Nursing Homes in Illinois

QUARTERLY REPORT

July - September 2013

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: Asta Care of Pontiac
FACILITY ADDRESS: 300 West Lowell
Pontiac, IL 61764

DOCKET #: NH 13-S0357
LICENSEE INFO: Asta Care of Pontiac, LLC
ADDRESS: 134 N. McLean Boulevard
Elgin, IL 60123

Re: Survey Date – July 18, 2013 Type B violation for violating one or more sections: 300.610a), 300.1210b)4)5), 300.1210d)6), 300.3240a). The fine was doubled in this instance in accordance with 300.282 i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)6), 300.3240a). For a total fine of $2200.

FACILITY NAME: Asta Care of Rockford
FACILITY ADDRESS: 707 West Riverside Boulevard
Rockford, IL 61103

DOCKET #: NH 13-C0312
LICENSEE INFO: Asta Care of Rockford, LLC
ADDRESS: 134 N. McLean Boulevard
Elgin, IL 60123

Re: Survey Date – July 3, 2013 Type B violation for violating one or more sections of 300.610a), 300.1010g), 300.1210c), 300.1210d)2)3)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.

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

DOCKET #: NH 13-C0356
LICENSEE INFO: Bellwood Nursing Center, LLC
ADDRESS: 5750 Old Orchard Road, Suite 420
Skokie, IL 60077

Re: Survey Date – July 26, 2013 Type B violation for violating one or more sections of 350.620a), 350.1060e), 350.3240a). For a total fine of $750.

FACILITY NAME: Bement Health Care Center
FACILITY ADDRESS: 601 North Morgan
Bement, IL 61813

DOCKET #: NH 13-C0278
LICENSEE INFO: Petersen Health Care, Inc.
ADDRESS: 830 West Trailcreek Drive
Peoria, IL 61614

Re: Survey Date – May 30, 2013 Type A violation for violating one or more of sections 300.1010h), 300.1210b), 300-1210b)5), 300.1210d)3), and 300.3240a), a fine of $25,000. 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), 300.1210b)5) and 300.3240a). For a total fine of $25,000.00

FACILITY NAME: Bethalto Care Center
FACILITY ADDRESS: 815 South Prairie St.
Bethalto, IL 62010

DOCKET #: NH 13-S0377
LICENSEE INFO: Bethalto Care Center, Inc.
ADDRESS: 11 Fall Creek Lane
St. Jacobs, IL 62281

Re: Survey Date – August 2, 2013 Type A violation for violating one or more sections of 300.680a), 300.1210a), 300.1210b), and 300.2420j). For a total fine of $12,500.

FACILITY NAME: Bridgeway Christian Village Rehab & SNF
FACILITY ADDRESS: 111 East Washington St.
Bensenville, IL 60106

DOCKET #: NH 13-C0284
LICENSEE INFO: Midwest Senior Ministries, Inc.
ADDRESS: 200 North Postville Drive
Lincoln, IL 62656

Re: Survey Date – May 30, 2013 B violation for violating one or more of sections 300.610a), 300.1210b), and 300.3240a). For a total fine of $1,100.

FACILITY NAME: Bronzeville Park Nursing & Living Center
FACILITY ADDRESS: 3400 South Indiana
Chicago, IL 60616

DOCKET #: NH 13-C0416
LICENSEE INFO: Chevy Chase Corp.
ADDRESS: 191 North Wacker Drive, Suite 1800
Chicago, IL 60606

Re: Survey Date – August 9, 2013 Type B violation for violating one or more sections 300.610a, 300.1210a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i)and (j) of the Code due to the violation of the 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: Brother James Court
FACILITY ADDRESS: 2508 St. James Road
Springfield, IL 62707

DOCKET #: NH 13-S0398
LICENSEE INFO: Brother James Court
ADDRESS: 1214 South 8th St.
Springfield, IL 62703

Re: Survey Date – August 22, 2013

For a total fine of 4,500.

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

DOCKET #: NH 13-S0409
LICENSEE INFO: The Chalet Living and Rehabilitation Center, LLC
ADDRESS: 191 North Wacker Drive, Suite 1800
Chicago, IL 60606

Re: Survey Date – August 15, 2013 Type B violation for violating one or more sections 300.1210a), 300.1210b), 300.1210d)3), 300.3240a), and 300.3240f). The fine was doubled in this instance in accordance with 300.282i)and (j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.

FACILITY NAME: Children's Habilitation Center
FACILITY ADDRESS: 121 West 154th St.
Harvey, IL 60426

DOCKET #: NH 13-S0096
LICENSEE INFO: Children's Habilitation Center, Inc.
ADDRESS: 121 West 154th St.
Harvey, IL 60426

Re: Survey Date – February 6, 2013 Type A violation for violating one or more of sections 390.620a), 390.620b)6), 390.700a), and 390.3240a). For a total fine of $10,000.

FACILITY NAME: Claridge Healthcare Center
FACILITY ADDRESS: 700 Jenkisson Avenue
Lake Bluff, IL 60044

DOCKET #: NH 13-S0359
LICENSEE INFO: Claridge Operations, LLC
ADDRESS: 325 N. Wells, 9th Floor
Chicago, IL 60610

Re: Survey Date – July 23, 2013 Type B violation for violating one or more sections: 300.1210b), 300.1210d)6), 300.1220b)3), 300.3240a). The fine was doubled in this instance in accordance with 300.282 i) 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), 300.3240a). For a total fine of $2,200.

FACILITY NAME: Crestwood Terrace Nursing Center
FACILITY ADDRESS: 13301 South Central Avenue
Crestwood, IL 60445

DOCKET #: NH 13-C0313
LICENSEE INFO: CT Care, LLC
ADDRESS: 1S443 Summit Avenue, Suite 204
Oakbrook Terrace, IL 60181

Re: Survey Date – June 20, 2013

For a total fine of $4,400.

FACILITY NAME: Dixon Rehab & HCC
FACILITY ADDRESS: 800 Division St.
Dixon, IL 61021

DOCKET #: NH 13-C0407
LICENSEE INFO: Dixon Manor, LLC
ADDRESS: 412 East Lawrence
Springfield, IL 62703

Re: Survey Date – August 13, 2013

For a total fine of $3,300.

FACILITY NAME: Forest View Rehab & Nursing Center
FACILITY ADDRESS: 535 South Elm
Itasca, IL 60143

DOCKET #: NH 13-C0370
LICENSEE INFO: Forest View Rehabilitation and Nursing Center, LLC
ADDRESS: 150 Fencl Lane
Hillside, IL 60162

Re: Survey Date – July 29, 2013 Type B violation for violating one or more sections of 300.610a), 300.1010h), 300.1210b), 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). A total fine of $2,200.

FACILITY NAME: Fosterburg Terrace
FACILITY ADDRESS: 4617 Wonderland Drive
Alton, IL 62002

DOCKET #: NH 13-S0431
LICENSEE INFO: Challenge Unlimited, Inc.
ADDRESS: #4 Emmie L Kaus Lane
Alton, IL 62002

Re: Survey Date – July 29, 2013 Type B violation for violating one or more sections 350.620a), 350.1210, 350.1230b)6)7), 350.1230d)2), 350.1230g), and 350.3240a. For a total fine of $550.

FACILITY NAME: Frankfort Healthcare & Rehabilitation Center
FACILITY ADDRESS: 2500 East St. Louis St.
West Frankfort, IL 62896

DOCKET #: NH 13-C0249
LICENSEE INFO: Frankfort Healthcare & Rehabilitation Center, LLC
ADDRESS: 600 South Second St.
Springfield, IL 62704

Re: Survey Date – May 9, 2013 Type B violation for violating one or more of sections 300.1010h), 300.1210b), 300.1210d)3)4)A)5)), 300.1220b)2), 300.3240a) a fine of $2,200. 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: Franklin Grove Group Home
FACILITY ADDRESS: 408 North Elm, P.O. Box 5
Franklin Grove, IL 61031

DOCKET #: NH 13-S0430
LICENSEE INFO: Kreider Services, Incorporated
ADDRESS: 500 Anchor Road, P.O. Box 366
Dixon, IL 61021

Re: Survey Date – August 22, 2013 Type A violation for violating one or more sections 350.1235a)3)4) and 350.3240a). A total fine of $6,250.

FACILITY NAME: Grove of LaGrange Park
FACILITY ADDRESS: 701 North LaGrange Road
LaGrange Park, IL 60526

DOCKET #: NH 13-S0385
LICENSEE INFO: The Grove of LaGrange Park, LLC
ADDRESS: 5750 Old Orchard Road, Suite 420
Skokie, IL 60077

Re: Survey Date – July 26, 2013 Type B violation for violating one or more sections 300.610a), 300.1210a), 300.1210b), 300.1210d)3), 300.1220b)2)3) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and (j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.

FACILITY NAME: Harbor Crest Home
FACILITY ADDRESS: 817 17th St.
Fulton, IL 61252

DOCKET #: NH 13-S0289
LICENSEE INFO: Harbor Crest
ADDRESS: 817 17th St.
Fulton, IL 61252

Re: Survey Date – May 28, 2013

For a total fine of $2,200.

FACILITY NAME: Helia Healthcare of Belleville
FACILITY ADDRESS: 40 North 64th St.
Belleville, IL 62223

DOCKET #: NH 13-C0383
LICENSEE INFO: Helia Healthcare of Belleville, LLC
ADDRESS: 600 South Second St., Suite 103
Springfield, IL 62704

Re: Survey Date – July 31, 2013 Type B violation for violating one or more sections 300.610a), 300.1010h), 300.1210b), 300.1210c), 300.1210d)3), 300.1810h), 300.1220b)2)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i)and (j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.

FACILITY NAME: Helia Healthcare of Champaign
FACILITY ADDRESS: 1915 South Mattis St.
Champaign, IL 61821

DOCKET #: NH 13-C0277
LICENSEE INFO: Helia Healthcare of Champaign, LLC
ADDRESS: 600 South 2nd St., Suite 103
Springfield, IL 62704

Re: Survey Date – May 16, 2013 Type B violation for violating one or more of sections 300.610a), 300.690a), 3001210a), 3001210b), 3001210d)6), and 300.3240a). The fine 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 high risk designation: 300.690, 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.

FACILITY NAME: Home Bridge Center
FACILITY ADDRESS: 1701 West 5th Avenue
Belvidere, IL 61008

DOCKET #: NH 13-S0286
LICENSEE INFO: Home Bridge Center, LLC
ADDRESS: 107 South Thirds St., Suite 3
Bloomingdale, IL 60108

Re: Survey Date – June 10, 2013

For a total fine of $4,400.

FACILITY NAME: Illinois Veterans' Home at Manteno
FACILITY ADDRESS: One Veteran's Drive
Manteno, IL 60950

DOCKET #: NH 13-S0351
LICENSEE INFO: Illinois Department of Veterans' Affairs
ADDRESS: 833 South Spring St., Box 19432
Springfield, IL 62794

Re: Survey Date – July 19, 2013 Type A violation for violating one or more sections of 340.1310d), 340.1440f), 340.1505b), 340.1505d)3), and 340.1505g). The fine was doubled in this instance in accordance with 340.1245j) of the Code due to the violation of the following sections of the Code with a high risk designation: 340.1505b) and 340.1505g). For a total fine of $25,000.

FACILITY NAME: Illinois Knights Templar Home
FACILITY ADDRESS: 450 Fulton St., P.O. Box 49
Paxton, IL 60957

DOCKET #: NH 13-S0305
LICENSEE INFO: Illinois Knights Templar Home
ADDRESS: 190 South LaSalle St., Suite 3700
Chicago, IL 60603

Re: Survey Date – May 15, 2013

For a total fine of $37,500.

FACILITY NAME: Leroy Manor
FACILITY ADDRESS: 509 South Buck Road, P.O. Box 149
Leroy, IL 61752

DOCKET #: NH 13-S0303
LICENSEE INFO: UDI #4, LLC
ADDRESS: 285 South Farnham St.
Galesburg, IL 61401

Re: Survey Date – June 13, 2013 Type B violation for violating one or more of sections 300.1010h), 300.1210b)3), 300.1220b)8), and 300.3240a). For a total fine of $1,100.

FACILITY NAME: Lieberman Center for Health & Rehab
FACILITY ADDRESS: 9700 Gross Point Road
Skokie, IL 60076

DOCKET #: NH 13-S0402
LICENSEE INFO: Council for Jewish Elderly
ADDRESS: 3003 West Touhy Avenue
Chicago, IL 60645

Re: Survey Date – August 14, 2013 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.

FACILITY NAME: Lutheran Home for the Aged
FACILITY ADDRESS: 800 West Oakton St.
Arlington Heights, IL 60004

DOCKET #: NH 13-S0287
LICENSEE INFO: Lutheran Home for the Aged
ADDRESS: 800 West Oakton St.
Arlington Heights, IL 60004

Re: Survey Date – May 30, 2013 Type B violation for violating one or more of sections 300.610a), 300.1210d)6), and 300.3240a). For a total fine of $1,100.

FACILITY NAME: Manorcare of Naperville
FACILITY ADDRESS: 200 Martin Avenue
Naperville, IL 60540

DOCKET #: NH 13-C0406
LICENSEE INFO: Manor Care of Naperville IL, LLC
ADDRESS: 208 South LaSalle St., Suite 814
Chicago, IL 60604

Re: Survey Date – August 15, 2013 Type B violation for violating one or more sections 300.1210b), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i)and (j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.

FACILITY NAME: Mar Ka Nursing Home
FACILITY ADDRESS: 201 South 10th St.
Mascoutah, IL 62258

DOCKET #: NH 13-S0363
LICENSEE INFO: Community Care Center of Mascoutah
ADDRESS: 21 South 10th St.
Mascoutah, IL 62258

Re: Survey Date – July 18, 2013

A total fine of $50,000.

FACILITY NAME: McAllister Nursing and Rehab
FACILITY ADDRESS: 18300 South Lavergne Avenue
Tinley Park, IL 60477

DOCKET #: NH 13-S0435
LICENSEE INFO: McAllister Nursing and Rehab LLC
ADDRESS: 9100 Karlov Avenue
Skokie, IL 60076

Re: Survey Date – August 27, 2013 Type B violation for violating one or more sections 300.610a), 300.1210b), 300.1210c), 300.1220b)3), 300.3100d)2) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i)and (j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A total fine of $2,200.

FACILITY NAME: Mooring Health Center
FACILITY ADDRESS: 761 Old Barn Lane
Arlington Heights, IL 60005

DOCKET #: NH 13-S0393
LICENSEE INFO: Presbyterian Homes
ADDRESS: 3200 Grant St.
Evanston, IL 60201

Re: Survey Date – August 8, 2013 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.

FACILITY NAME: Mooring Health Center
FACILITY ADDRESS: 761 Old Barn Lane
Arlington Heights, IL 60005

DOCKET #: NH 13-S0295
LICENSEE INFO: Presbyterian Homes
ADDRESS: 3200 Grant St.
Evanston, IL 60201

Re: Survey Date – June 10, 2013 Type B violation for violating one or more of 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.

FACILITY NAME: Our Lady of Angels Retirement Home
FACILITY ADDRESS: 1201 Wyoming Avenue
Joliet, IL 60435

DOCKET #: NH 13-S0301
LICENSEE INFO: Our Lady of Angels Retirement Home
ADDRESS: 2801 Black Road, 2nd Floor
Joliet, IL 60435

Re: Survey Date – June 12, 2013

For a total fine of $2,200.

FACILITY NAME: Parents & Friends of the SLC
FACILITY ADDRESS: 1450 Caseyville Avenue
Swansea, IL 62226

DOCKET #: NH 13-C0415
LICENSEE INFO: Parents and Friends of the Specialized Living Center
ADDRESS: 1450 Caseyville Avenue
Swansea, IL 62226

Re: Survey Date – July 25, 2013 Type B violation for violating one or more sections of 350.620a), 350.1210, 350.1230b)6)7), 350.1230d)2), 350.1230g), and 350.3240a). For a total fine of $1,100.

FACILITY NAME: Paris Health Care Center
FACILITY ADDRESS: 1011 North Main St.
Paris, IL 61944

DOCKET #: NH 13-S0358
LICENSEE INFO: Paris Health Care Center Investors, LLC
ADDRESS: 8170 North McCormick Boulevard, Suite 219
Skokie, IL 60076

Re: Survey Date – July 26, 2013 Type B violation for violating one or more sections 300.1210b), 300.1210d)2), 300.1210d)4)A), 300.1210d)6), 300.3240a). The fine was doubled in this instance in accordance with 300.282 i) 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), 300.3240a). For a total fine of $2,200.

FACILITY NAME: Renaissance at 87th St.
FACILITY ADDRESS: 2940 West 87th St.
Chicago, IL 60652

DOCKET #: NH 13-C0348
LICENSEE INFO: The Renaissance at 87th St., Inc
ADDRESS: 191 North Wacker Drive, Suite 1800
Chicago, IL 60606

Re: Survey Date – June 20, 2013 Type B violation for violating one or more sections 300.610a), 300.690a), 300.1210a), 300.1210b), 300.1210c)6), 300.3240a). The fine was doubled in this instance in accordance with 300.282 i) 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). For a total fine of $2,200.

FACILITY NAME: Rochelle Gardens Care Center
FACILITY ADDRESS: 1021 Caron Road
Rochelle, IL 61068

DOCKET #: NH 13-C0332
LICENSEE INFO: Petersen Health Network, LLC
ADDRESS: 830 W. Trailcreek Drive
Peoria, IL 61614

Re: Survey Date – June 18, 2013 Type B violation for violating one or more sections of 300.610a), 300.1210b), 300.3240a), 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 rish designation: 300.1210b), 300.3240a), and 300.3240e). For a total fine of $2,200.00.

FACILITY NAME: St. Mary's Square Living Center
FACILITY ADDRESS: 239 South Cherry St.
Galesburg, IL 61401

DOCKET #: NH 13-S0297
LICENSEE INFO: Community Residential Centers, Inc.
ADDRESS: 239 South Cherry St.
Galesburg, IL 61401

Re: Survey Date – June 5, 2013 Type A violation for violating one or more of sections 350.620a), 350.1210, 350.1230b)3)5)6)7), 350.1230d)2), 350.1230g), 350.3240a). A total fine of $12,500.

FACILITY NAME: St. Mary's Square Living Center
FACILITY ADDRESS: 239 South Cherry St.
Galesburg, IL 61401

DOCKET #: NH 13-C0292
LICENSEE INFO: Community Residential Centers, Inc.
ADDRESS: 239 South Cherry St.
Galesburg, IL 61401

Re: Survey Date – May 22, 2013 Type B violation for violating one or more of sections 350.620a), 350.1230b)6)7), 350.1230d)2), 350.1230g), 350.3240a), 350.3240c). A total fine of $1,100.

FACILITY NAME: Shawnee Christian Nursing Center
FACILITY ADDRESS: 1901 North 13th St.
Herrin, IL 62948

DOCKET #: NH 13-S0382
LICENSEE INFO: Shawnee Christian Nursing Center, LLC
ADDRESS: 23 South First St.
Belleville, IL 62220

Re: Survey Date – July 19, 2013 Type B violation for violating one or more sections 300.610a), 300.1210a), 300.1210b), 300.1210c), 300.1210d)6), 300.1220b)2)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i)and (j) of the Code due to the violation of the 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: Shelbyville Rehab & Health Care Center
FACILITY ADDRESS: 2116 South 3rd & Dacey Drive
Shelbyville, IL 62565

DOCKET #: NH 13-S0365
LICENSEE INFO: Petersen Health Operations, LLC
ADDRESS: 830 West Trailcreek Drive
Peoria, IL 61614

Re: Survey Date – July 8, 2013 Type A violation for violating one or more sections 300.1210a), 300.1210b), 300.1220b)2)3), 300.1210d)6), 300.3240a). The fine was doubled in this instance in accordance with 300.282 i) 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), 300.3240a). For a total fine of $25,000.

FACILITY NAME: Sycamore Healthcare Center
FACILITY ADDRESS: 720 Sycamore St.
Quincy, IL 62301

DOCKET #: NH 13-C0349
LICENSEE INFO: SH Care, LLC
ADDRESS: 1S443 Summitt Avenue, Suite 204
Oakbrook Terrace, IL 60181

Re: Survey Date – August 1, 2013

For a total fine of $25,000.

FACILITY NAME: Symphony of Crestwood
FACILITY ADDRESS: 14255 South Cicero Avenue
Crestwood, IL 60445

DOCKET #: NH 13-C0294
LICENSEE INFO: Symphony of Crestwood, LLC
ADDRESS: 8001 Adlai Stevenson Drive
Springfield, IL 62703

Re: Survey Date – June 3, 2013 Type B violation for violating one or more of sections 300.1010h), 300.1210b), 300.1210d)3)4)A)5)), 300.1220b)2), 300.3240a) a fine of $2,200. 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: Timbercreek Rehab & Health Care Center
FACILITY ADDRESS: 2220 State St.
Pekin, IL 61554

DOCKET #: NH 13-S0353
LICENSEE INFO: Petersen Health Operations, LLC
ADDRESS: 830 West Trailcreek Drive
Peoria, IL 61614

Re: Survey Date – July 24, 2013 Type B violation for violating one or more sections 300.610a), 300.1010h), 300.1210b), 300.1210d)3), 300.1220b)3), 300.3240a). The fine was doubled in this instance in accordance with 300.282 i) 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: Torrence Place
FACILITY ADDRESS: 2601 223rd St.
Sauk Village, IL 60411

DOCKET #: NH 13-S0388
LICENSEE INFO: Pioneer Concepts, Inc.
ADDRESS: 285 South Farnham St.
Galesburg, IL 61401

Re: Survey Date – August 23, 2013 Type B violation for violating one or more sections of 350.620a), 350.1060e), 350.1060h), 350.3240a). For a total fine of $550.

FACILITY NAME: Trafford Estates
FACILITY ADDRESS: 813 West Center
Fairfield, IL 62837

DOCKET #: NH 13-S0296
LICENSEE INFO: TDL Group, Inc.
ADDRESS: 11340 Arcadia Lake Road
Marion, IL 62959

Re: Survey Date – June 12, 2013

For a total fine of $1,100.

FACILITY NAME: Turner Manor
FACILITY ADDRESS: P.O. Box 303, 901 Oglesby Road
Harrisburg, IL 62946

DOCKET #: NH 13-S0362
LICENSEE INFO: Turner Manor, Inc.
ADDRESS: 105 So. Commercial St., P.O. Box 972
Harrisburg, IL 62946

Re: Survey Date – July 18, 2013

For a total fine of $1,500.

FACILITY NAME: Wauconda Healthcare and Rehab
FACILITY ADDRESS: 176 Thomas Court
Wauconda, IL 60084

DOCKET #: NH 13-S0394
LICENSEE INFO: Wauconda Healthcare and Rehabilitation Centre, LLC
ADDRESS: 8170 North McCormick Boulevard, Suite 219
Skokie, IL 60076

Re: Survey Date – August 15, 2013 Type B violation for violating one or more sections 300.1210b), 300.1210d)6), 300.2420j), 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: Way-Fair Nursing & Rehab Center
FACILITY ADDRESS: 305 Northwest 11th St.
Fairfield, IL 62837

DOCKET #: NH 13-S0281
LICENSEE INFO: Way-Fair Nursing & Rehabilitation Center, LLC
ADDRESS: 8170 McCormick Boulevard, Suite 219
Skokie, IL 60076

Re: Survey Date – May 22, 2013 Type B violation for violating one or more of sections 300.610a), 300.1210b)5), 300.1210d)6), 300.3240a), a fine of $2,200. 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 $2,200.

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Nursing Homes in Illinois
Illinois Department of Public Health
535 West Jefferson St.
Springfield, Illinois 62761
Phone 217-782-4977
Fax 217-782-3987
TTY 800-547-0466
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