Agencies
Services
Quarterly Report July - September 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: | Alden Estates of Orland Park |
| FACILITY ADDRESS: | 16450 South 97th Ave |
| FACILITY CITY, STATE, ZIP: | Orland Park, IL 60462 |
| DOCKET NUMBER: | 15-C0413 |
| LICENSEE INFO: | Alden-Orland Park Rehab and Health Care Center, Inc |
| LICENSEE ADDRESS: | 4200 W Peterson Ave, Ste 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 8/5/15 Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210c), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.00. |
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| FACILITY NAME: | Alden Long Grove Rehab & HCC |
| FACILITY ADDRESS: | Box 2308, RFD Old Hicks Rd |
| FACILITY CITY, STATE, ZIP: | Long Grove, IL 60047 |
| DOCKET NUMBER: | 15-C0356 |
| LICENSEE INFO: | Alden- Long Grove Rehab And Health Care Center, Inc |
| LICENSEE ADDRESS: | 4200 W. Petersen Ave, Ste 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 7/9/15 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. |
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| FACILITY NAME: | Alden Town Manor Rehab and HCC |
| FACILITY ADDRESS: | 6120 West Ogden |
| FACILITY CITY, STATE, ZIP: | Cicero, IL 60804 |
| DOCKET NUMBER: | 15-C0401 |
| LICENSEE INFO: | Alden- Town Manor Rehab and Health Care Center, Inc |
| LICENSEE ADDRESS: | 4200 W. Peterson Ave., Ste 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 8/12/15 Type C violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), 300.1210d)5), and 300.3240a). No fine. |
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| FACILITY NAME: | Aperion Care Center |
| FACILITY ADDRESS: | 2650 North Monroe Street |
| FACILITY CITY, STATE, ZIP: | Decatur, IL 62526 |
| DOCKET NUMBER: | 15-S0015 & 15-S0106 |
| LICENSEE INFO: | Lincoln Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 8131 Monticello Avenue |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 12-11-14 FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. |
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| FACILITY NAME: | Arba Care Center of Bloomington |
| FACILITY ADDRESS: | 1509 N. Calhoun St. |
| FACILITY CITY, STATE, ZIP: | Bloomington, IL 61701 |
| DOCKET NUMBER: | 15-C0329 |
| LICENSEE INFO: | Arba Care Center of Bloomington, LLC |
| LICENSEE ADDRESS: | 134 N McLean Blvd |
| LICENSEE CITY, STATE, ZIP: | Elgin, IL 60123 |
| Survey Date – 6/30/15 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 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. |
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| FACILITY NAME: | Belhaven Nursing and Rehab Center |
| FACILITY ADDRESS: | 11401 South Oakley Ave |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60643 |
| DOCKET NUMBER: | 15-C0376 |
| LICENSEE INFO: | Belhaven Nursing and Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 150 Fencl Ln |
| LICENSEE CITY, STATE, ZIP: | Hillside, IL 60162 |
| Survey Date – 7/23/15 Type B violation for violating one or more sections: 300.3300a)b)c)1). No fine. |
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| FACILITY NAME: | Bethany Home |
| FACILITY ADDRESS: | 4950 North Ashland |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60640 |
| DOCKET NUMBER: | 15-S0400 |
| LICENSEE INFO: | Bethany Homes and Methodist Hospital |
| LICENSEE ADDRESS: | 5015 N. Paulina St |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60640 |
| Survey Date - Type B violation for violating one or more sections: 330.1155a)4)c). No fine. |
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| FACILITY NAME: | Brentwood North NC & Rehab Center |
| FACILITY ADDRESS: | 3705 Deerfield Rd |
| FACILITY CITY, STATE, ZIP: | Riverwoods, IL 60015 |
| DOCKET NUMBER: | NH 15-S0373 |
| LICENSEE INFO: | Brentwood North Healthcare and Rehab Centre, Inc |
| LICENSEE ADDRESS: | 191 N. Wacker Drive, Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 7/16/15 Type A violation for violating one or more sections: 300.1210b), 300.1210d)6), 300.3130c)3)4)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), and 300.3240a) For a total fine of $25,000.00. |
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| FACILITY NAME: | Brentwood North HC & Rehab Centre |
| FACILITY ADDRESS: | 3705 Deerfield Rd |
| FACILITY CITY, STATE, ZIP: | Riverwoods, IL 60015 |
| DOCKET NUMBER: | 15-C0350 |
| LICENSEE INFO: | Brentwood North Healthcare and Rehab Centre, Inc |
| LICENSEE ADDRESS: | 191 n Wacker Dr. Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 7/1/15 Type A violation for violating one or more sections: 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 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. |
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| FACILITY NAME: | Brentwood Sub Acute Healthcare Center |
| FACILITY ADDRESS: | 5400 West 87th St |
| FACILITY CITY, STATE, ZIP: | Burbank, IL 60459 |
| DOCKET NUMBER: | 15-S0418 |
| LICENSEE INFO: | Brentwood Operating Company, LLC |
| LICENSEE ADDRESS: | 208 S LaSalle St., Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 7/31/15 Type B violation for violating one or more sections: 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 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. |
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| FACILITY NAME: | Bria of Geneva |
| FACILITY ADDRESS: | 1101 East State Street |
| FACILITY CITY, STATE, ZIP: | Geneva, IL 60134 |
| DOCKET NUMBER: | 15-S0332 |
| LICENSEE INFO: | Geneva Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 4711 Golf Rd., Ste 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 6/24/15 1. 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. 2. Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210c), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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. |
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| FACILITY NAME: | Buckingham Pavilion |
| FACILITY ADDRESS: | 2625 West Touhy Ave |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60645 |
| DOCKET NUMBER: | 15-S0372 |
| LICENSEE INFO: | Buckingham Pavilion |
| LICENSEE ADDRESS: | 191 N Wacker Dr., Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 7/16/15 Type B 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 $2,200.00. |
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| FACILITY NAME: | Burgin Manor of Olney, Inc |
| FACILITY ADDRESS: | 900 East Scott Street |
| FACILITY CITY, STATE, ZIP: | Olney, IL 62450 |
| DOCKET NUMBER: | 15-S0315 |
| LICENSEE INFO: | Burgin Manor of Olney, Inc |
| LICENSEE ADDRESS: | 858 Sunnyhill Lane |
| LICENSEE CITY, STATE, ZIP: | Columbia, IL 62236 |
| Survey Date – 2-11-15 FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. |
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| FACILITY NAME: | California Gardens Nursing and Rehab Center |
| FACILITY ADDRESS: | 2820 South California Blvd |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60608 |
| DOCKET NUMBER: | 15-C0344, 15-S0345 |
| LICENSEE INFO: | California Gardens Corp |
| LICENSEE ADDRESS: | 191 North Wacker Dr., Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60608 |
| Survey Date – 6-16-15 Type B violation for violating one or more sections: 300.1210b), 300.1210d)2), 300.1210d)3), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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. |
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| FACILITY NAME: | Chicago Ridge Nursing Center |
| FACILITY ADDRESS: | 10602 Southwest Highway |
| FACILITY CITY, STATE, ZIP: | Chicago Ridge, IL 60415 |
| DOCKET NUMBER: | 15-C0384 |
| LICENSEE INFO: | BM of Chicago Ridge, LLC |
| LICENSEE ADDRESS: | 8170 N McCormick Blvd., Ste 219 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 7/29/15 Type B violation for violating one or more sections: 300.1810a)b). No fine. |
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| FACILITY NAME: | Clark-Lindsey Village |
| FACILITY ADDRESS: | 101 West Windsor Rd |
| FACILITY CITY, STATE, ZIP: | Urbana, IL 61071 |
| DOCKET NUMBER: | 15-S0416 |
| LICENSEE INFO: | Clark-Lindsey Village, Inc |
| LICENSEE ADDRESS: | 1729 Georgetown Dr |
| LICENSEE CITY, STATE, ZIP: | Champaign, IL 61821 |
| Survey Date – 9/2/15 Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). No fine. |
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| FACILITY NAME: | Clayton Residential Home |
| FACILITY ADDRESS: | 2026 North Clark St |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60093 |
| DOCKET NUMBER: | 15-S0090 |
| LICENSEE INFO: | Clayton Residential Home, Inc |
| LICENSEE ADDRESS: | 465 Central Ave, Ste 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: | Clayton Residential Home |
| FACILITY ADDRESS: | 2026 North Clark St. |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60093 |
| DOCKET NUMBER: | 15-S0349 |
| LICENSEE INFO: | Clayton residential Home, Inc |
| LICENSEE ADDRESS: | 465 Central Ave. Ste 100 |
| LICENSEE CITY, STATE, ZIP: | Northfield, IL 60093 |
| Survey Date – 7/9/15 Type B violation for violating one or more sections: 300.1210d)1) and 300.696a)c)7). No fine. |
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| FACILITY NAME: | Covenant Healthcare Center |
| FACILITY ADDRESS: | 2155 Pfingsten Rd |
| FACILITY CITY, STATE, ZIP: | Northbrook, IL 60062 |
| DOCKET NUMBER: | 15-S0215 |
| LICENSEE INFO: | Covenant Healthcare Center, Inc |
| LICENSEE ADDRESS: | 2155 Pfingsten Rd |
| LICENSEE CITY, STATE, ZIP: | Northbrook, IL 60062 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Decatur Manor Healthcare |
| FACILITY ADDRESS: | 1016 West Pershing Road |
| FACILITY CITY, STATE, ZIP: | Decatur, IL 62526 |
| DOCKET NUMBER: | 14-S0430 |
| LICENSEE INFO: | Decatur Manor Healthcare, LLC |
| LICENSEE ADDRESS: | 6840 N Lincoln Avenue |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 9-4-14 FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. |
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| FACILITY NAME: | Dixie Manor Sheltered Care |
| FACILITY ADDRESS: | 15535 Dixie Highway |
| FACILITY CITY, STATE, ZIP: | Harvey, IL 60426 |
| DOCKET NUMBER: | 15-S0399 |
| LICENSEE INFO: | Dixie Manor Sheltered Care, Inc |
| LICENSEE ADDRESS: | 15535 Dixie Highway |
| LICENSEE CITY, STATE, ZIP: | Harvey, IL 60426 |
| Survey Date – 8/26/15 Type C violation for violating one or more sections: 330.790a), 330.790b), 330.790c)1)2)3), 330.1510a)2), 330.1950c)1)2)3), 330.1950d)1)2)3)4)5)6)7)8)9)10)11), 330.1950e), 330.1950f), and 330.1950g)1)2). No fine. |
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| FACILITY NAME: | Dobson Plaza |
| FACILITY ADDRESS: | 120 Dodge Avenue |
| FACILITY CITY, STATE, ZIP: | Evanston, IL 60202 |
| DOCKET NUMBER: | 14-C0436 |
| LICENSEE INFO: | Dobson Plaza Nursing & Rehab Center, LLC |
| LICENSEE ADDRESS: | 191 Wacker Drive, Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 9-3-14 FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. |
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| FACILITY NAME: | Eastview Terrace |
| FACILITY ADDRESS: | 100 Eastview Place |
| FACILITY CITY, STATE, ZIP: | Sullivan, IL 61951 |
| DOCKET NUMBER: | 15-S0341 |
| LICENSEE INFO: | Petersen Health Care, Inc |
| LICENSEE ADDRESS: | 830 West Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 7/15/15 Type B violation for violating one or more sections: 300.1230k). No fine. |
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| FACILITY NAME: | Elmhurst Extended Care Center |
| FACILITY ADDRESS: | 200 East Lake St |
| FACILITY CITY, STATE, ZIP: | Elmhurst, IL 60126 |
| DOCKET NUMBER: | 15-S0302 |
| LICENSEE INFO: | SBNB, Inc |
| LICENSEE ADDRESS: | 200 East Lake St |
| LICENSEE CITY, STATE, ZIP: | Elmhurst, IL 60126 |
| Survey Date – 6/9/15 Type A violation for violating one or more sections: 300.1010h), 300.1210b), 300.1210d)3)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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. |
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| FACILITY NAME: | Estates of Hyde Park |
| FACILITY ADDRESS: | 4505 S. Drexel Blvd |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60653 |
| DOCKET NUMBER: | 15-C0337 |
| LICENSEE INFO: | The Estates of Hyde Park, LLC |
| LICENSEE ADDRESS: | 4711 Golf Rd., Ste 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date -7/1/15 Type B violation for violating one or more sections: 300.1010h), 300.1210b), 300.1210d)2), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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. |
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| FACILITY NAME: | Fairview Nursing Plaza |
| FACILITY ADDRESS: | 321 Arnold Avenue |
| FACILITY CITY, STATE, ZIP: | Rockford, IL 61108 |
| DOCKET NUMBER: | 13-s0531 |
| LICENSEE INFO: | Fairview Nursing Plaza, Inc |
| LICENSEE ADDRESS: | 6840 N Lincoln Avenue |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 11-13-13 FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. |
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| FACILITY NAME: | Farmer City Rehab & Health CR |
| FACILITY ADDRESS: | 404 Brookview Drive |
| FACILITY CITY, STATE, ZIP: | Farmer City, IL 61842 |
| DOCKET NUMBER: | 15-C0288 |
| LICENSEE INFO: | Petersen Health Care – Farmer City, LLC |
| LICENSEE ADDRESS: | 830 West Trailcreek Drive |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 6-10-15 Type B violation for violating one or more sections of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.1230d)2) and 300.1230k). No Fine. |
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| FACILITY NAME: | Flora Gardens Care Center |
| FACILITY ADDRESS: | 701 Shadwell Ave |
| FACILITY CITY, STATE, ZIP: | Flora, IL 62839 |
| DOCKET NUMBER: | 15-S0346 |
| LICENSEE INFO: | Petersen Health Network, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 7/30/15 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 $2,200.00. |
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| FACILITY NAME: | Forest City Rehab & Nrsg Ctr |
| FACILITY ADDRESS: | 321 Arnold Avenue |
| FACILITY CITY, STATE, ZIP: | Rockford, IL 61108 |
| DOCKET NUMBER: | 15-C0305 |
| LICENSEE INFO: | Forest City Rehab & Nursing Center, LLC |
| LICENSEE ADDRESS: | 4711 Golf Rd Ste 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date - 6-1-15 Type B violation(s) for violating one or more sections of the Act and the Skilled Nursing and Intermediate Care Facilities: 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). For a fine of $2,200.00. |
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| FACILITY NAME: | Gilman Healthcare Center |
| FACILITY ADDRESS: | 1390 South Crescent St |
| FACILITY CITY, STATE, ZIP: | Gilman, IL 60938 |
| DOCKET NUMBER: | 15-C0352 |
| LICENSEE INFO: | Gilman Healthcare Center, LLC |
| LICENSEE ADDRESS: | 4711 Golf Rd., Ste 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 6/25/15 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. |
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| FACILITY NAME: | Gilman Healthcare Center |
| FACILITY ADDRESS: | 1390 South Cresent St |
| FACILITY CITY, STATE, ZIP: | Gilman, IL 60938 |
| DOCKET NUMBER: | 15-S0422 |
| LICENSEE INFO: | Gilman Healthcare Center, LLC |
| LICENSEE ADDRESS: | 4711 Golf Rd, Ste. 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 8/27/15 Type B violation for violating one or more sections: 300.1210a), 300.1210b), 300.1210d)1), 300.d)3), 300.1620a), 300.3240a). 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. Type B violation of an occurrence for violating the following section of the code: 300.615f). No fine. Type B violation of an occurrence for violating the following section of the code: 300.625c)1) and 300.625c)2). No fine. |
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| FACILITY NAME: | Glenview Terrace and Nursing Center |
| FACILITY ADDRESS: | 1511 Greenwood Rd |
| FACILITY CITY, STATE, ZIP: | Glenview, IL 60025 |
| DOCKET NUMBER: | 15-S0338 |
| LICENSEE INFO: | Glenview Terrace Nursing Center |
| LICENSEE ADDRESS: | 6633 North Lincoln Ave |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 6/17/15 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. |
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| FACILITY NAME: | Glenwood Health Care and Rehab |
| FACILITY ADDRESS: | 19330 South Cottage Grove |
| FACILITY CITY, STATE, ZIP: | Glenwood, IL 60425 |
| DOCKET NUMBER: | 15-C0313 |
| LICENSEE INFO: | Glenwood Healthcare & Rehab, Inc |
| LICENSEE ADDRESS: | 5750 Old Orchard Rd., Ste 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 6/10/15 Type A violation for violating one or more sections: 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 following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $25,000.00. |
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| FACILITY NAME: | Glenwood Healthcare and Rehab |
| FACILITY ADDRESS: | 19330 South Cottage Grove |
| FACILITY CITY, STATE, ZIP: | Glenwood, IL 60425 |
| DOCKET NUMBER: | 15-C0394, 15-S0395 |
| LICENSEE INFO: | Glenwood Healthcare & Rehab, Inc |
| LICENSEE ADDRESS: | 5750 Old Orchard Rd, Ste 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 8/6/15 Type A violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)5), 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 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. |
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| FACILITY NAME: | Grasmere Place |
| FACILITY ADDRESS: | 4621 North Sheridan |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60640 |
| DOCKET NUMBER: | 15-C0357 |
| LICENSEE INFO: | Grasmere Place, LLC |
| LICENSEE ADDRESS: | 2201 Main Street |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60202 |
| Survey Date – 8/5/15 Type C violation for violating one or more sections: 300.1630d). No fine. |
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| FACILITY NAME: | Greenfields of Geneva |
| FACILITY ADDRESS: | 0N801 Friendship Way |
| FACILITY CITY, STATE, ZIP: | Geneva, IL 60134 |
| DOCKET NUMBER: | 15-C0319 |
| LICENSEE INFO: | Friendship Village of Mill Creek, NFP |
| LICENSEE ADDRESS: | 10 S. LaSalle, Ste 2880 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60603 |
| Survey Date – 6/18/15 Type A violation for violating one or more sections: 300.610a), 300.1210b)5), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b)5), 300.1210d)6), and 300.3240a). For a total fine of $27,200.00. |
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| FACILITY NAME: | Heartland of Champaign |
| FACILITY ADDRESS: | 309 East Springfield |
| FACILITY CITY, STATE, ZIP: | Champaign, IL 61820 |
| DOCKET NUMBER: | 15-C0378 |
| LICENSEE INFO: | Heartland of Champaign IL, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St, Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 7/14/15 Type A violation for violating one or more sections: 300.1210b), 300.1210d)3), 300.1220d)6), 300.1220b)2), 300.1220B)3), AND 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: | Heartland of Normal |
| FACILITY ADDRESS: | 510 Broadway |
| FACILITY CITY, STATE, ZIP: | Normal, IL |
| DOCKET NUMBER: | 15-S0412 |
| LICENSEE INFO: | Heartland of Normal IL, LLC |
| LICENSEE ADDRESS: | 208 S LaSalle St., Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 8/20/15 Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.3240a). For a total fine of $2,200.00. |
|
| FACILITY NAME: | Highland Healthcare Center |
| FACILITY ADDRESS: | 1450-26th St |
| FACILITY CITY, STATE, ZIP: | Highland, IL 62249 |
| DOCKET NUMBER: | 15-C0392 |
| LICENSEE INFO: | Covenant Care Midwest, Inc |
| LICENSEE ADDRESS: | 2015 W. Main St, #11 |
| LICENSEE CITY, STATE, ZIP: | Carbondale, IL 62901 |
| Survey Date – 7/15/15 Type B violation for violating one or more sections: 300.3300a)b)c)1)A)B)C). No fine. |
|
| FACILITY NAME: | Hillsboro Rehab & HCC |
| FACILITY ADDRESS: | 1300 East Tremont St |
| FACILITY CITY, STATE, ZIP: | Hillsboro, IL 62049 |
| DOCKET NUMBER: | 15-S0397 |
| LICENSEE INFO: | Hillsboro Rehab and Health Care Center, LLC |
| LICENSEE ADDRESS: | 412 E. Lawrence |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 8/19/15 Type A violation for violating one or more sections: 300.610a), 300.1035a)3), 300.1035a)4), 300.1035b)2), 300.1210a), 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 $25,000.00. |
|
| FACILITY NAME: | Holy Family Villa |
| FACILITY ADDRESS: | 12220 South Cook Road |
| FACILITY CITY, STATE, ZIP: | Palos Heights, IL 60464 |
| DOCKET NUMBER: | 15-S0153 |
| LICENSEE INFO: | Holy Family Villa |
| LICENSEE ADDRESS: | 721 N LaSalle St |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60654 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Illini Restorative Care |
| FACILITY ADDRESS: | 1455 Hospital Rd |
| FACILITY CITY, STATE, ZIP: | Silvis, IL 61282 |
| DOCKET NUMBER: | 15-S0340 |
| LICENSEE INFO: | Genesis Health System |
| LICENSEE ADDRESS: | 801 Illini Dr. |
| LICENSEE CITY, STATE, ZIP: | Silvis, IL 61282 |
| Survey Date – 7/6/15 Type B violation for violating one or more sections: 300.610a), 300.1630c), and 300.3240a). 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: | Lake Shore Healthcare & Rehab |
| FACILITY ADDRESS: | 7200 North Sheridan Road |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60626 |
| DOCKET NUMBER: | 14-C0314 |
| LICENSEE INFO: | Lake Shore Healthcare & Rehabilitation Centre, LLC |
| LICENSEE ADDRESS: | 4600 West Touhy Avenue #200 |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 6-12-14 FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. |
|
| FACILITY NAME: | Lena Living Center |
| FACILITY ADDRESS: | 1010 South Logan Street |
| FACILITY CITY, STATE, ZIP: | Lena, IL 61048 |
| DOCKET NUMBER: | NH 15-C0284 |
| LICENSEE INFO: | Lena Living Center, L.L.C. |
| LICENSEE ADDRESS: | One IBM Plaza, Ste 3000 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60611 |
| Survey Date – 6-8-2015 Type B violation for violating one or more sections: 300.1210b) and 300.1210d)6). No Fine. |
|
| FACILITY NAME: | Leroy Manor |
| FACILITY ADDRESS: | 509 South Buck Rd |
| FACILITY CITY, STATE, ZIP: | Leroy, IL 61752 |
| DOCKET NUMBER: | 15-S0390 |
| LICENSEE INFO: | UDI #4, LLC |
| LICENSEE ADDRESS: | 285 South Farnham St |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| Survey Date – 8/5/15 Type B violation for violating one or more sections: 300.670c). No fine. |
|
| FACILITY NAME: | Lexington of Elmhurst |
| FACILITY ADDRESS: | 420 West Butterfield Rd |
| FACILITY CITY, STATE, ZIP: | Elmhurst, IL 60126 |
| DOCKET NUMBER: | 15-S0362 |
| LICENSEE INFO: | Lexington Healthcare Center of Elmhurst, Inc |
| LICENSEE ADDRESS: | 665 West North Ave |
| LICENSEE CITY, STATE, ZIP: | Lombard, IL 60148 |
| Survey Date – 7/24/15 1. 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. 2. Type B violation of an occurrence for violating the following sections of the code: 300.625a). No fine. |
|
| FACILITY NAME: | Lexington of LaGrange |
| FACILITY ADDRESS: | 4735 Willow Springs Rd |
| FACILITY CITY, STATE, ZIP: | LaGrange, IL 60525 |
| DOCKET NUMBER: | 15-S0343 |
| LICENSEE INFO: | Lexington Health Care Center of LaGrange, Inc |
| LICENSEE ADDRESS: | 665 West North Ave. |
| LICENSEE CITY, STATE, ZIP: | Lombard, IL 60148 |
| Survey Date – 7-13-15 Type C violation for violating one or more sections: 300.610a), 300.1210a)b)d)6), 300.1220b)3), and 300.3240a)b). No fine. |
|
| FACILITY NAME: | Lexington of Streamwood |
| FACILITY ADDRESS: | 815 East Irving Park Road |
| FACILITY CITY, STATE, ZIP: | Streamwood, IL 60107 |
| DOCKET NUMBER: | 15-S0308 |
| LICENSEE INFO: | Lexington Health Care Center of Streamwood. Inc |
| LICENSEE ADDRESS: | 665 West North Avenue |
| LICENSEE CITY, STATE, ZIP: | Lombard, IL 60148 |
| Survey Date – 5-29-15 Type B violation(s) for violating one or more sections of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.1210b), 300.1210b)3), 300.1210b)4), 300.1210b)4)A)B)C)D), 300.1210d)5), 300.3240a). No fine. |
|
| FACILITY NAME: | Lexington of Streamwood |
| FACILITY ADDRESS: | 815 East Irving Park Rd |
| FACILITY CITY, STATE, ZIP: | Streamwood, IL 60107 |
| DOCKET NUMBER: | 15-S0353 |
| LICENSEE INFO: | Lexington Health Care Center of Streamwood, Inc. |
| LICENSEE ADDRESS: | 665 West North Avenue |
| LICENSEE CITY, STATE, ZIP: | Lombard, IL 60184 |
| Survey Date – 6/24/15 Type B violation for violating one or more sections: 300.610a), 300.690a)b), 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: 300.690a)b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00. |
|
| FACILITY NAME: | Lydia Healthcare |
| FACILITY ADDRESS: | 13901 South Lydia |
| FACILITY CITY, STATE, ZIP: | Robbins, IL 60472 |
| DOCKET NUMBER: | 15-C0380 |
| LICENSEE INFO: | Lydia Healthcare I, LLC |
| LICENSEE ADDRESS: | 13901 S Lydia Ave |
| LICENSEE CITY, STATE, ZIP: | Robbins, IL 60472 |
| Survey Date – 8/18/15 Type B violation for violating one or more sections: 300.690b)c). No fine. |
|
| FACILITY NAME: | Magnolia Manor Sheltered Care H |
| FACILITY ADDRESS: | 1100 Grant |
| FACILITY CITY, STATE, ZIP: | Eldorado, IL 62930 |
| DOCKET NUMBER: | 15-S0348 |
| LICENSEE INFO: | John Zink |
| LICENSEE ADDRESS: | 150 South Route 45, PO Box 250 |
| LICENSEE CITY, STATE, ZIP: | Louisville, IL 62858 |
| Survey Date – 7/16/15 Type B violation for violating one or more sections: 330.2000. No fine. |
|
| FACILITY NAME: | Manor Court of Maryville |
| FACILITY ADDRESS: | 6955 State Route 162 |
| FACILITY CITY, STATE, ZIP: | Maryville, IL 62062 |
| DOCKET NUMBER: | 15-C0389 |
| LICENSEE INFO: | UDI #2, LLC |
| LICENSEE ADDRESS: | 285 S. Farnham St |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| Survey Date – 7/24/15 Type B violation for violating one or more sections: 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 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 Arlington Heights |
| FACILITY ADDRESS: | 715 West Central Road |
| FACILITY CITY, STATE, ZIP: | Arlington Hts, IL 60005 |
| DOCKET NUMBER: | 15-C0292 |
| LICENSEE INFO: | Manorcare Health Services, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle Street, Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date - 6-9-15 Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b), 300.1210c), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). For a Fine of $2,200.00. |
|
| FACILITY NAME: | Manorcare of South Holland |
| FACILITY ADDRESS: | 2145 East 170th St |
| FACILITY CITY, STATE, ZIP: | South Holland, IL 60473 |
| DOCKET NUMBER: | 15-C0404, 15-S0405 |
| LICENSEE INFO: | Manor Care of South Holland IL, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St, Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 7/31/15 Type B violation for violating one or more sections: 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 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: | Marigold Rehabilitation HCC |
| FACILITY ADDRESS: | 275 East Carl Sandburg Drive |
| FACILITY CITY, STATE, ZIP: | Galesburg, IL 61401 |
| DOCKET NUMBER: | NH 15-C0281 |
| LICENSEE INFO: | Petersen Health Network, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 5-16-2015 Type B violation for violating one or more sections: 300.1230b), 300.1230d)1)2), 300.1230L)1)2)3)4)5)6). No fine. |
|
| FACILITY NAME: | Mason Point |
| FACILITY ADDRESS: | One Masonic Way |
| FACILITY CITY, STATE, ZIP: | Sullivan, IL 61951 |
| DOCKET NUMBER: | 15-S0290 |
| LICENSEE INFO: | Petersen Health Care VII, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Drive |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date - 6-10-15 Type C violation(s) for violating one or more sections of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.1230k). No fine. |
|
| FACILITY NAME: | Mason Point |
| FACILITY ADDRESS: | One Masonic Way |
| FACILITY CITY, STATE, ZIP: | Sullivan, IL 61951 |
| DOCKET NUMBER: | 15-S0342 |
| LICENSEE INFO: | Petersen Health Care VII, LLC |
| LICENSEE ADDRESS: | 830 W Trailcreek Drive |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 7/1/15 Type B 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 $2,200.00 |
|
| FACILITY NAME: | Mclean County Nursing Home |
| FACILITY ADDRESS: | 901 North Main |
| FACILITY CITY, STATE, ZIP: | Normal, IL 61761 |
| DOCKET NUMBER: | 15-S0339 |
| LICENSEE INFO: | Mclean County |
| LICENSEE ADDRESS: | 202 N. Main, RM 205, PO Box 2400 |
| LICENSEE CITY, STATE, ZIP: | Bloomington, IL 61702 |
| Survey Date – 7/9/15 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 $2,200.00 |
|
| FACILITY NAME: | Meadows |
| FACILITY ADDRESS: | 3250 South Plum Grove Rd |
| FACILITY CITY, STATE, ZIP: | Rolling Meadows, IL 60008 |
| DOCKET NUMBER: | 15-C0039 |
| LICENSEE INFO: | Meadows Sheltered care, Inc |
| LICENSEE ADDRESS: | 3250 S Plum Grove Rd |
| LICENSEE CITY, STATE, ZIP: | Rolling Meadows, IL 60008 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Meadows Mennonite Home |
| FACILITY ADDRESS: | 24588 Church Street |
| FACILITY CITY, STATE, ZIP: | Chenoa, IL 61726 |
| DOCKET NUMBER: | 15-S0306 |
| LICENSEE INFO: | Meadows Mennonite Retirement Community Association, Inc |
| LICENSEE ADDRESS: | 24588 Church Street |
| LICENSEE CITY, STATE, ZIP: | Chenoa, IL 61726 |
| Survey Date - 6/09/15 Type B violation(s) of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.610a), 300.1210a), 300.1210b)5), 300.1210d)6), 300.1210b)2), 300.1210b)3), 300.3240a), 300.7020b)2). No fine. |
|
| FACILITY NAME: | Neighbors Rehabilitation Center |
| FACILITY ADDRESS: | 811 West 2nd St |
| FACILITY CITY, STATE, ZIP: | Byron, IL 61010 |
| DOCKET NUMBER: | 14-C162 |
| LICENSEE INFO: | Neighbors Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 6840 N Lincoln Ave |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Meadows Mennonite Home |
| FACILITY ADDRESS: | 24588 Church St |
| FACILITY CITY, STATE, ZIP: | Chenoa, IL 61726 |
| DOCKET NUMBER: | 15-C0386 |
| LICENSEE INFO: | Meadows Mennonite Retirement Community Association, Inc |
| LICENSEE ADDRESS: | 24588 Church St |
| LICENSEE CITY, STATE, ZIP: | Chenoa, IL 61726 |
| Survey Date – 8/6/15 Type B violation for violating one or more sections: 300.610a), 300.1210d)1), 300.1210d)2), 300.1620a), 300.1630c), and 300.3240a). 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: | Newman Rehab & Health Care Ctr |
| FACILITY ADDRESS: | 418 South Memorial Park Drive |
| FACILITY CITY, STATE, ZIP: | Newman, IL 61942 |
| DOCKET NUMBER: | 15-S0314 |
| LICENSEE INFO: | Petersen Health & Wellness, LLC |
| LICENSEE ADDRESS: | 830 W Trailcreek Drive |
| LICENSEE CITY, STATE, ZIP: | Peoria, Il 61614 |
| Survey Date – 6-25-15 One or more Type B violation(s) for violating one or more sections of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.670c),300.1230k), and 300.2010a)1). No fine. |
|
| FACILITY NAME: | Paris Health Care Center |
| FACILITY ADDRESS: | 1011 North Main St |
| FACILITY CITY, STATE, ZIP: | Paris, IL 61944 |
| DOCKET NUMBER: | 15-S0420 |
| LICENSEE INFO: | Paris Health Care Center Investors, LLC |
| LICENSEE ADDRESS: | 8170 N McCormick Blvd., Ste 219 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 8/14/15 Type B violation for violating one or more sections: 300.7060a). No fine. |
|
| FACILITY NAME: | Paxton Healthcare and Rehab |
| FACILITY ADDRESS: | 1240 North Market St |
| FACILITY CITY, STATE, ZIP: | Paxton, IL 60957 |
| DOCKET NUMBER: | 15-S0361 |
| LICENSEE INFO: | Paxton Healthcare and Rehab, LLC |
| LICENSEE ADDRESS: | 8170 McCormick Blvd |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 7/10/15 1. Type B violation for violating one or more sections: 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 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 2. Type B violation of an occurrence for violating the following section of the code: 300.690b)c). No fine. 3. Type B violation of an occurrence for violating the following section of the code: 300.3100d)2). No fine. |
|
| FACILITY NAME: | Pekin Manor |
| FACILITY ADDRESS: | 1520 El Camino Drive |
| FACILITY CITY, STATE, ZIP: | Pekin, IL 61554 |
| DOCKET NUMBER: | 15-C0309 |
| LICENSEE INFO: | UDI #10 |
| LICENSEE ADDRESS: | 285 South Farnham Street |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| Survey Date - 6-11-15 Type B violation(s) of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.610a), 300.1210b), 300.1210d)6), 300.3240a). No fine. |
|
| FACILITY NAME: | Presence Pine View Care Center |
| FACILITY ADDRESS: | 611 Allen Lane |
| FACILITY CITY, STATE, ZIP: | St. Charles, IL 60174 |
| DOCKET NUMBER: | 15-S0415 |
| LICENSEE INFO: | Presence Life Connections |
| LICENSEE ADDRESS: | 9223 West Saint Francis Rd |
| LICENSEE CITY, STATE, ZIP: | Frankfort, IL 60423 |
| Survey Date – 8/21/15 Type B violation for violating one or more sections: 300.690a), 300.1210b), 300.3240a), 300.3240b), 300.3240c), 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), 300.3240a), 300.3240d). For a total fine of $2,200.00. |
|
| FACILITY NAME: | Presence St. Joseph Center |
| FACILITY ADDRESS: | 659 East Jefferson St. |
| FACILITY CITY, STATE, ZIP: | Freeport, IL 61032 |
| DOCKET NUMBER: | 15-S0393 |
| LICENSEE INFO: | Presence Life Connections |
| LICENSEE ADDRESS: | 9223 West Saint Francis Rd |
| LICENSEE CITY, STATE, ZIP: | Frankfort, IL 60423 |
| Survey Date – 7/21/15 Type B violation for violating one or more sections: 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 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: | Presence Villa Franciscan |
| FACILITY ADDRESS: | 210 North Springfield Avenue |
| FACILITY CITY, STATE, ZIP: | Joliet, IL 60435 |
| DOCKET NUMBER: | 14-C0471 |
| LICENSEE INFO: | Presence Life Connection |
| LICENSEE ADDRESS: | 9223 West Saint Francis Road |
| LICENSEE CITY, STATE, ZIP: | Frankfort, IL 60423 |
| Survey Date – 10-7-14 FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. |
|
| FACILITY NAME: | Presence Villa Franciscan |
| FACILITY ADDRESS: | 210 North Springfield Avenue |
| FACILITY CITY, STATE, ZIP: | Joliet, IL 60435 |
| DOCKET NUMBER: | 14-C0472 |
| LICENSEE INFO: | Presence Life Connection |
| LICENSEE ADDRESS: | 9223 West Saint Francis Road |
| LICENSEE CITY, STATE, ZIP: | Frankfort, IL 60423 |
| Survey Date – 10-17-14 FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. |
|
| FACILITY NAME: | Riverwood Rehab |
| FACILITY ADDRESS: | 430 South 30th Ave |
| FACILITY CITY, STATE, ZIP: | East Moline, IL 61244 |
| DOCKET NUMBER: | 15-S0335 |
| LICENSEE INFO: | Riverwood Rehab, LLC |
| LICENSEE ADDRESS: | 8131 N Monticello |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 61244 |
| Survey Date – 7/17/15 Type B violation for violating one or more sections: 300.1230b), 300.1230d)1)2), 300.1230e), 300.1230h), 300.1230i), 300.1230j)1)5), 300.1230k), and 300.1230)1)2)3). No Fine. |
|
| FACILITY NAME: | Rock Island Nsg & Rehab Ctr |
| FACILITY ADDRESS: | 2545 24th Street |
| FACILITY CITY, STATE, ZIP: | Rock Island, IL 61201 |
| DOCKET NUMBER: | 15-C0294 |
| LICENSEE INFO: | Rock Island Nursing & Rehab Center, LLC |
| LICENSEE ADDRESS: | 6840 North Lincoln Avenue |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| FACILITY NAME: | St. Paul’s Home |
| FACILITY ADDRESS: | 1021 West E. St. |
| FACILITY CITY, STATE, ZIP: | Belleville, IL 62220 |
| DOCKET NUMBER: | 15-S0396 |
| LICENSEE INFO: | St. Paul’s Home |
| LICENSEE ADDRESS: | 23 Public Square #300 |
| LICENSEE CITY, STATE, ZIP: | Belleville, IL 62220 |
| Survey Date – 8/26/15 Type C violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)3), and 300.3240a). No fine. |
|
| FACILITY NAME: | St. Paul’s Home |
| FACILITY ADDRESS: | 1021 West E. St. |
| FACILITY CITY, STATE, ZIP: | Belleville, IL 62220 |
| DOCKET NUMBER: | 15-C0382 |
| LICENSEE INFO: | St Paul’s Home for the Aged |
| LICENSEE ADDRESS: | 23 Public Square #300 |
| LICENSEE CITY, STATE, ZIP: | Belleville, IL 62220 |
| Survey Date – 7/13/15 Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)2), 300.1210d)3), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: | Skokie Meadows Nrsg Center #2 |
| FACILITY ADDRESS: | 4600 West Golf Road |
| FACILITY CITY, STATE, ZIP: | Skokie, IL 60076 |
| DOCKET NUMBER: | 15-S0017 |
| LICENSEE INFO: | Skokie Meadows Nursing Centers II, LLC |
| LICENSEE ADDRESS: | 9615 North Knox Avenue |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 12-8-14 FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. |
|
| FACILITY NAME: | South Lawn Sheltered Care |
| FACILITY ADDRESS: | 512 South Franklin |
| FACILITY CITY, STATE, ZIP: | Bunker Hill, IL 62014 |
| DOCKET NUMBER: | 15-C0327 |
| LICENSEE INFO: | South Lawn Sheltered Care, Inc |
| LICENSEE ADDRESS: | RR 1, Route 159, PO Box H |
| LICENSEE CITY, STATE, ZIP: | Bunker Hill, IL 62014 |
| Survey Date – 7/2/15 Type B violation for violating one or more sections: 330.920d), 330.715a)c), and 330.725c)1)2)e)f)3)A)B)j)k)n)q). No fine. |
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| FACILITY NAME: | Southpoint Nrsg & Rehab Ctr |
| FACILITY ADDRESS: | 1010 West 95th Street |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60643 |
| DOCKET NUMBER: | 15-S0325 |
| LICENSEE INFO: | Southpoint Nrsg & Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 150 Fencl Lane |
| LICENSEE CITY, STATE, ZIP: | Hillside, IL 60162 |
| Survey Date – 6-11-15 Type B violation(s) of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.615. No fine. |
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| FACILITY NAME: | Springs at Crystal Lake |
| FACILITY ADDRESS: | 1000 East Brighton |
| FACILITY CITY, STATE, ZIP: | Crystal Lake, IL |
| DOCKET NUMBER: | 15-C0331 |
| LICENSEE INFO: | The Springs at Crystal Lake, LLC |
| LICENSEE ADDRESS: | 191 N. Wacker Dr., Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 6/30/15 Type C violation for violating one or more sections: 300.1210a), 300.1210c), 300.1210d)5), 300.1220b)3), and 300.3240a). No fine. |
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| FACILITY NAME: | Stephenson Nursing Center |
| FACILITY ADDRESS: | 2946 South Walnut Rd |
| FACILITY CITY, STATE, ZIP: | Freeport, IL 61032 |
| DOCKET NUMBER: | 15-C0351 |
| LICENSEE INFO: | Stephenson County Board of Supervisors |
| LICENSEE ADDRESS: | 50 W. Douglas St., Ste 1002 |
| LICENSEE CITY, STATE, ZIP: | Freeport, IL 61032 |
| Survey Date – 7/29/15 Type B violation for violating one or more sections: 300.690b) and 300.690c). No fine. |
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| FACILITY NAME: | Sterling Pavilion |
| FACILITY ADDRESS: | 105 East 23rd Street |
| FACILITY CITY, STATE, ZIP: | Sterling, IL 61081 |
| DOCKET NUMBER: | 15-S0291 |
| LICENSEE INFO: | Sterling Pavilion, Ltd |
| LICENSEE ADDRESS: | 191 North Wacker Dr. Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 6-9-15 1. Type B violation for violating one or more sections: 300.610a), 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: 300.1210d)5) and 300.3240a). For a total fine of $2,200.00. 2. Type B violation for violating one or more sections: 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 following sections of the Code with a high risk designation: 300.1210d)6), 300.1210b)5) and 300.3240a). For a total fine of $2,200.00. 3. Type B violation for violating one or more sections: 300.1010h), 300.1210b, 300.2040d), and 300.3240a). 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. |
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| FACILITY NAME: | Sterling Pavilion |
| FACILITY ADDRESS: | 105 East 23rd St |
| FACILITY CITY, STATE, ZIP: | Sterling, IL 61081 |
| DOCKET NUMBER: | 15-S0383 |
| LICENSEE INFO: | Sterling Pavilion, LTD |
| LICENSEE ADDRESS: | 191 North Wacker Dr., Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 8/6/15 Type B violation for violating one or more sections: 300.1210d)5). No fine. |
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| FACILITY NAME: | Sunset Rehabilitation & Hlth C |
| FACILITY ADDRESS: | 129 South 1st Avenue |
| FACILITY CITY, STATE, ZIP: | Canton, IL 61520 |
| DOCKET NUMBER: | 15-S0289 |
| LICENSEE INFO: | Sunset Home |
| LICENSEE ADDRESS: | 625 Vermont Street |
| LICENSEE CITY, STATE, ZIP: | Quincy, IL 62301 |
| Survey Date – 6-24-15 Type B violation(s) of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300:300.696A)C)2)7) and 300.2100. No fine. |
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| FACILITY NAME: | Swansea Rehab & Health Care Center |
| FACILITY ADDRESS: | 1405 North Second Street |
| FACILITY CITY, STATE, ZIP: | Swansea, IL 62226 |
| DOCKET NUMBER: | 14-C0333 |
| LICENSEE INFO: | Petersen Health Care II, 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: | Symphony of Evanston Healthcare |
| FACILITY ADDRESS: | 820 Foster St |
| FACILITY CITY, STATE, ZIP: | Evanston, IL 60201 |
| DOCKET NUMBER: | 15-S0381 |
| LICENSEE INFO: | Symphony of Evanston Healthcare, LLC |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 7/16/15 Type B violation for violating one or more sections: 300.7060a) and 300.615e). No fine. |
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| FACILITY NAME: | Thorton Heights Terrace |
| FACILITY ADDRESS: | 160 West 10th St. |
| FACILITY CITY, STATE, ZIP: | Chicago Heights, IL 60411 |
| DOCKET NUMBER: | 15-S0410 |
| LICENSEE INFO: | Thorton Heights Terrace, LTD |
| LICENSEE ADDRESS: | 465 Central Ave, Ste 100 |
| LICENSEE CITY, STATE, ZIP: | Northfield, IL 60093 |
| Survey Date – 8/13/15 Type B violation for violating one or more sections: 300.690b)c), 300.695a)3)b)c)1)2), and 300.3240d)f), No fine. |
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| FACILITY NAME: | Timber Point Healthcare Center |
| FACILITY ADDRESS: | 205 East Spring Street |
| FACILITY CITY, STATE, ZIP: | Camp Point, IL 62320 |
| DOCKET NUMBER: | 15-S0316 |
| LICENSEE INFO: | Timber Point Healthcare Center, Inc |
| LICENSEE ADDRESS: | 2201 Main Street |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60202 |
| Survey Date – 6-25-15 Type B violation(s) of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.615, 300.625, 300.690. No fine. |
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| FACILITY NAME: | Tri-State Nursing & Rehab Ctr |
| FACILITY ADDRESS: | 2500 East 175th Street |
| FACILITY CITY, STATE, ZIP: | Lansing, IL 60438 |
| DOCKET NUMBER: | 15-S0303 |
| LICENSEE INFO: | Tri-State Nursing & Rehabilitation Center, Inc |
| LICENSEE ADDRESS: | 2201 Main Street |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60202 |
| Survey Date – 6-4-15 Type B violation(s) of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.610a), 300.1210b), 300.1210d), 300.3240a). No fine. |
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| FACILITY NAME: | Twin Lakes Rehab & Health Care |
| FACILITY ADDRESS: | 310 Eads Ave |
| FACILITY CITY, STATE, ZIP: | Paris, IL 61944 |
| DOCKET NUMBER: | 15-S0322 |
| LICENSEE INFO: | Petersen Health Care II, Inc |
| LICENSEE ADDRESS: | 830 W Trailcreek Dr |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 6/26/15 4. Type B violation for violating one or more sections: 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 $2,200.00 5. Type B Violation of an occurrence for violating the following section of the Code: 300.690a), 300.690b), and 300.690c). No Fine. |
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| FACILITY NAME: | Warren Barr Lincolnshire |
| FACILITY ADDRESS: | 150 Jamestown Lane |
| FACILITY CITY, STATE, ZIP: | Lincolnshire, IL 60069 |
| DOCKET NUMBER: | 15-C0333 |
| LICENSEE INFO: | Lincolnshire Living and Rehab Center, LLC |
| LICENSEE ADDRESS: | 7040 N. Ridgeway |
| LICENSEE CITY, STATE, ZIP: | Lincolnshire, IL 60712 |
| Survey Date – 6/15/15 Type B violation for violating one or more sections: 300.1210b), 300.1210d)6), and 300.3240a). No Fine. |
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| FACILITY NAME: | Warren Barr Lincolnshire |
| FACILITY ADDRESS: | 150 Jamestown Lane |
| FACILITY CITY, STATE, ZIP: | Lincolnshire, IL 60069 |
| DOCKET NUMBER: | 15-S0411 |
| LICENSEE INFO: | Lincolnshire Living and Rehab Center, LLC |
| LICENSEE ADDRESS: | 7040 N Ridgeway |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 8/18/15 Type B violation for violating one or more sections: 300.610a), 300.1210a), 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 |
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| FACILITY NAME: | Waverly Place of Stockton |
| FACILITY ADDRESS: | 501 Front Street |
| FACILITY CITY, STATE, ZIP: | Stockton, IL 61085 |
| DOCKET NUMBER: | 15-C0355 |
| LICENSEE INFO: | Waverly Place of Stockton, LLC |
| LICENSEE ADDRESS: | 2711 W Howard Street |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60645 |
| Survey Date – 6/11/15 Type B violation for violating one or more sections: 300.610a), 300.1010H), 300.1210B)3), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)5), and 300.3240a). For a total fine of $2,200.00 |
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| FACILITY NAME: | West Chicago Terrace Nursing Home |
| FACILITY ADDRESS: | 928 Joliet Rd |
| FACILITY CITY, STATE, ZIP: | West Chicago, IL 60185 |
| DOCKET NUMBER: | 15-S0375 |
| LICENSEE INFO: | WCT Care, LLC |
| LICENSEE ADDRESS: | 1S443 Summitt Ave, Ste. 204 |
| LICENSEE CITY, STATE, ZIP: | Oakbrook Terrace, IL 60181 |
| Survey Date – 7/30/15 Type C violation for violating one or more sections: 300.690b)c). No Fine. |
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| FACILITY NAME: | Westchester Health & Rehab Ctr |
| FACILITY ADDRESS: | 2901 South Wolf Road |
| FACILITY CITY, STATE, ZIP: | Westchester, IL 60154 |
| DOCKET NUMBER: | 15-C0283 |
| LICENSEE INFO: | SSC Westchester Operating Company, LLC |
| LICENSEE ADDRESS: | 208 South LaSalle St, suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 6-3-15 Type B violation(s) of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.610a)< 300.1210b), 300.1210c), 300.1210d)6), 300.3240a). No Fine. |
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| FACILITY NAME: | Winchester House |
| FACILITY ADDRESS: | 1125 North Milwaukee Avenue |
| FACILITY CITY, STATE, ZIP: | Libertyville, IL 60048 |
| DOCKET NUMBER: | 15-C0323 |
| LICENSEE INFO: | County of Lake |
| LICENSEE ADDRESS: | 18 North County Street |
| LICENSEE CITY, STATE, ZIP: | Waukegan, IL 60085 |
| Survey Date – 6-3-15 Type B violation(s) of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.1210b), 300.1210c), 300.1210d)6), 300.1220b)3), 300.3240a). No Fine. |
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| FACILITY NAME: | Woodbridge Nursing Pavilion |
| FACILITY ADDRESS: | 2242 North Kedzie |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60647 |
| DOCKET NUMBER: | 15-C0320 |
| LICENSEE INFO: | Woodbridge Nursing Pavilion, LTD |
| LICENSEE ADDRESS: | 191 North Wacker Dr. ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 6-25-15 Type B violation(s) of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.1210a), 300.1210b), 300.1210c)3), 300.1210d)5). No fine. |
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| FACILITY NAME: | Watseka Rehab & Health Care Center |
| FACILITY ADDRESS: | 715 East Raymond Road |
| FACILITY CITY, STATE, ZIP: | Watseka, IL 60970 |
| DOCKET NUMBER: | NH 15-S0285 |
| LICENSEE INFO: | Peterson Health Care II, Inc. |
| LICENSEE ADDRESS: | 830 West Trailcreek Drive |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 5-26-2015 Type B violation(s) of the Act and the Skilled Nursing and Intermediate Care Facilities Code, 77 ILL Adm. Code 300: 300.1210b), 300.1210d)2), 300.1210d)6), 300.3240a). No Fine. |
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