Agencies
Services
Quarterly Report April - June 2015
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: | Aperion Care Plum Grove |
| FACILITY ADDRESS: | 24 S. Plum Grove Road |
| FACILITY CITY, STATE, ZIP: | Palatine, IL 60067 |
| DOCKET NUMBER: | NH 14-S-400 and NH 14-C-403 |
| LICENSEE INFO: | Aperion Care Inc. |
| LICENSEE ADDRESS: | 8131 N. Monticello Ave. |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Covenant Health Care Center - Batavia |
| FACILITY ADDRESS: | 831 N. Batavia Ave. |
| FACILITY CITY, STATE, ZIP: | Batavia, IL 60510 |
| DOCKET NUMBER: | NH 13-C-549 |
| LICENSEE INFO: | Covenant Health Care Center, Inc. |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr. |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Centralia Manor |
| FACILITY ADDRESS: | 1910 East McCord, Route 161 East |
| FACILITY CITY, STATE, ZIP: | Centralia, IL 62801 |
| DOCKET NUMBER: | NH 15-C0130 |
| LICENSEE INFO: | UDI #8 L.L.C. |
| LICENSEE ADDRESS: | 285 S. Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| Survey Date – 2-23-15 | |
| Type A violation for violating one or more sections: 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 following sections of the Code with a high risk designation:300.1210b),300.1210d)6) and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Mcallister Nursing and Rehab |
| FACILITY ADDRESS: | 18300 S. Lavergne |
| FACILITY CITY, STATE, ZIP: | Tinley Park, IL 60477 |
| DOCKET NUMBER: | NH 15-C0131 |
| LICENSEE INFO: | Mcallister Nursing and Rehab, LLC |
| LICENSEE ADDRESS: | 9100 Karlov Ave. |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 2-28-15 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b)5), 300.1210d)6) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b),300.1210d)6) and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Windmill Nursing Pavilion |
| FACILITY ADDRESS: | 16000 South Wabash Ave. |
| FACILITY CITY, STATE, ZIP: | South Holland, IL 60473 |
| DOCKET NUMBER: | NH 15-C0136 |
| LICENSEE INFO: | Windmill Nursing Pavilion, Ltd |
| LICENSEE ADDRESS: | 191 N. Wacker Dr., Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 3-9-15 | |
| Type B violation for violating one or more sections: 300.690a),300.690b) and 300.690c). | |
| FACILITY NAME: | Oak Lawn Respiratory and Rehab |
| FACILITY ADDRESS: | 9525 S. Mayfield Ave. |
| FACILITY CITY, STATE, ZIP: | Oaklawn, IL 60453 |
| DOCKET NUMBER: | NH 15-S0134 |
| LICENSEE INFO: | Oak Lawn Respiratory and Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 9525 S. Mayfield Ave. |
| LICENSEE CITY, STATE, ZIP: | Oak Lawn, IL 60453 |
| Survey Date – 2-27-15 | |
| Type B violation for violating one or more sections: 300.615e). | |
| FACILITY NAME: | Imboden Creek Living Center |
| FACILITY ADDRESS: | 180 W. Imboden Dr. |
| FACILITY CITY, STATE, ZIP: | Decatur, IL 62521 |
| DOCKET NUMBER: | NH 14-C0402 |
| LICENSEE INFO: | Living Center Inc |
| LICENSEE ADDRESS: | 20 Southside Country Club Road |
| LICENSEE CITY, STATE, ZIP: | Decatur, IL 62521 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Grove of Skokie Living and Rehabilitation Center |
| FACILITY ADDRESS: | 900 N. Lavergne Ave. |
| FACILITY CITY, STATE, ZIP: | Skokie, IL 60077 |
| DOCKET NUMBER: | NH 14-C357 |
| LICENSEE INFO: | Meyer Magence |
| LICENSEE ADDRESS: | 4711 Golf Road, Suite 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Highland Health Care Center |
| FACILITY ADDRESS: | 1450 26th St. |
| FACILITY CITY, STATE, ZIP: | Highland, IL 62249 |
| DOCKET NUMBER: | NH 15-C0142 |
| LICENSEE INFO: | Covenant Care Midwest Inc. |
| LICENSEE ADDRESS: | 208 South LaSalle, Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 3-6-15 | |
| Type B violation for violating one or more sections: 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 following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5) and 300.3240a. For a total fine of $2,200.00 | |
| FACILITY NAME: | The British Home |
| FACILITY ADDRESS: | 8700 W. 31st St. |
| FACILITY CITY, STATE, ZIP: | Brookfield, IL 60511 |
| DOCKET NUMBER: | NH 15-S0141 |
| LICENSEE INFO: | The British Home for Retired Men and Women |
| LICENSEE ADDRESS: | 31st St. & McCormick Ave. |
| LICENSEE CITY, STATE, ZIP: | Brookfield, IL 60513 |
| Survey Date – 2-27-15 | |
| Type B violation for violating one or more sections: 300.615 | |
| FACILITY NAME: | Crossroads Care Center Woodstock |
| FACILITY ADDRESS: | 309 McHenry Ave. |
| FACILITY CITY, STATE, ZIP: | Woodstock, IL 60098 |
| DOCKET NUMBER: | NH 15-C0145 |
| LICENSEE INFO: | Crossroads Care Center of Woodstock LLC |
| LICENSEE ADDRESS: | 5750 Old Orchard Rd, Suite 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 3-2-15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Thornton Heights Terrace |
| FACILITY ADDRESS: | 160 West 10th St. |
| FACILITY CITY, STATE, ZIP: | Chicago Heights, IL 60411 |
| DOCKET NUMBER: | NH 15-C0047 |
| LICENSEE INFO: | Thorton Heights Terrace, LTD |
| LICENSEE ADDRESS: | 465 Central Ave., Suite 100 |
| LICENSEE CITY, STATE, ZIP: | Northfield, IL 60093 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Care Center of Abingdon |
| FACILITY ADDRESS: | 801 West Martin St. |
| FACILITY CITY, STATE, ZIP: | Abingdon, IL 61410 |
| DOCKET NUMBER: | NH 14-C0270 |
| LICENSEE INFO: | UDI #6 L.L.C. |
| LICENSEE ADDRESS: | 285 S. Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Jackson Square Skilled Nursing & Living |
| FACILITY ADDRESS: | 5130 West Jackson Boulevard |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60644 |
| DOCKET NUMBER: | NH 15-S0140 |
| LICENSEE INFO: | Jackson Corp |
| LICENSEE ADDRESS: | 191 N. Wacker Dr., Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 2-20-15 | |
| Type A violation for violating one or more sections: 300.610a), 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 following sections of the Code with a high risk designation:300.1210b), 300.1210d)6) and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Aspen Rehab & Health Care |
| FACILITY ADDRESS: | 1403 9th Ave. |
| FACILITY CITY, STATE, ZIP: | Silvis, IL 61282 |
| DOCKET NUMBER: | NH 15-C0139 |
| LICENSEE INFO: | Petersen Health & Wellness, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 2-11-15 | |
| Type A violation for violating one or more sections: 300.610a), 300.690b), 300690c), 300.1210b), 300.3240a), 300.3240d) 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 following sections of the Code with a high risk designation:300.1210b) and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Oak Lawn Respiratory & Rehab |
| FACILITY ADDRESS: | 9525 S. Mayfield Ave. |
| FACILITY CITY, STATE, ZIP: | Oaklawn, IL 60453 |
| DOCKET NUMBER: | NH 15-C0135 |
| LICENSEE INFO: | Oak Lawn Respiratory & Rehab |
| LICENSEE ADDRESS: | 9525 S. Mayfield Ave. |
| LICENSEE CITY, STATE, ZIP: | Oaklawn, IL 60453 |
| Survey Date – 2-17-15 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210c), 300.1210d)6), 300.1220b)2), 300.1220b)6), 300.1220b)8) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210b), 300.1210d)6) and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Oak Lawn Respiratory & Rehab |
| FACILITY ADDRESS: | 9525 S. Mayfield Ave. |
| FACILITY CITY, STATE, ZIP: | Oak Lawn, IL 60453 |
| DOCKET NUMBER: | NH 15-C0149 |
| LICENSEE INFO: | Oak Lawn Respiratory & Rehab |
| LICENSEE ADDRESS: | 9525 S. Mayfield Ave. |
| LICENSEE CITY, STATE, ZIP: | Oak Lawn, IL 60453 |
| Survey Date – 3-4-15 | |
| Type B violation for violating one or more sections: 300.1210d)2) and 300.1210d)6). | |
| FACILITY NAME: | Manor Care of Oak Lawn West |
| FACILITY ADDRESS: | 6300 W. 95th St. |
| FACILITY CITY, STATE, ZIP: | Oak Lawn, IL 60453 |
| DOCKET NUMBER: | NH 14-S0265 |
| LICENSEE INFO: | Manor Care of Oak Lawn West |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Arden Courts at Manorcare - S. Holland |
| FACILITY ADDRESS: | 2045 E. 170th St. |
| FACILITY CITY, STATE, ZIP: | South Holland, IL 60473 |
| DOCKET NUMBER: | NH 15-S0154 |
| LICENSEE INFO: | Manorcare Health Services, INC |
| LICENSEE ADDRESS: | 208 S. LaSalle St. |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 4-1-15 | |
| Type B violation for violating one or more sections: 330.710A)C)3)A) and 330.4240A) | |
| FACILITY NAME: | Providence Palos Heights |
| FACILITY ADDRESS: | 13259 S. Central Ave. |
| FACILITY CITY, STATE, ZIP: | Palos Heights, IL 60463 |
| DOCKET NUMBER: | NH 15-S0147 and 15-C0159 |
| LICENSEE INFO: | Providence Operations, LLC |
| LICENSEE ADDRESS: | 18601 N. Creek Dr., Suite A |
| LICENSEE CITY, STATE, ZIP: | Tinley Park, IL 60477 |
| Survey Date – 3-4-15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1010H), 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 following sections of the Code with a high risk designation:300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Wauconda Healthcare and Rehab |
| FACILITY ADDRESS: | 176 Thomas Court |
| FACILITY CITY, STATE, ZIP: | Wauconda, IL 60084 |
| DOCKET NUMBER: | NH 15-C0160 |
| LICENSEE INFO: | Wauconda Healthcare and Rehab |
| LICENSEE ADDRESS: | 176 Thomas Court |
| LICENSEE CITY, STATE, ZIP: | Wauconda, IL 60084 |
| Survey Date – 2-19-15 | |
| Type B violation for violating one or more sections: 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 following sections of the Code with a high risk designation:300.1210B) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Villa at Evergreen Park |
| FACILITY ADDRESS: | 10124 S. Kedzie Ave. |
| FACILITY CITY, STATE, ZIP: | Evergreen Park, IL 60805 |
| DOCKET NUMBER: | NH 15-S0155 |
| LICENSEE INFO: | Evergreen Living & Rehab Center, LLC |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr. |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 2-25-15 | |
| Type B violation for violating one or more sections: 300.610A), 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 following sections of the Code with a high risk designation:300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Holy Family Villa |
| FACILITY ADDRESS: | 12220 S. Will Cook Road |
| FACILITY CITY, STATE, ZIP: | Palos Park, IL 60464 |
| DOCKET NUMBER: | NH 15-S0153 |
| LICENSEE INFO: | Holy Family Villa |
| LICENSEE ADDRESS: | 721 N. LaSalle St. |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60654 |
| Survey Date – 2-25-15 | |
| Type B violation for violating one or more sections: 300.610A), 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 following sections of the Code with a high risk designation:300.1210D)6) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Heather Health Care Center |
| FACILITY ADDRESS: | 15600 South Honore Ave. |
| FACILITY CITY, STATE, ZIP: | Harvey, IL 60426 |
| DOCKET NUMBER: | NH 15-C0161 |
| LICENSEE INFO: | Heather Health Care Center Inc. |
| LICENSEE ADDRESS: | 4200 W. Peterson Ave., Suite 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 3-12-15 | |
| Type B violation for violating one or more sections: 300.690B)C), 300.1010H), 300.1210A), 300.1210B), 300.1210C), 300.1210D)2)3) and 300.3240A). | |
| FACILITY NAME: | Tillers Nursing & Rehab Center |
| FACILITY ADDRESS: | 4390 Route 71 |
| FACILITY CITY, STATE, ZIP: | Oswego, IL 60543 |
| DOCKET NUMBER: | NH 14-S-0397 |
| LICENSEE INFO: | Tillers Nursing and Rehabilitation, Inc |
| LICENSEE ADDRESS: | 190 S. LaSalle St., Suite 3700 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60603-3433 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Rochelle Health Care |
| FACILITY ADDRESS: | 900 N. 3rd St. |
| FACILITY CITY, STATE, ZIP: | Rochelle, IL 61068 |
| DOCKET NUMBER: | NH 13-C0343 |
| LICENSEE INFO: | Petersen HealthCare Inc |
| LICENSEE ADDRESS: | 830 West Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | St. Anthony's Nursing & Rehab Center |
| FACILITY ADDRESS: | 767 30th St. |
| FACILITY CITY, STATE, ZIP: | Rock Island, IL 61201 |
| DOCKET NUMBER: | NH 15-C0157 |
| LICENSEE INFO: | St. Anthony's Nursing and Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 330 N. Wabash #1700 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60611 |
| Survey Date – 2-25-15 | |
| Type A violation for violating one or more sections: 300.610A), 300.1210B), 300.1220B)6), 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 following sections of the Code with a high risk designation: 300.1210B), 300.3240A) and 300.3240E). For a total fine of $25,000.00. | |
| FACILITY NAME: | Ballard Respiratory and Rehab |
| FACILITY ADDRESS: | 9300 Ballard Road |
| FACILITY CITY, STATE, ZIP: | Des Plaines, IL 60016 |
| DOCKET NUMBER: | NH 15-S0156 |
| LICENSEE INFO: | Ballard Respiratory and Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 55 W. Monroe ST., Suite 2400 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60603 |
| Survey Date – 3-17-15 | |
| Type A violation for violating one or more sections: 300.610A), 300.670A), 300.670C)1), 300.670C)2), 300.670D), 300.670E), 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 following sections of the Code with a high risk designation: 300.1210B), 300.1210D6) and 300.6240A). For a total fine of $25,000.00. | |
| FACILITY NAME: | Park Place of Belvidere |
| FACILITY ADDRESS: | 1701 5th Ave. |
| FACILITY CITY, STATE, ZIP: | Belvidere, IL 61008 |
| DOCKET NUMBER: | NH 15-C0151 |
| LICENSEE INFO: | The Gardens of Belvidere, LLC |
| LICENSEE ADDRESS: | 8170 McCormick Blvd., #124 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 3-3-15 | |
| Type A violation for violating one or more sections: 300.610A), 300.1210A), 300.1210B), 300.1210D)6), 300.1220B)3) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.1210D)6) and 300.3240A). For a total fine of 25,000.00 | |
| FACILITY NAME: | Prairie View Cr Center - Lewiston |
| FACILITY ADDRESS: | 175 East Sycamore |
| FACILITY CITY, STATE, ZIP: | Lewiston, IL 61542 |
| DOCKET NUMBER: | NH 14-C-0450 |
| LICENSEE INFO: | Prairie View Care Center of Lewiston, Inc |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Suite 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Timbercreek Rehab & Health Care Center |
| FACILITY ADDRESS: | 220 State St. |
| FACILITY CITY, STATE, ZIP: | Pekin, IL 61554 |
| DOCKET NUMBER: | NH 15-S0162 |
| LICENSEE INFO: | Petersen Health Operations, L.L.C |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 2-23-15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210C), 300.1210D)6), 300.1220B)3), 300.1230B), 300.1230D), 300.1230D)2), 300.1230E), 300.1230F), 300.1230H), 300.1230I), 300.1230J01), 300.1230J)5), 300.1230K)1), 300.1230K)2), 300.1230K)3),300.1230K)4), 300.1230K)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 following sections of the Code with a high risk designation:300.1210B), 300.1210D)6), 300.1230B)D)E)F)H)I)J)1)5)K)1)2)3)4)5) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Timbercreek Rehab & Health Care Center |
| FACILITY ADDRESS: | 220 State St. |
| FACILITY CITY, STATE, ZIP: | Pekin, IL 61554 |
| DOCKET NUMBER: | NH 15-C0163 |
| LICENSEE INFO: | Petersen Health Operations, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 3-5-15 | |
| Type B violation for violating one or more sections: 300.610A, 300.1210D)6), 300.2210A), 300.2210B_2) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210D)6) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Kensington Place Nrsg & Rehab |
| FACILITY ADDRESS: | 3405 S. Michigan Ave. |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60616 |
| DOCKET NUMBER: | NH 15-S0173 |
| LICENSEE INFO: | Kensington Place Nursing and Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 8170 McCormick Blvd., Suite 219 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60079 |
| Survey Date – 3-20-15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1010H), 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 following sections of the Code with a high risk designation: 300.1210D)6) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Lena Living Center |
| FACILITY ADDRESS: | 1010 S. Logan St. |
| FACILITY CITY, STATE, ZIP: | Lena, IL 61048 |
| DOCKET NUMBER: | NH 15-S0165 |
| LICENSEE INFO: | Lena Living Center, L.L.C. |
| LICENSEE ADDRESS: | One IBM Plaza, Suite 3000 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60611 |
| Survey Date – 3-5-15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210C), 300.1210D)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 following sections of the Code with a high risk designation: 300.1210B), 300.1210D)5) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Midwest Rehab & Respiratory |
| FACILITY ADDRESS: | 727 N. 17th St. |
| FACILITY CITY, STATE, ZIP: | Belleville, IL 62226 |
| DOCKET NUMBER: | NH 15-C0174 |
| LICENSEE INFO: | Midwest Rehabilitation & Respiratory Center, LLC |
| LICENSEE ADDRESS: | 8170 McCormick Blvd, Suite 219 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 4-29-15 | |
| Type AA violation for violating one or more sections: 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 following sections of the Code with a high risk designation:300.1210B),200.1210)6) and 300.3240A). For a total fine of $50,000.00 | |
| FACILITY NAME: | Spring Valley Nursing |
| FACILITY ADDRESS: | 1300 N. Greenwood St. |
| FACILITY CITY, STATE, ZIP: | Spring Valley, IL 61362 |
| DOCKET NUMBER: | NH 15-C0166 |
| LICENSEE INFO: | Spring Valley Nursing Center – A Limited Partnership |
| LICENSEE ADDRESS: | 1300 N Green St |
| LICENSEE CITY, STATE, ZIP: | Spring Valley, IL 61362 |
| Survey Date – 3-25-15 | |
| Type AA violation for violating one or more sections: 300.610A), 300.1010H), 300.1210B) and 300.3240A. The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B and 300.3240A). For a total fine of $50,000.00 | |
| FACILITY NAME: | Warren Barr North Shore |
| FACILITY ADDRESS: | 2773 Skokie Valley Road |
| FACILITY CITY, STATE, ZIP: | Highland Park, IL 60035 |
| DOCKET NUMBER: | NH 15-S0172 |
| LICENSEE INFO: | Warren Barr North Shore, LLC |
| LICENSEE ADDRESS: | 7040 N Ridgeway Ave. |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 4-9-15 | |
| Type C violation for violating one or more sections: 300.1210A), 3001210A)4) and 300.1210B)3). | |
| FACILITY NAME: | South Elgin Rehab & HCC |
| FACILITY ADDRESS: | 746 West Spring St. |
| FACILITY CITY, STATE, ZIP: | South Elgin, IL 60177 |
| DOCKET NUMBER: | NH 15-C0169 |
| LICENSEE INFO: | Petersen Health Properties, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 3-30-15 | |
| Type B violation for violating one or more sections: 300.610A), 30031210B), 300.1220B)3), 300.3220F) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Wabash Christian Retirement |
| FACILITY ADDRESS: | 216 College Boulevard |
| FACILITY CITY, STATE, ZIP: | Carmi, IL 62821 |
| DOCKET NUMBER: | NH 15-C0175 |
| LICENSEE INFO: | Christian Homes Inc, |
| LICENSEE ADDRESS: | 200 N. Postville Dr. |
| LICENSEE CITY, STATE, ZIP: | Lincoln, IL 62656 |
| Survey Date – 4-7-15 | |
| Type B violation for violating one or more sections: 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 following sections of the Code with a high risk designation:300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | The Villa at South Holland |
| FACILITY ADDRESS: | 16300 Wausau St. |
| FACILITY CITY, STATE, ZIP: | South Holland, IL 60473 |
| DOCKET NUMBER: | NH 15-C0176 |
| LICENSEE INFO: | The Villa At South Holland, LLC |
| LICENSEE ADDRESS: | 191 N Wacker Dr, Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | South Holland, IL 60473 |
| Survey Date – 3-18-15 | |
| Type B violation for violating one or more sections: 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 following sections of the Code with a high risk designation: 300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Concordia Village Care Center |
| FACILITY ADDRESS: | 4101 West Iles Ave. |
| FACILITY CITY, STATE, ZIP: | Springfield, IL 62711 |
| DOCKET NUMBER: | NH 15-C0170 |
| LICENSEE INFO: | Lutheran Senior Services |
| LICENSEE ADDRESS: | 1150 Hanley Industrial Court |
| LICENSEE CITY, STATE, ZIP: | St. Louis, MO 63144 |
| Survey Date – 3-17-15 | |
| Type A violation for violating one or more sections: 300.610A), 300.1010H), 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 following sections of the Code with a high risk designation: 300.1210D)6) and 300.3240A). For a total fine of $25,000.00 | |
| FACILITY NAME: | Atrium Health Care Center |
| FACILITY ADDRESS: | 1425 West Estes Ave. |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60626 |
| DOCKET NUMBER: | NH 15-S0168 |
| LICENSEE INFO: | Atrium Health Care center, LTD |
| LICENSEE ADDRESS: | 191 N. Wacker Dr., Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 3-26-15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1010H), 300.1210A), 300.1210B), 300.1210D)3), 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 following sections of the Code with a high risk designation:300.1210B),300.1210D)5) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Gibson Community Hospital Annex |
| FACILITY ADDRESS: | 430 E. 19th |
| FACILITY CITY, STATE, ZIP: | Gibson City, IL 60936 |
| DOCKET NUMBER: | NH- 15-S0171 |
| LICENSEE INFO: | Gibson Area Hospital & Health Services |
| LICENSEE ADDRESS: | 1120 N. Melvin St. |
| LICENSEE CITY, STATE, ZIP: | Gibson City, IL 60936 |
| Survey Date – 4-8-15 | |
| Type B violation for violating one or more sections: 300.1210A)5), 300.615F) and 300.615). There was no fine. | |
| FACILITY NAME: | Meadowbrook Manor-Naperville |
| FACILITY ADDRESS: | 720 Raymond Dr. |
| FACILITY CITY, STATE, ZIP: | Naperville, IL 61108 |
| DOCKET NUMBER: | NH 13-S0546 |
| LICENSEE INFO: | Butterfield Health Care II, Inc |
| LICENSEE ADDRESS: | 161 N. Clark St., Suite 4200 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60601 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Heritage Health-Carlinville |
| FACILITY ADDRESS: | 1200 University Ave. |
| FACILITY CITY, STATE, ZIP: | Carlinville, IL 62626 |
| DOCKET NUMBER: | NH 14-S0303 |
| LICENSEE INFO: | Heritage Manor-Carlinville, LLC |
| LICENSEE ADDRESS: | 202 N. Center |
| LICENSEE CITY, STATE, ZIP: | Bloomington, IL 61701 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Tillers Nursing & Rehab Center |
| FACILITY ADDRESS: | 4390 Route 71 |
| FACILITY CITY, STATE, ZIP: | Oswego, IL 60543 |
| DOCKET NUMBER: | NH 14-S-0397 |
| LICENSEE INFO: | Tillers Nursing and Rehabilitation Center, Inc. |
| LICENSEE ADDRESS: | 4390 Route 71 |
| LICENSEE CITY, STATE, ZIP: | Oswego, IL 60543 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Rochelle Health Care Center |
| FACILITY ADDRESS: | 900 N. 3rd St. |
| FACILITY CITY, STATE, ZIP: | Rochelle, IL 61068 |
| DOCKET NUMBER: | NH 13-C0343 |
| LICENSEE INFO: | Petersen HealthCare, Inc. |
| LICENSEE ADDRESS: | 830 West Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Gardenview Manor |
| FACILITY ADDRESS: | 14792 Catlin- Tilton Road |
| FACILITY CITY, STATE, ZIP: | Danville, IL 61834 |
| DOCKET NUMBER: | NH 15-S0177 |
| LICENSEE INFO: | Gardenview Manor, LLC |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Suite 420 |
| LICENSEE CITY, STATE, ZIP: | Danville, IL 61834 |
| Survey Date – 03-12-15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1210A), 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 following sections of the Code with a high risk designation: 300.1210D)6) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Alton Rehab and Nursing Center |
| FACILITY ADDRESS: | 3523 Wickenhauser |
| FACILITY CITY, STATE, ZIP: | Alton, IL 62002 |
| DOCKET NUMBER: | NH 15-S0179 |
| LICENSEE INFO: | Alton Rehabilitation and Nursing Center, LLC |
| LICENSEE ADDRESS: | 8170 McCormick Blvd, Suite 219 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 3-13-15 | |
| Type B violation for violating one or more sections: 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 following sections of the Code with a high risk designation: 300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Alden Trails |
| FACILITY ADDRESS: | 273 Army Trail Road |
| FACILITY CITY, STATE, ZIP: | Bloomingdale, IL 60108 |
| DOCKET NUMBER: | NH 15-C0180 |
| LICENSEE INFO: | Alden Trails, Inc. |
| LICENSEE ADDRESS: | 4200 W Peterson Ave, Suite 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 4-3-15 | |
| Type B violation for violating one or more sections: 350.620A), 350.1230D)1), 350.1230D)2), 350.11230D)3 and 350.3240A) . For a total fine of $550.00 | |
| FACILITY NAME: | Iroquois Resident Home, The |
| FACILITY ADDRESS: | 200 Fairman Ave. |
| FACILITY CITY, STATE, ZIP: | Wateska, IL 60970 |
| DOCKET NUMBER: | NH 15-S0182 |
| LICENSEE INFO: | The Iroquois Memorial Hospital and Resident Home |
| LICENSEE ADDRESS: | 200 Fairman Ave. |
| LICENSEE CITY, STATE, ZIP: | Wateska, IL 60970 |
| Survey Date – 4-15-15 | |
| No fine given. | |
| FACILITY NAME: | Belmont Village Oak Park |
| FACILITY ADDRESS: | 1035 Madison St. |
| FACILITY CITY, STATE, ZIP: | Oak Park, IL 60302 |
| DOCKET NUMBER: | NH 15-S0183 |
| LICENSEE INFO: | Belmont Village Oak Park Leasing, L.L.C. |
| LICENSEE ADDRESS: | 208 South LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 3-17-15 | |
| No fine given. | |
| FACILITY NAME: | Bloomington Rehabilitation and HCC |
| FACILITY ADDRESS: | 1925 S. Main St. |
| FACILITY CITY, STATE, ZIP: | Bloomington, IL 61701 |
| DOCKET NUMBER: | NH 15-C0185 |
| LICENSEE INFO: | Petersen Health Operations, L.L.C. |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 4-15-15 | |
| Type C violation for violating one or more sections: 300.610A), 300.1010H), 300.1210B), 300.1210D)2), 300.1210D)5) and 300.3240A). No fine given. | |
| FACILITY NAME: | Glencrest Healthcr & Rehab Centre |
| FACILITY ADDRESS: | 2451 W. Touhy Ave. |
| FACILITY CITY, STATE, ZIP: | Chicago, Il 60645 |
| DOCKET NUMBER: | NH 15-C0181 |
| LICENSEE INFO: | Glencrest Healthcare and Rehabilitation Centre, LTD |
| LICENSEE ADDRESS: | 191 N. Wacker Dr., Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 4-9-15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210D)6)300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B), 300.1210D)6) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Heddington Oaks |
| FACILITY ADDRESS: | 2223 W. Heading Ave. |
| FACILITY CITY, STATE, ZIP: | Peoria, IL 61064 |
| DOCKET NUMBER: | NH 15-C0186 |
| LICENSEE INFO: | Peoria County Board |
| LICENSEE ADDRESS: | 324 Main St., Room 502 |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61602 |
| Survey Date – 3-25-15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210D)1), 300.1210D)2), 300.162A), 300.1620C), 300.3220F) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | St. Anthony's Nursing & Rehab Center |
| FACILITY ADDRESS: | 767 30th St. |
| FACILITY CITY, STATE, ZIP: | Rock Island, IL 61201 |
| DOCKET NUMBER: | NH 15-C0190 |
| LICENSEE INFO: | St. Anthony's Nursing and Rehabilitation Center L.L.C |
| LICENSEE ADDRESS: | 330 N. Wabash, #1700 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60611 |
| Survey Date – 4-1-15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1210D)6), 300.1220B), 300.3100J) and 300.3100K). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210D)6). For a total fine of $2,200.00 | |
| FACILITY NAME: | Aledo Health Rehab & Health Care Center |
| FACILITY ADDRESS: | 304 SW 12th St. |
| FACILITY CITY, STATE, ZIP: | Aldo, IL 61231 |
| DOCKET NUMBER: | NH 15-S0194 |
| LICENSEE INFO: | Midwest Health Operations LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 4-9-15 | |
| Type B violation for violating one or more sections: No fine given. | |
| FACILITY NAME: | Bement Health Care Center |
| FACILITY ADDRESS: | 601 N. Morgan |
| FACILITY CITY, STATE, ZIP: | Bement, IL 61813 |
| DOCKET NUMBER: | NH 15-S0195 |
| LICENSEE INFO: | Petersen Health Quality, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 4-16-15 | |
| Type B violation for violating one or more sections: No fine given. | |
| FACILITY NAME: | Mason Point |
| FACILITY ADDRESS: | One Masonic Way |
| FACILITY CITY, STATE, ZIP: | Sullivan, IL 61951 |
| DOCKET NUMBER: | NH 15-S0196 |
| LICENSEE INFO: | Petersen Health Care VII, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 3-26-15 | |
| Type B violation for violating one or more sections: No fine given. | |
| FACILITY NAME: | Arba Care Center of Colfax |
| FACILITY ADDRESS: | 402 S. Harrison |
| FACILITY CITY, STATE, ZIP: | Colfax, IL 61728 |
| DOCKET NUMBER: | NH 15-S0198 |
| LICENSEE INFO: | Arba Care center of Colfax, LLC |
| LICENSEE ADDRESS: | 134 N. McLean Blvd |
| LICENSEE CITY, STATE, ZIP: | Elgin, IL 60123 |
| Survey Date – 4-29-15 | |
| Type B violation for violating one or more sections: 300.670C), 300.670K)1), 300.670K)2) and 300.670K)3). No fine given. | |
| FACILITY NAME: | Symphony of Lincoln |
| FACILITY ADDRESS: | 2202 N. Kickapoo St. |
| FACILITY CITY, STATE, ZIP: | Lincoln, IL 62656 |
| DOCKET NUMBER: | NH 15-C0199 |
| LICENSEE INFO: | Symphony Maple Ridge, LLC |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr. |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 3-19-15 | |
| Type B violation for violating one or more sections: 300.1210B)1), 300.1210D)1), 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Rivershores Health & Rehab Center |
| FACILITY ADDRESS: | 578 West Commercial St. |
| FACILITY CITY, STATE, ZIP: | Marseilles, IL 60712 |
| DOCKET NUMBER: | NH 15-C0191 |
| LICENSEE INFO: | Rivershores Healthcare and Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 4600 West Touhy Ave, Suite 200 |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 4-13-15 | |
| Type A violation for violating one or more sections: 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 following sections of the Code with a high risk designation: 300.1210B),300.1210D)6) and 300.3240A). For a total fine of $25,000.00 | |
| FACILITY NAME: | Carthage Terrace |
| FACILITY ADDRESS: | 1205 N. Center St. |
| FACILITY CITY, STATE, ZIP: | Carthage, IL 62321 |
| DOCKET NUMBER: | NH 15-C0200 |
| LICENSEE INFO: | Community Living Options, INC |
| LICENSEE ADDRESS: | 285 S. Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| Survey Date – 3-18-15 | |
| Type B violation for violating one or more sections: 350.620A), 350.1210), 350.1230D)2) and 350.3240A). For a total fine of $550.00 | |
| FACILITY NAME: | Estates of Hyde Park |
| FACILITY ADDRESS: | 4505 S. Drexel Blvd |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60653 |
| DOCKET NUMBER: | NH 15-S0201 |
| LICENSEE INFO: | The Estates of Hyde Park, LLC |
| LICENSEE ADDRESS: | 4711 Golf Road Suite 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 4-15-15 | |
| Type B violation for violating one or more sections: 300.3130) and 300.3130)C). No fine. | |
| FACILITY NAME: | Belhaven Nursing & Rehab Center |
| FACILITY ADDRESS: | 11401 South Oakley Ave. |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60643 |
| DOCKET NUMBER: | NH 15-S0202 |
| LICENSEE INFO: | Belhaven Nursing & Rehab Center |
| LICENSEE ADDRESS: | 150 Fencl Lane |
| LICENSEE CITY, STATE, ZIP: | Hillside, IL 60162 |
| Survey Date – 4-22-15 | |
| Type B violation for violating one or more sections: 300.615) and 300.625). No fine. | |
| FACILITY NAME: | Manor Court of Princeton |
| FACILITY ADDRESS: | 140 N. Sixth St. |
| FACILITY CITY, STATE, ZIP: | Princeton, IL 61356 |
| DOCKET NUMBER: | NH 15-S0203 |
| LICENSEE INFO: | Residential Alternatives of Illinois, Inc. |
| LICENSEE ADDRESS: | 285 S. Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| Survey Date – 4-3-15 | |
| Type B violation for violating one or more sections: 300.1210B), 300.1210D)6) and 300.1220B)3), 300.3240S). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.1210D)60 and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Midwest Rehab & Respiratory |
| FACILITY ADDRESS: | 727 N. 17th St. |
| FACILITY CITY, STATE, ZIP: | Belleville, IL 62226 |
| DOCKET NUMBER: | NH-15-C0189 |
| LICENSEE INFO: | Midwest Rehabilitation & Respiratory Center, LLC |
| LICENSEE ADDRESS: | 8170 McCormick Blvd., Suite 219 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 3-26-15 | |
| Type A violation for violating one or more sections: 300.610A), 300.1210B), 300.1620C) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B) and 300.3240A). For a total 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 15-C0204 |
| LICENSEE INFO: | Pleasant Meadows Senior Living, LLC |
| LICENSEE ADDRESS: | 5750 Old Orchard Rd, Suite 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 4-8-15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1010H), 300.1210B), 300.1210D)3), 300.1210D)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 following sections of the Code with a high risk designation: 300.1210B), 300.1210D)5) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Arba Care Center of Bloomington |
| FACILITY ADDRESS: | 1509 N Calhoun St. |
| FACILITY CITY, STATE, ZIP: | Bloomington, IL 61701 |
| DOCKET NUMBER: | NH 15-C0205 |
| LICENSEE INFO: | Arba Care Center of Bloomington, LLC |
| LICENSEE ADDRESS: | 134 N McLean Blvd |
| LICENSEE CITY, STATE, ZIP: | Elgin, IL 60123 |
| Survey Date – 3-31-15 | |
| Type B violation for violating one or more sections: 300.1210B), 300.1210D)1), 300.1620A) and 300.3240A). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210B) and 300.3240A). For a total fine of $2,200.00 | |
| FACILITY NAME: | Manorcare of Palos Heights East |
| FACILITY ADDRESS: | 7850 W. College Dr. |
| FACILITY CITY, STATE, ZIP: | Palos Heights, IL 60463 |
| DOCKET NUMBER: | NH 15-C0208 |
| LICENSEE INFO: | Manor Care of Palos Heights IL, LLC |
| LICENSEE ADDRESS: | 208 S LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date -4-16-15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1210B), 300.1210D)6), 300.1220B)3) and 300.3240A). No fine given | |
| FACILITY NAME: | Pleasant View Rehab & HCC |
| FACILITY ADDRESS: | 500 N. Jackson St. |
| FACILITY CITY, STATE, ZIP: | Morrison, IL 61270 |
| DOCKET NUMBER: | NH 15-S0211 |
| LICENSEE INFO: | Petersen Health Business, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 4-17-15 | |
| Type 2-B violation for violating one or more sections: 300.610A), 300.1010H), 300.1210B), 300.1210D)3), 300.1210D)5),300.1210D)6), 300.1220B)3) and 300.3240A) . The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210B), 300.1210D)5), and 300.3240A). For a total fine of $4,400.00 | |
| FACILITY NAME: | Arden Courts of Palos Heights |
| FACILITY ADDRESS: | 7880 W College Dr. |
| FACILITY CITY, STATE, ZIP: | Palos Heights, IL 60463 |
| DOCKET NUMBER: | NH 15-S0214 |
| LICENSEE INFO: | Arden Courts of Palos Heights IL, LLC |
| LICENSEE ADDRESS: | 208 S LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 4-29-15 | |
| Type B violation for violating one or more sections: No fine given. | |
| FACILITY NAME: | Covenant Health Cr Center-Northbrook |
| FACILITY ADDRESS: | 2155 Pfingsten Road |
| FACILITY CITY, STATE, ZIP: | Northbrook, Il 60062 |
| DOCKET NUMBER: | NH 15-S0215 |
| LICENSEE INFO: | Covenant Health Care Center, Inc |
| LICENSEE ADDRESS: | 2155 Pfingsten Road |
| LICENSEE CITY, STATE, ZIP: | Northbrook, IL 60062 |
| Survey Date – 4-23-15 | |
| Type B violation for violating one or more sections: 300.3100D)2). No fine given. | |
| FACILITY NAME: | Danish Home, The |
| FACILITY ADDRESS: | 5656 N. Newcastle Ave. |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60631 |
| DOCKET NUMBER: | NH 15-C0218 |
| LICENSEE INFO: | The Society for the Danish Old Peoples' Home |
| LICENSEE ADDRESS: | 5656 N. Newcastle Ave. |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60631 |
| Survey Date – 3/27/15 | |
| Type B violation for violating one or more sections: 300.610A), 300.1210A), 300.1210B), 300.1210D)6), 300.1220B)3) and 300.3240A). No fine given | |
| FACILITY NAME: | Hancock County Sheltered Care |
| FACILITY ADDRESS: | 97 Main St., P.O. Box 157 |
| FACILITY CITY, STATE, ZIP: | Augusta, IL 62311 |
| DOCKET NUMBER: | NH 15-S0236 |
| LICENSEE INFO: | Hancock County Board |
| LICENSEE ADDRESS: | Hancock County Courthouse |
| LICENSEE CITY, STATE, ZIP: | Carthage, IL 62321 |
| Survey Date – 5/7/15 | |
| Type B violation for violating one or more sections: 330.785c)1)2)3)d), 330.11251)c)1)2), 330.1160a)b)c)d), 330.1530a)b)c), and 330.2000. No fine given. | |
| FACILITY NAME: | Alden Terrace of McHenry Rehab |
| FACILITY ADDRESS: | 803 Royal Dr. |
| FACILITY CITY, STATE, ZIP: | McHenry, IL 60050 |
| DOCKET NUMBER: | NH 15-S0247 |
| LICENSEE INFO: | Alden Terrace of McHenry Rehab and HCC, Inc |
| LICENSEE ADDRESS: | 4200 W. Petersen Ave., Suite 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 4/23/15 | |
| Type B violation for violating one or more sections: 300.615e). No fine given. | |
| FACILITY NAME: | Brookdale Hoffman Estates |
| FACILITY ADDRESS: | 2150 West Golf Road |
| FACILITY CITY, STATE, ZIP: | Hoffman Estates, IL 60169 |
| DOCKET NUMBER: | NH 15-S0237 |
| LICENSEE INFO: | S-H OPCO Hoffman Estates, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St, Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 5/21/15 | |
| Type B violation for violating one or more sections: 330.790a)b)c)1)2)3)4), 330.710A)B)C), and 330.1520a). No fine given. | |
| FACILITY NAME: | Westminster Place |
| FACILITY ADDRESS: | 3200 Grant St. |
| FACILITY CITY, STATE, ZIP: | Evanston, IL 60201 |
| DOCKET NUMBER: | NH 15-S0226 |
| LICENSEE INFO: | Presbyterian Homes |
| LICENSEE ADDRESS: | 3200 Grant St. |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60201 |
| Survey Date – 4/14/15 | |
| Type B violation for violating one or more sections: 300.1620a). No fine given. | |
| FACILITY NAME: | Alden Village Health Facility |
| FACILITY ADDRESS: | 267 East Lake St. |
| FACILITY CITY, STATE, ZIP: | Bloomingdale, IL 60108 |
| DOCKET NUMBER: | NH 15-S0227 |
| LICENSEE INFO: | Alden Village Health Facility for Children/Young Adults |
| LICENSEE ADDRESS: | 4200 W. Petersen Ave., Suite 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 4/3/15 | |
| Type B violation for violating one or more sections: 350.620a), 350.1210, 350.1230d)2), and 350.3240a). No fine given. | |
| FACILITY NAME: | Palm Terrace of Mattoon |
| FACILITY ADDRESS: | 1000 Palm Ave |
| FACILITY CITY, STATE, ZIP: | Mattoon, IL 61938 |
| DOCKET NUMBER: | NH 15-C0213 |
| LICENSEE INFO: | Petersen Management Company, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 4/15/15 | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210d)2), 300.1210d)3), 300.1220b)2), 300.1220b)3), 300.1220b)7), and 300.3240a).. The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a).. For a total fine of $2,200. | |
| FACILITY NAME: | Arden Courts of Hazel Crest |
| FACILITY ADDRESS: | 3701 West 183rd St. |
| FACILITY CITY, STATE, ZIP: | Hazel Crest, IL 60429 |
| DOCKET NUMBER: | NH 15-C0228 |
| LICENSEE INFO: | Arden Courts of Hazel Crest IL, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 5/12/15 | |
| Type B violation for violating one or more sections: 330.710a). No Fine Given. | |
| FACILITY NAME: | Arba Care of Toluca |
| FACILITY ADDRESS: | 101 East Via Ghiglieri |
| FACILITY CITY, STATE, ZIP: | Toluca, IL 61369 |
| DOCKET NUMBER: | NH 15-S0223 |
| LICENSEE INFO: | Arba Care Center of Toluca, LLC |
| LICENSEE ADDRESS: | 134 N. McLean Blvd. |
| LICENSEE CITY, STATE, ZIP: | Elgin, IL 60123 |
| Survey Date – 4/30/15 | |
| Type B violation for violating one or more sections: 300.4060a). No fine given. | |
| FACILITY NAME: | Renaissance Care Center |
| FACILITY ADDRESS: | 1675 east Ash St. |
| FACILITY CITY, STATE, ZIP: | Canton, IL 61520 |
| DOCKET NUMBER: | NH 15-C0224 |
| LICENSEE INFO: | Renaissance Care Center, Inc. |
| LICENSEE ADDRESS: | 5750 Old Orchard Rd, Suite 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 4/21/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 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 following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200. | |
| FACILITY NAME: | Regency Rehab Center |
| FACILITY ADDRESS: | 6631 Milwaukee Ave. |
| FACILITY CITY, STATE, ZIP: | Niles, IL 60714 |
| DOCKET NUMBER: | NH 15-S0231 |
| LICENSEE INFO: | Regency Rehab Center, LLC |
| LICENSEE ADDRESS: | 6840 N. Lincoln Ave. |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 4-15-15 | |
| Type B violation for violating one or more sections: 300.1610a)1), 300.1620a), 300.1630C, 300.1640a)1)2), 300.2040b)e)f), 300.2070b), 300.2100, 750.120a), 750.151a), 75054a)1), 750820e)2), and 750830h)3) | |
| FACILITY NAME: | Colonial Manor |
| FACILITY ADDRESS: | 620 Warrington Ave. |
| FACILITY CITY, STATE, ZIP: | Danville, IL 61832 |
| DOCKET NUMBER: | NH 15-S0233 |
| LICENSEE INFO: | Heritage Manor- Danville, LLC |
| LICENSEE ADDRESS: | 202 N. Center St |
| LICENSEE CITY, STATE, ZIP: | Bloomington, IL 61701 |
| Survey Date – 4/2/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b)5), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200. | |
| FACILITY NAME: | Flora Gardens Care Center |
| FACILITY ADDRESS: | 701 Shadwell Ave. |
| FACILITY CITY, STATE, ZIP: | Flora, IL 62839 |
| DOCKET NUMBER: | NH 15-C0219 |
| LICENSEE INFO: | Petersen Health Network, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 4/22/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.690a), 300.1210b), 300.3240a), 300.3240d), and 300.3240e). . The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.690a), 300.1210b), 300.3240a), 300.3240d), and 300.3240e). For a total fine of $2,200. | |
| FACILITY NAME: | Jerseyville Manor |
| FACILITY ADDRESS: | 1251 N. State St. |
| FACILITY CITY, STATE, ZIP: | Jerseyville, IL 62052 |
| DOCKET NUMBER: | NH 15-S0232 |
| LICENSEE INFO: | UDI #11, LLC |
| LICENSEE ADDRESS: | 285 S. Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| Survey Date – 4/17/15 | |
| Type B violation for violating one or more sections: 300.1210b)1) | |
| FACILITY NAME: | H & S Care Center |
| FACILITY ADDRESS: | 310 Third St., P.O. Box 376 |
| FACILITY CITY, STATE, ZIP: | Tamms, IL 62988 |
| DOCKET NUMBER: | NH 15-C0234 |
| LICENSEE INFO: | Tweedy Inc. |
| LICENSEE ADDRESS: | 101 W Market St, PO Box I |
| LICENSEE CITY, STATE, ZIP: | Jonesboro, IL 62952 |
| Survey Date – 5-5-15 | |
| Type A violation for violating one or more sections: 330.720e)3), 300.1110d), 330.1710f), and 330.4240f). For a total fine of $12,500. | |
| FACILITY NAME: | Arden Courts of Hazel Crest |
| FACILITY ADDRESS: | 3701 West 183rd St. |
| FACILITY CITY, STATE, ZIP: | Hazel Crest, IL 60429 |
| DOCKET NUMBER: | NH 15-C0228 |
| LICENSEE INFO: | Arden Courts of Hazel Crest IL, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 5-12-15 | |
| Type C violation for violating one or more sections: 330.710a) | |
| FACILITY NAME: | Hancock County Sheltered Care |
| FACILITY ADDRESS: | 97 Main St., PO Box 157 |
| FACILITY CITY, STATE, ZIP: | Augusta, IL 62311 |
| DOCKET NUMBER: | NH 15-S0236 |
| LICENSEE INFO: | Hancock County Board |
| LICENSEE ADDRESS: | Hancock County Courthouse |
| LICENSEE CITY, STATE, ZIP: | |
| Survey Date – 5-7-15 | |
| Type B violation for violating one or more sections: 330.785, 330.1160, 330.1530, 330.2000 | |
| FACILITY NAME: | Brookdale Hoffman Estates |
| FACILITY ADDRESS: | 2150 West Golf Road |
| FACILITY CITY, STATE, ZIP: | Hoffman Estates, IL 60194 |
| DOCKET NUMBER: | NH 15-S0237 |
| LICENSEE INFO: | S-H OPCO Hoffman Estates, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Suite. 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 5-21-15 | |
| Type B violation for violating one or more sections: 330.792, 330.710, 330.1520 | |
| FACILITY NAME: | Sunnymere |
| FACILITY ADDRESS: | 925 Sixth Ave. |
| FACILITY CITY, STATE, ZIP: | Aurora, IL 60505 |
| DOCKET NUMBER: | NH 15-S0238 |
| LICENSEE INFO: | Sunnymere |
| LICENSEE ADDRESS: | 407 W. Galena, PO Box 1625 |
| LICENSEE CITY, STATE, ZIP: | Aurora, IL 60507 |
| Survey Date – 4-30-15 | |
| Type B violation for violating one or more sections: 330.710a), 330.790a) b) c), 330.1155, 330.1530, | |
| FACILITY NAME: | Ottawa Pavilion |
| FACILITY ADDRESS: | 800 East Center St. |
| FACILITY CITY, STATE, ZIP: | Ottawa, IL 61350 |
| DOCKET NUMBER: | NH 15-C0239 |
| LICENSEE INFO: | Ottawa Pavilion, LTD. |
| LICENSEE ADDRESS: | 191 N. Wacker Dr., Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60636 |
| Survey Date – 4-23-15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.3240a), 300.1210, 300.1210, 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) and300.3240a), for a total fine of $2.200. | |
| FACILITY NAME: | Moorings Health Center, The |
| FACILITY ADDRESS: | 761 Old Barn Lane |
| FACILITY CITY, STATE, ZIP: | Arlington Heights, IL 60005 |
| DOCKET NUMBER: | NH 15-S0241 |
| LICENSEE INFO: | Presbyterian Homes |
| LICENSEE ADDRESS: | 3200 Grant St. |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60201 |
| Survey Date – 5-14-15 | |
| Type B violation for violating one or more sections: 300.696a)c)2, 300.1210b)4)d)4), 300.7060a), | |
| FACILITY NAME: | Jacksonville Skilled Nursing & Rehab |
| FACILITY ADDRESS: | 1517 West Walnut St. |
| FACILITY CITY, STATE, ZIP: | Jacksonville, IL 62650 |
| DOCKET NUMBER: | NH 15-S0243 |
| LICENSEE INFO: | Covenant Care Jacksonville, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 4-24-15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 3001210d)5), 300.3240a). The fine was doubled in this instance in accordance with 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). For a total fine of $2,200 | |
| FACILITY NAME: | Carlinville Rehab & HCC |
| FACILITY ADDRESS: | 751 N. Oak St. |
| FACILITY CITY, STATE, ZIP: | Carlinville, IL 62626 |
| DOCKET NUMBER: | NH 15-C0244 |
| LICENSEE INFO: | Carlinville Rehabilitation and Health Care Center, LLC |
| LICENSEE ADDRESS: | 412 E. Lawrence |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 4-26-15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 3001210d)6), 300.3240a). The fine was doubled in this instance in accordance with 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). For a total fine of $2,200 | |
| FACILITY NAME: | Alden Terrace of McHenry Rehab |
| FACILITY ADDRESS: | 803 Royal Dr. |
| FACILITY CITY, STATE, ZIP: | McHenry, IL 60050 |
| DOCKET NUMBER: | NH 15-S0247 |
| LICENSEE INFO: | Alden Terrace of McHenry Rehabilitation and Health Care Center, Inc. |
| LICENSEE ADDRESS: | 4200 W. Peterson Ave., Suite 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 4-23-15 | |
| Type B violation for violating one or more sections: 300.615e),300.7000, | |
| FACILITY NAME: | Piper City Rehab & Living Center |
| FACILITY ADDRESS: | 600 Maple St. |
| FACILITY CITY, STATE, ZIP: | Piper City, IL 60959 |
| DOCKET NUMBER: | NH 15-C0245 |
| LICENSEE INFO: | Midwest Health Operations, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 4-23-15 | |
| Type B violation for violating one or more sections: 300.1210a), 300.1210b)5), 300.1210d)6), 300.3240a), the fine was doubled in the instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b)5), 300.1210d)6), and 300.3240a). For a total fine of $2,200. | |
| FACILITY NAME: | Heartland of Moline |
| FACILITY ADDRESS: | 833 Sixteenth Ave. |
| FACILITY CITY, STATE, ZIP: | Moline, IL 61265 |
| DOCKET NUMBER: | NH 15-C0240 |
| LICENSEE INFO: | Heartland of Moline IL, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 4-18-15 | |
| Type B violation for violating one or more sections: 300.1010h), 300.1210b), 300.1210d)5), 300.3240a), The fine was doubled in this instance in accordance with 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). For a total fine of $2,200 | |
| FACILITY NAME: | Capitol Healthcare and Rehab Center |
| FACILITY ADDRESS: | 555 West Carpenter |
| FACILITY CITY, STATE, ZIP: | Springfield, IL 62702 |
| DOCKET NUMBER: | NH 15-C0246 |
| LICENSEE INFO: | Capitol Healthcare and Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 4600 West Touhy Ave, Suite 200 |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 4-20-15 | |
| Type B violation for violating one or more sections: 300.610a), 300.696a), 300.1010h), 300.1210b), 300.1210d)2)3)5), 300.3240a), the fine was doubled in this instance in accordance with 300.282i) and j), of the code due to the violations of the sections of the code with a high risk designation: 300.696a), 300.1210b), and 300.3240a). For a total fine of $2,200 | |
| FACILITY NAME: | Arcola Health Care Center |
| FACILITY ADDRESS: | 422 E. Fourth St., P.O. Box 70 |
| FACILITY CITY, STATE, ZIP: | Arcola, IL 61910 |
| DOCKET NUMBER: | NH 15-S0249 |
| LICENSEE INFO: | Petersen Health Care, Inc. |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 5-28-15 | |
| Type B violation for violating one or more sections: 300.615, 300.1230b), 300.1230d)1)2), 300.1230j)5), 300.1230k), 300.1650a), 300.1650b), 300.1650c) | |
| FACILITY NAME: | Terrace Nursing Home, The |
| FACILITY ADDRESS: | 1615 Sunset Ave. |
| FACILITY CITY, STATE, ZIP: | Waukegan, IL 60087 |
| DOCKET NUMBER: | NH 15-S0252 |
| LICENSEE INFO: | TN Care, LLC |
| LICENSEE ADDRESS: | 1S443 Summitt Ave., Suite 204 |
| LICENSEE CITY, STATE, ZIP: | Oakbrook Terrace, IL 60181 |
| Survey Date – 4-9-15 | |
| Type B violation for violating one or more sections: 300.615e) | |
| FACILITY NAME: | Lexington of Wheeling |
| FACILITY ADDRESS: | 730 West Hintz Road |
| FACILITY CITY, STATE, ZIP: | Wheeling, IL 60090 |
| DOCKET NUMBER: | NH 15-C0253 |
| LICENSEE INFO: | Lexington Health Care Center of Wheeling, Inc. |
| LICENSEE ADDRESS: | 665 W. North Ave. |
| LICENSEE CITY, STATE, ZIP: | Lombard, IL 60148 |
| Survey Date – 5-8-2015 | |
| Type B violation for violating one or more sections: 300.1010h), 3001210b), 300.1210d)5), 300.3240a), the fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with high risk designation: 300.1210b), 300.1210d)5) and 300.3240a). For a total fine of $2,200. | |
| FACILITY NAME: | Heritage Health-Robinson |
| FACILITY ADDRESS: | 600 East Robinwood Dr. |
| FACILITY CITY, STATE, ZIP: | Robinson, IL 62454 |
| DOCKET NUMBER: | NH 15-C0251 |
| LICENSEE INFO: | Heritage Manor – Robinson, LLC |
| LICENSEE ADDRESS: | 202 N. Center St. |
| LICENSEE CITY, STATE, ZIP: | Bloomington, IL 61701 |
| Survey Date – 5-5-2015 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210c), 300.1210d)6), 300.3240a), the fine was doubled in this instance with 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). For a total fine of $2,200. | |
| FACILITY NAME: | Meadowbrook Manor - LaGrange |
| FACILITY ADDRESS: | 339 9th Ave. |
| FACILITY CITY, STATE, ZIP: | LaGrange, IL 60525 |
| DOCKET NUMBER: | NH 15-S0248 |
| LICENSEE INFO: | Butterfield Health Care VII, L.L.C. |
| LICENSEE ADDRESS: | 161 N. Clark St., Suite 4200 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60601 |
| Survey Date – 5-14-2015 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)6), 300.3240a), the fine was doubled in the instance in accordance with 300.282i) and j) of the Code due to the violation of sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). For a total fine of $2,200. | |
| FACILITY NAME: | Our Lady of Angels Retirement Home |
| FACILITY ADDRESS: | 1201 Wyoming Ave. |
| FACILITY CITY, STATE, ZIP: | Joliet, IL 60435 |
| DOCKET NUMBER: | NH 15-C0250 |
| LICENSEE INFO: | Our Lady of Angels Retirement Home |
| LICENSEE ADDRESS: | 2601 Black Road, 2nd Floor |
| LICENSEE CITY, STATE, ZIP: | Joliet, IL 60435 |
| Survey Date – 5-8-2015 | |
| Type A violation for violating one or more sections: 300.610a), 300.1010i), 300.1210a), 300.1210b)5), 300.1210d)6), 300.1220b)3), 300.3240a), the was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b)5), 300.1210d)6) and 300.3240a). For a total fine of | |
| FACILITY NAME: | Pavilion of Waukegan |
| FACILITY ADDRESS: | 2217 Washington St. |
| FACILITY CITY, STATE, ZIP: | Waukegan, IL 60085 |
| DOCKET NUMBER: | NH 15-S0255 |
| LICENSEE INFO: | Pavilion of Waukegan, LLC |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Suite 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 5-21-2015 | |
| Type B violation for violating one or more sections: 300.615e), 300.3060a)4, 300.2010, 300.2100 | |
| FACILITY NAME: | Eastern Star Home |
| FACILITY ADDRESS: | 9890 Star Lane, P.O. Box 317 |
| FACILITY CITY, STATE, ZIP: | Macon, IL 62544 |
| DOCKET NUMBER: | NH 15-S0256 |
| LICENSEE INFO: | Grand Chapter Order of the Eastern Star of the State of |
| LICENSEE ADDRESS: | 9894 Star Lane, PO Box 317 |
| LICENSEE CITY, STATE, ZIP: | Macon, IL 62544 |
| Survey Date – 6-2-2015 | |
| Type B violation for violating one or more sections: 300.1210d)6) | |
| FACILITY NAME: | DuPage Convalescent Center |
| FACILITY ADDRESS: | 400 N. County Farm Road, P.O. Box 708 |
| FACILITY CITY, STATE, ZIP: | Wheaton, IL 60187 |
| DOCKET NUMBER: | NH 15-C0265 |
| LICENSEE INFO: | DuPage County Board of Supervisors |
| LICENSEE ADDRESS: | 421 County Farm Road |
| LICENSEE CITY, STATE, ZIP: | Wheaton, IL 60187 |
| Survey Date – 4-27-2015 | |
| Type B violation for violating one or more sections: 300.690, 300.1030. | |
| FACILITY NAME: | Heritage Health-Dwight |
| FACILITY ADDRESS: | 300 East Mazon Ave. |
| FACILITY CITY, STATE, ZIP: | Dwight, IL 60420 |
| DOCKET NUMBER: | NH 15-S0266 |
| LICENSEE INFO: | Heritage Manor – Dwight, LLC |
| LICENSEE ADDRESS: | 115 West Jefferson, Suite 4004 |
| LICENSEE CITY, STATE, ZIP: | Bloomington, IL 61701 |
| Survey Date – 5-21-2015 | |
| Type B violation for violating one or more sections: 300.615, 300.615e), 300.615f). | |
| FACILITY NAME: | Manor Court of Peru |
| FACILITY ADDRESS: | 3230 Becker Dr. |
| FACILITY CITY, STATE, ZIP: | Peru, IL 61354 |
| DOCKET NUMBER: | NH 15-S0254 |
| LICENSEE INFO: | Residential Alternatives of Illinois, Inc. |
| LICENSEE ADDRESS: | 285 S. Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| Survey Date – 5-14-2015 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.2040b), 300.2040e), 300.2040g), 300.3240a), The fine was doubled in this instance in accordance with 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), for a total fine of $2,200. | |
| FACILITY NAME: | Sharon Health Care Elms |
| FACILITY ADDRESS: | 3611 North Rochelle |
| FACILITY CITY, STATE, ZIP: | Peoria, IL 61604 |
| DOCKET NUMBER: | NH 15-C0259 |
| LICENSEE INFO: | Sharon Health Care Elms, Inc. |
| LICENSEE ADDRESS: | 4654 Central Ave., Suite 100 |
| LICENSEE CITY, STATE, ZIP: | Northfield, IL 60093 |
| Survey Date – 5-19-2015 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 3001210b), 300.1210d)6), 300.3240a), The fine was doubled in two separate instances in accordance with 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), for a total fine of $4,400. | |
| FACILITY NAME: | Alden Alma Nelson Manor |
| FACILITY ADDRESS: | 550 South Mulford Ave. |
| FACILITY CITY, STATE, ZIP: | Rockford, IL 61108 |
| DOCKET NUMBER: | NH 15-C0264 |
| LICENSEE INFO: | Alden – Alma Nelson Manor |
| LICENSEE ADDRESS: | 550 South Mulford Ave. |
| LICENSEE CITY, STATE, ZIP: | Rockford, IL 61108 |
| Survey Date – 5-5-2015 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)3), 300.1210d)5), 300.1210d)6), 300.3240a), The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the section of the Code with a high risk designation: 300.121b), 300.1210d)5), 300.1210d)6) and 300.3240a), for a total fine of $2,200. | |
| FACILITY NAME: | Imperial Grove Pavilion, The |
| FACILITY ADDRESS: | 1366 West Fullerton Ave. |
| FACILITY CITY, STATE, ZIP: | Chicago, Il 60614 |
| DOCKET NUMBER: | NH 15-S0267 |
| 15-C0268 | |
| LICENSEE INFO: | Claridge Imperial LTD |
| LICENSEE ADDRESS: | 191 North Wacker Dr, Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 5-6-2015 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 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 section of the Code with high risk designation: 300.1210b), and 300.1210d)6), for a total fine of $2,200. | |
| FACILITY NAME: | Lutheran Home, The |
| FACILITY ADDRESS: | 6901 N. Galena Road |
| FACILITY CITY, STATE, ZIP: | Peoria, IL 61614 |
| DOCKET NUMBER: | NH 15-C0269 |
| LICENSEE INFO: | Lutheran Hillside Village |
| LICENSEE ADDRESS: | 6901 N. Galena Road |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 5-20-2015 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.3240a), the fine was doubled in this instance in accordance with 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), for a total fine of $2,200. | |
| FACILITY NAME: | Jerseyville Nursing & Rehab Center |
| FACILITY ADDRESS: | 1001 S. State St. |
| FACILITY CITY, STATE, ZIP: | Jerseyville, IL 62052 |
| DOCKET NUMBER: | NH 15-S0270 |
| LICENSEE INFO: | Helia Healthcare of Jerseyville, LLC |
| LICENSEE ADDRESS: | 600 South Second St. |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62701 |
| Survey Date – 6-4-2015 | |
| Administrative Warning for violating one or more sections: 300.2930 | |
| FACILITY NAME: | Helia Healthcare of Benton |
| FACILITY ADDRESS: | 1310 Mark Franklin Louis St. |
| FACILITY CITY, STATE, ZIP: | Benton, IL 62812 |
| DOCKET NUMBER: | NH 15-S0271 |
| LICENSEE INFO: | Helia Healthcare of Benton, LLC |
| LICENSEE ADDRESS: | 600 South Second St., Suite 103 |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62812 |
| Survey Date – 5-29-2015 | |
| Type B violation for violating one or more sections: 300.615e), 300.1230a)1)2)3), 300.1230b)5) | |
| FACILITY NAME: | ManorCare of South Holland |
| FACILITY ADDRESS: | 2145 East 170th St. |
| FACILITY CITY, STATE, ZIP: | South Holland, IL 60473 |
| DOCKET NUMBER: | NH 15-S0274 |
| LICENSEE INFO: | ManorCare of South Holland IL, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 5-14-2015 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a)b), 300.1210d)6, 300.3240a), the fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the section of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a), for a total fine of $2,200.00. | |
| FACILITY NAME: | Heartland of Canton |
| FACILITY ADDRESS: | 2081 N. Main St. |
| FACILITY CITY, STATE, ZIP: | Canton, IL 61520 |
| DOCKET NUMBER: | NH 15-C0272 |
| LICENSEE INFO: | Heartland of Canton IL, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 6-3-2015 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)6), 300.3240a), the fine was doubled in this instance in accordance with 300.282i) and j) of the Code to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a), for a total fine of $2,200.00. | |
| FACILITY NAME: | Centralia Manor |
| FACILITY ADDRESS: | 1910 East McCord St., Route 161 East |
| FACILITY CITY, STATE, ZIP: | Centralia, IL 62801 |
| DOCKET NUMBER: | NH 15-C0130 |
| LICENSEE INFO: | UDI #8, L.C.C. |
| LICENSEE ADDRESS: | 285 S. Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, Illinois 61401 |
| Survey Date – 2-23-2015 | |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Highland Health Care Center |
| FACILITY ADDRESS: | 1450 26th St. |
| FACILITY CITY, STATE, ZIP: | Highland, IL 62249 |
| DOCKET NUMBER: | NH 14-S0524 |
| LICENSEE INFO: | Covenant Care Midwest, Inc. |
| LICENSEE ADDRESS: | 208 South LaSalle, Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 11-5-2014 | |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Brother James Court |
| FACILITY ADDRESS: | 2508 St. James Road |
| FACILITY CITY, STATE, ZIP: | Springfield, IL 62707 |
| DOCKET NUMBER: | NH 14-S0412 |
| LICENSEE INFO: | Brother James Court |
| LICENSEE ADDRESS: | 1214 S 8th St. |
| LICENSEE CITY, STATE, ZIP: | Springfield, Illinois 62703 |
| Survey Date – 8-21-2014 | |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Chester Rehab & Nursing Center |
| FACILITY ADDRESS: | 770 State St. |
| FACILITY CITY, STATE, ZIP: | Chester, IL 62233 |
| DOCKET NUMBER: | NH 15-C0278 |
| LICENSEE INFO: | Chester Rehabilitation and Nursing Center, LLC |
| LICENSEE ADDRESS: | 8170 N. McCormick Blvd, Suite 219 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 5-6-2015 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.3240a), the fine was doubled in this instance in accordance with 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), for a total fine of $2,200 | |
| FACILITY NAME: | Rochelle Rehab & Health Care Center |
| FACILITY ADDRESS: | 900 N. 3rd St. |
| FACILITY CITY, STATE, ZIP: | Rochelle, IL 61068 |
| DOCKET NUMBER: | NH 15-S0276 |
| LICENSEE INFO: | Petersen Health Network, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 6-3-2015 | |
| Type B violation for violating one or more sections: 300.510a), 300.615b)e)f), 300.1210b)1)2)3)4)5). | |
| FACILITY NAME: | A Merkle C Knipprath Nursing Home |
| FACILITY ADDRESS: | 1190 E 2900 North Road |
| FACILITY CITY, STATE, ZIP: | Clifton, IL 60927 |
| DOCKET NUMBER: | NH 15-S0279 |
| LICENSEE INFO: | Arther Merkle – Clara Knipprath Nursing Home |
| LICENSEE ADDRESS: | 9223 West Saint Francis Road |
| LICENSEE CITY, STATE, ZIP: | Frankfurt, IL 60423 |
| Survey Date – 5-8-2015 | |
| Type B violation for violating one or more sections: 300.670k1)2)3), 300.2620d). | |
| FACILITY NAME: | Arden Courts of Hazel Crest |
| FACILITY ADDRESS: | 3701 West 183rd St. |
| FACILITY CITY, STATE, ZIP: | Hazel Crest, IL 60429 |
| DOCKET NUMBER: | NH 14-S0473 NH 14-C0474 |
| LICENSEE INFO: | Arden Courts of Hazel Crest IL, LLC |
| LICENSEE ADDRESS: | 208 South LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 10-23-2014 | |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Waterfront Terrace |
| FACILITY ADDRESS: | 7750 South Shore Dr. |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60649 |
| DOCKET NUMBER: | NH 15-C-0037 |
| LICENSEE INFO: | Waterfront Terrace, Inc. |
| LICENSEE ADDRESS: | 191 N. Wacker Dr., Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 12-17-2014 | |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Sandwich Rehabilitation & HCC |
| FACILITY ADDRESS: | 902 E. Arnold St. |
| FACILITY CITY, STATE, ZIP: | Sandwich, IL 60548 |
| DOCKET NUMBER: | NH 14-C-0326 |
| LICENSEE INFO: | Peterson Health Operations, LLC |
| LICENSEE ADDRESS: | 830 West Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 7-9-2014 | |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Alden Town Manor Rehab & HCC |
| FACILITY ADDRESS: | 6120 West Ogden |
| FACILITY CITY, STATE, ZIP: | Cicero, IL 60804 |
| DOCKET NUMBER: | NH 15-C-0011 |
| LICENSEE INFO: | Alden – Town Manor Rehabilitation and Health Care Center, Inc. |
| LICENSEE ADDRESS: | 4200 W. Peterson Ave., Suite 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 12-12-2014 | |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Neighbors Rehabilitation Center |
| FACILITY ADDRESS: | 811 West 2nd St. |
| FACILITY CITY, STATE, ZIP: | Byron, IL 61010 |
| DOCKET NUMBER: | NH 14-C162 |
| LICENSEE INFO: | Neighbors Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 6840 N Lincoln Ave. |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 2-26-2014 | |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Villa Health Care East |
| FACILITY ADDRESS: | 100 Marian Parkway, PO Box 109 |
| FACILITY CITY, STATE, ZIP: | Sherman, IL 62684 |
| DOCKET NUMBER: | NH 14-S0322 |
| LICENSEE INFO: | Villa Health Care, Inc. |
| LICENSEE ADDRESS: | 313 Saratoga Chase |
| LICENSEE CITY, STATE, ZIP: | Sherman, IL 62684 |
| Survey Date – 7-11-2014 | |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Arden Courts of Northbrook |
| FACILITY ADDRESS: | 3240 Milwaukee Ave. |
| FACILITY CITY, STATE, ZIP: | Northbrook, IL 60062 |
| DOCKET NUMBER: | NH 14-S0429 |
| LICENSEE INFO: | Arden Courts of Northbrook IL, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 8-27-14 | |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Alden Alma Nelson Manor |
| FACILITY ADDRESS: | 550 South Mulford Ave. |
| FACILITY CITY, STATE, ZIP: | Rockford, IL 61108 |
| DOCKET NUMBER: | NH 14-C0231 |
| LICENSEE INFO: | Alden-Alma Nelson Manor, Inc |
| LICENSEE ADDRESS: | 4200 West Peterson |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 5-12-14 | |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Capitol Healthcare and Rehab Center |
| FACILITY ADDRESS: | 555 West Carpenter |
| FACILITY CITY, STATE, ZIP: | Springfield, IL 62702 |
| DOCKET NUMBER: | 15-C0246 |
| LICENSEE INFO: | Capitol Healthcare and Rehab Center, LLC |
| LICENSEE ADDRESS: | 4600 West Touhy Ave, Suite 200 |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 4-20-15 | |
| Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 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: 300.696a), 300.1210b) and 300.3240a). | |
| FACILITY NAME: | Cahokia Nursing & Rehab Center |
| FACILITY ADDRESS: | 2 Annabelle Court |
| FACILITY CITY, STATE, ZIP: | Cahokia, IL 62206 |
| DOCKET NUMBER: | 15-C0277 |
| LICENSEE INFO: | Cahokia Nursing & Rehabilitation Center, Inc |
| LICENSEE ADDRESS: | 7434 N. Skokie Boulevard |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 5-6-15 | |
| Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 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: 300.696a), 300.1210b) and 300.3240a). | |
| FACILITY NAME: | Meadows Mennonite Home |
| FACILITY ADDRESS: | 24588 Church St. |
| FACILITY CITY, STATE, ZIP: | Chenoa, IL 61726 |
| DOCKET NUMBER: | 15-C0132 |
| LICENSEE INFO: | Meadows Mennonite Retirement Community Association, Inc. |
| LICENSEE ADDRESS: | 24588 Church St. |
| LICENSEE CITY, STATE, ZIP: | Chenoa, IL 61726 |
| Survey Date – 3-17-15 | |
| Type B violation of an occurrence for violating one or more of the following sections of the Code:300.690b, 300.690c). | |