee Manor

FACILITY ADDRESS: 1301 Lee Street
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60018

DOCKET NUMBER: NH 20-C0128

LICENSEE INFO: Seneca Nursing Home, Inc.
LICENSEE ADDRESS: 200 S. Wacker Drive, Suite 3800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 02/27/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Lexington of Orland Park

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

DOCKET NUMBER: NH 20-C0064

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 – 01/22/2020
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: Lieberman Center for Health & Rehab

FACILITY ADDRESS: 9700 Gross Point Road
FACILITY CITY, STATE, ZIP: Skokie, IL 60076

DOCKET NUMBER: NH 20-S0098

LICENSEE INFO: Council for Jewish Elderly
LICENSEE ADDRESS: 3003 West Touhy Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645

Survey Date – 01/30/2020
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: Little Village Nrsg & Rhb Ctr

FACILITY ADDRESS: 2320 South Lawndale Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60623

DOCKET NUMBER: NH 20-C0127
NH 20-S0173

Little Village Nursing & Rehab Center
LICENSEE ADDRESS: 5750 Old Orchard Road, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 02/06/2020
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: Manor Court of Freeport

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

DOCKET NUMBER: NH 20-C0091

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

Survey Date – 01/23/2020
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), 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 Fine: $27,200.00

FACILITY NAME: Manorcare of Palos Heights East

FACILITY ADDRESS: 7850 West College Drive
FACILITY CITY, STATE, ZIP: Palos Heights, IL 60463

DOCKET NUMBER: NH 20-C0138

LICENSEE INFO: Manor Care of Palos Heights, IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 02/07/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)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 $25,000.00
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
Total Fines: $50,000.00

FACILITY NAME: Marigold Rehabilitation HCC

FACILITY ADDRESS: 275 East Carl Sandburg Drive
FACILITY CITY, STATE, ZIP: Galesburg, IL 61401

DOCKET NUMBER: NH 20-S0149

LICENSEE INFO: Marigold HCO, LLC
LICENSEE ADDRESS: 833 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 03/05/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)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: 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, L.L.C.
LICENSEE ADDRESS: 150 North Riverside Plaza. Ste 3000
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 04/04/2019
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn

FACILITY NAME: Mercy Circle

FACILITY ADDRESS: 3659 West 99^th Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60655

DOCKET NUMBER: NH 20-S0078

LICENSEE INFO: Mercy Circle
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 01/17/2020
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: Michaelsen Health Center

FACILITY ADDRESS: 831 North Batavia Avenue
FACILITY CITY, STATE, ZIP: Batavia, IL 60510

DOCKET NUMBER: NH 20-C0075

LICENSEE INFO: Covenant Health Care Center, Inc.
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 01/27/2020
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: Parc Joliet

FACILITY ADDRESS: 222 N. Hammes Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60435

DOCKET NUMBER: NH 20-S0140

LICENSEE INFO: Parc Joliet Nursing, LLC
LICENSEE ADDRESS: 6302 N. Monticello Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659

Survey Date – 02/20/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210d)1), 300.1620a), and 300.1630a)2). A fine of $1,100.00
Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)3). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.1210)b). A fine of $500.00
Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)4), 300.1210d)4)A), 300.1210d)4)B), 300.1210d)4)C). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $500.00
Total Fines: $2,100.00

FACILITY NAME: Pinckneyville Nursing & Rehab

FACILITY ADDRESS: 708 Virginia Court
FACILITY CITY, STATE, ZIP: Pinckneyville, IL 62274

DOCKET NUMBER: NH 20-S0158

LICENSEE INFO: Pinckneyville Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 215 E. Locust Street
LICENSEE CITY, STATE, ZIP: Harrisburg, IL 62946

Survey Date – 02/28/2020
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: Pine Crest Health Care

FACILITY ADDRESS: 3300 West 175^th Street
FACILITY CITY, STATE, ZIP: Hazel Crest, IL 60429

DOCKET NUMBER: NH 20-C0111

LICENSEE INFO: Pine Crest Health Care, LLC
LICENSEE ADDRESS: 191 N. Wacker Drive, Suite 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 01/31/2020
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) 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: Pleasant Meadows Senior Living

FACILITY ADDRESS: 400 West Washington
FACILITY CITY, STATE, ZIP: Chrisman, IL 61924

DOCKET NUMBER: NH 20-C0126

LICENSEE INFO: Pleasant Meadows Senior Living, LLC
LICENSEE ADDRESS: 5750 Old Orchard Road, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 02/19/2020
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: Pleasant View Luther Home

FACILITY ADDRESS: 505 College Avenue
FACILITY CITY, STATE, ZIP: Ottawa, IL 61350

DOCKET NUMBER: NH 20-S0157

LICENSEE INFO: Pleasant View Luther Home, Inc.
LICENSEE ADDRESS: 800 W. Oakton Street
LICENSEE CITY, STATE, ZIP: Arlington Heights, IL 60004

Survey Date – 02/28/2020
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), 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: Radford Green

FACILITY ADDRESS: 960 Audubon Way
FACILITY CITY, STATE, ZIP: Lincolnshire, IL 60069

DOCKET NUMBER: NH 20-S0092

LICENSEE INFO: Sedgebrook OPCO (SL-VII0, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 02/10/2020
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: Randolph County Care Center

FACILITY ADDRESS: 312 West Belmont
FACILITY CITY, STATE, ZIP: Sparta, IL 62286

DOCKET NUMBER: NH 20-S0104

LICENSEE INFO: Randolph County Board
LICENSEE ADDRESS: #1 Taylor Street
LICENSEE CITY, STATE, ZIP: Chester, IL 62233

FACILITY NAME: Red Bud Regional Care

FACILITY ADDRESS: 350 West South First Street
FACILITY CITY, STATE, ZIP: Red Bud, IL 62278

DOCKET NUMBER: NH 20-S0164

LICENSEE INFO: Red Bud Illinois Hospital Company, LLC
LICENSEE ADDRESS: 201 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 01/23/2020
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: Renaissance Care Center

FACILITY ADDRESS: 1675 East Ash Street
FACILITY CITY, STATE, ZIP: Canton, IL 61520

DOCKET NUMBER: NH 20-C0012
NH 20-S0013

LICENSEE INFO: Renaissance Care Center, Inc.
LICENSEE ADDRESS: 5750 Old Orchard Road, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 11/20/2019
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn

FACILITY NAME: Riverside Rehab & Healthcare

FACILITY ADDRESS: 3490 Humbert Road
FACILITY CITY, STATE, ZIP: Alton, IL 62002

DOCKET NUMBER: NH 20-C0175

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

Survey Date – 03/16/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)5), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Rock River Gardens

FACILITY ADDRESS: 3601 Sixteenth Avenue
FACILITY CITY, STATE, ZIP: Sterling, IL 61081

DOCKET NUMBER: NH 20-C0179

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

Survey Date – 03/11/2020
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), 300.3240a), 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: Rosewood Care Center of Moline

FACILITY ADDRESS: 7300 34^th Avenue
FACILITY CITY, STATE, ZIP: Moline, IL 61265

DOCKET NUMBER: NH 19-S0392

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

Survey Date – 07/16/2019
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn

FACILITY NAME: Royal Oaks Care Center

FACILITY ADDRESS: 605 East Church Street, P.O. Box 600
FACILITY CITY, STATE, ZIP: Kewanee, IL 61443

DOCKET NUMBER: NH 19-C0379

LICENSEE INFO: Petersen Health Care II, Inc.
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 06/27/2019
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn

FACILITY NAME: Sharon Health Care Pines

FACILITY ADDRESS: 3614 North Rochelle
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 20-C0171

LICENSEE INFO: Sharon Health Care Pines, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093

Survey Date – 03/04/2020
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: Sharon Health Care Willows

FACILITY ADDRESS: 3520 North Rochelle
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 20-C0143

LICENSEE INFO: Sharon Health Care Willows, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093

Survey Date – 02/26/2020
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)5), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a).
A fine of $25,000.00

FACILITY NAME: Sheltered Village

FACILITY ADDRESS: 600 Borden Street
FACILITY CITY, STATE, ZIP: Woodstock, IL 60098

DOCKET NUMBER: NH 19-S0400

LICENSEE INFO: Dorr-Wood, LTD
LICENSEE ADDRESS: 600 Borden Street
LICENSEE CITY, STATE, ZIP: Woodstock, IL 60098

Survey Date – 07/03/2019
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn

FACILITY NAME: Snyder Village

FACILITY ADDRESS: 1200 East Partridge
FACILITY CITY, STATE, ZIP: Metamora, IL 61548

DOCKET NUMBER: NH 20-S0123

LICENSEE INFO: Metamora Community Nursing Home
LICENSEE ADDRESS: 1200 East Partridge
LICENSEE CITY, STATE, ZIP: Metamora, IL 61548

Survey Date – 02/05/2020
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: Spring Creek

FACILITY ADDRESS: 777 Draper Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60432

DOCKET NUMBER: NH 19-C0360

LICENSEE INFO: Spring Creek SNF, LLC
LICENSEE ADDRESS: 6302 N Monticello Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659

Survey Date – 06/21/2019
FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn

FACILITY NAME: Spring Creek

FACILITY ADDRESS: 777 Draper Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60432

DOCKET NUMBER: NH 20-S0133

LICENSEE INFO: Spring Creek SNF, LLC
LICENSEE ADDRESS: 6302 N. Monticello Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659

Survey Date – 01/30/2020
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)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: Spring Creek

FACILITY ADDRESS: 777 Draper Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60432

DOCKET NUMBER: NH 20-C0178

LICENSEE INFO: Spring Creek SNF, LLC
LICENSEE ADDRESS: 6302 N. Monticello Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659

Survey Date – 03/12/2020
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: Spring Creek

FACILITY ADDRESS: 777 Draper Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60432

DOCKET NUMBER: NH 20-C0180

LICENSEE INFO: Spring Creek SNF, LLC
LICENSEE ADDRESS: 6302 N. Monticello Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659

Survey Date – 03/06/2020
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), 300.1210c), and 300.1210d)2)5)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5)6). 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), 300.1060c), and 300.1060d. A fine of $1,100.00

Total Fine: $3,300.00

FACILITY NAME: St. Anthony’s Nursing & Rehab Center

FACILITY ADDRESS: 767 30^th Street
FACILITY CITY, STATE, ZIP: Rock Island, IL 61201

DOCKET NUMBER: NH 20-C0096

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 – 01/22/2020
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: St. James Wellness Rehab Villas

FACILITY ADDRESS: 1251 East Richton Road
FACILITY CITY, STATE, ZIP: Crete, IL 60417

DOCKET NUMBER: NH 20-C0186

LICENSEE INFO: St. James Wellness Rehab & Villas, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202

Survey Date – 03/13/2020
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

FACILITY NAME: St. Joseph’s Home of Springfield

FACILITY ADDRESS: 3306 South 6^th Street Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62703

DOCKET NUMBER: NH 20-C0145

LICENSEE INFO: St. Joseph’s Home of Springfield
LICENSEE ADDRESS: 2408 West Heading Avenue
LICENSEE CITY, STATE, ZIP: Peoria, IL 61604

Survey Date – 02/27/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b)4)5), and 300.1210d)2)3)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5). A fine of $25,000.00

FACILITY NAME: Symphony of Bronzeville

FACILITY ADDRESS: 3400 South Indiana
FACILITY CITY, STATE, ZIP: Chicago, IL 60616

DOCKET NUMBER: NH 20-C0174

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

Survey Date – 03/12/2020
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: Symphony of Buffalo Grove

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

DOCKET NUMBER: NH 20-S0152

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

Survey Date – 02/19/2020
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: Symphony of Lincoln Park

FACILITY ADDRESS: 1366 West Fullerton Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60614

DOCKET NUMBER: NH 20-C0169

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

Survey Date – 03/11/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1)2), 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 of South Shore

FACILITY ADDRESS: 2425 East 71^st Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60649

DOCKET NUMBER: NH 20-C0155
NH 20-S0156

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

Survey Date – 02/27/2020
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: Terrance Nursing Home

FACILITY ADDRESS: 1615 Sunset Avenue
FACILITY CITY, STATE, ZIP: Waukegan, IL 60087

DOCKET NUMBER: NH 20-S0129

LICENSEE INFO: TN Care, LLC
LICENSEE ADDRESS: 1S443 Summit Avenue, Suite 204
LICENSEE CITY, STATE, ZIP: Oakbrook Terrace, IL 60181

Survey Date – 02/26/2020
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: Tri-State Village Nrsg & Rhb

FACILITY ADDRESS: 2500 East 175^th Street
FACILITY CITY, STATE, ZIP: Lansing, IL 60438

DOCKET NUMBER: NH 20-C0139

LICENSEE INFO: Tri-State Village Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 02/26/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.690a), 300.690b), 300.690c), 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: 300.690), 300.1210b), 300.1210d)6), and 300.3240a).
A fine of $2,200.00

FACILITY NAME: University Rehab at Northmoor

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

DOCKET NUMBER: NH 20-S0161

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

Survey Date – 03/11/2020
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)7), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)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: $27,200.00

FACILITY NAME: Uptown Health Center

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

DOCKET NUMBER: NH 20-C0130

LICENSEE INFO: Uptown Health Center, LLC
LICENSEE ADDRESS: 1900 E. Golf Road, Suite 950
LICENSEE CITY, STATE, ZIP: Schaumburg, IL 60173

Survey Date – 02/21/2020
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)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: Villa Clara Post Acute

FACILITY ADDRESS: 500 West McKinley Avenue
FACILITY CITY, STATE, ZIP: Decatur, IL 62526

DOCKET NUMBER: NH 20-C0134

LICENSEE INFO: Villa Clara Post Acute, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712

Survey Date – 02/05/2020
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 300.3240a). 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 South Loop

FACILITY ADDRESS: 1725 South Wabash Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60616

DOCKET NUMBER: NH 20-S0135

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

Survey Date – 02/06/2020
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)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 $2,200.00

FACILITY NAME: Wentworth Rehab & HCC

FACILITY ADDRESS: 201 West 69^th Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60621

DOCKET NUMBER: NH 20-C0144

LICENSEE INFO: Wentworth Rehabilitation & Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Avenue, Suite 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646

Survey Date – 02/26/2020
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: Willow Rose Rehab & Health

FACILITY ADDRESS: 410 Fletcher
FACILITY CITY, STATE, ZIP: Jerseyville, IL 62052

DOCKET NUMBER: NH 20-C0147

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

Survey Date – 03/12/2020
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: Windsor Estates Nsg & Rehab

FACILITY ADDRESS: 18300 South Lavergne
FACILITY CITY, STATE, ZIP: Country Club Hills, IL 60478

DOCKET NUMBER: NH 20-S0068

LICENSEE INFO: McAllister Nursing and Rehab, LLC
LICENSEE ADDRESS: 9100 Karlov Avenue
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076

Survey Date – 12/27/2019
Type B violation of an occurrence for violating one or more of the following sections of the Code: 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