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2021 4th Quarterly Report

The Illinois Department of Public Health has initiated action, as indicated, against the following facilities which have been determined to be in violation of the Nursing Home Care Act, or has recommended decertification to the Director of the Department of Healthcare and Family Service, or the Secretary of the United States Department of Health and Human Services for violations in relation to patient care, pursuant to Titles XVIII and XIX of the Federal Social Security Act.

FACILITY NAME: Accolade Healthcare of Pontiac
FACILITY ADDRESS: 300 West Lowell
FACILITY CITY, STATE, ZIP: Pontiac, IL 61764

DOCKET NUMBER: NH 21-S0606

LICENSEE INFO: Accolade Healthcare of Pontiac, LLC
LICENSEE ADDRESS: 2501 Chatham Road, Ste R
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 07/20/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)6), 300.2900d)2), 300.3100d)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), 300.2900d)2), 300.3100d)2), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Addolorata Villa
FACILITY ADDRESS: 555 McHenry Road
FACILITY CITY, STATE, ZIP: Wheeling, IL 60090

DOCKET NUMBER: NH 21-C0711

LICENSEE INFO: Franciscan Communities, Inc.
LICENSEE ADDRESS: 208 South LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/16/2021

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: Alden Courts of Waterford
FACILITY ADDRESS: 1991 Randi Drive
FACILITY CITY, STATE, ZIP: Aurora, IL 60504

DOCKET NUMBER: NH 21-S0774

LICENSEE INFO: Alden Courts of Waterford, LLC
LICENSEE ADDRESS: 4200 W. Peterson Ave, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 09/28/2021

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

FACILITY NAME: Alden Estates Cts of Huntley
FACILITY ADDRESS: 12140 Regency Parkway
FACILITY CITY, STATE, ZIP: Huntley, IL 60142

DOCKET NUMBER: NH 21-C0623

LICENSEE INFO: Alden Estates Courts of Huntley, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Avenue, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 07/20/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)1), 300.1220b)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), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Alden Estates Cts of Huntley
FACILITY ADDRESS: 12140 Regency Parkway
FACILITY CITY, STATE, ZIP: Huntley, IL 60142

DOCKET NUMBER: NH 21-S0680

LICENSEE INFO: Alden Estates Courts of Huntley, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave. Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 08/18/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010c), 300.1010e), 300.1210b), 300.1210c)1), 300.1210d)6), 300.3220f), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)2)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

Total Fine: $27,200.00

FACILITY NAME: Alden Estates of Barrington
FACILITY ADDRESS: 1420 South Barrington Road
FACILITY CITY, STATE, ZIP: Barrington, IL 60010

DOCKET NUMBER: NH 21-C0830

LICENSEE INFO: Alden Estates of Barrington, Inc.
LICENSEE ADDRESS: 4200 West Peterson Ave., Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 10/12/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d)2)3)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Alden Estates of Naperville
FACILITY ADDRESS: 1525 South Oxford Lane
FACILITY CITY, STATE, ZIP: Naperville, IL 60565

DOCKET NUMBER: NH 21-C0662

LICENSEE INFO: Alden Estates of Naperville, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave., Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 09/14/2021

Type A 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 $25,000.00

FACILITY NAME: Alden Estates of Northmoor
FACILITY ADDRESS: 5831 North Northwest Highway
FACILITY CITY, STATE, ZIP: Chicago, IL 60631

DOCKET NUMBER: NH 21-S0708

LICENSEE INFO: Alden Northmoor Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645
Survey Date – 08/20/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 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: Alden Terrace of McHenry Rehab
FACILITY ADDRESS: 803 Royal Drive
FACILITY CITY, STATE, ZIP: McHenry, IL 60050

DOCKET NUMBER: NH 21-C0855

LICENSEE INFO: Alden Terrace of McHenry Rehabilitation and Health Care Center
LICENSEE ADDRESS: 4200 W. Peterson Ave, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 10/25/2021

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: Aldeo Rehab & Health Care Ctr
FACILITY ADDRESS: 304 SW 12^th Street
FACILITY CITY, STATE, ZIP: Aldeo, IL 61231

DOCKET NUMBER: NH 21-C0643

LICENSEE INFO: Aldeo HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/30/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 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: Alton Memorial Rehab & Therapy
FACILITY ADDRESS: 1251 College Avenue
FACILITY CITY, STATE, ZIP: Alton, IL 62002

DOCKET NUMBER: NH 21-S0832

LICENSEE INFO: Alton Memorial Hospital
LICENSEE ADDRESS: One Memorial Drive
LICENSEE CITY, STATE, ZIP: Alton, IL 62002
Survey Date – 10/22/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)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: Aperion Care Bradley
FACILITY ADDRESS: 650 North Kenzie
FACILITY CITY, STATE, ZIP: Bradley, IL 60915

DOCKET NUMBER: NH 21-C0668

LICENSEE INFO: Aperion Care Bradley, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/01/2021

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 300.3240e). 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 16^th Place
FACILITY CITY, STATE, ZIP: Chicago, IL 60411

DOCKET NUMBER: NH 21-C0548 & NH 21-S0550

LICENSEE INFO: Riviera Care Center, LLC
LICENSEE ADDRESS: 208 So. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 07/07/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.1210d)6), 300.2210b)6), and 300.2210b)7). The fine was doubled in this instance in accordance with 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: Aperion Care Chicago Heights
FACILITY ADDRESS: 490 West 16^th Place
FACILITY CITY, STATE, ZIP: Chicago Heights, IL 60411

DOCKET NUMBER: NH 21-C0677

LICENSEE INFO: Riviera Care Center, LLC
LICENSEE ADDRESS: 208 So. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/02/2021

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

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

DOCKET NUMBER: NH 21-C0697

LICENSEE INFO: Berkshire Nursing & Rehab Center, LLC
LICENSEE ADDRESS: 208 So. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/02/2021

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

FACILITY NAME: Aperion Care Hillside
FACILITY ADDRESS: 323 Oakridge Avenue
FACILITY CITY, STATE, ZIP: Hillside, IL 60162

DOCKET NUMBER: NH 21-C0751

LICENSEE INFO: Oakridge Healthcare Center, LLC
LICENSEE ADDRESS: 180 N. LaSalle Street, Ste 3300
LICENSEE CITY, STATE, ZIP: Chicago, IL 60601
Survey Date – 09/23/2021

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

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

DOCKET NUMBER: NH 21-C0760

LICENSEE INFO: North Church Nursing & Rehab, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/16/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)2), 300.2040a), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

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

DOCKET NUMBER: NH 21-C0869

LICENSEE INFO: North Church Nursing & Rehab, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/20/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010b), 300.1030a)3), 300.1210a), 300.1210b)5), 300.1210c), 300.1210d)6), and 300.3220f). The fine was doubled in this instance in accordance with 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: Aperion Care Midlothian
FACILITY ADDRESS: 3249 West 147^th Street
FACILITY CITY, STATE, ZIP: Midlothian, IL 60445

DOCKET NUMBER: NH 21-C0679

LICENSEE INFO: Plaza Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/16/2021

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

DOCKET NUMBER: NH 21-C0685

LICENSEE INFO: Aperion Care Morton Villa, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/01/2021

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), 300.1210d)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: Aperion Care Oak Lawn
FACILITY ADDRESS: 9401 South Ridgeland Avenue
FACILITY CITY, STATE, ZIP: Oak Lawn, IL 60453

DOCKET NUMBER: NH 21-C0673

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 – 08/10/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a) and 300.3220f). A fine of $12,500.00

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

DOCKET NUMBER: NH 21-C0714

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 – 09/07/2021

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

FACILITY NAME: Aperion Care Springfield
FACILITY ADDRESS: 525 S. Martin Luther King Drive
FACILITY CITY, STATE, ZIP: Springfield, IL 62703

DOCKET NUMBER: NH 21-S0618

LICENSEE INFO: Springfield Care Center, LLC
LICENSEE ADDRESS: 208 So. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 07/29/2021

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), 300.1210c), and 300.1210d)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Aperion Care West Chicago
FACILITY ADDRESS: 201 West North Avenue
FACILITY CITY, STATE, ZIP: West Chicago, IL 60185

DOCKET NUMBER: NH 21-S0800

LICENSEE INFO: Aperion Care West Chicago, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/07/2021

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

FACILITY NAME: Aperion Care Westchester
FACILITY ADDRESS: 2901 South Wolf Road
FACILITY CITY, STATE, ZIP: Westchester, IL 60154

DOCKET NUMBER: NH 21-S0684

LICENSEE INFO: Aperion Care Westchester, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/26/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b)4), , 300.1210d)2), and 300.1220b)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Aperion Care Westchester
FACILITY ADDRESS: 2901 South Wolf Road
FACILITY CITY, STATE, ZIP: Westchester, IL 60154

DOCKET NUMBER: NH 21-C0825

LICENSEE INFO: Aperion Care Westchester, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/14/2021

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

FACILITY NAME: Apostolic Christian Restmor
FACILITY ADDRESS: 1500 Parkside Avenue
FACILITY CITY, STATE, ZIP: Morton, IL 61550

DOCKET NUMBER: NH 21-S0598

LICENSEE INFO: Apostolic Christian Restmor, Inc.
LICENSEE ADDRESS: 100 North Main Street
LICENSEE CITY, STATE, ZIP: Morton, IL 61550
Survey Date – 08/11/2021

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 300.3240a). The fine was doubled in this instance in accordance with 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: Arden Courts South Holland
FACILITY ADDRESS: 2045 East 170^th Street
FACILITY CITY, STATE, ZIP: South Holland, IL 60473

DOCKET NUMBER: NH 21-S0629

LICENSEE INFO: Arden Courts of South Holland IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 07/19/2021

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

FACILITY NAME: Astoria Place Living & Rehab
FACILITY ADDRESS: 6300 North California Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60659

DOCKET NUMBER: NH 21-C0692

LICENSEE INFO: Astoria Place Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/19/2021

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

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

DOCKET NUMBER: NH 21-C0783

LICENSEE INFO: The Austin Oasis, LLC
LICENSEE ADDRESS: 4711 Golf Rd, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 09/20/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)1), 300.1210d)2), and 300.1210d)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: Austin Oasis, The
FACILITY ADDRESS: 901 South Austin Boulevard
FACILITY CITY, STATE, ZIP: Chicago, IL 60644

DOCKET NUMBER: NH 21-S0804

LICENSEE INFO: The Austin Oasis, LLC
LICENSEE ADDRESS: 4711 Golf Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 10/07/2021

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 300.3240f). 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 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Avantara Park Ridge
FACILITY ADDRESS: 1601 North Western Avenue
FACILITY CITY, STATE, ZIP: Park Ridge, IL 60068

DOCKET NUMBER: NH 21-C0599

LICENSEE INFO: Avantara Park Ridge, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 07/12/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1220b)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: Beacon Hill
FACILITY ADDRESS: 2400 South Finley Road
FACILITY CITY, STATE, ZIP: Lombard, IL 60148

DOCKET NUMBER: NH 21-S0456

LICENSEE INFO: Lifespace Communities, Inc.
LICENSEE ADDRESS: 118 W. Edwards St., Ste 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 06/21/2021

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

FACILITY NAME: Beacon Hill
FACILITY ADDRESS: 2400 South Finley Road
FACILITY CITY, STATE, ZIP: Lombard, IL 60148

DOCKET NUMBER: NH 21-S0699

LICENSEE INFO: Lifespace Communities, Inc.
LICENSEE ADDRESS: 118 W. Edwards St., Ste 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 09/10/2021

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

FACILITY NAME: Bella Terra Elmhurst
FACILITY ADDRESS: 420 W. Butterfield Road
FACILITY CITY, STATE, ZIP: Elmhurst, IL 60126

DOCKET NUMBER: NH 21-S0700

LICENSEE INFO: Butterfield Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 09/09/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)2)3)4), 300.1210d)1)2)4)A)5)6), 300.1630d), 300.1630e), and 300.3220f). The fine was doubled in this instance in accordance with 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: Bella Terra LaGrange
FACILITY ADDRESS: 4735 Willow Springs Road
FACILITY CITY, STATE, ZIP: LaGrange, IL 60525

DOCKET NUMBER: NH 21-C0876

LICENSEE INFO: Willow Springs Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 10/21/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1)2), and 300.3220f). The fine was doubled in this instance in accordance with 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

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

DOCKET NUMBER: NH 21-C0750

LICENSEE INFO: Morton Grove Living & Rehab Center, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/26/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)2), 300.1210d)5), 300.3220f), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Bella Terra Schaumburg
FACILITY ADDRESS: 675 S. Roselle Road
FACILITY CITY, STATE, ZIP: Schaumburg, IL 60193

DOCKET NUMBER: NH 21-C0747

LICENSEE INFO: Schaumburg Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 09/15/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.696c)6)7). The fine was doubled in this instance in accordance 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 B violation of an occurrence for violating one or more of the following sections of the Code: 300.1035d) and 300.1035g). A fine of $1,100.00

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

Total Fine: $5,500.00

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

DOCKET NUMBER: NH 21-C0582

LICENSEE INFO: Streamwood Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 07/03/2021

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), 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: Bella Terra Wheeling
FACILITY ADDRESS: 730 West Hintz Road
FACILITY CITY, STATE, ZIP: Wheeling, IL 60090

DOCKET NUMBER: NH 21-S0672

LICENSEE INFO: Wheeling Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 08/18/2021

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

FACILITY NAME: Bellwood Developmental Center
FACILITY ADDRESS: 105 Eastern Avenue
FACILITY CITY, STATE, ZIP: Bellwood, IL 60104

DOCKET NUMBER: NH 21-C0765

LICENSEE INFO: Bellwood Nursing Center, LLC
LICENSEE ADDRESS: 2711 W. Howard St
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645
Survey Date – 09/08/2021

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.700a), 350.700b), 350.700c), and 350.3240a). A fine of $750.00

FACILITY NAME: Belmont Village Oak Park
FACILITY ADDRESS: 1035 Madison Street
FACILITY CITY, STATE, ZIP: Oak Park, IL 60302

DOCKET NUMBER: NH 21-S0874

LICENSEE INFO: Belmont Village Oak Park Tenant, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/14/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.710a), 330.710c)1)3)A)B)C)D)E)F)G), and 330.710d)1)2). A fine of $1,100.00

FACILITY NAME: Bethesda Rehab & Senior Care
FACILITY ADDRESS: 2833 North Nordica Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60634

DOCKET NUMBER: NH 21-C0532

LICENSEE INFO: Norwegian Lutheran Bethesda Home Association
LICENSEE ADDRESS: 6016 North Nina Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60631
Survey Date – 07/01/2021

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), 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: Bria of Belleville
FACILITY ADDRESS: 150 North 27^th Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62226

DOCKET NUMBER: NH 21-C0577

LICENSEE INFO: Belleville Healthcare & Rehabilitation Center, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Ste 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 06/28/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Bria of Belleville
FACILITY ADDRESS: 150 North 27^th Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62226

DOCKET NUMBER: NH 21-S0593

LICENSEE INFO: Belleville Healthcare & Rehabilitation Center, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Ste 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 07/15/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1035a)3), 300.1035e), 300.1210a), 300.1210d)2), and 300.3220f). A fine of $12,500.00

FACILITY NAME: Bria of Forest Edge
FACILITY ADDRESS: 8001 South Western Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60620

DOCKET NUMBER: NH 21-C0648

LICENSEE INFO: Forest Edge Healthcare & Rehabilitation Center, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 08/19/2021

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 300.3240f). 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). A fine of $2,200.00

FACILITY NAME: Bria of River Oaks
FACILITY ADDRESS: 14500 South Manistee
FACILITY CITY, STATE, ZIP: Burnham, Illinois 60633

DOCKET NUMBER: NH 21-C0635

LICENSEE INFO: River Oaks Healthcare & Rehabilitation Center, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60044
Survey Date – 07/30/2021

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

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

DOCKET NUMBER: NH 21-C0767

LICENSEE INFO: Briar Place Nursing, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/10/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c)3), 300.1210d)6), 300.1220b)2)3), and 300.3240). The fine was doubled in this instance in accordance with 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: Briarbrook Place
FACILITY ADDRESS: 228 Briarbrook Drive
FACILITY CITY, STATE, ZIP: East Peoria, IL 61611

DOCKET NUMBER: NH 21-C0653

LICENSEE INFO: Progressive House, Inc.
LICENSEE ADDRESS: 20180 Governors Dr. Ste 300
LICENSEE CITY, STATE, ZIP: Olympia Fields, IL 60461
Survey Date – 08/13/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) 350.1210, 350.1230b)3), 350.1230b)7), 350.3240a), and 350.3240f). A fine of $6,250.00

FACILITY NAME: Brother James Court
FACILITY ADDRESS: 2508 St James Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62707

DOCKET NUMBER: NH 21-C0790

LICENSEE INFO: Brother James Court
LICENSEE ADDRESS: 1215 S. 4^th Street
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/23/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) 350.760a), 350.760c), 350.1210, and 350.3240a). A fine of $10.000.00

FACILITY NAME: Burgess Square Healthcare Ctr
FACILITY ADDRESS: 5801 South Cass Avenue
FACILITY CITY, STATE, ZIP: Westmont, IL 60559

DOCKET NUMBER: NH 21-S0556

LICENSEE INFO: Burgess Square Healthcare and Rehabilitation Centre, LLC
LICENSEE ADDRESS: 190 S. LaSalle St., Ste 3700
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 07/08/2021

FACILITY NAME: Burgess Square Healthcare Ctr
FACILITY ADDRESS: 5801 South Cass Avenue
FACILITY CITY, STATE, ZIP: Westmont, IL 60559

DOCKET NUMBER: NH 21-S0666

LICENSEE INFO: Burgess Square Healthcare and Rehabilitation Centre, LLC
LICENSEE ADDRESS: 190 S. LaSalle St., Ste 3700
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 08/27/2021

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

FACILITY NAME: Carlinville Rehab & HCC
FACILITY ADDRESS: 751 North Oak Street
FACILITY CITY, STATE, ZIP: Carlinville, IL 62626

DOCKET NUMBER: NH 21-C0621

LICENSEE INFO: Carlinville Rehabilitation and Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/09/2021

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

DOCKET NUMBER: NH 21-S0829

LICENSEE INFO: Carlinville Rehabilitation and Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/04/2021

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), 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: Carlton at the Lake, The
FACILITY ADDRESS: 725 West Montrose Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60613

DOCKET NUMBER: NH 21-S0571

LICENSEE INFO: Carlton Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 07/08/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a) 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: Carmi Manor Rehab & Nrsg Ctr
FACILITY ADDRESS: 615 W. Webb Street, P.O. Box 133
FACILITY CITY, STATE, ZIP: Carmi, IL 62821

DOCKET NUMBER: NH 21-C0655

LICENSEE INFO: Carmi Manor Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 615 W. Webb Street
LICENSEE CITY, STATE, ZIP: Carmi, IL 62821
Survey Date – 08/20/2021

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), 300.1020a), 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

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

DOCKET NUMBER: NH 21-C0732

LICENSEE INFO: Cedar Ridge Care and Rehabilitation Center, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/23/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)2), 300.1210d)3), 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: Center Home Hispanic Elderly
FACILITY ADDRESS: 1400 North California
FACILITY CITY, STATE, ZIP: Chicago, IL 60622

DOCKET NUMBER: NH 21-C0661

LICENSEE INFO: Center Home Hispanic Elderly, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 08/26/2021

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

FACILITY NAME: Chalet Living & Rehab
FACILITY ADDRESS: 7350 North Sheridan Road
FACILITY CITY, STATE, ZIP: Chicago, IL 60626

DOCKET NUMBER: NH 21-S0856

LICENSEE INFO: Chalet Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Dr.
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/08/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)6), and 300.1220b)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: Champaign Urbana Nrsg & Rehab
FACILITY ADDRESS: 302 Burwash Avenue
FACILITY CITY, STATE, ZIP: Savoy, IL 61874

DOCKET NUMBER: NH 21-C0786

LICENSEE INFO: Champaign Urbana Nursing and Rehab, LP
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 10/07/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.610c)2), 300.696a), 300.696b), 300.696c)1), 300.1210b), 300.1210d)2), and 300.3220f). The fine was doubled in this instance in accordance 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: Charter Sr Lvg Poplar Creek
FACILITY ADDRESS: 2150 West Golf Road
FACILITY CITY, STATE, ZIP: Hoffman Estates, IL 60169

DOCKET NUMBER: NH 21-S0860

LICENSEE INFO: S-H OPCO Hoffman Estates, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/13/2021

Type C violation of an occurrence for violating one or more of the following sections of the Code: 330.715a) and 330.715b). This instance in accordance with 330.282f) i) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 330.715a) and 330.715b). A fine of $500.00

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

DOCKET NUMBER: NH 21-S0557

LICENSEE INFO: Chateau Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 08/26/2021

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: Chestnut Corner SC
FACILITY ADDRESS: 905 West Chestnut St., Box 250
FACILITY CITY, STATE, ZIP: Louisville, IL 62858

DOCKET NUMBER: NH 21-C0519

LICENSEE INFO: Diamond Development Co.
LICENSEE ADDRESS: 150 South State Rt 45, Box 250
LICENSEE CITY, STATE, ZIP: Louisville, IL 62858
Survey Date – 06/29/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.725i), 330.725k), 330.725l), and 330.725n). 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: 330.725k), 330.725l), and 330.725n). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.710a), 330.1710c)1), 330.4210a), 330.4210f), 330.4210g), 330.4210o), 330.4240a), 330.4240c) and 330.4240d). 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) and 330.4240d). A fine of $2,200.00

Total Fine: $4,400.00

FACILITY NAME: Chestnut Corner S.C.
FACILITY ADDRESS: 905 West Chestnut St, Box 250
FACILITY CITY, STATE, ZIP: Louisville, IL 62858

DOCKET NUMBER: NH 21-C0639

LICENSEE INFO: Diamond Development Co.
LICENSEE ADDRESS: 150 South State Rte 45, Box 250
LICENSEE CITY, STATE, ZIP: Louisville, IL 62858
Survey Date – 08/23/2021

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

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.2220a)1) and 330.2220a)3). A fine of $1,100.00

Total Fine: $1,600.00

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

DOCKET NUMBER: NH 21-C0799

LICENSEE INFO: Chicago Ridge SNF, LLC
LICENSEE ADDRESS: 3531 Howard St., Ste 1006
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 09/22/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.690a), 300.690b), 300.690c), 300.1210b), 300.1210c), and 300.1210d)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.690 and 300.1210b). A fine of $25,000.00

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

DOCKET NUMBER: NH 21-C0899

LICENSEE INFO: Chicago Ridge SNF, LLC
LICENSEE ADDRESS: 3531 Howard St. Ste 1006
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 10/25/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.650e), 300.650f)1), 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

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

Total Fine: $4.400.00

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

DOCKET NUMBER: NH 21-C0845

LICENSEE INFO: Christian Homes, Inc.
LICENSEE ADDRESS: 208 S. LaSalle Ste., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/25/2021

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: Cisne Rehab & Health Care Ctr
FACILITY ADDRESS: 107 North Watkins P.O. Box 370
FACILITY CITY, STATE, ZIP: Cisne, IL 62823

DOCKET NUMBER: NH 21-C0857 & NH 21-S0858

LICENSEE INFO: Petersen Health Operations, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 10/07/2021

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)7), 300.1020a), 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: Citadel of Northbrook, The
FACILITY ADDRESS: 3300 Milwaukee Avenue
FACILITY CITY, STATE, ZIP: Northbrook, IL 60062

DOCKET NUMBER: NH 21-S0888

LICENSEE INFO: Citadel of Northbrook, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/21/2021

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

FACILITY NAME: City View Multicare Center
FACILITY ADDRESS: 5825 West Cermak Road
FACILITY CITY, STATE, ZIP: Cicero, IL 60804

DOCKET NUMBER: NH 21-C0720 & NH 21-S0770

LICENSEE INFO: City View Multicare Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 08/24/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 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 A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210d)6), 300.2210a), and 300.2210b)2)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: 300.1210d)6). 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), 300.1210a), 300.1210b), 300.1210c), 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 $25,000.00

Total Fine: $52,200.00

FACILITY NAME: City View Multicare Center
FACILITY ADDRESS: 5825 West Cermak Road
FACILITY CITY, STATE, ZIP: Cicero, IL 60804

DOCKET NUMBER: NH 21-C0722

LICENSEE INFO: City View Multicare Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 09/15/2021

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 300.3240f). 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 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Community Care Center
FACILITY ADDRESS: 4314 South Wabash Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60653

DOCKET NUMBER: NH 21-S0828

LICENSEE INFO: Laureate Chicago Operations, LLC
LICENSEE ADDRESS: 208 S. LaSalle St. Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/15/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b) and 300.1210d)1)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.686a)8). 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: $25,500.00

FACILITY NAME: Countryside Nrsg & Rehab Ctr
FACILITY ADDRESS: 1635 East 154^th Street
FACILITY CITY, STATE, ZIP: Dolton, IL 60419

DOCKET NUMBER: NH 21-S0604

LICENSEE INFO: Countryside Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 W. Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 07/15/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.690b), 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: 300.690, 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Countryview Care Center Macomb
FACILITY ADDRESS: 400 West Grant Street
FACILITY CITY, STATE, ZIP: Macomb, IL 61455

DOCKET NUMBER: NH 21-S0807

LICENSEE INFO: Petersen Health Properties, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/28/2021

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

FACILITY NAME: Decatur Rehab & Health Care Ct
FACILITY ADDRESS: 136 South Dipper Lane
FACILITY CITY, STATE, ZIP: Decatur, IL 62522

DOCKET NUMBER: NH 21-S0801

LICENSEE INFO: Decatur HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 10/05/2021

FACILITY NAME: Dimensions Living Prospect Hts
FACILITY ADDRESS: 700 East Euclid Avenue
FACILITY CITY, STATE, ZIP: Prospect Heights, IL 60070

DOCKET NUMBER: NH 21-S0627

LICENSEE INFO: S-H OPCO Prospect Heights, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 07/25/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.1510)4). A fine of $1,100.00

FACILITY NAME: Doctors Nursing & Rehab Center
FACILITY ADDRESS: 1201 Hawthorn Road
FACILITY CITY, STATE, ZIP: Salem, IL 62881

DOCKET NUMBER: NH 21-C0575

LICENSEE INFO: Helia Healthcare of Salem, LLC
LICENSEE ADDRESS: 600 S. Second Street, Suite 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 07/15/2021

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

FACILITY NAME: Du Page Care Center
FACILITY ADDRESS: 400 N. County Farm Rd
FACILITY CITY, STATE, ZIP: Wheaton, IL 60187

DOCKET NUMBER: NH 21-S0687

LICENSEE INFO: DuPage County Board
LICENSEE ADDRESS: 421 County Farm Road
LICENSEE CITY, STATE, ZIP: Wheaton, IL 60187
Survey Date – 08/04/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.696a), 300.696c)2)6)7), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.696) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Eastview Terrace
FACILITY ADDRESS: 100 Eastview Place
FACILITY CITY, STATE, ZIP: Springfield, IL 61951

DOCKET NUMBER: NH 21-S0608

LICENSEE INFO: Eastview HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/12/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 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: Elevate Care Country Club Hill
FACILITY ADDRESS: 18300 South Lavergne
FACILITY CITY, STATE, ZIP: Country Club Hills, IL 60478

DOCKET NUMBER: NH 21-C0678

LICENSEE INFO: McAllister Nursing and Rehab, LLC
LICENSEE ADDRESS: 180 N. LaSalle Street, Ste 3300
LICENSEE CITY, STATE, ZIP: Chicago, IL 60601
Survey Date – 08/18/2021

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

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

Total Fine: $50,000.00

FACILITY NAME: Elevate Care Riverwoods
FACILITY ADDRESS: 3705 Deerfield Road
FACILITY CITY, STATE, ZIP: Riverwoods, IL 60015

DOCKET NUMBER: NH 21-C0771

LICENSEE INFO: Elevate Care Riverwoods, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/14/2021

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

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

DOCKET NUMBER: NH 21-C0715 & NH 21-S0716

LICENSEE INFO: Fairmont Care Center, Inc.
LICENSEE ADDRESS: 5061 North Pulaski Road
LICENSEE CITY, STATE, ZIP: Chicago, IL 60630
Survey Date – 08/23/2021

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), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $50,000.00

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

Total Fine: $52,200.00

FACILITY NAME: Fairview Haven
FACILITY ADDRESS: 605 North 4^th Street
FACILITY CITY, STATE, ZIP: Fairbury, IL 61739

DOCKET NUMBER: NH 21-S0742

LICENSEE INFO: Fairview Haven
LICENSEE ADDRESS: 605 N. Fourth St
LICENSEE CITY, STATE, ZIP: Fairbury, IL 61739
Survey Date – 08/30/2021

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

FACILITY NAME: Foster Health & Rehab Center
FACILITY ADDRESS: 2840 West Foster Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60625

DOCKET NUMBER: NH 21-C0487 & NH 21-S0488

LICENSEE INFO: Foster Health & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2835 W. North Shore Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645
Survey Date – 06/23/2021

FACILITY NAME: Foster Health & Rehab Center
FACILITY ADDRESS: 2840 West Foster Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60625

DOCKET NUMBER: NH 21-C0646

LICENSEE INFO: Foster Health & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2835 W. North Shore Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645
Survey Date – 08/18/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.3320a) and 300.3320b). A fine of $1,100.00

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

DOCKET NUMBER: NH 21-C0573

LICENSEE INFO: Franciscan Communities, Inc.
LICENSEE ADDRESS: 208 So, LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 07/12/2021

Type A 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 $25,000.00

FACILITY NAME: Freeburg Terrace
FACILITY ADDRESS: #4 Hill Mine Road
FACILITY CITY, STATE, ZIP: Freeburg, IL 62243

DOCKET NUMBER: NH 21-C0632

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 07/22/2021

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.810a), 350.810e), 350.1060a), 350.1060b)2), 350.1060d), 350.1060e), 350.1060f), 350.1060h), 350.1060j), 350.1060k), 350.1070), 350.1210, 350.1610h)1), 350.1610h)2), 350.3240a), 350.3240b), 350.3240c), and 350.3240d). A fine of $550.00

FACILITY NAME: Friendship Village Schaumburg
FACILITY ADDRESS: 350 West Schaumburg Road
FACILITY CITY, STATE, ZIP: Schaumburg, IL 60194

DOCKET NUMBER: NH 21-S0694

LICENSEE INFO: Evangelical Retirement Homes of Greater Chicago, Inc.
LICENSEE ADDRESS: 350 West Schaumburg Road
LICENSEE CITY, STATE, ZIP: Schaumburg, IL 60194
Survey Date – 08/25/2021

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

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

DOCKET NUMBER: NH 21-C0642

LICENSEE INFO: Gardenview Manor, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 07/27/2021

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

DOCKET NUMBER: NH 21-C0718

LICENSEE INFO: Generations at Elmwood Park, Inc.
LICENSEE ADDRESS: 6840 N. Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 09/09/2021

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

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

DOCKET NUMBER: NH 21-S0776

LICENSEE INFO: Generations at Rock Island, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 09/14/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b), 300.1210d)6), and 300.1220b)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: Generations at Rock Island
FACILITY ADDRESS: 2545 24^th Street
FACILITY CITY, STATE, ZIP: Rock Island, IL 61201

DOCKET NUMBER: NH 21-C0819

LICENSEE INFO: Generations at Rock Island, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/08/2021

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)1)2), 300.1220b)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Glenwood Terrace Springfield
FACILITY ADDRESS: 2724 Glenwood Avenue
FACILITY CITY, STATE, ZIP: Springfield, IL 62704

DOCKET NUMBER: NH 21-C0792

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 09/27/2021

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1210, 350.1230d)2), 350.1410a), 350.1420a), 350.1430a)3), 350.1430d), 350.1430e), 350.1450a), 350.1450c), and 350.3220f). A fine of $550.00

FACILITY NAME: Golfview Developmental Center
FACILITY ADDRESS: 9555 West Golf Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60016

DOCKET NUMBER: NH 21-C0757 & NH 21-S0758

LICENSEE INFO: Golfview Developmental Center, Inc
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/02/2021

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

FACILITY NAME: Good Samaritan Pontiac
FACILITY ADDRESS: 1225 S. Ewing Drive
FACILITY CITY, STATE, ZIP: Pontiac, IL 61764

DOCKET NUMBER: NH 21-C0752

LICENSEE INFO: Good Samaritan-Pontiac
LICENSEE ADDRESS: 1225 S. Ewing Dr
LICENSEE CITY, STATE, ZIP: Pontiac, IL 61764
Survey Date – 09/23/2021

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

FACILITY NAME: Grove of Berwyn, The
FACILITY ADDRESS: 3601 South Harlem Avenue
FACILITY CITY, STATE, ZIP: Berwyn, IL 60402

DOCKET NUMBER: NH 21-C0719

LICENSEE INFO: Berwyn Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/16/2021

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

FACILITY NAME: Grove of Berwyn, The
FACILITY ADDRESS: 3601 South Harlem Avenue
FACILITY CITY, STATE, ZIP: Berwyn, IL 60402

DOCKET NUMBER: NH 21-C0863

LICENSEE INFO: Berwyn Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/20/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)2)4), 300.1230e), and 300.3220f). The fine was doubled in this instance in accordance with 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 300.1230. A fine of $25,000.00

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

DOCKET NUMBER: NH 21-S0624

LICENSEE INFO: St. Charles Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/24/2021

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

FACILITY NAME: Harris Place
FACILITY ADDRESS: 209 Harris Road
FACILITY CITY, STATE, ZIP: East Peoria, IL 61611

DOCKET NUMBER: NH 21-S0713

LICENSEE INFO: Progressive Housing, Inc
LICENSEE ADDRESS: 20180 Governors Dr., Ste 300
LICENSEE CITY, STATE, ZIP: Olympia Fields, IL 60461
Survey Date – 08/19/2021

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1060a), 350.1060d), 350.1060e), 350.1060f), 350.1060j), 350.1210, 350.1430a)3), and 350.3240a). A fine of $550,00

FACILITY NAME: Harris Place
FACILITY ADDRESS: 209 Harris Road
FACILITY CITY, STATE, ZIP: East Peoria, IL 61611

DOCKET NUMBER: NH 21-C0849 & NH 21-S0850

LICENSEE INFO: Progressive Housing, Inc.
LICENSEE ADDRESS: 20180 Governors Dr., Ste 300
LICENSEE CITY, STATE, ZIP: Olympia Fields, IL 60461
Survey Date – 10/11/2021

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

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1210b), 350.1230b), 350.1230e), 350.3240a), and 350.3750. A fine of $550.00

Total Fine: $1,100.00

FACILITY NAME: Heather Health Care Center
FACILITY ADDRESS: 15600 South Honore Street
FACILITY CITY, STATE, ZIP: Harvey, IL 60426

DOCKET NUMBER: NH 21-C0572

LICENSEE INFO: Heather Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 07/11/2021

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

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

DOCKET NUMBER: NH 21-S0817

LICENSEE INFO: Heartland of Galesburg IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/06/2021

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: Henry Rehab and Nursing
FACILITY ADDRESS: 1650 Old Indian Town Rd
FACILITY CITY, STATE, ZIP: Henry, IL 61537

DOCKET NUMBER: NH 21-S0675

LICENSEE INFO: Henry Rehab and Nursing, LLC
LICENSEE ADDRESS: 615 W. Webb St
LICENSEE CITY, STATE, ZIP: Carmi, IL 62821
Survey Date – 09/02/2021

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

FACILITY NAME: Heritage Health Carlinville
FACILITY ADDRESS: 1200 University Avenue
FACILITY CITY, STATE, ZIP: Carlinville, IL 62626

DOCKET NUMBER: NH 21-S0628

LICENSEE INFO: Heritage Manor Carlinville, LLC
LICENSEE ADDRESS: 115 W. Jefferson, Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 07/23/2021

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

FACILITY NAME: Heritage Heath Carlinville
FACILITY ADDRESS: 1200 University Avenue
FACILITY CITY, STATE, ZIP: Carlinville, IL 62626

DOCKET NUMBER: NH 21-C0710

LICENSEE INFO: Heritage Manor Carlinville, LLC
LICENSEE ADDRESS: 115 W. Jefferson Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 08/16/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b)4), and 300.1210d)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

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

DOCKET NUMBER: NH 21-S0636

LICENSEE INFO: Heritage Manor – Mt. Zion, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Ste 400
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 08/06/2021

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

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

DOCKET NUMBER: NH 21-S0640

LICENSEE INFO: Rutledge Joint Ventures, LLC
LICENSEE ADDRESS: 202 N. Center
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 08/16/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1), 300.1220b)2), and 300.1630d). The fine was doubled in this instance in accordance with 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: Heritage Health Springfield
FACILITY ADDRESS: 900 North Rutledge
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 21-C0686

LICENSEE INFO: Rutledge Joint Ventures
LICENSEE ADDRESS: 202 N. Center
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 09/09/2021

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

FACILITY NAME: Hickorypoint Christian Village
FACILITY ADDRESS: 565 West Marion Avenue
FACILITY CITY, STATE, ZIP: Forsyth, IL 62535

DOCKET NUMBER: NH 21-S0592

LICENSEE INFO: Fair Haven Christian Homes, Inc.
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/04/2021

FACILITY NAME: Hillsboro Rehab & HCC
FACILITY ADDRESS: 1300 East Tremont Street
FACILITY CITY, STATE, ZIP: Hillsboro, IL 62049

DOCKET NUMBER: NH 21-C0924

LICENSEE INFO: Hillsboro Rehabilitation and Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/14/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.650c), 300.650d), 300.650e), 300.661, 300.810a), 300.1210b), 300.1210d)3), 300.1220b)4), 300.1220b)6), 300.1230b)2)A)B)C), 300.1630a), 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: 300.661, 300.1210b), 300.1230, and 300.3240a). A fine of $25,000.00

FACILITY NAME: Hilltop Skilled Nsg & Rehab
FACILITY ADDRESS: 910 West Polk Avenue
FACILITY CITY, STATE, ZIP: Charleston, IL 61920

DOCKET NUMBER: NH 21-C0745 & NH 21-S0746

LICENSEE INFO: Hilltop Care and Rehabilitation Center, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/10/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

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

DOCKET NUMBER: NH 21-S0558

LICENSEE INFO: Holy Family Villa
LICENSEE ADDRESS: 721 N. LaSalle St., 5^th FL
LICENSEE CITY, STATE, ZIP: Chicago, IL 60654
Survey Date – 07/01/2021

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: Illini Restorative Care
FACILITY ADDRESS: 1455 Hospital Rd
FACILITY CITY, STATE, ZIP: Silvis, IL 61282

DOCKET NUMBER: NH 21-S0585

LICENSEE INFO: Wellspire, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 06/25/2021

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

FACILITY NAME: Illini Restorative Care
FACILITY ADDRESS: 1455 Hospital Rd
FACILITY CITY, STATE, ZIP: Silvis, IL 61282

DOCKET NUMBER: NH 21-S0610

LICENSEE INFO: Wellspire, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 06/25/2021

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

FACILITY NAME: Illinois Veterans’ Home of Quincy
FACILITY ADDRESS: 1707 North 12 Street
FACILITY CITY, STATE, ZIP: Quincy, IL 62301

DOCKET NUMBER: NH 21-C0726 & NH 21-S0727

LICENSEE INFO: Illinois Department of Veterans’ Affairs
LICENSEE ADDRESS: 833 South Spring Street, Box 19432
LICENSEE CITY, STATE, ZIP: Springfield, IL 62794
Survey Date – 08/24/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 340.1505g). 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: 340.1505g). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 340.1560a). A fine of $1,100.00

Total Fine: $3,300.00

FACILITY NAME: Integrity HC of Marion
FACILITY ADDRESS: 1301 East DeYoung
FACILITY CITY, STATE, ZIP: Marion, IL 62959

DOCKET NUMBER: NH 21-C0634

LICENSEE INFO: Marion Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 600 S. 2^nd Street, Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 07/30/2021

FACILITY NAME: Jacksonville Skld Nur & Rehab
FACILITY ADDRESS: 1517 West Walnut Street
FACILITY CITY, STATE, ZIP: Jacksonville, IL 62650

DOCKET NUMBER: NH 21-C0625

LICENSEE INFO: Jacksonville Care and Rehabilitation Center, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 07/28/2021

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

FACILITY NAME: Jacksonville Skld Nur & Rehab
FACILITY ADDRESS: 1517 West Walnut Street
FACILITY CITY, STATE, ZIP: Jacksonville, IL 62650

DOCKET NUMBER: NH 21-C0626

LICENSEE INFO: Jacksonville Care and Rehabilitation Center, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 07/28/2021

Type AA 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 $50,000.00

FACILITY NAME: Joshua Manor
FACILITY ADDRESS: 120 West Locust Street
FACILITY CITY, STATE, ZIP: Hoyleton, IL 62803

DOCKET NUMBER: NH 21-S0698

LICENSEE INFO: Progressive Housing, Inc.
LICENSEE ADDRESS: 20180 Governors Dr., Ste 300
LICENSEE CITY, STATE, ZIP: Olympia Fields, IL 60461
Survey Date – 08/17/2021

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

FACILITY NAME: Knox County Nursing Home
FACILITY ADDRESS: 800 North Market Street
FACILITY CITY, STATE, ZIP: Knoxville, IL 61448

DOCKET NUMBER: NH 21-S0695

LICENSEE INFO: Knox County
LICENSEE ADDRESS: Knox County Courthouse
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 08/31/2021

FACILITY NAME: Lakeview Rehab & Nsg Center
FACILITY ADDRESS: 735 West Diversey
FACILITY CITY, STATE, ZIP: Chicago, IL 60614

DOCKET NUMBER: NH 21-C0569

LICENSEE INFO: Lakeview Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 07/15/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)2), 300.1210d)2), 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: Landmark of Richton Park
FACILITY ADDRESS: 22660 South Cicero Ave
FACILITY CITY, STATE, ZIP: Richton Park, IL 60471

DOCKET NUMBER: NH 21-C0885

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 – 10/19/2021

FACILITY NAME: LaSalle County Nursing Home
FACILITY ADDRESS: 1380 North 27^th Road
FACILITY CITY, STATE, ZIP: Ottawa, IL 61350

DOCKET NUMBER: NH 21-S0620

LICENSEE INFO: LaSalle County
LICENSEE ADDRESS: 707 Etna Road, LCBO Rm 245
LICENSEE CITY, STATE, ZIP: Ottawa, IL 61350
Survey Date – 08/06/2021

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), 300.1220b)2), and 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

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

DOCKET NUMBER: NH 21-C0676

LICENSEE INFO: Lebanon HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/02/2021

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

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

DOCKET NUMBER: NH 21-C0798

LICENSEE INFO: Lebanon HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 10/05/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610c)2), 300.1210a), 300.1210b)4), and 300.1210d)4). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

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

DOCKET NUMBER: NH 21-C0683

LICENSEE INFO: Seneca Nursing Home, Inc.
LICENSEE ADDRESS: 200 S. Wacker Dr., Ste 3800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 09/03/2021

FACILITY NAME: Libertyville Manor Ext Care
FACILITY ADDRESS: 610 Peterson Road
FACILITY CITY, STATE, ZIP: Libertyville, IL 60048

DOCKET NUMBER: NH 21-S0796

LICENSEE INFO: Libertyville Manor Extended Care Facility, Inc.
LICENSEE ADDRESS: 400 Lathrop Ave., Ste 100
LICENSEE CITY, STATE, ZIP: River Forest, IL 60305
Survey Date – 10/14/2021

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

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

DOCKET NUMBER: NH 21-C0696

LICENSEE INFO: Lincoln Village Healthcare Center, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 08/23/2021

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

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

DOCKET NUMBER: NH 21-C0826

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 10/04/2021

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.810a), 350.1420a), 350.1430d), 350.1620d)15), 350.3240d), and 350.3240f). A fine of $550.00

FACILITY NAME: Lincolnwood Place
FACILITY ADDRESS: 7000 N. McCormick Boulevard
FACILITY CITY, STATE, ZIP: Lincolnwood, IL 60712

DOCKET NUMBER: NH 21-S0502

LICENSEE INFO: GA HC REIT II Lincolnwood TRS SUB, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 06/29/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.710a), 330.1145c), 330.4240a), 330.4240b), and 330.4240e). 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) and 330.4240e). A fine of $2,200.00

FACILITY NAME: Linton Terrace
FACILITY ADDRESS: 330 Linton Avenue
FACILITY CITY, STATE, ZIP: Wood River, IL 62095

DOCKET NUMBER: NH 21-S0725

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 08/25/2021

Type B violation for violating one or more of the following sections of the Code: 350.610a), 350.1060a) and 350.1610e). A fine of $550.00

FACILITY NAME: Little Sisters of the Poor
FACILITY ADDRESS: 2325 North Lakewood Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60614

DOCKET NUMBER: NH 21-S0847

LICENSEE INFO: Little Sisters of the Poor of Chicago, Inc.
LICENSEE ADDRESS: 111 W. Washington, Ste 1437
LICENSEE CITY, STATE, ZIP: Chicago, IL 60602
Survey Date – 10/08/2021

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), 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: Loft Rehabilitation & Nursing
FACILITY ADDRESS: 700 N. Main Street
FACILITY CITY, STATE, ZIP: Eureka, IL 61530

DOCKET NUMBER: NH 21-C0787

LICENSEE INFO: The Loft Rehabilitation & Nursing, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 09/21/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.3210t), 300.3240c), 300.3240d), 300.3240e), and 300.3240g). The fine was doubled in this instance in accordance 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) and 300.3240e). A fine of $2,200.00

FACILITY NAME: Loft Rehab & Nursing of Canton
FACILITY ADDRESS: 2081 North Main Street
FACILITY CITY, STATE, ZIP: Canton, IL 61520

DOCKET NUMBER: NH 21-S0562

LICENSEE INFO: The Loft Rehabilitation and Nursing of Canton, LLC
LICENSEE ADDRESS: 55 W. Monroe Street, Suite 2400
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 07/01/2021

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), 300.1210c), 300.1210d)1)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: Loft Rehab & Nursing of Normal
FACILITY ADDRESS: 510 Broadway
FACILITY CITY, STATE, ZIP: Normal, IL 61761

DOCKET NUMBER: NH 21-C0547

LICENSEE INFO: The Loft Rehabilitation and Nursing of Normal, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 07/06/2021

FACILITY NAME: Loft Rehab of Rock Springs, The
FACILITY ADDRESS: 2530 North Monroe Street
FACILITY CITY, STATE, ZIP: Decatur, IL 62526

DOCKET NUMBER: NH 21-S0802

LICENSEE INFO: The Loft Rehabilitation of Rock Springs, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/07/2021

FACILITY NAME: Loft Rehab of Rock Springs, The
FACILITY ADDRESS: 2530 North Monroe Street
FACILITY CITY, STATE, ZIP: Decatur, IL 62526

DOCKET NUMBER: NH 21-S0816

LICENSEE INFO: The Loft Rehabilitation of Rock Springs, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/21/2021

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

FACILITY NAME: Macomb Post Acute Care Center
FACILITY ADDRESS: 8 Doctors Lane
FACILITY CITY, STATE, ZIP: Macomb, IL 61455

DOCKET NUMBER: NH 21-S0706

LICENSEE INFO: Macomb Post Acute Care Center, LLC
LICENSEE ADDRESS: 615 W. Webb St
LICENSEE CITY, STATE, ZIP: Carmi, IL 62821
Survey Date – 09/17/2021

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

FACILITY NAME: Magnolia Manor Shelter Care H
FACILITY ADDRESS: 1100 Grant
FACILITY CITY, STATE, ZIP: Eldorado, IL 62930

DOCKET NUMBER: NH 21-S0591

LICENSEE INFO: John Zink
LICENSEE ADDRESS: 150 South Route 45, P.O. Box 250
LICENSEE CITY, STATE, ZIP: Louisville, IL 62858
Survey Date – 07/22/2021

Type C violation of an occurrence for violating one or more of the following sections of the Code: 330.715a), 330.715b), 330.910a), and 330.911. This instance in accordance with 330.282f) i) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 330.715a), 330.715b), and 330.911). A fine of $500.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.920b), 330.1110e), 330.1135, 330.1160a), 330.1160b), 330.1310c)1), 330.1310c)4), 330.1310g), and 330.1520a). A fine of $1,100.00

Total Fine: $1,600.00

FACILITY NAME: Marigold Rehabilitation HCC
FACILITY ADDRESS: 275 East Carl Sandburg Drive
FACILITY CITY, STATE, ZIP: Galesburg, IL 61401

DOCKET NUMBER: NH 21-S0613

LICENSEE INFO: Marigold HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/14/2021

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

FACILITY NAME: Marshall Rehab & Nursing
FACILITY ADDRESS: 410 North Second Street
FACILITY CITY, STATE, ZIP: Marshall, IL 62441

DOCKET NUMBER: NH 21-S0739

LICENSEE INFO: Marshall Rehabilitation and Nursing, LLC
LICENSEE ADDRESS: 615 W. Webb Street
LICENSEE CITY, STATE, ZIP: Carmi, IL 62821
Survey Date – 09/29/2021

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

FACILITY NAME: Matteson Court
FACILITY ADDRESS: 237 Central Avenue
FACILITY CITY, STATE, ZIP: Matteson, IL 60443

DOCKET NUMBER: NH 21-C0756

LICENSEE INFO: Pioneer Concepts, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 08/31/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) and 350.3240a). A fine of $6,250.00

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

DOCKET NUMBER: NH 21-C0656

LICENSEE INFO: Mattoon Manor, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/12/2021

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

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

Total Fine: $4,400.00

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

DOCKET NUMBER: NH 21-C0689 & NH 21-S0690

LICENSEE INFO: Mattoon Manor, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/07/2021

FACILITY NAME: Metropolis Rehab & HCC
FACILITY ADDRESS: 2299 Metropolis Street
FACILITY CITY, STATE, ZIP: Metropolis, IL 62960

DOCKET NUMBER: NH 21-S0811

LICENSEE INFO: Metropolis Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/14/2021

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: Moweaqua Rehab & HCC
FACILITY ADDRESS: 525 South Macon Street
FACILITY CITY, STATE, ZIP: Moweaqua, IL 62550

DOCKET NUMBER: NH 21-S0864

LICENSEE INFO: Moweaqua Rehabilitation & Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence Avenue
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/20/2021

FACILITY NAME: Mulberry Manor
FACILITY ADDRESS: 612 East Davie Street, PO Box 88
FACILITY CITY, STATE, ZIP: Anna, IL 62906

DOCKET NUMBER: NH 21-S0766

LICENSEE INFO: Mulberry Manor, Inc.
LICENSEE ADDRESS: 158 E. Vienna St., P.O. Box 88
LICENSEE CITY, STATE, ZIP: Anna, IL 62906
Survey Date – 09/10/2021

Type B violation for violating one or more of the following sections of the Code: 350.620a). A fine of $750.00

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

DOCKET NUMBER: NH 21-C0615

LICENSEE INFO: Niles Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 07/15/2021

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

FACILITY NAME: Oak Brook Care
FACILITY ADDRESS: 2013 Midwest Road
FACILITY CITY, STATE, ZIP: Oak Brook, IL 60523

DOCKET NUMBER: NH 21-C0596

LICENSEE INFO: Oakbrook Healthcare Centre, Ltd
LICENSEE ADDRESS: 5061 N. Pulaski Road
LICENSEE CITY, STATE, ZIP: Chicago, IL 60630
Survey Date – 07/22/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), 300.1210d)2), 300.1210d)3), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Oak Brook Care
FACILITY ADDRESS: 2013 Midwest Road
FACILITY CITY, STATE, ZIP: Oak Brook, IL 60523

DOCKET NUMBER: NH 21-C0630

LICENSEE INFO: Oakbrook Healthcare Centre, Ltd
LICENSEE ADDRESS: 5061 N. Pulaski Road
LICENSEE CITY, STATE, ZIP: Chicago, IL 60630
Survey Date – 08/12/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 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: Oak Hill
FACILITY ADDRESS: 623 Hamacher Street
FACILITY CITY, STATE, ZIP: Waterloo, IL 62298

DOCKET NUMBER: NH 21-C0600

LICENSEE INFO: County of Monroe
LICENSEE ADDRESS: 100 South Main Street
LICENSEE CITY, STATE, ZIP: Waterloo, IL 62298
Survey Date – 07/30/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)3), 300.1210d)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: Odd Fellow Rebekah Home
FACILITY ADDRESS: 201 Lafayette Avenue East
FACILITY CITY, STATE, ZIP: Moline, IL 61938

DOCKET NUMBER: NH 21-C0682

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 – 08/16/2021

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), 300.1210d)5), 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)5). A fine of $2,200.00

FACILITY NAME: Odd Fellow Rebekah Home
FACILITY ADDRESS: 201 Lafayette Ave East
FACILITY CITY, STATE, ZIP: Mattoon, IL 61938

DOCKET NUMBER: NH 21-C0827

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 – 10/04/2021

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

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

DOCKET NUMBER: NH 21-S0691

LICENSEE INFO: PA Peterson at the Citadel, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 08/11/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.690a) 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 $25,000.00

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.625b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.625b). A fine of $500.00

Total Fine: $25,500.00

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

DOCKET NUMBER: NH 21-C0744

LICENSEE INFO: PA Peterson at the Citadel, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 09/07/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)1), 300.1620a), and 300.1630d). The fine was doubled in this instance in accordance with 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: Palos Heights Rehabilitation
FACILITY ADDRESS: 13259 South Central Avenue
FACILITY CITY, STATE, ZIP: Crestwood, IL 60418

DOCKET NUMBER: NH 21-C0738

LICENSEE INFO: Palos Heights Rehabilitation, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 09/02/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1220b)2), and 300.3250a). A fine of $1,100.00

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

Total Fine: $3,300.00

FACILITY NAME: Parc Joliet
FACILITY ADDRESS: 222 N. Hammes Ave
FACILITY CITY, STATE, ZIP: Joliet, IL 60435

DOCKET NUMBER: NH 21-C0617

LICENSEE INFO: Parc Joliet Nursing, LLC
LICENSEE ADDRESS: 6302 N. Monticello Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659
Survey Date – 07/26/2021

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)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

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

Total Fine: $4,400.00

FACILITY NAME: Parc Joliet
FACILITY ADDRESS: 222 N. Hammes Ave
FACILITY CITY, STATE, ZIP: Joliet, IL 60435

DOCKET NUMBER: NH 21-C0731

LICENSEE INFO: Parc Joliet Nursing, LLC
LICENSEE ADDRESS: 6302 N. Monticello Ave
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659
Survey Date – 08/30/2021

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

Total Fine: $4,400.00

FACILITY NAME: Parc Joliet
FACILITY ADDRESS: 222 N. Hammes Ave
FACILITY CITY, STATE, ZIP: Joliet, IL 60435

DOCKET NUMBER: NH 21-C0784

LICENSEE INFO: Parc Joliet Nursing, LLC
LICENSEE ADDRESS: 6302 N. Monticello Ave
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659
Survey Date – 09/23/2021

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), 300.1210d)1)2)5), 300.1220b), 300.1230e), 300.1230f), and 300.3240a). The fine was doubled in this instance in accordance with 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), 300.1230, and 300.3240a). A fine of $25,000.00

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

DOCKET NUMBER: NH 21-C0788

LICENSEE INFO: Parker Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 10/01/2021

Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.620b), 300.1010h), 300.1210b), 300.1210d)2)3), 300.1220b)10), and 300.3240a). The fine was doubled in this instance in accordance with 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: Parkshore Estates Nrsg & Rehab
FACILITY ADDRESS: 6125 South Kenwood
FACILITY CITY, STATE, ZIP: Chicago, IL 60637

DOCKET NUMBER: NH 21-C0814

LICENSEE INFO: Parkshore Estates Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 10/01/2021

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

DOCKET NUMBER: NH 21-S0748

LICENSEE INFO: Parkview Home of Freeport, Illinois, Inc.
LICENSEE ADDRESS: 1234 South Park Boulevard
LICENSEE CITY, STATE, ZIP: Freeport, IL 61032
Survey Date – 09/30/2021

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.696a). The fine was doubled in this instance in accordance 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 $500.00

FACILITY NAME: Paul House & Health Cr Ctr
FACILITY ADDRESS: 3800 North California
FACILITY CITY, STATE, ZIP: Chicago, IL 60618

DOCKET NUMBER: NH 21-S0846

LICENSEE INFO: Paul House & Health Care Center, LLC
LICENSEE ADDRESS: 6500 North Hamlin Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/14/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)1), 300.1630a)3), 300.1640a), and 300.1640f). The fine was doubled in this instance in accordance with 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

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

Total Fine: $4,400.00

FACILITY NAME: Piatt County Nursing Home
FACILITY ADDRESS: 1111 N. State St., P.O. Box 410
FACILITY CITY, STATE, ZIP: Monticello, IL 61856

DOCKET NUMBER: NH 21-S0669

LICENSEE INFO: Piatt County
LICENSEE ADDRESS: 101 W. Washington, Room 107
LICENSEE CITY, STATE, ZIP: Monticello, IL 61856
Survey Date – 08/25/2021

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), 300.1220b)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Pleasant Meadows Senior Living
FACILITY ADDRESS: 400 West Washington
FACILITY CITY, STATE, ZIP: Chrisman, IL 61924

DOCKET NUMBER: NH 21-C0650 & NH 21-S0651

LICENSEE INFO: Pleasant Meadows Senior Living, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 08/03/2021

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 300.1220b)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

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)1), and 300.1210d)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

Total Fine: $27,200.00

FACILITY NAME: Pleasant Meadows Senior Living
FACILITY ADDRESS: 400 West Washington
FACILITY CITY, STATE, ZIP: Chrisman, IL 61924

DOCKET NUMBER: NH 21-C0809 & NH 21-S0810

LICENSEE INFO: Pleasant Meadows Senior Living, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd., Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/27/2021

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

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

Total Fine: $27,200

FACILITY NAME: Pleasant View Rehab & HCC
FACILITY ADDRESS: 500 North Jackson Street
FACILITY CITY, STATE, ZIP: Morrison, IL 61270

DOCKET NUMBER: NH 21-C0769

LICENSEE INFO: Pleasant View HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/16/2021

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

FACILITY NAME: Prairie Rose Health Care Ctr
FACILITY ADDRESS: 900 South Chestnut Street
FACILITY CITY, STATE, ZIP: Pana, IL 62557

DOCKET NUMBER: NH 21-C0681

LICENSEE INFO: SJL Health Systems, Inc.
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/19/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)3), 300.1210d)6), 300.1220b)2)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), 300.1210d)6), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Promedica Skilled Nursing AH
FACILITY ADDRESS: 715 West Central Road
FACILITY CITY, STATE, ZIP: Arlington Hts, IL 60005

DOCKET NUMBER: NH 21-C0667

LICENSEE INFO: Manorcare Health Services, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 07/26/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), 300.1210d)2), 300.1210d)3), 300.1220b)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Promedica Skilled Nursing Hin
FACILITY ADDRESS: 600 West Ogden Avenue
FACILITY CITY, STATE, ZIP: Hinsdale, IL 60521

DOCKET NUMBER: NH 21-S0712

LICENSEE INFO: Manor Care of Hinsdale IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/18/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)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: Quincy Terrace
FACILITY ADDRESS: 1233 North Sixth Street
FACILITY CITY, STATE, ZIP: Quincy, IL 62301

DOCKET NUMBER: NH 21-C0848

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 10/12/2021

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

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

DOCKET NUMBER: NH 21-C0762

LICENSEE INFO: Sterling SNF Management, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/29/2021

FACILITY NAME: River Crossing of Alton
FACILITY ADDRESS: 3490 Humbert Road
FACILITY CITY, STATE, ZIP: Alton, IL 62002

DOCKET NUMBER: NH 21-C0794

LICENSEE INFO: Alton NH, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/15/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)1), 300.1620a), and 300.1630b). The fine was doubled in this instance in accordance with 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

FACILITY NAME: River Crossing of East Peoria
FACILITY ADDRESS: 900 Centennial Drive
FACILITY CITY, STATE, ZIP: East Peoria, IL 61611

DOCKET NUMBER: NH 21-C0789

LICENSEE INFO: East Peoria NH LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/14/2021

FACILITY NAME: River Crossing of Moline
FACILITY ADDRESS: 7300 34^th Avenue
FACILITY CITY, STATE, ZIP: Moline, IL 61265

DOCKET NUMBER: NH 21-S0622

LICENSEE INFO: Moline NH, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 07/12/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)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: River Crossing of St, Charles
FACILITY ADDRESS: 850 Dunham Road
FACILITY CITY, STATE, ZIP: St. Charles, IL 60174

DOCKET NUMBER: NH 21-C0546

LICENSEE INFO: St. Charles NH, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/16/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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: Rochelle Gardens Care Center
FACILITY ADDRESS: 1021 Caron Road
FACILITY CITY, STATE, ZIP: Rochelle, IL 61068

DOCKET NUMBER: NH 21-S0734

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/22/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)4)5) and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.686a)8) and 300.686f)1)2)3)4)5)6)7)8)9)10)11)12). 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: Rochelle Gardens Care Center
FACILITY ADDRESS: 1021 Caron Road
FACILITY CITY, STATE, ZIP: Rochelle, IL 61068

DOCKET NUMBER: NH 21-C0773

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/16/2021

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

DOCKET NUMBER: NH 21-C0614

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/19/2021

FACILITY NAME: Rock River Health Care
FACILITY ADDRESS: 707 West Riverside Boulevard
FACILITY CITY, STATE, ZIP: Rockford, IL 61103

DOCKET NUMBER: NH 21-C0777

LICENSEE INFO: Rock River Health Care., LLC
LICENSEE ADDRESS: 4711 Golf Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 09/23/2021

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.686a)8), 300.686e), 300.686f)1), and 300.686f)2). 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

FACILITY NAME: Rushville Nursing & Rehab Ctr
FACILITY ADDRESS: 135 South Morgan Street
FACILITY CITY, STATE, ZIP: Rushville, IL 62681

DOCKET NUMBER: NH 21-C0785

LICENSEE INFO: Rushville Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 09/21/2021

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), 300.1210d)3), 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 $25,000.00

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

DOCKET NUMBER: NH 21-S0586

LICENSEE INFO: Saline Care Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 215 E. Locust St
LICENSEE CITY, STATE, ZIP: Harrisburg, IL 62946
Survey Date – 07/13/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.690b), 300.1210b), 300.1210d)6), 300.3240a), 300.3240b), 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), 300.1210d)6), 300.3240a), 300.3240d), and 300.3240e). A fine of $25,000.00

FACILITY NAME: Salud Wellness
FACILITY ADDRESS: 306 North Larkin Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60435

DOCKET NUMBER: NH 21-C0831

LICENSEE INFO: Symphony Deerbrook, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/07/2021

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

FACILITY NAME: Selfhelp Home of Chicago
FACILITY ADDRESS: 908 West Argyle Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 21-S0563

LICENSEE INFO: The Selfhelp Home, Inc.
LICENSEE ADDRESS: 10 South Wacker Drive, 40^th FL
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 07/15/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.696a) and 300.696c)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: 300.696. A fine of $2,200.00

FACILITY NAME: Sharon Health Care Elms
FACILITY ADDRESS: 3611 North Rochelle
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 21-C0594

LICENSEE INFO: Sharon Health Care Elms, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 08/02/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 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 $25,000.00

FACILITY NAME: Sharon Health Care Elms
FACILITY ADDRESS: 3611 North Rochelle
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 21-C0595

LICENSEE INFO: Sharon Health Care Elms, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 07/20/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)1), 300.1210d)2), and 300.3220f). The fine was doubled in this instance in accordance with 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

FACILITY NAME: Sharon Health Care Pines
FACILITY ADDRESS: 3614 North Rochelle
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 21-C0641

LICENSEE INFO: Sharon Health Care Pines, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 08/04/2021

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

FACILITY NAME: Sharon Health Care Pines
FACILITY ADDRESS: 3614 North Rochelle
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 21-S0688

LICENSEE INFO: Sharon Health Care Pines, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 08/12/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)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: 300.1210a), 300.1210b), 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). A fine of $2,200.00

Total Fine: $27,200.00

FACILITY NAME: Sharon Health Care Pines
FACILITY ADDRESS: 3614 North Rochelle
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 21-S0693

LICENSEE INFO: Sharon Health Care Pines, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 08/26/2021

FACILITY NAME: Shawnee Rose Care Center
FACILITY ADDRESS: 1000 West Sloan Street
FACILITY CITY, STATE, ZIP: Harrisburg, IL 62946

DOCKET NUMBER: NH 21-S0859

LICENSEE INFO: Midwest Health Operations, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 10/15/2021

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), 300.1210c), 300.1210d)2), and 300.2040d). The fine was doubled in this instance in accordance with 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: Southpoint Nrsg & Rehab Ctr
FACILITY ADDRESS: 1010 West 95^th Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60643

DOCKET NUMBER: NH 21-C0821

LICENSEE INFO: Southpoint Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 10/22/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.2010a)1), 300.2090a), 300.2090b), and 300.2100. A fine of $1,100.00

FACILITY NAME: Southview Manor
FACILITY ADDRESS: 3311 South Michigan Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60616

DOCKET NUMBER: NH 21-S0779

LICENSEE INFO: Laureate Southview Operations, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/22/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1020a), 300.1020b), 300.1020c), 300.1210b), 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) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Squire’s Sheltered Care Home
FACILITY ADDRESS: 2601 North California
FACILITY CITY, STATE, ZIP: Chicago, IL 60647

DOCKET NUMBER: NH 21-C0797

LICENSEE INFO: Fellowship House, Inc.
LICENSEE ADDRESS: 180 N. LaSalle St., Ste 3300
LICENSEE CITY, STATE, ZIP: Chicago, IL 60601
Survey Date – 09/24/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.2220a)1) and 330.2220a)2). A fine of $1,100.00

FACILITY NAME: St Clara’s Rehab & Senior Care
FACILITY ADDRESS: 1450 Castle Manor Drive
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 21-S0581

LICENSEE INFO: St. Clara’s Manor
LICENSEE ADDRESS: 1 N. Old State Capitol Plaza, 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62701
Survey Date – 07/08/2021

FACILITY NAME: St. Clara’s Rehab & Senior Care
FACILITY ADDRESS: 1450 Castle Manor Drive
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 21-S0834

LICENSEE INFO: St Clara’s Manor
LICENSEE ADDRESS: 1 N. Old State Capitol Plaza 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62701
Survey Date – 10/07/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1220b)8). The fine was doubled in this instance in accordance with 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: St Paul’s Senior Community
FACILITY ADDRESS: 1021 West E. Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62220

DOCKET NUMBER: NH 21-C0560

LICENSEE INFO: St Paul’s Senior Community, LLC
LICENSEE ADDRESS: 412 E. Lawrence Ave
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 07/09/2021

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

FACILITY NAME: St. Paul’s Senior Community
FACILITY ADDRESS: 1021 West E Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62220

DOCKET NUMBER: NH 21-S0815

LICENSEE INFO: St. Paul’s Senior Community, LLC
LICENSEE ADDRESS: 412 E. Lawrence Ave
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/08/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)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: 330.710a) and 330.720b). A fine of $1,100.00

Total Fine: $3,300.00

FACILITY NAME: Stevens House
FACILITY ADDRESS: 2182 Windish Drive
FACILITY CITY, STATE, ZIP: Galesburg, IL 61401

DOCKET NUMBER: NH 21-C0740

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 09/14/2021

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

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

DOCKET NUMBER: NH 21-S0609

LICENSEE INFO: Sunset of Hazel Crest, LLC
LICENSEE ADDRESS: 453 E. Montrose Avenue
LICENSEE CITY, STATE, ZIP: Wood Dale, IL 60191
Survey Date – 07/18/2021

Type C violation of an occurrence for violating one or more of the following sections of the Code: 330.780a), 330.780b), and 330.780c). This instance in accordance with 330.282f) i) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 330.780). A fine of $500.00

FACILITY NAME: Sunset Rehabilitation & Hlth C
FACILITY ADDRESS: 129 South 1^st Avenue
FACILITY CITY, STATE, ZIP: Canton, IL 61520

DOCKET NUMBER: NH 21-S0597

LICENSEE INFO: Petersen Health Junction, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/13/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.1220b)3), 300.2040b), 300.2040g), and 300.3240a). The fine was doubled in this instance in accordance with 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: Symphony at Midway
FACILITY ADDRESS: 4437 South Cicero
FACILITY CITY, STATE, ZIP: Chicago, IL 60632

DOCKET NUMBER: NH 21-C0589

LICENSEE INFO: Symphony Midway, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/05/2021

FACILITY NAME: Symphony Encore
FACILITY ADDRESS: 2829 South California Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60608

DOCKET NUMBER: NH 21-C0664

LICENSEE INFO: Symphony of California Gardens, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/27/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.3260a), 300.3260c), and 300.3260e). A fine of $1,100.00

FACILITY NAME: Symphony Encore
FACILITY ADDRESS: 2829 South California Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60608

DOCKET NUMBER: NH 21-S0749

LICENSEE INFO: Symphony of California Gardens, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/28/2021

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

DOCKET NUMBER: NH 21-C0638

LICENSEE INFO: Symphony Bronzeville Park, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 07/30/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)4), 300.1210b)5), 300.1210d)4)C), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

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

DOCKET NUMBER: NH 21-S0674

LICENSEE INFO: Symphony Bronzeville Park, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/10/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)3), and 300.3240. The fine was doubled in this instance in accordance with 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: Symphony of South Shore
FACILITY ADDRESS: 2425 East 71^st Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60649

DOCKET NUMBER: NH 21-C0659 & NH 21-S0660

LICENSEE INFO: Symphony of South Shore, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/13/2021

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

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

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

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1230e) and 300.1230f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1230). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.60a) 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: $33,800.00

FACILITY NAME: Symphony of South Shore
FACILITY ADDRESS: 2425 East 71^st Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60649

DOCKET NUMBER: NH 21-C0882 & NH 21-S0883

LICENSEE INFO: Symphony South Shore, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/05/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1), and 300.1210d)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

Total Fine: $27,200.00

FACILITY NAME: Taylorville Care Center
FACILITY ADDRESS: 600 South Houston
FACILITY CITY, STATE, ZIP: Taylorville, IL 62568

DOCKET NUMBER: NH 21-S0803

LICENSEE INFO: Palladian Taylorville SNF, LLC
LICENSEE ADDRESS: 600 S. Second St., Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 09/29/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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: Thomas Herbstritt House
FACILITY ADDRESS: 4003 N. Rt 1 & 17, P.O. Box 260
FACILITY CITY, STATE, ZIP: Momence, IL 60954

DOCKET NUMBER: NH 21-S0808

LICENSEE INFO: Good Shepherd Manor, Inc.
LICENSEE ADDRESS: 4129 N. Rt 1 & 17, P.O. Box 260
LICENSEE CITY, STATE, ZIP: Momence, IL 60954
Survey Date – 09/30/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) 350.700a), 350.1210b), 350.1230e), and 350.3240a). A fine of $6,250.00

FACILITY NAME: Three Crowns Park
FACILITY ADDRESS: 2323 McDaniel Avenue
FACILITY CITY, STATE, ZIP: Evanston, IL 60201

DOCKET NUMBER: NH 21-S0854

LICENSEE INFO: Three Crowns Park
LICENSEE ADDRESS: 2323 McDaniel Avenue
LICENSEE CITY, STATE, ZIP: Evanston, IL 60201
Survey Date – 10/22/2021

FACILITY NAME: Timber Point Healthcare Center
FACILITY ADDRESS: 205 East Spring Street
FACILITY CITY, STATE, ZIP: Camp Point, IL 62320

DOCKET NUMBER: NH 21-S0631

LICENSEE INFO: Timber Point Healthcare Center, Inc.
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 10/15/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1), 300.1610a)1), and 300.1630c). The fine was doubled in this instance in accordance with 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

FACILITY NAME: Tuscola Health Care Center
FACILITY ADDRESS: 1203 Egyptian Trail
FACILITY CITY, STATE, ZIP: Tuscola, IL 61953

DOCKET NUMBER: NH 21-S0611

LICENSEE INFO: Tuscola HCO, LLC
LICENSEE ADDRESS: 831 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/06/2021

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

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

DOCKET NUMBER: NH 21-C0568

LICENSEE INFO: Village Health Care Management, LLC
LICENSEE ADDRESS: 2101 James Street
LICENSEE CITY, STATE, ZIP: Lawrenceville, IL 62439
Survey Date – 07/15/2021

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), 300.1210d)6), and 300.7020a)4). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

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

DOCKET NUMBER: NH 21-C0616

LICENSEE INFO: University Care Center, LLC
LICENSEE ADDRESS: 111 North Ottawa Street
LICENSEE CITY, STATE, ZIP: Joliet, IL 60432
Survey Date – 07/16/2021

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

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

DOCKET NUMBER: NH 21-C0654

LICENSEE INFO: The Villa at South Holland, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 08/06/2021

FACILITY NAME: Villa at Windsor Park, The
FACILITY ADDRESS: 2649 East 75^th Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60649

DOCKET NUMBER: NH 21-C0812

LICENSEE INFO: The Villa at Windsor Park Nursing and Rehab Center, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 09/30/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 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: Warren Park Hlth & Living Ctr
FACILITY ADDRESS: 6700 North Damen
FACILITY CITY, STATE, ZIP: Chicago, IL 60645

DOCKET NUMBER: NH 21-S0759

LICENSEE INFO: Warren Park Health and Living Center, LLC
LICENSEE ADDRESS: 6700 North Damen Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645
Survey Date – 08/27/2021

FACILITY NAME: Waterfront Terrace
FACILITY ADDRESS: 7750 South Shore Drive
FACILITY CITY, STATE, ZIP: Chicago, IL 60649

DOCKET NUMBER: NH 21-S0795

LICENSEE INFO: Waterfront Terrace, Inc.
LICENSEE ADDRESS: 191 North Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/01/2021

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

FACILITY NAME: Watseka Rehab & Hlth Care Ctr
FACILITY ADDRESS: 715 East Raymond Road
FACILITY CITY, STATE, ZIP: Watseka, IL 60970

DOCKET NUMBER: NH 21-C0603

LICENSEE INFO: Watseka HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/13/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b)4, 300.1210d)3), 300.1220b)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

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

DOCKET NUMBER: NH 21-C0645

LICENSEE INFO: West Suburban Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 08/24/2021

Type A 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 $25,000.00

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

DOCKET NUMBER: NH 21-S0729

LICENSEE INFO: West Suburban Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 09/30/2021

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

DOCKET NUMBER: NH 21-C0791

LICENSEE INFO: West Suburban Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 10/07/2021

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

FACILITY NAME: Willow Health Center
FACILITY ADDRESS: 4054 Albright Lane
FACILITY CITY, STATE, ZIP: Rockford, IL 61103

DOCKET NUMBER: NH 21-S0782

LICENSEE INFO: Willows Health Center
LICENSEE ADDRESS: 4141 North Rockton Avenue
LICENSEE CITY, STATE, ZIP: Rockford, IL 61103
Survey Date – 10/13/2021

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.610a) and 300.1210d)6). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.1210d)6). A fine of $500.00

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

DOCKET NUMBER: NH 21-C0701

LICENSEE INFO: Winning Wheels, Inc.
LICENSEE ADDRESS: 701 East Third Street
LICENSEE CITY, STATE, ZIP: Prophetstown, IL 61277
Survey Date – 08/06/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)5), and 300.3210b). The fine was doubled in this instance in accordance with 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: Winning Wheels
FACILITY ADDRESS: 701 East 3^rd Street
FACILITY CITY, STATE, ZIP: Prophetstown, IL 61277

DOCKET NUMBER: NH 21-C0805

LICENSEE INFO: Winning Wheels, Inc.
LICENSEE ADDRESS: 701 East Third Street
LICENSEE CITY, STATE, ZIP: Prophetstown, IL 61277
Survey Date – 10/20/2021

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

2021 4th Quarterly Report

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2021 4th Quarterly Report

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