| 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 Public Aid, 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: | Ambassador Nursing Center |
|---|---|
| FACILITY ADDRESS: | 4900 North Bernard Street |
| Chicago, Illinois 60625 | |
| DOCKET #: | NH 04-C0077 |
| NAME OF OWNER | |
| OR LICENSEE: | Ambassador Nursing and Rehabilitation Center, Inc. |
| ADDRESS: | 4900 North Bernard Street |
| Chicago, Illinois 60625 | |
| On May 3, 2004 sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $5,000. A hearing has been requested. | |
| FACILITY NAME: | Apostolic Christian Home Of Eureka |
| FACILITY ADDRESS: | 610 Cruger |
| Eureka, Illinois 61530 | |
| DOCKET #: | NH 04-S0087 |
| NAME OF OWNER | |
| OR LICENSEE: | Apostolic Christian Home of Eureka, Illinois |
| ADDRESS: | 610 West Cruger Street |
| Eureka, Illinois 61530 | |
| On May 11, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $20,000. A hearing has been requested. | |
| FACILITY NAME: | Asta Care Center of Rockford |
| FACILITY ADDRESS: | 707 West Riverside Boulevard |
| Rockford, Illinois 61103 | |
| DOCKET #: | NH 04-S0067 |
| NAME OF OWNER | |
| OR LICENSEE: | Asta Care Center of Rockford, L.L.C. |
| ADDRESS: | 134 North McLean Boulevard |
| Elgin, Illinois 60123 | |
| On May 3, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $5000. A hearing has been requested. | |
| FACILITY NAME: | Ballard Nursing Center |
| FACILITY ADDRESS: | 9300 Ballard Road |
| Des Plaines, Illinois 60016 | |
| DOCKET #: | NH 04-C0082 |
| NAME OF OWNER | |
| OR LICENSEE: | Ballard Nursing Center, Inc. |
| ADDRESS: | 9300 Ballard Road |
| Des Plaines, Illinois 60016 | |
| On May 12, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $5000. A hearing has been requested. | |
| FACILITY NAME: | Boxwood Health Care Center |
| FACILITY ADDRESS: | Memorial Drive, P.O. Box 319 |
| Newman, Illinois 61942 | |
| DOCKET #: | NH 04-S0080 |
| NAME OF OWNER | |
| OR LICENSEE: | Senior Living Properties, L.L.C. |
| ADDRESS: | 208 South LaSalle Street |
| Chicago, Illinois 60604 | |
| On May 3, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $5000. A hearing has been requested. | |
| FACILITY NAME: | Burnside Nursing Home |
| FACILITY ADDRESS: | 410 North Second Street |
| Marshall, Illinois 62441 | |
| DOCKET #: | NH 03-S0264 |
| NAME OF OWNER | |
| OR LICENSEE: | Burnside Nursing Home, A Non-Profit Corporation |
| ADDRESS: | 410 North Second Street |
| Marshall, Illinois 62441 | |
| By Final Order, Violation Affirmed, Fine Assessment Reduced and Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Cardinal Health Care |
| FACILITY ADDRESS: | 210 East College |
| Energy, Illinois 62933 | |
| DOCKET #: | NH 04-S0113 |
| NAME OF OWNER | |
| OR LICENSEE: | Bridgemark of Energy, L.L.C. |
| ADDRESS: | 600 South 2nd Street |
| Springfield, Illinois 62704 | |
| On June 11, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $5000. A hearing has been requested. | |
| FACILITY NAME: | Chestnut Manor |
| FACILITY ADDRESS: | 1404 South 14th Street |
| Herrin, Illinois 62226 | |
| DOCKET #: | NH 02-C0194 |
| NAME OF OWNER | |
| OR LICENSEE: | New Way Developers, Inc. |
| ADDRESS: | 105 South Commercial, P.O. Box 5 |
| Harrisburg, Illinois 62946 | |
| By Final Order, Violation Reduced, Fine Assessment Reduced and Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Colonial Plaza |
| FACILITY ADDRESS: | 618 West Goodner |
| Nashville, Illinois 62263 | |
| DOCKET #: | NH 04-C0110 |
| NAME OF OWNER | |
| OR LICENSEE: | Developmental Management, Inc. |
| ADDRESS: | 15755 Nixon Road |
| Nashville, Illinois 62863 | |
| On May 27, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $10,000. A hearing has been requested. | |
| FACILITY NAME: | Cornerstone Home |
| FACILITY ADDRESS: | 1009 South Irving |
| Monticello, Illinois 61856 | |
| DOCKET #: | NH 04-S0083 |
| NAME OF OWNER | |
| OF LICENSEE: | The Residential Developers, Inc. |
| ADDRESS: | 30 Main Street, P.O. Box 560 |
| Champaign, Illinois 61820 | |
| On May 11, 2004, sent Notice of Type “A” Violation relating to the area of nursing,and Notice of Fine Assessment of $20,000. A hearing has been requested. | |
| FACILITY NAME: | Dolton Healthcare Centre |
| FACILITY ADDRESS: | 14325 South Blackstone |
| Dolton, Illinois 60419 | |
| DOCKET #: | NH 04-C0056 |
| NAME OF OWNER | |
| OR LICENSEE: | Drew Corporation |
| ADDRESS: | 2576 North Greenwood Road |
| Cerro Gordo, Illinois 61818 | |
| On April 20, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $ 5000. | |
| FACILITY NAME: | East Side Terrace |
| FACILITY ADDRESS: | 3850 East Fulton |
| Decatur, Illinois 62521 | |
| DOCKET #: | NH 04-o0051 |
| NAME OF OWNER | |
| OR LICENSEE: | Gregory Scott Cornell |
| ADDRESS: | 805 East Johns Avenue |
| Decatur, Illinois 62521 | |
| On April 5, 2004, sent Notice of Type Repeat “A” Violation relating to the area of nursing, Notice of License Revocation and Notice of Fine Assessment of $30,000. A hearing has been requested. | |
| FACILITY NAME: | Emerald Park Health Care Center |
| FACILITY ADDRESS: | 9125 South Pulaski |
| Evergreen Park, Illinois 60805 | |
| DOCKET #: | NH 04-o0071 |
| NAME OF OWNER | |
| OR LICENSEE: | Emerald Park Health Care Center, Inc. |
| ADDRESS: | 7366 N. Lincoln Ave., Ste. 404 |
| Lincolnwood, Illinois 60712 | |
| On June 16, 2004, sent Notice of Type “A” Violation relating to the area of nursing, Notice of License Revocation and Notice of Fine Assessment of $10,000. A hearing has been requested. | |
| FACILITY NAME: | Forest Hill Health and Rehab Center |
| FACILITY ADDRESS: | 4747 11th Street |
| East Moline, Illinois 61244 | |
| DOCKET #: | NH 04-C0106 |
| NAME OF OWNER | |
| OR LICENSEE: | Forest Hill Health and Rehab Center, Inc. |
| ADDRESS: | 3553 W. Peterson, Suite #101 |
| Chicago, Illinois 60659 | |
| On May 21, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $10,000. A hearing has been requested. | |
| FACILITY NAME: | Fox River Pavilion |
| FACILITY ADDRESS: | 400 East New York Street |
| Aurora, Illinois 60505 | |
| DOCKET #: | NH 04-S0057 |
| NAME OF OWNER | |
| OR LICENSEE: | Fox River Pavilion, Limited Partnership |
| ADDRESS: | 8950 Gross Point Road, Suite E |
| Skokie, Illinois 60077 | |
| On April 20, 2004, sent Notice of Type ”A” Violation relating to the area of nursing and Notice of Fine Assessment of $25,000. | |
| FACILITY NAME: | Good Samaritan Home |
| FACILITY ADDRESS: | 2130 Harrison Street |
| Quincy, Illinois 62301 | |
| DOCKET #: | NH 04-S0116 |
| NAME OF OWNER | |
| OR LICENSEE: | The Good Samaritan Home of Quincy |
| ADDRESS: | 2130 Harrison Street |
| Quincy, Illinois 62301 | |
| On June 11, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $5000. A hearing has been requested. | |
| FACILITY NAME: | Heritage Manor-Chillicothe |
| FACILITY ADDRESS: | 1028 Hillcrest Drive |
| Chillicothe, Illinois 61523 | |
| DOCKET #: | NH 04-C0115 |
| NAME OF OWNER | |
| OR LICENSEE: | Heritage Enterprises, Inc. |
| ADDRESS: | 115 W. Jefferson Street, #401 |
| Bloomington, Illinois 61701 | |
| On June 11, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $10,000. A hearing has been requested. | |
| FACILITY NAME: | Jennings Terrace |
| FACILITY ADDRESS: | 275 South LaSalle |
| Aurora, Illinois 60505 | |
| DOCKET #: | NH 04-C0076 |
| NAME OF OWNER | |
| OR LICENSEE: | Jennings Terrace |
| ADRESS: | 275 S. LaSalle Street |
| Aurora, Illinois 60505 | |
| On May 12, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $50,000. A hearing has been requested. | |
| FACILITY NAME: | The Lincoln Home |
| FACILITY ADDRESS: | 150 North 27th Street |
| Belleville, Illinois 62226 | |
| DOCKET #: | NH 04-C0005 |
| NAME OF OWNER | |
| OR LICENSEE: | The Lincoln Home, Inc. |
| ADDRESS: | 465 Central Avenue, Ste. 100 |
| Northfield, Illinois 60093 | |
| By Final Order, Violation Affirmed, Fine Assessment reduced reflecting Federal fine paid and Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Lynwood Estates |
| FACILITY ADDRESS: | 301 Roddy Road |
| Salem, Illinois 62881 | |
| DOCKET #: | NH 04-C0114 |
| NAME OF OWNER | |
| OR LICENSEE: | Penta Nascent Corporation |
| ADDRESS: | 623 East Broadway |
| Centralia, Illinois 62801 | |
| On June 11, 2004, sent Notice of Type “A” violation relating to the area of policy and procedures and Notice of Fine Assessment of $5,000. A hearing request has been requested. | |
| FACILITY NAME: | Maple Ridge Care Centre |
| FACILITY ADDRESS: | 2202 North Kickapoo Street |
| Lincoln, Illinois 62656 | |
| DOCKET #: | NH 04-C0055 |
| NAME OF OWNER | |
| OR LICENSEE: | Maple Ridge Care Center, L.L.C. |
| ADDRESS: | 8140 River Drive |
| Morton Grove, Illinois 60053 | |
| On April 13, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $5000. A hearing has been requested. | |
| FACILITY NAME: | Meadowbrook Manor-Naperville |
| FACILITY ADDRESS: | 720 Raymond Drive |
| Naperville, Illinois 60563 | |
| DOCKET #: | NH 02-C0087 |
| NAME OF OWNER | |
| OR LICENSEE: | Butterfield Health Care II, Inc. |
| ADDRESS: | 4N 645 School Road |
| St. Charles, Illinois 60175 | |
| By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Mount St. Joseph |
| FACILITY ADDRESS: | 24955 North Highway 12 |
| Lake Zurich, Illinois 60047 | |
| DOCKET #: | NH 02-S0222 |
| NAME OF OWNER | |
| OR LICENSEE: | Mount St. Joseph |
| ADDRESS: | 24955 North Highway 12 |
| Lake Zurich, Illinois 6004 | |
| By Final Order, Violation Affirmed, Fine Assessment Reduced and Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Oak Grove Rehab and Skilled Care |
| FACILITY ADDRESS: | 120 North Tower Road |
| Carbondale, Illinois 62901 | |
| DOCKET #: | NH 04-S0060 |
| NAME OF OWNER | |
| OR LICENSEE: | The Willow of Carbondale, Inc. |
| ADDRESS: | 30 South Wacker Drive, 29th Floor |
| Chicago, Illinois 60606 | |
| On April 23, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $5000. A hearing has been requested. | |
| FACILITY NAME: | Oakbrook Healthcare Centre |
| FACILITY ADDRESS: | 2013 Midwest Road |
| Oakbrook, Illinois 60521 | |
| DOCKET #: | NH 04-C0079 |
| NAME OF OWNER | |
| OR LICENSEE: | Oakbrook Healthcare Centre, LTD. |
| ADDRESS: | 7366 North Lincoln, Suite 305 |
| Lincolnwood, Illinois 60646 | |
| On May 12, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $10,000. | |
| FACILITY NAME: | Pine Lawn Manor |
| FACILITY ADDRESS: | 200 Poplar Drive |
| Sumner, Illinois 62466 | |
| DOCKET #: | 04-o0109 |
| NAME OF OWNER | |
| OR LICENSEE: | Saint Simons Healthcare, L.L.C. |
| ADDRESS: | 208 South LaSalle Street |
| Chicago, Illinois 60604 | |
| On June 7, 2004, sent Notice of Type “A” Violation relating to the area of policy and procedures, Notice of License Revocation and Notice of Fine Assessment of $95,000. A hearing had been requested. | |
| FACILITY NAME: | Prairie City Health Care Center |
| FACILITY ADDRESS: | 825 East Main Street, RR #2, Box #97 |
| Prairie City, Illinois 61470 | |
| DOCKET #: | NH 04-S0078 |
| NAME OF OWNER | |
| OR LICENSEE: | Prairie City Health Care Center, Inc |
| ADDRESS: | 121 West Elm Street, P.O. Box 400 |
| Canton, Illinois 61520 | |
| On May 3, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $5,000. | |
| FACILITY NAME: | Regency Nursing Care Residence |
| FACILITY ADDRESS: | 2120 West Washington |
| Springfield, Illinois 62702 | |
| DOCKET #: | NH 04-C0084 |
| NAME OF OWNER | |
| OR LICENSEE: | Parentech, Inc. |
| ADDRESS: | 15 South Old State Capitol Plaza |
| Springfield, Illinois 62701 | |
| On May 12, 2004, sent Notice of Type “A” Violations relating to the area of nursing and Notice of Fine Assessment of $20,000. A hearing has been requested. | |
| FACILITY NAME: | Rockford Health Care Center |
| FACILITY ADDRESS: | 310 Arnold Avenue |
| Rockford, Illinois 61108 | |
| DOCKET #: | NH 03-S0160 |
| NAME OF OWNER | |
| OR LICENSEE: | Nexion Health at Rockford, Inc. |
| ADDRESS: | 208 South LaSalle Street |
| Chicago, Illinois 60604 | |
| By Final Order, Violation Amended, Fine Assessment Reduced reflecting Federal fine paid, and Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Sheridan Health Care Center |
| FACILITY ADDRESS: | 2534 Elim Avenue |
| Zion, Illinois 60099 | |
| DOCKET #: | NH 04-C0085 |
| NAME OF OWNER | |
| OR LICENSEE: | Sheridan Health Care Associates |
| ADDRESS: | 2534 Elim Avenue |
| Zion, Illinois 60099 | |
| On May 12, 2004, sent Notice of Type “A” Violation relating to the area of policy and procedure and Notice of Fine Assessment of $10,000. A hearing has been requested. | |
| FACILITY NAME: | Sterling Pavilion |
| FACILITY ADDRESS: | 105 East 23rd Street |
| Sterling, Illinois 61081 | |
| DOCKET #: | NH 03-S0053 |
| NAME OF OWNER | |
| OR LICENSEE: | Sterling Pavilion, Ltd. |
| ADDRESS: | 30 South Wacker Drive, 29th Floor |
| Chicago, Illinois 60606 | |
| By Final Order, Violation Amended, Fine Assessment Reduced reflecting Federal fine paid and Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Taylor House |
| FACILITY ADDRESS: | 3021 Taylor Avenue |
| Springfield, Illinois 62703 | |
| DOCKET #: | NH 04-C0120 |
| NAME OF OWNER | |
| OR LICENSEE: | Community Living Options, Inc. |
| ADDRESS: | 115st South Street |
| Galesburg, Illinois 61401 | |
| On June 25, 2004, sent Notice of Type “A” Violation relating to the area of policy and procedure and Notice of Fine Assessment of $10,000. A hearing has been requested. | |
| FACILITY NAME: | Thomas Herbstritt House |
| FACILITY ADDRESS: | 4003 N. Rtes 1 & 17, P.O. Box 260 |
| Momence, Illinois 60954 | |
| DOCKET #: | 04-S0095 |
| NAME OF OWNER | |
| OR LICENSEE: | Good Shepherd Manor Group Homes, Inc. |
| ADDRESS: | 4129 N. Rtes 1 & 17, P.O. Box 260 |
| Momence, Illinois 60954 | |
| On May 14, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $10,000. A hearing has been requested. | |
| FACILITY NAME: | Walnut Manor |
| FACILITY ADDRESS: | 308 South Second Street |
| Walnut, Illinois 61376 | |
| DOCKET #: | NH 04-S0101 |
| NAME OF OWNER | |
| OR LICENSEE: | Walnut Manor, Inc. |
| ADDRESS: | 308 South 2nd Street, P.O. Box 623 |
| Walnut, Illinois 61376 | |
| On May 18, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $5,000. A hearing has been requested. | |
| FACILITY NAME: | Warren Barr Pavilion |
| FACILITY ADDRESS: | 66 West Oak Street |
| Chicago, Illinois 60610 | |
| DOCKET #: | NH 04-C0118 |
| NAME OF OWNER | |
| OR LICENSEE: | Warren Barr Nursing Pavilion, L.L.C. |
| ADDRESS: | 30 South Wacker Drive, 29th Floor |
| Chicago, Illinois 60606 | |
| On June 29, 2004, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $10,000. | |
| FACILITY NAME: | Winston Manor Convalescent and Nursing |
| FACILITY ADDRESS: | 2155 West Pierce |
| Chicago, Illinois 60622 | |
| DOCKET #: | NH 04-C0054 |
| NAME OF OWNER | |
| OR LICENSEE: | RREM, Inc. |
| ADDRESS: | 2450 North Central Avenue |
| Chicago, Illinois 60639 | |
| On April 9, 2004,sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $10,000. A hearing has been requested. | |
| FACILITY NAME: | Woodstock Residence |
| FACILITY ADDRESS: | 309 McHenry Avenue |
| Woodstock, Illinois 60098 | |
| DOCKET #: | NH 04-S0011 |
| NAME OF OWNER | |
| OR LICENSEE: | WRHC & RC, Inc. |
| ADDRESS: | 30 South Wacker Drive, 29th Floor |
| Chicago, Illinois 60606 | |
| By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn. | |
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Illinois Department
of Public Health 535 West Jefferson Street Springfield, Illinois 62761 Phone 217-782-4977 Fax 217-782-3987 TTY 800-547-0466 Questions or Comments |