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2021 1st 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: Aberdeen Terrace

FACILITY ADDRESS: 4029 Aberdeen
FACILITY CITY, STATE, ZIP: Alton, IL 62002

DOCKET NUMBER: NH 21-S0187

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

Survey Date – 11/09/2020

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1210b), 350.1210c), 350.1210d), 350.1220j), 350.1230d)1)2), and 350.3240a). A fine of $550.00

FACILITY NAME: Accolade HC of Paxton on Pells

FACILITY ADDRESS: 1001 East Pells Street
FACILITY CITY, STATE, ZIP: Paxton, IL 60957

DOCKET NUMBER: NH 20-C0360

LICENSEE INFO: Accolade Healthcare of the Heartland, LLC
LICENSEE ADDRESS: 1901 E. Gold Road, Ste 950A
LICENSEE CITY, STATE, ZIP: Schaumburg, IL 60173

Survey Date – 10/29/2020
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: Alden Courts of Shorewood

FACILITY ADDRESS: 700 West Black Road
FACILITY CITY, STATE, ZIP: Shorewood, IL 60404

DOCKET NUMBER: NH 20-C0365

LICENSEE INFO: Alden Courts of Shorewood, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Avenue, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646

Survey Date – 11/06/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 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 Estate of Barrington

FACILITY ADDRESS: 1420 South Barrington Road
FACILITY CITY, STATE, ZIP: Barrington, IL 60010

DOCKET NUMBER: NH 20-S0368

LICENSEE INFO: Alden Estates of Barrington, Inc.
LICENSEE ADDRESS: 4200 West Peterson Ave, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646

Survey Date – 11/16/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)5), 300.1210c), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Alden Town Manor Rehab & HCC

FACILITY ADDRESS: 6120 West Ogden
FACILITY CITY, STATE, ZIP: Cicero, IL 60804

DOCKET NUMBER: NH 20-C0321

LICENSEE INFO: Alden Town Manor Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave,, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646

Survey Date – 11/04/2020
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: Alden Town Manor Rehab & HCC

FACILITY ADDRESS: 6120 West Ogden
FACILITY CITY, STATE, ZIP: Cicero, IL 60804

DOCKET NUMBER: NH 21-C0140

LICENSEE INFO: Alden Town Manor Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646

Survey Date – 01/15/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.12103), 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: 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Alhambra Rehab & Healthcare

FACILITY ADDRESS: 417 East Main Street, P.O. Box 208
FACILITY CITY, STATE, ZIP: Alhambra, IL 62001

DOCKET NUMBER: NH 20-C0371

LICENSEE INFO: Alhambra Rehab & Healthcare, LLC
LICENSEE ADDRESS: 215 E. Locust Street
LICENSEE CITY, STATE, ZIP: Harrisburg, IL 62946

Survey Date – 11/17/2020
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: Allure of Geneseo

FACILITY ADDRESS: 704 South Illinois Street
FACILITY CITY, STATE, ZIP: Geneseo, IL 61254

DOCKET NUMBER: NH 21-S0058

LICENSEE INFO: Allure of Geneseo, LLC
LICENSEE ADDRESS: 2711 W. Howard Street
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645

Survey Date – 10/01/2020
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: Ambassador Nsg & Rehab Center

FACILITY ADDRESS: 4900 N. Bernard
FACILITY CITY, STATE, ZIP: Chicago, IL 60625

DOCKET NUMBER: NH 21-S0063

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

Survey Date – 12/15/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210d)3), 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: 300.1210d)6). 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-C0347

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

Survey Date – 10/29/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)5), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Aperion Care Capitol

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

DOCKET NUMBER: NH 21-C0083

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

Survey Date – 12/18/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)3), 300.1220b)3), 300.3240a), and 300.3240e). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.3240a), and 300.3240e). A fine of $2,200.00

FACILITY NAME: Aperion Care Chicago Heights

FACILITY ADDRESS: 490 West 16th Place
FACILITY CITY, STATE, ZIP: Chicago Heights, IL 60411

DOCKET NUMBER: NH 21-C0095

LICENSEE INFO: Riviera Care Center, LLC
LICENSEE ADDRESS: 208 So. LaSalle St., Ste 817
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 12/15/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.610c)4)B)C), 300.1210d)3), 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: 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Aperion Care Fairfield

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

DOCKET NUMBER: NH 21-C0127

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

Survey Date – 01/06/2021
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: Aperion Care International

FACILITY ADDRESS: 4815 South Western Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60609

DOCKET NUMBER: NH 21-C0013

LICENSEE INFO: International Nursing & Rehab Center. LLC
LICENSEE ADDRESS: 208 So. LaSalle St, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 11/25/2020
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), 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 Marseilles

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

DOCKET NUMBER: NH 21-C0116

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

Survey Date – 12/17/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.1020a)b), 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: 300.696, 300.1210b), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Aperion Care Oak Lawn

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

DOCKET NUMBER: NH 21-S0170

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

Survey Date – 01/15/2021
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: Aperion Care Peoria Heights

FACILITY ADDRESS: 1629 Gardner Lane
FACILITY CITY, STATE, ZIP: Peoria, Heights, IL 61616

DOCKET NUMBER: NH 21-C0065

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

Survey Date – 11/24/2020
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), 300.1210d)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: Aperion Care Plum Grove

FACILITY ADDRESS: 24 South Plum Grove Road
FACILITY CITY, STATE, ZIP: Palatine, IL 60067

DOCKET NUMBER: NH 21-C0026

LICENSEE INFO: Plum Grove Nursing and Rehab, LLC
LICENSEE ADDRESS: 208 So. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 11/15/2020
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)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 $2,200.00

FACILITY NAME: Apostolic Christian Restmoor

FACILITY ADDRESS: 1500 Parkside Avenue
FACILITY CITY, STATE, ZIP: Morton, IL 61550

DOCKET NUMBER: NH 21-S0076

LICENSEE INFO: Apostolic Christian Restmoor, Inc.
LICENSEE ADDRESS: 100 North Main Street
LICENSEE CITY, STATE, ZIP: Morton, IL 61550

Survey Date – 12/11/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.696a), 300.696b), 300.696c), 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: 300.696 and 300.1210b). A fine of $2,200.00

FACILITY NAME: Arcadia of Danville

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

DOCKET NUMBER: NH 20-C0382 & NH 20-S0383

LICENSEE INFO: Danville Operations, LLC
LICENSEE ADDRESS: 600 South Second Street, Suite 404
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704

Survey Date – 11/09/2020
Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $50.000.00

Type A 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 $25,000.00

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)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: 300.696) and 300.3240a). A fine of $25,000.00

Total Fine $100,000.00

FACILITY NAME: Arcadia Care Danville

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

DOCKET NUMBER: NH 21-S0018

LICENSEE INFO: Danville Operations, LLC
LICENSEE ADDRESS: 600 South Second St, Suite 404
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704

Survey Date – 12/17/2020
Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1220b)3), 300.1220b)8), 300.1220b)9), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $50,000.00

FACILITY NAME: Arista Healthcare

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

DOCKET NUMBER: NH 21-C0040

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

Survey Date – 11/04/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.690a), 300.690b), 300.1210b), 300.1210d)6), 300.3240a), 300.3240c), 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: 300.690, 300.1210b), 300.1210d)6), 300.3240a), and 300.3240d). A fine of $25,000.00

FACILITY NAME: Ascension Nazarethville Place

FACILITY ADDRESS: 300 North River Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60016

DOCKET NUMBER: NH 21-S0081

LICENSEE INFO: Presence Senior Services - Chicagoland
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 11/25/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)5, 300.1210c), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Aspen Rehab & Healthcare

FACILITY ADDRESS: 1403 9th Avenue
FACILITY CITY, STATE, ZIP: Silvis, IL 61282

DOCKET NUMBER: NH 20-S0329

LICENSEE INFO: Aspen HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 10/29/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1030a)1)2), 300.1030c), 300.1030d), 300.1210a), 300.1210b)4), 300.1210c), 300.1210d)2)6), 300.2040b), and 300.3240a). The fine was doubled in this instance in accordance with 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: Austin Oasis, The

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

DOCKET NUMBER: NH 21-C0005

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

Survey Date – 11/16/2020
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: Belhaven Nursing & Rehab Ctr

FACILITY ADDRESS: 11401 South Oakley Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60643

DOCKET NUMBER: NH 21-C0141

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

Survey Date – 01/19/2021
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)3), and 300.1220b)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: Bria of Belleville

FACILITY ADDRESS: 150 North 27th Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62226

DOCKET NUMBER: NH 21-C0149

LICENSEE INFO: Belleville Healthcare & Rehabilitation Center, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Ste 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093

Survey Date – 01/07/2021
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), and 300.3240a). The fine was doubled in this instance in accordance with 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), 300.1210b), 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

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

Total Fine: $52,200.00

FACILITY NAME: Bria of Forest Edge

FACILITY ADDRESS: 8001 South Western Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60620

DOCKET NUMBER: NH 20-C0374

LICENSEE INFO: Forest Edge Healthcare & Rehabilitation Center, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 11/30/2020
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: Bridge Care Suites, The

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

DOCKET NUMBER: NH 20-C0366

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

Survey Date – 10/29/2020
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)2)3), 300.1210d)5), 300.1220b)2)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Campbell Court

FACILITY ADDRESS: 426 E. Douglas
FACILITY CITY, STATE, ZIP: Jacksonville, IL 62650

DOCKET NUMBER: NH 21-C0056

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

Survey Date – 12/23/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) 350.1210, 350.1220j), 350.1230d)1), 350.1230d)2), and 350.3240a). A fine of $6,250.00

FACILITY NAME: Carlinville Rehab & HCC

FACILITY ADDRESS: 751 North Oak Street
FACILITY CITY, STATE, ZIP: Carlinville, IL 62626

DOCKET NUMBER: NH 21-C0166

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

Survey Date – 01/20/2021
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)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 $2,200.00

FACILITY NAME: Carriage Rehab & Healthcare

FACILITY ADDRESS: 1660 South Mulford Road
FACILITY CITY, STATE, ZIP: Rockford, IL 61108

DOCKET NUMBER: NH 21-C0014 & NH 21-S0015

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

Survey Date – 12/03/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)7), 300.1020a), and 300.1020b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.696. 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), 300.696a), 300.696c)7), and 300.1020a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.696. A fine of $2,200.00

Total Fine $27,200.00

FACILITY NAME: Center Home Hispanic Elderly

FACILITY ADDRESS: 1401 North California
FACILITY CITY, STATE, ZIP: Chicago, IL 60622

DOCKET NUMBER: NH 21-C0074

LICENSEE INFO: Center Home Hispanic Elderly, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr. Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 12/30/2020
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)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 $2,200.00

FACILITY NAME: Charleston Rehab & Health CC

FACILITY ADDRESS: 716 Eighteenth Street
FACILITY CITY, STATE, ZIP: Charleston, IL 61920

DOCKET NUMBER: NH 20-S0387

LICENSEE INFO: Charleston HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 12/08/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.696a) and 300.696c). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.696. A fine of $2,200.00

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.610a) and 300.686d). 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: 300.686. A fine of $500.00

Total Fine $2,700.00

FACILITY NAME: Citadel of Northbrook, The

FACILITY ADDRESS: 3300 Milwaukee Avenue
FACILITY CITY, STATE, ZIP: Northbrook, IL 60062

DOCKET NUMBER: NH 21-C0002

LICENSEE INFO: Citadel of Northbrook, LLC
LICENSEE ADDRESS: 191 N. Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 11/23/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)2)3)5), 300.1220b)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: Clark – Lindsey Village

FACILITY ADDRESS: 101 West Windsor Road
FACILITY CITY, STATE, ZIP: Urbana, IL 61801

DOCKET NUMBER: NH 20-C0370

LICENSEE INFO: Clark Lindsey Village, Inc.
LICENSEE ADDRESS: 2110 Boudreau Drive
LICENSEE CITY, STATE, ZIP: Urbana, IL 61801

Survey Date – 11/02/2020
Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), 300.1210d)3), 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 $50,000.00

FACILITY NAME: Cornerstone Rehab & HC

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

DOCKET NUMBER: NH 21-S0090

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

Survey Date – 12/19/2020
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), 300.310d)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 $2,200.00

FACILITY NAME: East Bank Center

FACILITY ADDRESS: 6131 Park Ridge Road
FACILITY CITY, STATE, ZIP: Loves Park, IL 61111

DOCKET NUMBER: NH 20-C0335 & NH 20-M0336

LICENSEE INFO: East Bank Center, LLC
LICENSEE ADDRESS: 107 South Third Street
LICENSEE CITY, STATE, ZIP: Bloomingdale, IL 60108

Survey Date – 10/30/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)6)7), 300.1020a), 300.1020b), 300.1020c), 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: 300.696, 300.1210b), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Eastern Star Home

FACILITY ADDRESS: 9890 Star Lane, P.O. Box 317
FACILITY CITY, STATE, ZIP: Macon, IL 62544

DOCKET NUMBER: NH 21-C0007

LICENSEE INFO: Grand Chapter Order of the Eastern Star of the State of
LICENSEE ADDRESS: 9894 Star Lane, P.O. Box 317
LICENSEE CITY, STATE, ZIP: Macon, IL 62544

Survey Date – 11/17/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.695a)1), 300.695b)4), 300.695c)1), 300.3240a), 300.3240b), 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: 300.695b), 300.3240a), and 300.3240e). 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-C0299

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

Survey Date – 10/29/2020
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), 300.1210d)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

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)2), 300.3220f), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Total Fine: $52,200.00

FACILITY NAME: Effingham Rehab & Health C Ctr

FACILITY ADDRESS: 1610 North Lakewood Drive
FACILITY CITY, STATE, ZIP: Effingham, IL 62401

DOCKET NUMBER: NH 21-C0068 & NH 21-S0069

LICENSEE INFO: Effingham HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 12/17/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)2)6)7), 300.1010a), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.696 and 300.3240a). A fine of $25,000.00

FACILITY NAME: Elevate Care Irving Park

FACILITY ADDRESS: 4340 N. Keystone
FACILITY CITY, STATE, ZIP: Chicago, IL 60641

DOCKET NUMBER: NH 21-C0071

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

Survey Date – 12/24/2020
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)2), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $2,200.00

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

Total Fine: $4,400.00

FACILITY NAME: Elevate Care Niles

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

DOCKET NUMBER: NH 21-C0099

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

Survey Date – 01/12/2021
Type B violation of an occurrence for violating one or more of the following sections of the Code: 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: 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Elmwood Nursing & Rehab Center

FACILITY ADDRESS: 152 Wilma Drive
FACILITY CITY, STATE, ZIP: Maryville, IL 62062

DOCKET NUMBER: NH 21-C0066

LICENSEE INFO: Elmwood Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2202 Main Street, Ste 180
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202

Survey Date – 12/23/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210c), 300.1210d)6), 300.1220b)2)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Elmwood Terrace Healthcare Ctr

FACILITY ADDRESS: 1017 West Galena
FACILITY CITY, STATE, ZIP: Aurora, IL 60506

DOCKET NUMBER: NH 21-C0011

LICENSEE INFO: Elmwood Terrace Healthcare Center, Inc.
LICENSEE ADDRESS: 2201 Main Street, Ste 180
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202

Survey Date – 11/05/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.695c)1), 300.1210b), 300.1220b)2), 300.3240a), 300.3240c), 300.3240d), and 300.3240e). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.3240a), 300.3240d), and 300.3240e). A fine of $2,200.00.

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.661, 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: 300.661 and 300.3240a). A fine of $500.00

Total Fine: $2,700.00

FACILITY NAME: Estates of Hyde Park, The

FACILITY ADDRESS: 4505 S. Drexel Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60653

DOCKET NUMBER: NH 20-C0364

LICENSEE INFO: The Estates of Hyde Park, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202

Survey Date – 10/30/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1010i), 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: 300.690a), 300.690b), and 300.690c). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.690). A fine of $2,200.00

Total Fine $27,200.00

FACILITY NAME: Fair Havens Senior Living

FACILITY ADDRESS: 1790 South Fairview Avenue
FACILITY CITY, STATE, ZIP: Decatur, IL 62521

DOCKET NUMBER: NH 21-S0073

LICENSEE INFO: Fair Havens Senior Living, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202

Survey Date – 12/09/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210d)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: 300.1210d)5). A fine of $2,200.00

FACILITY NAME: Fair Haven Senior Living

FACILITY ADDRESS: 1790 South Fairview Avenue
FACILITY CITY, STATE, ZIP: Decatur, IL 62521

DOCKET NUMBER: NH 21-C0104

LICENSEE INFO: Fair Havens Senior Living, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202

Survey Date – 01/06/2021
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.3240a), and 300.3240e). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.3240a), and 300.3240e). A fine of $2,200.00

FACILITY NAME: Fair Oaks Health Care Center

FACILITY ADDRESS: 471 Terra Cotta Avenue
FACILITY CITY, STATE, ZIP: Crystal Lake, IL 60014

DOCKET NUMBER: NH 21-S0017

LICENSEE INFO: Wisconsin Illinois Cotta Avenue
LICENSEE ADDRESS: 471 West Terra Cotta Avenue
LICENSEE CITY, STATE, ZIP: Crystal Lake, IL 60014

Survey Date – 12/01/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.1010a), and 300.1010b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.696). A fine of $25,000.00

FACILITY NAME: Friendship Manor Health Care

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

DOCKET NUMBER: NH 21-C0119 & NH 21-S0120

LICENSEE INFO: Friendship Manor Group, LLC
LICENSEE ADDRESS: 485 South Friendship Drive
LICENSEE CITY, STATE, ZIP: Nashville, IL 62263

Survey Date – 12/22/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)2)7), 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: 300.696, 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Gardenview Manor

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

DOCKET NUMBER: NH 21-C0004

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

Survey Date – 12/03/2020
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), and 300.3240a). The fine was doubled in this instance in accordance with 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: Gardenview Manor

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

DOCKET NUMBER: NH 21-S0103

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

Survey Date – 01/05/2021
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 300.1210d)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: Generations at Elmwood Park

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

DOCKET NUMBER: NH 21-C0163

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

Survey Date – 01/19/2021
Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)2), 300.1210d)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Generations at Riverview

FACILITY ADDRESS: 500 Centennial Drive
FACILITY CITY, STATE, ZIP: East Peoria, IL 61611

DOCKET NUMBER: NH 20-C0379

LICENSEE INFO: Generations at Riverview, LLC
LICENSEE ADDRESS: 6840 N. Lincoln Ave
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712

Survey Date – 11/10/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)2), 300.1210d)3), 300.1210d)5), 300.1220b)2), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Glenview Terrace Nursing Ctr

FACILITY ADDRESS: 1511 Greenwood Road
FACILITY CITY, STATE, ZIP: Glenview, IL 60025

DOCKET NUMBER: NH 21-S0114

LICENSEE INFO: Glenview Terrace Nursing Center
LICENSEE ADDRESS: 6633 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712

Survey Date – 01/07/2021
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210d)3), 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: 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Granite Nsg & Rehab Center

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

DOCKET NUMBER: NH 21-C0045

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

Survey Date – 12/10/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.625). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.625)a), 300.625b), 300.625c), 300.625f), 300.625j), 300.625k), 300.625l), 300.625n), and 300.625o). A fine of $2,200.00

FACILITY NAME: Grove at the Lake, The

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

DOCKET NUMBER: NH 21-C0048

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 – 10/29/2020
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), and 300.3240a). The fine was doubled in this instance in accordance with 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: Grove of LaGrange Park, The

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

DOCKET NUMBER: NH 21-C0086

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

Survey Date – 12/17/2020
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: Heather Health Care Center

FACILITY ADDRESS: 15600 South Honore Street
FACILITY CITY, STATE, ZIP: Harvey, IL 60426

DOCKET NUMBER: NH 21-C0053

LICENSEE INFO: Heather Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave., Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646

Survey Date – 12/17/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1035a)2)3)5), 300.1035d), 300.1035h), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.3240a). A fine of $25,000.00

FACILITY NAME: Healthcare of Arlington Hts

FACILITY ADDRESS: 1200 N. Arlington Heights Rd
FACILITY CITY, STATE, ZIP: Arlington Hts, IL 60004

DOCKET NUMBER: NH 21-C0035 & NH 21-S0036

LICENSEE INFO: Healthbridge of Arlington Heights, LLC
LICENSEE ADDRESS: 55 W. Monroe St., Ste 2400
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603

Survey Date – 12/21/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)6)7), 300.1020a), 300.1020b), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.696 and 300.3240a). A fine of $25,000.00

FACILITY NAME: Helia Healthcare of Belleville

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

DOCKET NUMBER: NH 21-C0034

LICENSEE INFO: Helia Healthcare of Belleville, LLC
LICENSEE ADDRESS: 600 S. Second Street, Suite 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704

Survey Date – 10/23/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)2), 300.1220b)2), 300.1810h), and 300.3240a). The fine was doubled in this instance in accordance with 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: Heritage Health - Jacksonville

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

DOCKET NUMBER: NH 21-C0028

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

Survey Date – 11/20/2020
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: Hickory Nursing Pavilion

FACILITY ADDRESS: 9246 South Roberts Road
FACILITY CITY, STATE, ZIP: Hickory Hills, IL 60457

DOCKET NUMBER: NH 20-C0350

LICENSEE INFO: Hickory Nursing Pavilion, Inc.
LICENSEE ADDRESS: 191 N. Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 10/29/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210d)3), 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: 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Hillside Rehab & Care Center

FACILITY ADDRESS: 1308 Game Farm Road
FACILITY CITY, STATE, ZIP: Yorkville, IL 60560

DOCKET NUMBER: NH 21-C0094

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

Survey Date – 01/13/2021
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)2), 300.1620c), 300.3220f), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Hitz Memorial Home

FACILITY ADDRESS: 201 Belle Street, P.O. Box 79
FACILITY CITY, STATE, ZIP: Alhambra, IL 62001

DOCKET NUMBER: NH 21-C0057

LICENSEE INFO: Hitz Memorial Home
LICENSEE ADDRESS: 201 Belle Street, P.O. Box 79
LICENSEE CITY, STATE, ZIP: Alhambra, IL 62001

Survey Date – 12/03/2020
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: IL Veterans’ Home at LaSalle

FACILITY ADDRESS: 1015 O’Connor Avenue
FACILITY CITY, STATE, ZIP: LaSalle, IL 61301

DOCKET NUMBER: NH 20-C0381

LICENSEE INFO: Illinois Department of Veterans’ Affairs
LICENSEE ADDRESS: 833 South Spring Street, Box 19432
LICENSEE CITY, STATE, ZIP: Springfield, IL 62794

Survey Date – 11/23/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 340.1300a) and 340.1335a). The fine was doubled in this instance in accordance with 340.1245i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 340.1335. A fine of $2,200.00

FACILITY NAME: Illini Heritage Rehab & HC

FACILITY ADDRESS: 1315 Curt Drive, P.O. Box 6179
FACILITY CITY, STATE, ZIP: Champaign, IL 61820

DOCKET NUMBER: NH 21-C0024

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

Survey Date – 11/17/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696b), 300.696c)7), 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: 300.696, 300.1210b), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Imboden Creek Living Center

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

DOCKET NUMBER: NH 21-C0146

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

Survey Date – 01/20/2021
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 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Integrity HC of Herrin

FACILITY ADDRESS: 1900 North Park Avenue
FACILITY CITY, STATE, ZIP: Herrin, IL 62948

DOCKET NUMBER: NH 20-C0384

LICENSEE INFO: Herrin Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 600 S. 2nd Street, Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704

Survey Date – 11/13/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)4), 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: Integrity HC of Smithton

FACILITY ADDRESS: 107 South Lincoln
FACILITY CITY, STATE, ZIP: Smithton, IL 62285

DOCKET NUMBER: NH 21-C0049 & NH 21-S0050

LICENSEE INFO: Park Haven Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 600 S. 2nd Street, Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704

Survey Date – 09/29/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a)b), 300.1020a), 300.1020b), 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: 300.696, 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Integrity HC of Smithton

FACILITY ADDRESS: 107 South Lincoln
FACILITY CITY, STATE, ZIP: Smithton, IL 62285

DOCKET NUMBER: NH 21-C0060

LICENSEE INFO: Park Haven Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 600 S. 2nd Street, Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704

Survey Date – 12/07/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)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

FACILITY NAME: Lakeside Rehab & Healthcare

FACILITY ADDRESS: 900 Centennial Drive
FACILITY CITY, STATE, ZIP: East Peoria, IL 61611

DOCKET NUMBER: NH 21-C0032 & NH 21-S0033

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

Survey Date – 11/30/20 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: Lakeview Rehab & Nrsg Center

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

DOCKET NUMBER: NH 21-C0134

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

Survey Date – 12/28/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)4)A)B), 300.1210d)6), 300.1230a)1)2)3), 300.1230b), 300.1230d)1), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a)1). 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), 300.1210c)1)3), 300.1630d), and 300.3240a). The fine was doubled in this instance in accordance with 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: Lakeview Rehab & Nrsg Center

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

DOCKET NUMBER: NH 21-C0150

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

Survey Date – 01/08/2021
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.690c), 300.1210b), 300.3240a), and 300.3240e). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.3240a), and 300.3240e). A fine of $2,200.00

FACILITY NAME: Landmark of Richton Park

FACILITY ADDRESS: 22660 South Cicero Avenue
FACILITY CITY, STATE, ZIP: Richton Park, IL 60471

DOCKET NUMBER: NH 21-C0139

LICENSEE INFO: Landmark of Richton Park Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 5683 N. Lincoln Ave
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659

Survey Date – 12/30/2020
Type AA 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 $50,000.00

FACILITY NAME: Lee Manor

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

DOCKET NUMBER: NH 21-C0101 & NH 21-S0102

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

Survey Date – 01/11/2021
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)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: 300.696 and 300.3240a). A fine of $25,000.00

FACILITY NAME: Lemont Nrsg & Rehab Center

FACILITY ADDRESS: 12450 Walker Road
FACILITY CITY, STATE, ZIP: Lemont, IL 60539

DOCKET NUMBER: NH 21-C0059

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

Survey Date – 12/07/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210d)3), 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: Lena Living Center

FACILITY ADDRESS: 1010 South Logan Street
FACILITY CITY, STATE, ZIP: Lena, IL 61048

DOCKET NUMBER: NH 20-C0377

LICENSEE INFO: Lena Living Center, LLC
LICENSEE ADDRESS: 150 N. Riverside Plaza, #3000
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 10/30/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.696a), 300.696b), 300.696c)2)7), 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: 300.696, 300.1210b), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Lincoln Terrace

FACILITY ADDRESS: 2324 North Kickapoo Street
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 21-S0006

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

Survey Date – 11/13/2020
Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1210) and 350.3240a). A fine of $550.00

FACILITY NAME: Loft Rehabilitation & Nursing

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

DOCKET NUMBER: NH 21-C0109

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

Survey Date – 01/09/2021
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210d)3), 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: 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Manor Court of Maryville

FACILITY ADDRESS: 6955 State Route 162
FACILITY CITY, STATE, ZIP: Maryville, IL 62062

DOCKET NUMBER: NH 21-C0030

LICENSEE INFO: UDI #2, LLC
LICENSEE ADDRESS: 285 S. Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401

Survey Date – 11/23/2020
Type A 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), and 300.3240c). The fine was doubled in this instance in accordance with 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), 300.1210b), 300.1220b)2), 300.1610a)1), and 300.1620a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

Total Fine: $50,000.00

FACILITY NAME: Manorcare of Elk Grove Village

FACILITY ADDRESS: 1920 Merge Road
FACILITY CITY, STATE, ZIP: Elk Grove Village, IL 60007

DOCKET NUMBER: NH 21-C0110

LICENSEE INFO: Manor Care of Elk Grove Village IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle St. Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 01/04/2021
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)4), 300.1210d)3), 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: Manorcare of Palos Heights East

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

DOCKET NUMBER: NH 21-C0019

LICENSEE INFO: Manorcare of Palos Heights, IL , LLC
LICENSEE ADDRESS: 208 S. LaSalle St, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 11/10/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b)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: McLean County Nursing Home

FACILITY ADDRESS: 901 North Main
FACILITY CITY, STATE, ZIP: Normal, IL 61761

DOCKET NUMBER: NH 21-S0062

LICENSEE INFO: McLean County
LICENSEE ADDRESS: 115 E. Washington Street, Rm 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61702

Survey Date – 12/14/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.1010a), 300.1010b), 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: 300.696 and 300.1210b). A fine of $25,000.00

FACILITY NAME: Miller Health Care Center

FACILITY ADDRESS: 1601 Butterfield Trail
FACILITY CITY, STATE, ZIP: Kankakee, IL 60901

DOCKET NUMBER: NH 21-C0044

LICENSEE INFO: Riverside Senior Living Center
LICENSEE ADDRESS: 350 North Wall Street
LICENSEE CITY, STATE, ZIP: Kankakee, IL 60901

Survey Date – 12/13/2020
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), and 300.3240a). The fine was doubled in this instance in accordance with 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: Montebello Healthcare Center

FACILITY ADDRESS: 1599 Keokuk Street
FACILITY CITY, STATE, ZIP: Hamilton, IL 62341

DOCKET NUMBER: NH 21-C0128

LICENSEE INFO: SSC Hamilton Operating Company, LLC
LICENSEE ADDRESS: 208 South LaSalle Street. Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 11/30/2020
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), 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: New Athens Home for the Aged

FACILITY ADDRESS: 203 South Johnson Street
FACILITY CITY, STATE, ZIP: New Athens. IL 62264

DOCKET NUMBER: NH 21-S0132

LICENSEE INFO: New Athens Home for the Aged
LICENSEE ADDRESS: 203 South Johnson Street
LICENSEE CITY, STATE, ZIP: New Athens, IL 62264

Survey Date – 01/12/2021
Type A 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), and 300.3240b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Oak Crest

FACILITY ADDRESS: 2944 Greenwood Acres Drive
FACILITY CITY, STATE, ZIP: DeKalb, IL 60115

DOCKET NUMBER: NH 21-C0115

LICENSEE INFO: DeKalb Area Retirement Center
LICENSEE ADDRESS: 2944 Greenwood Acres Drive
LICENSEE CITY, STATE, ZIP: DeKalb, IL 60115

Survey Date – 01/05/2021
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.3240)b), and 300.3240d). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.3240d). A fine of $2,200.00

FACILITY NAME: Odd Fellow Rebekah Home

FACILITY ADDRESS: 201 Lafayette Avenues East
FACILITY CITY, STATE, ZIP: Mattoon, IL 61938

DOCKET NUMBER: NH 21-C0164

LICENSEE INFO: Illinois I.O.O.F. Old Folks’ Home, Mattoon Illinois
LICENSEE ADDRESS: 201 Lafayette East
LICENSEE CITY, STATE, ZIP: Mattoon, IL 61938

Survey Date – 01/19/2021
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 300.1220b)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Oregon Living & Rehab Center

FACILITY ADDRESS: 811 South 10th Street
FACILITY CITY, STATE, ZIP: Oregon, IL 61061

DOCKET NUMBER: NH 21-S0016

LICENSEE INFO: Oregon Living & Rehabilitation Center, LLC
LICENSEE ADDRESS: 7434 Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 12/02/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)7), 300.1020a), and 300.1020b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.696. A fine of $2,200.00

FACILITY NAME: Park Place of Belvidere

FACILITY ADDRESS: 1701 5th Avenue
FACILITY CITY, STATE, ZIP: Belvidere, IL 61008

DOCKET NUMBER: NH 21-S0039

LICENSEE INFO: The Gardens of Belvidere, LLC
LICENSEE ADDRESS: 8150 Central Park
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076

Survey Date – 11/23/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.696a), 300.696b), 300.696c)7), 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: 300.696, 300.1210b), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Park View Rehab Center

FACILITY ADDRESS: 5888 North Ridge
FACILITY CITY, STATE, ZIP: Chicago, IL 60660

DOCKET NUMBER: NH 21-C0089

LICENSEE INFO: Park View Rehab Center, LLC
LICENSEE ADDRESS: 191 N. Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 12/28/2020
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)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 $2,200.00

FACILITY NAME: Pearl of Rolling Meadows, The

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

DOCKET NUMBER: NH 21-C0125

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

Survey Date – 01/11/2021
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 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). 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 21-C0047

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

Survey Date – 12/10/2020
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: Prairie Manor Nrsg & Rehab Ctr

FACILITY ADDRESS: 345 Dixie Highway
FACILITY CITY, STATE, ZIP: Chicago Heights, IL 60411

DOCKET NUMBER: NH 21-C0010

LICENSEE INFO: Prairie Manor Nursing & Rehabilitation Center
LICENSEE ADDRESS: 2201 West Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 6020

Survey Date – 10/30/2020
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: Prairie Oasis

FACILITY ADDRESS: 16000 Wabash Avenue
FACILITY CITY, STATE, ZIP: South Holland, IL 60473

DOCKET NUMBER: NH 20-C0376

LICENSEE INFO: Prairie Oasis, LLC
LICENSEE ADDRESS: 4711 Golf Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076

Survey Date – 10/30/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)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: Regency Care of Morris

FACILITY ADDRESS: 1095 Twilight Drive
FACILITY CITY, STATE, ZIP: Morris, IL 60450

DOCKET NUMBER: NH 21-C0084

LICENSEE INFO: Morris SNF Management, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 11/25/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210c)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: Schultz House

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

DOCKET NUMBER: NH 21-S0037

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

Survey Date – 12/04/2020
Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1210), 350.1840b), 350.1840e), and 350.3240a). A fine of $550.00

FACILITY NAME: Seminary Manor

FACILITY ADDRESS: 2345 North Seminary Street
FACILITY CITY, STATE, ZIP: Galesburg, IL 61401

DOCKET NUMBER: NH 21-S0027

LICENSEE INFO: UDI #7, LLC
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401

Survey Date – 11/11/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696b), 300.696c)7), 300.1210b), 300.1220d)b)1)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: 300.696, 300.1210b), 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-C0369

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

Survey Date – 11/13/2020
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: Sharon Health Care Willows

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

DOCKET NUMBER: NH 21-S0043

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

Survey Date – 12/15/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a)c), 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: Sharon Health Care Willows

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

DOCKET NUMBER: NH 21-C0133

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

Survey Date – 01/06/2021
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.696a), 300.696c), 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: 300.696, 300.1210b), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Smith Village

FACILITY ADDRESS: 2320 West 113th Place
FACILITY CITY, STATE, ZIP: Chicago, IL 60643

DOCKET NUMBER: NH 21-S0118

LICENSEE INFO: The Washington and Jane Smith Community Beverly
LICENSEE ADDRESS: 208 S. LaSalle Street, Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 01/11/2021
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.610b), 300.610c), 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: South Suburban Rehab Center

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

DOCKET NUMBER: NH 20-C0380

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

Survey Date – 11/09/2020
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

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: Southgate Health Care Center

FACILITY ADDRESS: 900 E. Nineth Street, P.O. Box 843
FACILITY CITY, STATE, ZIP: Metropolis, IL 62960

DOCKET NUMBER: NH 21-S0082

LICENSEE INFO: Southgate Health Care, Inc.
LICENSEE ADDRESS: 900 E. 9th Street
LICENSEE CITY, STATE, ZIP: Metropolis, IL 62960

Survey Date – 11/30/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 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: Southpoint Nrsg & Rehab Ctr

FACILITY ADDRESS: 1010 West 95th Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60643

DOCKET NUMBER: NH 20-C0356

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

Survey Date – 11/21/2020
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), 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: St. Joseph’s Home of Springfield

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

DOCKET NUMBER: NH 21-C0031

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

Survey Date – 12/04/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c), 300.1020a), 300.1210a), and 300.1210b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.696 and 300.1210b). A fine of $25,000.00

FACILITY NAME: St. Paul’s Senior Community

FACILITY ADDRESS: 1021 West E. Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62220

DOCKET NUMBER: NH 20-C0348

LICENSEE INFO: St. Paul’s Senior Community, LLC
LICENSEE ADDRESS: 412 E. Lawrence Avenue
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703

Survey Date – 11/05/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1030a)2), 300.1035a)4), 300.1035e), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.3240a). A fine of $25,000.00

FACILITY NAME: Sunny Acres Nursing Home

FACILITY ADDRESS: 19130 Sunny Acres Road
FACILITY CITY, STATE, ZIP: Petersburg, IL 62675

DOCKET NUMBER: NH 21-C0070

LICENSEE INFO: Menard County
LICENSEE ADDRESS: 102 S. 7th St, P.O. Box 464
LICENSEE CITY, STATE, ZIP: Petersburg, IL 62675

Survey Date – 12/07/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 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: 300.696, 300.1210b), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Symphony of Crestwood

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

DOCKET NUMBER: NH 21-C0088

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

Survey Date – 12/18/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $25,000.00

Type 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

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 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: 300.3240a). A fine of $2,200.00

Total Fine: $29,400.00

FACILITY NAME: Taylorville Skld Nur & Rehab

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

DOCKET NUMBER: NH 21-C0061

LICENSEE INFO: Taylorville Skilled Nursing & Rehab, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 12/17/20 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: Timbercreek Rehab & Hlth C Ctr

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

DOCKET NUMBER: NH 21-S0137

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

Survey Date – 01/14/2021
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), 300.3240a), and 300.3240f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Toulon Rehab & Health Care Ctr

FACILITY ADDRESS: Highway 17 East, P.O. Box 249
FACILITY CITY, STATE, ZIP: Toulon, IL 61483

DOCKET NUMBER: NH 21-C0054 & NH 21-S0055

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

Survey Date – 12/10/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)2)6)7), 300.1010a), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.696 and 300.3240a). A fine of $25,000.00

FACILITY NAME: Tower Hill Healthcare Center

FACILITY ADDRESS: 759 Kane Street
FACILITY CITY, STATE, ZIP: South Elgin, IL 60177

DOCKET NUMBER: NH 21-C0008

LICENSEE INFO: Tower Hill Rehabilitation, LLC
LICENSEE ADDRESS: 7434 Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077

Survey Date – 11/21/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.3240a), and 300.3240f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

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: University Rehab

FACILITY ADDRESS: 500 South Art Bartell Road
FACILITY CITY, STATE, ZIP: Urbana, IL 61802

DOCKET NUMBER: NH 21-C0075

LICENSEE INFO: University Rehabilitation Center of C-U, LLC
LICENSEE ADDRESS: 208 S. LaSalle St, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 12/15/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010b), 300.1010c), 300.1210b), 300.1210d)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

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

Total fine $50,000.00

FACILITY NAME: University Rehab at Northmoor

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

DOCKET NUMBER: NH 21-S0100

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

Survey Date – 01/07/2021
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210d)1), and 300.1620a). A fine of $1,100.00

FACILITY NAME: University Rehab at Northmoor

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

DOCKET NUMBER: NH 21-C0147

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

Survey Date – 01/13/2021
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: Valley Hi Nursing Home

FACILITY ADDRESS: 2406 Hartland Road
FACILITY CITY, STATE, ZIP: Woodstock, IL 60098

DOCKET NUMBER: NH 21-C0181

LICENSEE INFO: McHenry County
LICENSEE ADDRESS: 2200 North Seminary Avenue
LICENSEE CITY, STATE, ZIP: Woodstock, IL 60098

Survey Date – 01/05/2021
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.696a), 300.696c)7), 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: 300.696 and 300.3240a). A fine of $25,000.00

FACILITY NAME: Villa at South Holland, The

FACILITY ADDRESS: 16300 Wausau Street
FACILITY CITY, STATE, ZIP: South Holland, IL 60473

DOCKET NUMBER: NH 20-C0359

LICENSEE INFO: The Villa at South Holland, LLC
LICENSEE ADDRESS: 191 N. Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 11/12/2020
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: Village at Victory Lakes, The

FACILITY ADDRESS: 1055 East Grand Avenue
FACILITY CITY, STATE, ZIP: Lindenhurst, IL 60046

DOCKET NUMBER: NH 21-S0046

LICENSEE INFO: Franciscan Communities, Inc.
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604

Survey Date – 12/09/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.696a), 300.696b), 300.696)c)7), 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: 300.696 and 300.1210b). A fine of $2,200.00

FACILITY NAME: Vines at Countryside, The

FACILITY ADDRESS: 971 Bode Rd
FACILITY CITY, STATE, ZIP: Elgin, IL 60120

DOCKET NUMBER: NH 21-C0009

LICENSEE INFO: The Vines Senior Homes, LLC
LICENSEE ADDRESS: 13N315 Brindlewood Lane
LICENSEE CITY, STATE, ZIP: Elgin, IL 60124

Survey Date – 12/05/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.1130c). The fine was doubled in this instance in accordance with 330.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 330.4240a). A fine of $1,100.00

FACILITY NAME: Warren Barr South Loop

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

DOCKET NUMBER: NH 21-C0087

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

Survey Date – 12/04/2020
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 $2,2000.00

FACILITY NAME: Watseka Rehab & Hlth Care Ctr

FACILITY ADDRESS: 715 East Raymond Road
FACILITY CITY, STATE, ZIP: Watseka, IL 60970

DOCKET NUMBER: NH 21-S0067

LICENSEE INFO: Watseka HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614

Survey Date – 12/08/2020
Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696b), 300.696c)7), 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: 300.696, 300.1210b), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Willows Health Center

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

DOCKET NUMBER: NH 21-S0052

LICENSEE INFO: Willows Health Center
LICENSEE ADDRESS: 4141 North Rockton Avenue
LICENSEE CITY, STATE, ZIP: Rockford, IL 61103

Survey Date – 12/22/2020
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b)5), 300.1210c), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d.6). A fine of $2,200.00

FACILITY NAME: Willow Rose Rehab & Health

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

DOCKET NUMBER: NH 21-C0098

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

Survey Date – 01/11/2021
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210d)1), 300.1230i), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.3240a). A fine of $2,200.00

FACILITY NAME: Windsor Estates Nsg & Rehab

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

DOCKET NUMBER: NH 21-C0138

LICENSEE INFO: McAllister Nursing and Rehab, LLC
LICENSEE ADDRESS: 180 N. LaSalle Street, Suite 3300
LICENSEE CITY, STATE, ZIP: Chicago, IL 60601

Survey Date – 01/07/2021
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 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)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: 300.1010h), 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

Total Fine: $4,400.00

FACILITY NAME: Winning Wheels

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

DOCKET NUMBER: NH 21-S0124

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

Survey Date – 01/07/2021
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Woodbridge Nursing Pavilion

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

DOCKET NUMBER: NH 21-S0072

LICENSEE INFO: Woodbridge Nursing Pavilion, Ltd
LICENSEE ADDRESS: 191 North Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606

Survey Date – 01/05/2021
Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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: 300.3240a). A fine of $2,200.00