QUARTERLY REPORT
January - March 2015
The Illinois Department of Public Health has initiated action, as indicated, against the following facilities which have been determined to be in violation of the Nursing Home Care Act, or has recommended decertification to the Director of the Department of Healthcare and Family Service, or the Secretary of the United States Department of Health and Human Services for violations in relation to patient care, pursuant to Titles XVIII and XIX of the Federal Social Security Act.
| FACILITY NAME: | Aperion Care International |
| FACILITY ADDRESS: | 4815 S. Western Ave. |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60609 |
| DOCKET NUMBER: | NH 14-C-0154 |
| LICENSEE INFO: | International Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 8131 N Monticello |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Aperion Care Decatur |
| FACILITY ADDRESS: | 2650 N. Monroe |
| FACILITY CITY, STATE, ZIP: | Decatur, IL 62526 |
| DOCKET NUMBER: | NH 14-C0123 |
| LICENSEE INFO: | Lincoln Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 8131 Monticello Ave |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Alden Estates of Shorewood |
| FACILITY ADDRESS: | 710 West Black Road |
| FACILITY CITY, STATE, ZIP: | Shorewood, IL 60404 |
| DOCKET NUMBER: | NH 14-S0539 |
| LICENSEE INFO: | Alden Estates of Shorewood, Inc |
| LICENSEE ADDRESS: | 4200 W Peterson Ave., Ste 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 11/26/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Pontiac Healthcare and Rehab |
| FACILITY ADDRESS: | 300 W. Lowell |
| FACILITY CITY, STATE, ZIP: | Pontiac, IL 61764 |
| DOCKET NUMBER: | NH 14-S0540 |
| LICENSEE INFO: | Pontiac Healthcare and Rehab, LLC |
| LICENSEE ADDRESS: | 8170 McCormick Blvd., Ste 219 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 11/13/14 | |
| 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 | |
| FACILITY NAME: | Wesley Village |
| FACILITY ADDRESS: | 1200 East Grant St. |
| FACILITY CITY, STATE, ZIP: | Macomb, IL61455 |
| DOCKET NUMBER: | NH 14-S0542 |
| LICENSEE INFO: | Wesley Village, Inc |
| LICENSEE ADDRESS: | 1200 East Grant St. |
| LICENSEE CITY, STATE, ZIP: | Macomb, IL 61455 |
| Survey Date - 12/4/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1220b)3), 300.3240a), and 300.3240d). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.3240a), and 300.3240d). For a total fine of $2,200.00 | |
| FACILITY NAME: | Arcola Healthcare Center |
| FACILITY ADDRESS: | 422 East 4th St. |
| FACILITY CITY, STATE, ZIP: | Arcola, IL 61910 |
| DOCKET NUMBER: | NH 14-S0543 |
| LICENSEE INFO: | Petersen Health Quality, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date - 11/19/14 | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210b)2), 300.1210b)5), 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 | |
| FACILITY NAME: | Prairie Manor Nursing and Rehab Center |
| FACILITY ADDRESS: | 345 Dixie Highway |
| FACILITY CITY, STATE, ZIP: | Chicago Heights, IL 60411 |
| DOCKET NUMBER: | NH 15-C0006 |
| LICENSEE INFO: | Prairie Manor Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 2201 West Main St. |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60202 |
| Survey Date – 12/14/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210d)3), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)6) and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Renaissance Care Center |
| FACILITY ADDRESS: | 1675 East Ash St. |
| FACILITY CITY, STATE, ZIP: | Canton, IL 61520 |
| DOCKET NUMBER: | NH 15-C0003 |
| LICENSEE INFO: | Renaissance Care Center, Inc |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Ste 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 12/5/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), 300.1210d)5, and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Sharon Health Care Elms |
| FACILITY ADDRESS: | 3611 North Rochelle |
| FACILITY CITY, STATE, ZIP: | Peoria, IL 61604 |
| DOCKET NUMBER: | NH 15-C0001 |
| LICENSEE INFO: | Sharon Health Care Elms, Inc |
| LICENSEE ADDRESS: | 465 Central Ave, Ste 100 |
| LICENSEE CITY, STATE, ZIP: | Northfield, IL 60093 |
| Survey Date – 11/19/14 | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210d)6), and 300.32140a). 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: | Lexington of Orland Park |
| FACILITY ADDRESS: | 14601 S. John Humphrey Dr. |
| FACILITY CITY, STATE, ZIP: | Orland Park, IL 60462 |
| DOCKET NUMBER: | NH 15-C0005 |
| LICENSEE INFO: | Lexington Health Care Center of Orland Park, Inc |
| LICENSEE ADDRESS: | 665 West North Ave |
| LICENSEE CITY, STATE, ZIP: | Lombard, IL 60148 |
| Survey Date – 11/19/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Eagle Court |
| FACILITY ADDRESS: | 1890 East Eagle St. |
| FACILITY CITY, STATE, ZIP: | Kankakee, IL 60901 |
| DOCKET NUMBER: | NH 14-S0350 |
| LICENSEE INFO: | Pinnacle Opportunities, Inc |
| LICENSEE ADDRESS: | 285 S. Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Alden Town Manor Rehab and HCC |
| FACILITY ADDRESS: | 6120 West Ogden |
| FACILITY CITY, STATE, ZIP: | Cicero, IL 60804 |
| DOCKET NUMBER: | NH 15-C0011 |
| LICENSEE INFO: | Alden Town Manor Rehab and HCC, Inc |
| LICENSEE ADDRESS: | 4200 W. Peterson Ave., Ste 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 12/12/14 | |
| Type B violation for violating one or more sections: 955.165c)h)4)5). No Fine | |
| FACILITY NAME: | Prairie Crossing Living and Rehab |
| FACILITY ADDRESS: | 409 West Comanche Ave |
| FACILITY CITY, STATE, ZIP: | Shabbona, IL 60550 |
| DOCKET NUMBER: | NH 15-S0019 |
| LICENSEE INFO: | Prairie Crossing Living and Rehab Center, LLC |
| LICENSEE ADDRESS: | 7434 Skokie Blvd |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 11/25/14 | |
| Type B violation for violating one or more sections: 300.661 and 300.615e). No Fine | |
| FACILITY NAME: | Aperion Care Decatur |
| FACILITY ADDRESS: | 2650 North Monroe |
| FACILITY CITY, STATE, ZIP: | Decatur, IL 62526 |
| DOCKET NUMBER: | NH 15-S0015 |
| LICENSEE INFO: | Lincoln Rehab Center, LLC |
| LICENSEE ADDRESS: | 8131 Monticello Ave |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 12/11/14 | |
| Type B violation for violating one or more sections: 300.6251, 300.1230j)5), 300.1230k), and 300.3260c). No Fine. | |
| FACILITY NAME: | Sandwich Rehab and HCC |
| FACILITY ADDRESS: | 902 East Arnold St. |
| FACILITY CITY, STATE, ZIP: | Sandwich, IL 60548 |
| DOCKET NUMBER: | NH 15-S0010 |
| LICENSEE INFO: | Petersen Health & Wellness, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 12/5/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3242a).. For a total fine of $2,200.00 | |
| FACILITY NAME: | Rivershores Health and Rehab Center |
| FACILITY ADDRESS: | 578 West Commercial St. |
| FACILITY CITY, STATE, ZIP: | Marseilles, IL 61341 |
| DOCKET NUMBER: | NH 15-C0007 |
| LICENSEE INFO: | Rivershores Healthcare and Rehab Centre, LLC |
| LICENSEE ADDRESS: | 4600 West Touhy, Ste 200 |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 11/21/14 | |
| 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 | |
| FACILITY NAME: | Manorcare of Oak Lawn East |
| FACILITY ADDRESS: | 9401 S. Kostner Ave |
| FACILITY CITY, STATE, ZIP: | Oak Lawn, IL 60453 |
| DOCKET NUMBER: | NH 15-C0012 |
| LICENSEE INFO: | Manor Care of Oak Lawn (East) IL, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 12/11/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Bria of Geneva |
| FACILITY ADDRESS: | 1101 East State St. |
| FACILITY CITY, STATE, ZIP: | Geneva, IL 60134 |
| DOCKET NUMBER: | NH 15-C0009 |
| LICENSEE INFO: | Geneva Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 4711 Golf Road., Ste 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 12/5/14 | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210d)3), 300.1220b)1), 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: | Thomas Herbstritt House |
| FACILITY ADDRESS: | 4003 N Rt 1 & 17, PO Box 260 |
| FACILITY CITY, STATE, ZIP: | Momence, IL 60954 |
| DOCKET NUMBER: | NH 14-C0431 |
| LICENSEE INFO: | Good Shepherd Manor, Inx |
| LICENSEE ADDRESS: | 4129 N Rt 1 & 17, PO Box 260 |
| LICENSEE CITY, STATE, ZIP: | Momence, IL 60954 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | St. Paul’s Home |
| FACILITY ADDRESS: | 1021 West E St. |
| FACILITY CITY, STATE, ZIP: | Belleville, IL 62220 |
| DOCKET NUMBER: | NH 15-S0042 NH 15-C0043 |
| LICENSEE INFO: | St. Paul’s Home for the Aged |
| LICENSEE ADDRESS: | 23 Public Square #300 |
| LICENSEE CITY, STATE, ZIP: | Belleville, IL 62220 |
| Survey Date – 11/24/14 | |
| Type A violation for violating one or more sections: 300.610a), 300.690a), 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: 300.690a), 300.1210b), and 300.3240a). For a total fine of $25,000.00 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a) . For a total fine of $25,000.00 | |
| 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 | |
| FACILITY NAME: | Lake Shore Healthcare and Rehab |
| FACILITY ADDRESS: | 7200 North Sheridan Road |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60626 |
| DOCKET NUMBER: | NH 14-S-98 |
| LICENSEE INFO: | Lake Shore Healthcare and Rehab Centre, LLC |
| LICENSEE ADDRESS: | 4600 W Toughy Ave #200 |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Waterford Nursing and Rehab |
| FACILITY ADDRESS: | 7445 North Sheridan Road |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60626 |
| DOCKET NUMBER: | NH 14-C-0206 |
| LICENSEE INFO: | Waterford Nursing and Rehab Center, Inc |
| LICENSEE ADDRESS: | 191 N Wacker Dr, Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Aperion Care Decatur |
| FACILITY ADDRESS: | 2650 North Monroe |
| FACILITY CITY, STATE, ZIP: | Decatur, IL 62526 |
| DOCKET NUMBER: | NH 14-S0129 |
| LICENSEE INFO: | Lincoln Rehab Center, LLC |
| LICENSEE ADDRESS: | 8131 Monticello |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Stockton Healthcare and Rehab |
| FACILITY ADDRESS: | 501 Front St. |
| FACILITY CITY, STATE, ZIP: | Stockton, IL 61085 |
| DOCKET NUMBER: | NH 14-S-399 |
| LICENSEE INFO: | Stockton Healthcare and Rehab Center. Inc |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Ste 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Symphony of Lincoln |
| FACILITY ADDRESS: | 2202 N. Kickapoo St. |
| FACILITY CITY, STATE, ZIP: | Lincoln, IL 62656 |
| DOCKET NUMBER: | NH 15-S0028 |
| LICENSEE INFO: | Symphony Maple Ridge, LLC |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 1/9/15 | |
| Type B violation for violating one or more sections: 300.626c). No Fine | |
| FACILITY NAME: | Belhaven Nursing and Rehab Center |
| FACILITY ADDRESS: | 11401 S. Oakley Ave |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60643 |
| DOCKET NUMBER: | NH 15-C0029 |
| LICENSEE INFO: | Belhaven Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 150 Fencl Lane |
| LICENSEE CITY, STATE, ZIP: | Hillside, IL 60162 |
| Survey Date – 11/25/14 | |
| Type B violation for violating one or more sections: 300.660a)b)1) and 300.661. No fine. | |
| FACILITY NAME: | Manorcare of Palos Heights East |
| FACILITY ADDRESS: | 7850 W. College Dr. |
| FACILITY CITY, STATE, ZIP: | Palos Heights, IL 60463 |
| DOCKET NUMBER: | NH 15-C0032 |
| LICENSEE INFO: | Manor Care of Palos Heights IL, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 12/15/14 | |
| Type C violation for violating one or more sections: 300.696. No Fine. | |
| FACILITY NAME: | Rosewood Care Center St. Charles |
| FACILITY ADDRESS: | 850 Dunham Road |
| FACILITY CITY, STATE, ZIP: | St. Charles, IL 60174 |
| DOCKET NUMBER: | NH 15-S0031 |
| LICENSEE INFO: | Bravo Care of St. Charles, Inc |
| LICENSEE ADDRESS: | 412 E. Lawrence |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 12/10/14 | |
| Type C violation for violating one or more sections: 300.1630d). No fine. | |
| FACILITY NAME: | Heritage Health - Mt. Zion |
| FACILITY ADDRESS: | 1225 Woodland Drive |
| FACILITY CITY, STATE, ZIP: | Mt Zion, IL 62549 |
| DOCKET NUMBER: | NH 15-S0021 |
| LICENSEE INFO: | Heritage Manor- Mt Zion, LLC |
| LICENSEE ADDRESS: | 115 W. Jefferson St., Ste 400 |
| LICENSEE CITY, STATE, ZIP: | Bloomington, IL 61701 |
| Survey Date – 12/17/14 | |
| 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 | |
| FACILITY NAME: | Brookdale Burr Ridge |
| FACILITY ADDRESS: | 6801 Highgrove Blvd |
| FACILITY CITY, STATE, ZIP: | Burr Ridge, IL 60527 |
| DOCKET NUMBER: | NH 15-S0035 |
| LICENSEE INFO: | S-H OPCO Burr Ridge, LLC |
| LICENSEE ADDRESS: | 6801 S. LaSalle St., Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 12/17/14 | |
| Type B violation for violating one or more sections: 300.696c)2)7), 300.1620a), 300.2030e)f)h)i), 300.2220a)1)d), 300.2230a)2)A)D), and 300.3220f) | |
| FACILITY NAME: | Three Springs Lodge Nursing Home |
| FACILITY ADDRESS: | 161 Three Springs Road |
| FACILITY CITY, STATE, ZIP: | Chester, IL 62233 |
| DOCKET NUMBER: | NH 15-S0024 |
| LICENSEE INFO: | Three Springs Lodge Nursing Home, LLC |
| LICENSEE ADDRESS: | 1001 E. Main St. |
| LICENSEE CITY, STATE, ZIP: | Carbondale, IL 62901 |
| Survey Date – 12/17/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Alden Long Grove Rehab and HCC |
| FACILITY ADDRESS: | Box 2308, RFD Old Hicks Road |
| FACILITY CITY, STATE, ZIP: | Long Grove, IL 60047 |
| DOCKET NUMBER: | NH 15-S0018 |
| LICENSEE INFO: | Alden- Long Grove Rehab and Healthcare Center, Inc |
| LICENSEE ADDRESS: | 4200 W. Peterson Ave., Ste 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60047 |
| Survey Date – 12/11/14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.1220b)3) 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: | Meadows |
| FACILITY ADDRESS: | 3250 S. Plum Grove Road |
| FACILITY CITY, STATE, ZIP: | Rolling Meadows, IL 60008 |
| DOCKET NUMBER: | NH 15-C0039 |
| LICENSEE INFO: | Meadows Sheltered Care, Inc |
| LICENSEE ADDRESS: | 3250 S. Plum Grove Road |
| LICENSEE CITY, STATE, ZIP: | Rolling Meadows, IL 60008 |
| Survey Date – 11/20/14 | |
| Type A violation for violating one or more sections: 350.620a), 350.1210, 350.3240a), and 350.3240d). For a total fine of $10,000.00. | |
| FACILITY NAME: | Homestead House |
| FACILITY ADDRESS: | 905 North Jefferson |
| FACILITY CITY, STATE, ZIP: | West Frankfort, IL 62896 |
| DOCKET NUMBER: | NH 15-S0033 |
| LICENSEE INFO: | William J., Christine A. Mattingly |
| LICENSEE ADDRESS: | 1120 North Division |
| LICENSEE CITY, STATE, ZIP: | Carterville, IL 62918 |
| Survey Date – 11/25/14 | |
| Type A violation for violating one or more sections: 350.620a), 350.1060e), 350.1060h), 350.1060j), 350.1210, 350.1220m), 350.3240a), 350.3240b), 350.3240c), 350.3240d), and 350.3240f). For a total fine of $6,250.00 | |
| Type A violation with fine of an occurrence for violating one or more of the following sections of the code: 350.1225, 350.1230b)7), and 350.3240a). For a fine of $6,250.00 | |
| FACILITY NAME: | Countryview Care Center- Macomb |
| FACILITY ADDRESS: | 400 West Grant St. |
| FACILITY CITY, STATE, ZIP: | Macomb, IL 61455 |
| DOCKET NUMBER: | NH 15-S0023 |
| LICENSEE INFO: | Petersen Health Properties, LLC |
| LICENSEE ADDRESS: | 830 West Trailcreek Dr |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 11/11/14 | |
| Type A violation for violating one or more sections: 300.3240a) and 300.3240e) The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.3240a) and 300.3240e). For a total fine of $25,000.00. | |
| Type A violation for violating one or more sections: 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: 300.3240a) and 300.3240a). For a total fine of $25,000.00. | |
| FACILITY NAME: | Jerseyville Nursing and Rehab Center |
| FACILITY ADDRESS: | 1001 S. State St. |
| FACILITY CITY, STATE, ZIP: | Jerseyville, IL 62052 |
| DOCKET NUMBER: | NH 15-S0036 |
| LICENSEE INFO: | Jerseyville Nursing and Rehab Center, Inc |
| LICENSEE ADDRESS: | 1001 S. State St. |
| LICENSEE CITY, STATE, ZIP: | Jerseyville, IL 62052 |
| Survey Date – 12/19/14 | |
| Type A violation for violating one or more sections: 300.310a), 300.1010h), 300.1210b), 300.1210c), 300.1210d)1), 300.1210d)2), 300.1630e), and 300.3240e). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Lewis Memorial Christian Village |
| FACILITY ADDRESS: | 3400 West Washington |
| FACILITY CITY, STATE, ZIP: | Springfield, IL 62711 |
| DOCKET NUMBER: | NH 15-C0016 |
| LICENSEE INFO: | Lewis Memorial Christian Village |
| LICENSEE ADDRESS: | 200 North Postville Road |
| LICENSEE CITY, STATE, ZIP: | Lincoln, IL 62656 |
| Survey Date – 12/1/14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Waterfront Terrace |
| FACILITY ADDRESS: | 7750 South Shore Drive |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60649 |
| DOCKET NUMBER: | NH 15-C0037 |
| LICENSEE INFO: | Waterfront Terrace, Inc |
| LICENSEE ADDRESS: | 191 North Wacker Dr., Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 12/17/14 | |
| Type A 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 $25,000.00 | |
| FACILITY NAME: | Grasmere Place |
| FACILITY ADDRESS: | 4621 North Sheridan |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60640 |
| DOCKET NUMBER: | NH 15-C0040 NH 15-S0041 |
| LICENSEE INFO: | Grasmere Place, LLC |
| LICENSEE ADDRESS: | 2201 Main St. |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60202 |
| Survey Date – 1/15/15 | |
| Type C violation for violating one or more sections: 300.696a), 300.1210b)d)1), 300.1630b), 300.2100, 750.810, 300.3140e)2), and 300.3300b)d) | |
| FACILITY NAME: | Sycamore Healthcare Center |
| FACILITY ADDRESS: | 720 Sycamore St. |
| FACILITY CITY, STATE, ZIP: | Quincy, IL 62301 |
| DOCKET NUMBER: | NH 15-S0030 |
| LICENSEE INFO: | SH Care, LLC |
| LICENSEE ADDRESS: | 1S442 Summitt Ave, Ste 204 |
| LICENSEE CITY, STATE, ZIP: | Oakbrook, Terrace, IL 60181 |
| Survey Date – 1/7/14 | |
| 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), 300.3240a). For a total fine of $2,200.00. | |
| FACILITY NAME: | Thorton Heights Terrace |
| FACILITY ADDRESS: | 160 West 10th St. |
| FACILITY CITY, STATE, ZIP: | Chicago Heights, IL 60411 |
| DOCKET NUMBER: | NH 15-C0047 |
| LICENSEE INFO: | Thorton Heights Terrace, LTD |
| LICENSEE ADDRESS: | 465 Central Ave, Ste 100 |
| LICENSEE CITY, STATE, ZIP: | Northfield, IL 60093 |
| Survey Date – 1-22-15 | |
| Type B violation for violating one or more sections: 300.625I). No fine. | |
| FACILITY NAME: | Illinois Presbyterian Home |
| FACILITY ADDRESS: | 2005 West Lawrence |
| FACILITY CITY, STATE, ZIP: | Springfield, IL 62704 |
| DOCKET NUMBER: | NH 15-S0048 |
| LICENSEE INFO: | Illinois Presbyterian Home |
| LICENSEE ADDRESS: | 205 S. 5th St, Ste 700 |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62701 |
| Survey Date – 1-29-15 | |
| Type B violation for violating one or more sections: 300.1210a)b). 300.1210d)6), and 330.1110f)d)3)B). No fine. | |
| FACILITY NAME: | Magnolia Manor Shelter Care HM |
| FACILITY ADDRESS: | 1100 Grant |
| FACILITY CITY, STATE, ZIP: | Eldorado, IL 62930 |
| DOCKET NUMBER: | NH 15-C0046 |
| LICENSEE INFO: | John Zink |
| LICENSEE ADDRESS: | 150 S. Route 45, PO Box 250 |
| LICENSEE CITY, STATE, ZIP: | Louisville, IL 62858 |
| Survey Date – 1/20/15 | |
| Type B violation for violating one or more sections: 330.4300C)1)2)d). No fine. | |
| FACILITY NAME: | Paxton Healthcare and Rehab |
| FACILITY ADDRESS: | 1240 North Market St. |
| FACILITY CITY, STATE, ZIP: | Paxton, IL 60957 |
| DOCKET NUMBER: | NH 15-S0049 |
| LICENSEE INFO: | Paxton Healthcare and Rehab, LLC |
| LICENSEE ADDRESS: | 8170 McCormick Blvd |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 1/22/15 | |
| Type B violation for violating one or more sections: 300.670b), 300.1210d)6), and 300.1620. No fine. | |
| FACILITY NAME: | Hillsboro Rehab and HCC |
| FACILITY ADDRESS: | 1300 East Tremont St. |
| FACILITY CITY, STATE, ZIP: | Hillsboro, IL 62049 |
| DOCKET NUMBER: | NH 14-S0264 |
| LICENSEE INFO: | Hillsboro Rehab and Health Care Center, LLC |
| LICENSEE ADDRESS: | 412 E. Lawrence |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Glen Bridge Nursing and Rehab Centre |
| FACILITY ADDRESS: | 8333 West Golf Road |
| FACILITY CITY, STATE, ZIP: | Niles, IL 60714 |
| DOCKET NUMBER: | NH 15-S0052 |
| NH 15-C0053 | |
| LICENSEE INFO: | Glen Bridge Nursing and Rehab Centre, LTD |
| LICENSEE ADDRESS: | 191 North Wacker Dr., Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 1/8/15 | |
| Type B violation for violating one or more sections: 300.1210. No Fine. | |
| FACILITY NAME: | Moweaqua Nursing and Rehab Center |
| FACILITY ADDRESS: | 525 S. Macon St. |
| FACILITY CITY, STATE, ZIP: | Moweaqua, IL 62550 |
| DOCKET NUMBER: | NH 15-S0057 |
| LICENSEE INFO: | Moweaqua Nursing Ventures, LLC |
| LICENSEE ADDRESS: | 480 S. Meadowbrook Road |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62707 |
| Survey Date – 1/13/15 | |
| Type B violation for violating one or more sections: 300.615e). No fine. | |
| FACILITY NAME: | Skokie Meadows Nursing Center #2 |
| FACILITY ADDRESS: | 4600 West Golf Road |
| FACILITY CITY, STATE, ZIP: | Skokie, IL 60076 |
| DOCKET NUMBER: | NH 15-S0017 |
| LICENSEE INFO: | Skokie Meadows Nursing Centers II, LLC |
| LICENSEE ADDRESS: | 9615 North Knox Ave |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 1/16/15 | |
| Type B violation for violating one or more sections: 300..610a), 300.686a), 300.686F)3), 300.686F)5), 300.1010h), 300.1210a), 300.1210b), 300.1210b)4), 300.1210d)2), 300.1420, 300.1620a), and 300.3240a) The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.686, 300.1210b), and 300.3240a). For a total fine of $2,200.00 | |
| Type B violation for violating one or more sections: 300.610a), 300.2100 (Department’s rules entitled “Food Service Sanitation” (77 Ill. Adm. Code 750) (750.250 and 750.820e)2. Fine of $1,100.00. | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210a), 300.1210b)4), 300.1410a), 300.1410g), 300.1410h), 300.3240a), 300.4010b), 300.4010c), 300.4010c)3)A), 300.4010c)3)B), 300.4010c)3)D), 300.4010c)3)E), 300.4010c)7)A), 300.4010c)7)B), 300.4010d), 300.4020b), 300.4020b)3), 300.4020b)4), 300.4040a), 300.4040a)4), 300.4040b), 300.4040c)1), 300.4040c)7), 300.4050a), 300.4050b), 300.4090b)C)4), and 300.4090b)3)C)5) For a total fine of $1,100.00 | |
| FACILITY NAME: | Marigold Rehab Health Care Center |
| FACILITY ADDRESS: | 275 East Carl Sandburg Dr. |
| FACILITY CITY, STATE, ZIP: | Galesburg, IL 61401 |
| DOCKET NUMBER: | NH 15-S0058 |
| LICENSEE INFO: | Petersen Health Network, LLC |
| LICENSEE ADDRESS: | 830 West Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 1/27/15 | |
| Type B violation for violating one or more sections: 300.696a)c)2)7), 300.1210d)1)2), 300.1210d)6), 300.1630a)3), 300.1640e), 300.2210b)1)2)9), 300.3200f)1), and 300.3200l). No Fine. | |
| FACILITY NAME: | Bellwood Developmental Center |
| FACILITY ADDRESS: | 105 Eastern Ave |
| FACILITY CITY, STATE, ZIP: | Bellwood, IL 60104 |
| DOCKET NUMBER: | NH 14-C-311 |
| LICENSEE INFO: | Bellwood Nursing Center |
| LICENSEE ADDRESS: | 5750 Old Orchard Road., Ste 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Shawnee Christian Nursing Center |
| FACILITY ADDRESS: | 1901 North 13th St. |
| FACILITY CITY, STATE, ZIP: | Herrin, IL 62948 |
| DOCKET NUMBER: | NH 15-C0044 |
| LICENSEE INFO: | Shawnee Christian Nursing Center, LLC |
| LICENSEE ADDRESS: | 200 North Postville Road |
| LICENSEE CITY, STATE, ZIP: | Lincoln, IL 62656 |
| Survey Date – 12/11/14 | |
| Type AA violation for violating one or more sections: 300.1210d)6), 300.1220b)3), and 300.3240a) The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)6) and 300.3240a). For a total fine of $50,000.00 | |
| FACILITY NAME: | Alden Orland Park Rehab & HCC |
| FACILITY ADDRESS: | 16450 S. 97th Ave |
| FACILITY CITY, STATE, ZIP: | Orland Park, IL 60462 |
| DOCKET NUMBER: | NH 15-C0050 |
| 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 – 12/18/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210a), 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: | John C Proctor Endowment Home |
| FACILITY ADDRESS: | 2624 West Reservoir |
| FACILITY CITY, STATE, ZIP: | Peoria, IL 61615 |
| DOCKET NUMBER: | NH 15-S0061 |
| LICENSEE INFO: | Trustees J.C. Proctor Endowment |
| LICENSEE ADDRESS: | 2724 West Reservoir |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61615 |
| Survey Date – 2/5/15 | |
| Type C violation for violating one or more sections: 300.1210d)6) and 300.2100. No fine. | |
| FACILITY NAME: | Jerseyville Nursing and Rehab Center |
| FACILITY ADDRESS: | 1001 S. State St. |
| FACILITY CITY, STATE, ZIP: | Jerseyville, IL 62052 |
| DOCKET NUMBER: | |
| LICENSEE INFO: | Jerseyville Nursing and Rehab Center, Inc |
| LICENSEE ADDRESS: | 1001 S. State St. |
| LICENSEE CITY, STATE, ZIP: | Jerseyville, IL 62052 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Gardenview Manor |
| FACILITY ADDRESS: | 14792 Catlin-Tilton Road |
| FACILITY CITY, STATE, ZIP: | Danville, IL 61834 |
| DOCKET NUMBER: | NH 15-C0056 |
| LICENSEE INFO: | Gardenview Manor, LLC |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Ste 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 1/8/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Bridge Care Suites |
| FACILITY ADDRESS: | 3089 Old Jacksonville Road |
| FACILITY CITY, STATE, ZIP: | Springfield, IL 62704 |
| DOCKET NUMBER: | NH 15-S0055 |
| LICENSEE INFO: | OJCC, LLC |
| LICENSEE ADDRESS: | 2920 W. Coyle Ave |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60645 |
| Survey Date – 1/16/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Grove at the Lake Living and Rehab |
| FACILITY ADDRESS: | 2534 Elim Ave |
| FACILITY CITY, STATE, ZIP: | Zion, IL 60099 |
| DOCKET NUMBER: | NH 15-C0060 |
| LICENSEE INFO: | The Grove at the Lake Living and Rehab Center, LLC |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr. |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 1/9/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Pittsfield Manor |
| FACILITY ADDRESS: | 610 Lowry St. |
| FACILITY CITY, STATE, ZIP: | Pittsfield, IL 62363 |
| DOCKET NUMBER: | NH 14-C0316 |
| LICENSEE INFO: | UDI #9, LLC |
| LICENSEE ADDRESS: | 285 S. Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Stockton Healthcare and Rehab |
| FACILITY ADDRESS: | 501 Front St. |
| FACILITY CITY, STATE, ZIP: | Stockton, IL 61085 |
| DOCKET NUMBER: | NH 15-C0065 |
| LICENSEE INFO: | Stockton Healthcare and Rehab Center, Inc |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Ste 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 1/16/15 | |
| Type B violation for violating one or more sections: 300.661 and 300.650d). No Fine. | |
| FACILITY NAME: | Generations HCN at Oakton Pavilion |
| FACILITY ADDRESS: | 1660 Oakton Place |
| FACILITY CITY, STATE, ZIP: | Des Plaines, IL 60018 |
| DOCKET NUMBER: | NH 15-C0067 |
| LICENSEE INFO: | Generations Health Care Network at Oakton Pavilion, LLC |
| LICENSEE ADDRESS: | 6840 N. Lincoln Ave. |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 1/15/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), and 300.3240a). No Fine. | |
| FACILITY NAME: | The Ponds of Wealshire |
| FACILITY ADDRESS: | 170 Jamestown Lane |
| FACILITY CITY, STATE, ZIP: | Lincolnshire, IL 60069 |
| DOCKET NUMBER: | NH 15-S0071 |
| LICENSEE INFO: | The Ponds of Wealshire, LLC |
| LICENSEE ADDRESS: | 77 West Washington St., 1211 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60602 |
| Survey Date – 1/22/15 | |
| Type C violation for violating one or more sections: 330.710a), 330.1510a)c)g), and 330.2000. No Fine. | |
| FACILITY NAME: | Spring Valley Nursing |
| FACILITY ADDRESS: | 1300 North Greenwood St. |
| FACILITY CITY, STATE, ZIP: | Spring Valley, IL 61362 |
| DOCKET NUMBER: | NH 15-S0069 |
| LICENSEE INFO: | Spring Valley Nursing Center-A limited Partnership |
| LICENSEE ADDRESS: | 1300 N Green St. |
| LICENSEE CITY, STATE, ZIP: | Spring Valley, IL 61362 |
| Survey Date – 1/30/15 | |
| Type B violation for violating one or more sections: 300.615e)f) and 300.625a)b)c)1)2)d)e)f). No Fine. | |
| FACILITY NAME: | Oakbrook Healthcare Centre |
| FACILITY ADDRESS: | 2013 Midwest Road |
| FACILITY CITY, STATE, ZIP: | Oakbrook, IL 60523 |
| DOCKET NUMBER: | NH 15-S0068 |
| LICENSEE INFO: | Oakbrook Healthcare Centre, LTD |
| LICENSEE ADDRESS: | 5061 N Pulaski Road |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60630 |
| Survey Date – 2/9/15 | |
| Type B violation for violating one or more sections: 300.615e). No Fine. | |
| FACILITY NAME: | Aperion Care Plum Grove |
| FACILITY ADDRESS: | 24 S Plum Grove Road. |
| FACILITY CITY, STATE, ZIP: | Palatine, IL 60067 |
| DOCKET NUMBER: | |
| LICENSEE INFO: | Plum Grove Nursing and Rehab, LLC |
| LICENSEE ADDRESS: | 8131 N Monticello |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Watseka Rehab and Health Care Center |
| FACILITY ADDRESS: | 715 East Raymond Road. |
| FACILITY CITY, STATE, ZIP: | Watseka, IL 60970 |
| DOCKET NUMBER: | NH 15-C0054 |
| LICENSEE INFO: | Petersen Health Care II, Inc |
| LICENSEE ADDRESS: | 830 West Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 1/16/15 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.1220b)7), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a) For a total fine of $25,000.00 | |
| FACILITY NAME: | Regency Rehab Center |
| FACILITY ADDRESS: | 6631 Milwaukee Ave |
| FACILITY CITY, STATE, ZIP: | Niles, IL 60714 |
| DOCKET NUMBER: | NH 15-C0064 |
| LICENSEE INFO: | Regency Rehab Center, LLC |
| LICENSEE ADDRESS: | 6840 N Lincoln Ave |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 12/26/14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a) For a total fine of $25,000.00 | |
| FACILITY NAME: | Arden Courts of Hazel Crest |
| FACILITY ADDRESS: | 3701 West 183rd St. |
| FACILITY CITY, STATE, ZIP: | Hazel Crest, IL 60429 |
| DOCKET NUMBER: | NH 15-S0074 |
| LICENSEE INFO: | Arden Courts of Hazel Crest IL, LLC |
| LICENSEE ADDRESS: | 208 LaSalle St., Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 1/29/15 | |
| Type C violation for violating one or more sections: 330.1110f) and 330.1710d). No fine | |
| FACILITY NAME: | Morton Terrace H & R Centre |
| FACILITY ADDRESS: | 191 East Queenwood Road |
| FACILITY CITY, STATE, ZIP: | Morton, IL 61550 |
| DOCKET NUMBER: | NH 14-S-0332 |
| LICENSEE INFO: | Morton Terrace Healthcare and Rehab Centre, LLC |
| LICENSEE ADDRESS: | 4600 West Touhy Ave, Ste 200 |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Abington of Glenview |
| FACILITY ADDRESS: | 3901 Glenview Road |
| FACILITY CITY, STATE, ZIP: | Glenview, IL 60025 |
| DOCKET NUMBER: | NH 15-S0077 |
| LICENSEE INFO: | Glen Ridge Associates II Limited Partnership |
| LICENSEE ADDRESS: | 3901 Glenview Road |
| LICENSEE CITY, STATE, ZIP: | Glenview, IL 60025 |
| Survey Date – 1/22/15 | |
| Type B violation for violating one or more sections: 300.615e) | |
| FACILITY NAME: | Asta Care Center of Colfax |
| FACILITY ADDRESS: | 402 S. Harrison |
| FACILITY CITY, STATE, ZIP: | Colfax, IL 61728 |
| DOCKET NUMBER: | NH 14-S0425 NH 14-C0426 |
| LICENSEE INFO: | Asta Care Center of Colfax, LLC |
| LICENSEE ADDRESS: | 134 N McLean Blvd |
| LICENSEE CITY, STATE, ZIP: | Elgin, IL 60123 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | The British Home |
| FACILITY ADDRESS: | 8700 West 31st St. |
| FACILITY CITY, STATE, ZIP: | Brookfield, IL 60513 |
| DOCKET NUMBER: | NH 14-C0516 |
| LICENSEE INFO: | The British Home for Retired Men and Women |
| LICENSEE ADDRESS: | 31St St. & McCormick Ave |
| LICENSEE CITY, STATE, ZIP: | Brookfield, IL 60513 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Park Pointe Healthcare and Rehab |
| FACILITY ADDRESS: | 123 Edgewater Dr. |
| FACILITY CITY, STATE, ZIP: | Morris, IL 60532 |
| DOCKET NUMBER: | NH 15-C0072 |
| LICENSEE INFO: | Park Pointe Healthcare and Rehab Center, LLC |
| LICENSEE ADDRESS: | 1001 Warrenville Road, Ste 500 |
| LICENSEE CITY, STATE, ZIP: | Lisle, IL 60532 |
| Survey Date – 1/9/15 | |
| Type A 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 $25,000.00 | |
| FACILITY NAME: | Bement Health Care Center |
| FACILITY ADDRESS: | 601 North Morgan |
| FACILITY CITY, STATE, ZIP: | Bement, IL 61813 |
| DOCKET NUMBER: | NH 15-S0075 |
| LICENSEE INFO: | Petersen Health Quality, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 1/29/15 | |
| Type B violation for violating one or more sections: 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: 300.1210d)6) and 300.3240a) For a total fine of $2,200.00 | |
| FACILITY NAME: | South Lawn Sheltered Care |
| FACILITY ADDRESS: | 512 S. Franklin |
| FACILITY CITY, STATE, ZIP: | Bunker Hill, IL 62014 |
| DOCKET NUMBER: | NH 15-C0079 |
| 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 - N/A | |
| Type B violation for violating one or more sections: 330.710a), 330.780a)b)c), 330.785a)b)3)c)1)4)5)d)e), 330.4240a)c)e)f), and 330.1710c)f). No fine. | |
| FACILITY NAME: | Aperion Care of Springfield |
| FACILITY ADDRESS: | 525 S. Martin Luther King Dr. |
| FACILITY CITY, STATE, ZIP: | Springfield, IL 62703 |
| DOCKET NUMBER: | NH 14-S0294 |
| LICENSEE INFO: | Springfield Care Center, LLC |
| LICENSEE ADDRESS: | 8131 N Monticello Ave. |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Casey Health Care Center |
| FACILITY ADDRESS: | 100 N. E. 15th |
| FACILITY CITY, STATE, ZIP: | Casey, IL 62420 |
| DOCKET NUMBER: | NH 15-S0084 |
| LICENSEE INFO: | Petersen Management Company |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 2/5/15 | |
| Type B violation for violating one or more sections: 300.4090a)1), 300.4090b)1)A)B), and 300.4090b)3)A)B). No Fine. | |
| FACILITY NAME: | Westminster Village |
| FACILITY ADDRESS: | 2025 East Lincoln St. |
| FACILITY CITY, STATE, ZIP: | Bloomington, IL 61701 |
| DOCKET NUMBER: | NH 15-S0087 |
| LICENSEE INFO: | Westminster Village, Inc |
| LICENSEE ADDRESS: | 2025 E. Lincoln St. |
| LICENSEE CITY, STATE, ZIP: | Bloomington, IL 61701 |
| Survey Date – 2/17/15 | |
| Type B violation for violating one or more sections: 300.1210d)5). No fine. | |
| FACILITY NAME: | ManorCare of Hinsdale |
| FACILITY ADDRESS: | 600 West Ogden Ave |
| FACILITY CITY, STATE, ZIP: | Hinsdale, IL 60521 |
| DOCKET NUMBER: | NH 15-C0081 |
| LICENSEE INFO: | Manor Care Of Hinsdale, IL, LLC |
| LICENSEE ADDRESS: | 208 S LaSalle St., Ste. 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 1/20/15 | |
| Type B violation for violating one or more sections: 300.610a), 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: | River Crossing Rehab |
| FACILITY ADDRESS: | 1145 Frank St. |
| FACILITY CITY, STATE, ZIP: | Galesburg, IL 61401 |
| DOCKET NUMBER: | NH 14-C0200 |
| NH 14-S0201 | |
| LICENSEE INFO: | River Crossing Rehab, LLC |
| LICENSEE ADDRESS: | 8131 Monticello Ave |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Brentwood Sub Acute Healthcare Center |
| FACILITY ADDRESS: | 5400 West 87th St. |
| FACILITY CITY, STATE, ZIP: | Burbank, IL 60459 |
| DOCKET NUMBER: | NH14-S-213 |
| LICENSEE INFO: | Brentwood Operating Company, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Carbondale Rehab and Nrsg Center II |
| FACILITY ADDRESS: | 500 S. Lewis Lane |
| FACILITY CITY, STATE, ZIP: | Carbondale, IL 62901 |
| DOCKET NUMBER: | NH 14-S-0380 |
| LICENSEE INFO: | Carbondale rehab and Nrsg Centre II, LLC |
| LICENSEE ADDRESS: | 8707 Skokie Blvd, Ste 310 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| 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: | NH 15-S0090 |
| LICENSEE INFO: | Clayton Residential Home, Inc |
| LICENSEE ADDRESS: | 465 Central Ave, Ste 100 |
| LICENSEE CITY, STATE, ZIP: | Northfield, IL 60093 |
| Survey Date – 2/26/15 | |
| Type B violation for violating one or more sections: 300.1010e)h), 300.3240f), and 300.4020. | |
| FACILITY NAME: | Presence St. Joseph Center |
| FACILITY ADDRESS: | 659 East Jefferson St. |
| FACILITY CITY, STATE, ZIP: | Freeport, IL 61032 |
| DOCKET NUMBER: | NH 15-C0083 |
| LICENSEE INFO: | Presence Life Connections |
| LICENSEE ADDRESS: | 9223 West Saint Frances Road |
| LICENSEE CITY, STATE, ZIP: | Frankfort, IL 60423 |
| Survey Date – 1/29/15 | |
| 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: 300.1210b)5), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Aperion Care Bridgeport |
| FACILITY ADDRESS: | 900 East Corporation St. |
| FACILITY CITY, STATE, ZIP: | Bridgeport, IL 62417 |
| DOCKET NUMBER: | NH 14-S-0420 |
| LICENSEE INFO: | Aperion Care Bridgeport, LLC |
| LICENSEE ADDRESS: | 8131 Monticello Ave |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Arden Courts of South Holland |
| FACILITY ADDRESS: | 2045 East 170th St. |
| FACILITY CITY, STATE, ZIP: | South Holland, IL 60473 |
| DOCKET NUMBER: | NH 15-S0093 |
| LICENSEE INFO: | Arden Courts of South Holland IL, LLC |
| LICENSEE ADDRESS: | 208 S LaSalle St., Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date -2/19/15 | |
| Type B violation for violating one or more sections: 330.1710b) | |
| Type C violation for violating one or more sections: 330.1110a) | |
| FACILITY NAME: | Park Ridge Care Center |
| FACILITY ADDRESS: | 665 Busse Highway |
| FACILITY CITY, STATE, ZIP: | Park Ridge, IL 60068 |
| DOCKET NUMBER: | NH 15-S0095 |
| LICENSEE INFO: | Park Ridge Care Center, LTD |
| LICENSEE ADDRESS: | 191 North Wacker Dr., Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 2/19/15 | |
| Type B violation for violating one or more sections: 300.615e) | |
| FACILITY NAME: | Titus Memorial Presbyterian Home |
| FACILITY ADDRESS: | 513 North Worth St. |
| FACILITY CITY, STATE, ZIP: | Sullivan, IL 61951 |
| DOCKET NUMBER: | NH 15-S0096 |
| LICENSEE INFO: | Joseph and Louise Titus Memorial Presbyterian Home, Inc |
| LICENSEE ADDRESS: | 513 North Worth St. |
| LICENSEE CITY, STATE, ZIP: | Sullivan, IL 61951 |
| Survey Date – 2/6/15 | |
| Type A violation for violating one or more sections: 330.1110g), 330.1125a)1), 330.1125e), and 330.4240a). 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: 330.4240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Lewis Memorial Christian Village |
| FACILITY ADDRESS: | 3400 West Washington St. |
| FACILITY CITY, STATE, ZIP: | Springfield, IL 62711 |
| DOCKET NUMBER: | NH 15-C0098 |
| LICENSEE INFO: | Lewis Memorial Christian Village |
| LICENSEE ADDRESS: | 200 North Postville Road |
| LICENSEE CITY, STATE, ZIP: | Lincoln, IL 62656 |
| Survey Date – 2/6/15 | |
| Type A violation for violating one or more sections: 300.610a), 300.1010h), 300.1030a)3), 300.1210b), 300.1210d)3), 300.1210d)6), and 300.3240a) The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)6) and 300.3240a) For a total fine of $25,000.00 | |
| FACILITY NAME: | Riverview Rehab Center |
| FACILITY ADDRESS: | 50 North Jane |
| FACILITY CITY, STATE, ZIP: | Elgin, IL 60123 |
| DOCKET NUMBER: | NH 14-S0439 |
| LICENSEE INFO: | River View Rehab Center, LLC |
| LICENSEE ADDRESS: | 4711 Golf Road, Ste 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Waterfront Terrace |
| FACILITY ADDRESS: | 7750 South Shore Dr. |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60649 |
| DOCKET NUMBER: | NH 15-C0097 |
| LICENSEE INFO: | Waterfront Terrace, Inc |
| LICENSEE ADDRESS: | 191 North Wacker Dr., Ste. 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 1/29/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)6), 300.1220b)3), and 300.3240a). 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: | Sauk Valley Senior Living |
| FACILITY ADDRESS: | 1000 Dixion Ave |
| FACILITY CITY, STATE, ZIP: | Rock Falls, IL 61071 |
| DOCKET NUMBER: | NH 15-S0105 |
| LICENSEE INFO: | Midwest Health Operations, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 3/5/15 | |
| Type B violation for violating one or more sections: 300.3130c)4). No fine. | |
| FACILITY NAME: | Aperion Care Decatur |
| FACILITY ADDRESS: | 2650 North Monroe |
| FACILITY CITY, STATE, ZIP: | Decatur, IL 62526 |
| DOCKET NUMBER: | NH 15-S0106 |
| LICENSEE INFO: | Lincoln Rehab Center, LLC |
| LICENSEE ADDRESS: | 8131 Monticello Ave |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 2/24/15 | |
| Type B violation for violating one or more sections: 300.1230j)5), 300.1230k), and 300.3260c). No fine | |
| FACILITY NAME: | Champaign Urbana Nursing & Rehab |
| FACILITY ADDRESS: | 302 Burwash Ave |
| FACILITY CITY, STATE, ZIP: | Savoy, IL 61874 |
| DOCKET NUMBER: | NH 15-C0104 |
| LICENSEE INFO: | Champaign Urbana Nursing and Rehab, LP |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Ste 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 2/18/15 | |
| Type B violation for violating one or more sections: 300.1230d)2)j)5). No fine | |
| FACILITY NAME: | Trafford Estates |
| FACILITY ADDRESS: | 813 West Center |
| FACILITY CITY, STATE, ZIP: | Fairfield, IL 62837 |
| DOCKET NUMBER: | NH 15-C0078 |
| LICENSEE INFO: | TDL Group, Inc |
| LICENSEE ADDRESS: | 11340 Arcadia Lake Road |
| LICENSEE CITY, STATE, ZIP: | Marion, IL 62959 |
| Survey Date – 1/6/15 | |
| Type A violation for violating one or more sections: 350.620a), 350.1060e), 350.1210, 350.1430a)2), 350.1430d), 350.3220f), and 350.3240a). For a total fine of $10,000.00 | |
| FACILITY NAME: | Crossroads Care Center Woodstock |
| FACILITY ADDRESS: | 309 McHenry Ave |
| FACILITY CITY, STATE, ZIP: | Woodstock, IL 60098 |
| DOCKET NUMBER: | NH 15-S0086 |
| LICENSEE INFO: | Crossroads Care Center of Woodstock, LLC |
| LICENSEE ADDRESS: | 5750 Old Orchard Road., Ste 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 1/13/15 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.2210a), 300.2210b)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Prairie Manor Nursing & Rehab Center |
| FACILITY ADDRESS: | 345 Dixie Highway |
| FACILITY CITY, STATE, ZIP: | Chicago Heights, IL 60411 |
| DOCKET NUMBER: | NH 15-C0006 |
| LICENSEE INFO: | Prairie Manor Nursing & Rehab Center, LLC |
| LICENSEE ADDRESS: | 2201 West Main St. |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60202 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Mulberry Manor |
| FACILITY ADDRESS: | 612 East Davie St., Box 88 |
| FACILITY CITY, STATE, ZIP: | Anna, IL 62906 |
| DOCKET NUMBER: | NH 15-S0092 |
| LICENSEE INFO: | Mulberry Manor, Inc |
| LICENSEE ADDRESS: | 159 E. Vienna St. PO Box 88 |
| LICENSEE CITY, STATE, ZIP: | Anna, IL 62906 |
| Survey Date – 1/23/15 | |
| Type B violation for violating one or more sections: 350.620a), 350.1210 and 350.3240a). For a total fine of $750.00 | |
| FACILITY NAME: | Midwest Rehab and Respiratory |
| FACILITY ADDRESS: | 727 North 17th St. |
| FACILITY CITY, STATE, ZIP: | Belleville, IL 62226 |
| DOCKET NUMBER: | NH 15-C0100 |
| LICENSEE INFO: | Midwest Rehab and Respiratory Center, LLC |
| LICENSEE ADDRESS: | 8170 McCormick Blvd, Ste 219 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 2/17/15 | |
| Type A violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), 300.1210d)3), 300.1210d)5), 300.1220b)3), 300.1620a), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $25,000.00. | |
| Type A violation for violating one or more sections: 300.610a), 300.690a), 300.1210b), 300.1210d)6), 300.1230b) 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), 300.3240a). For a total fine of $25,000.00. | |
| FACILITY NAME: | Cedar Ridge Health and Rehab Center |
| FACILITY ADDRESS: | One Perryman St. |
| FACILITY CITY, STATE, ZIP: | Lebanon, IL 62254 |
| DOCKET NUMBER: | NH 15-C0091 NH 15-S0110 |
| LICENSEE INFO: | Covenant Care Midwest, Inc |
| LICENSEE ADDRESS: | 208 S. LaSalle, Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 1/15/15 | |
| Type A violation for violating one or more sections: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $25,000.00. | |
| Type B violation for violating one or more sections: 300.1010h), 300.1210b), 300.1220b)3), and 300.3240a) The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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 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 $2,200.00. | |
| Type B violation for violating one or more sections: 300.1210b)3), 300.1210d)4)B), 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: | Glen Bridge Nursing and Rehab Centre |
| FACILITY ADDRESS: | 8333 West Golf Road |
| FACILITY CITY, STATE, ZIP: | Niles, IL 60714 |
| DOCKET NUMBER: | NH 15-C0102 |
| LICENSEE INFO: | Glenbridge Nursing and Rehab Centre, LTD |
| LICENSEE ADDRESS: | 191 North Wacker Dr., Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 1/28/15 | |
| Type B violation for violating one or more sections: 300.690a)b)c). No fine. | |
| FACILITY NAME: | Gardenview Manor |
| FACILITY ADDRESS: | 14792 Catlin-Tilton Road |
| FACILITY CITY, STATE, ZIP: | Danville, IL 61834 |
| DOCKET NUMBER: | NH 15-C0108 |
| LICENSEE INFO: | Gardenview Manor, LLC |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Ste 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 3/3/15 | |
| Type B violation for violating one or more sections: 300.1230j)5) and 300.1230k). No fine. | |
| FACILITY NAME: | Chicago Ridge Nursing Center |
| FACILITY ADDRESS: | 10602 Southwest Highway |
| FACILITY CITY, STATE, ZIP: | Chicago, Ridge, IL 60415 |
| DOCKET NUMBER: | NH 15-C0101 |
| LICENSEE INFO: | BM of Chicago Ridge, LLC |
| LICENSEE ADDRESS: | 8170 N McCormick Blvd, Ste. 219 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 2/24/15 | |
| Type B violation for violating one or more sections: 300.690b)c). No fine. | |
| FACILITY NAME: | Burgin Manor of Olney |
| FACILITY ADDRESS: | 900 East Scott St. |
| FACILITY CITY, STATE, ZIP: | Olney, IL 62450 |
| DOCKET NUMBER: | NH 15-S0107 |
| LICENSEE INFO: | Burgin Manor of Olney, Inc |
| LICENSEE ADDRESS: | 858 Sunnyhill Lane |
| LICENSEE CITY, STATE, ZIP: | Columbia, IL 62236 |
| Survey Date – 2/11/15 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210c), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $25,000.00. | |
| FACILITY NAME: | St. Joseph Nursing Home |
| FACILITY ADDRESS: | 401 9th St. |
| FACILITY CITY, STATE, ZIP: | Lacon, IL 61540 |
| DOCKET NUMBER: | NH 15 S-0113 |
| LICENSEE INFO: | St. Joseph Nursing Home, Inc Lacon, Illinois |
| LICENSEE ADDRESS: | 401 9th St. |
| LICENSEE CITY, STATE, ZIP: | Lacon, IL 61540 |
| Survey Date – 2/25/15 | |
| Type B violation for violating one or more sections: 300.615e). No fine. | |
| FACILITY NAME: | Sterling Pavilion |
| FACILITY ADDRESS: | 105 East 23rd St. |
| FACILITY CITY, STATE, ZIP: | Sterling, IL 61081 |
| DOCKET NUMBER: | NH 15-C0109 |
| LICENSEE INFO: | Sterling Pavilion, LTD |
| LICENSEE ADDRESS: | 191 North Wacker Dr., Ste 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 1/30/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), 300.1210d)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: | Manor Court of Clinton |
| FACILITY ADDRESS: | 1 Park Lane West |
| FACILITY CITY, STATE, ZIP: | Clinton, IL 61727 |
| DOCKET NUMBER: | NH 15-S0117 |
| LICENSEE INFO: | Residential Alternatives of Illinois, Inc |
| LICENSEE ADDRESS: | 285 S. Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| Survey Date – 2/6/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)6), 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Community Care Center |
| FACILITY ADDRESS: | 4314 S. Wabash Ave |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60653 |
| DOCKET NUMBER: | NH 15-S0114 |
| LICENSEE INFO: | CC Care, LLC |
| LICENSEE ADDRESS: | 1S443 Summit Ave, Ste 204 |
| LICENSEE CITY, STATE, ZIP: | Oakbrook Terrace, IL 60181 |
| Survey Date - N/A | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Manorcare of South Holland |
| FACILITY ADDRESS: | 2145 East 170th St. |
| FACILITY CITY, STATE, ZIP: | South Holland, IL 60473 |
| DOCKET NUMBER: | NH 14-C0292 |
| LICENSEE INFO: | Manorcare of South Holland IL, LLC |
| LICENSEE ADDRESS: | 208 S LaSalle St., Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | The Estates of Hyde Park |
| FACILITY ADDRESS: | 4505 S. Drexel Blvd |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60653 |
| DOCKET NUMBER: | NH 15-C0116 |
| LICENSEE INFO: | The Estates of Hyde Park, LLC |
| LICENSEE ADDRESS: | 4711 Golf Road., Ste 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 2/9/15 | |
| 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), 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Sharon Health Care Elms |
| FACILITY ADDRESS: | 3611 North Rochelle |
| FACILITY CITY, STATE, ZIP: | Peoria, IL 61604 |
| DOCKET NUMBER: | NH 15-C-0001 |
| LICENSEE INFO: | Sharon Health Care Elms, Inc |
| LICENSEE ADDRESS: | 465 Central Ave, Suite 100 |
| LICENSEE CITY, STATE, ZIP: | Northfield, IL 60093 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Snyders-Vaughn Haven |
| FACILITY ADDRESS: | 135 S. Morgan St. |
| FACILITY CITY, STATE, ZIP: | Rushville, IL 62681 |
| DOCKET NUMBER: | NH 14-S-0198 |
| LICENSEE INFO: | Synders’-Vaughn Haven, Inc |
| LICENSEE ADDRESS: | 135 S. Morgan |
| LICENSEE CITY, STATE, ZIP: | Rushville, IL 62681 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Glenview Terrace Nursing Center |
| FACILITY ADDRESS: | 1511 Greenwood Road |
| FACILITY CITY, STATE, ZIP: | Glenview, IL 60025 |
| DOCKET NUMBER: | NH 15-C0120 |
| LICENSEE INFO: | Glenview Terrace Nursing Center |
| LICENSEE ADDRESS: | 6633 North Lincoln Ave |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 2/5/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), 300.1210d)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 $2,200.00 | |
| FACILITY NAME: | Heritage Manor - El Paso |
| FACILITY ADDRESS: | 555 East Clay |
| FACILITY CITY, STATE, ZIP: | El Paso, IL 61738 |
| DOCKET NUMBER: | NH 15-S0121 |
| LICENSEE INFO: | Heritage Manor- El Paso, LLC |
| LICENSEE ADDRESS: | 202 N. Center |
| LICENSEE CITY, STATE, ZIP: | Bloomington, IL 61701 |
| Survey Date – 2/19/15 | |
| Type B 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 $2,200.00 | |
| FACILITY NAME: | Hickory Nursing Pavilion |
| FACILITY ADDRESS: | 9246 S. Roberts Road |
| FACILITY CITY, STATE, ZIP: | Hickory Hills, IL 60457 |
| DOCKET NUMBER: | NH 15-S0119 |
| LICENSEE INFO: | Hickory Nursing Pavilion, Inc |
| LICENSEE ADDRESS: | 10 S. Wacker Dr, 40th floor |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 2/13/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010b), 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), 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Sycamore Healthcare Center |
| FACILITY ADDRESS: | 720 Sycamore St. |
| FACILITY CITY, STATE, ZIP: | Quincy, IL 62301 |
| DOCKET NUMBER: | NH 15-C0122 |
| LICENSEE INFO: | SH Care, LLC |
| LICENSEE ADDRESS: | 1S443 Sumitt Ave, Ste 204 |
| LICENSEE CITY, STATE, ZIP: | Oakbrook Terrace, IL 60181 |
| Survey Date – 2/18/15 | |
| Type B violation for violating one or more sections: 300.610a). 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Avanti Wellness and Rehab |
| FACILITY ADDRESS: | 694 West Touhy Ave |
| FACILITY CITY, STATE, ZIP: | Niles, IL 60714 |
| DOCKET NUMBER: | NH 15-S0115 |
| LICENSEE INFO: | Forest Villa Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 7257 North Lincoln Ave |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 2/6/15 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Jerseyville Manor |
| FACILITY ADDRESS: | 1251 North State St. |
| FACILITY CITY, STATE, ZIP: | Jerseyville, IL 62052 |
| DOCKET NUMBER: | NH 15-C0118 |
| LICENSEE INFO: | UDI #11, LLC |
| LICENSEE ADDRESS: | 285 S. Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| Survey Date – 2/24/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b)1)3), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Manor Care of Homewood IL |
| FACILITY ADDRESS: | 940 Maple Ave., |
| FACILITY CITY, STATE, ZIP: | Homewood, IL 60430 |
| DOCKET NUMBER: | NH 15-C0123 |
| LICENSEE INFO: | Manor Care of Homewood IL, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., STE 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 3/10/15 | |
| Type B violation for violating one or more sections: 300.1210d)6) | |
| FACILITY NAME: | Meadows Mennonite Home |
| FACILITY ADDRESS: | 24599 Church St. |
| FACILITY CITY, STATE, ZIP: | Chenoa, IL 61726 |
| DOCKET NUMBER: | NH 15-C0085 |
| LICENSEE INFO: | Meadows Mennonite Retirement Community Association, Inc |
| LICENSEE ADDRESS: | 24588 Church St. |
| LICENSEE CITY, STATE, ZIP: | Chenoa, IL 61726 |
| Survey Date – 1/21/15 | |
| Type A violation for violating one or more sections: of the code:300.610a),300.690; 300.690a):300.1210b), 300.1210d)6); 300.1220b)1); 300.1220b)2); 300.1220b)3); 300.1220b)6); 300.1220b)7); 300.3240a); 300.3240b) and 300.3240d. The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.690; 300.1210b); 300.1210d)6); 300.3240a) and 300.3240d. For a total fine of $25,000.00 | |
| FACILITY NAME: | White Oak Rehabilitation HCC |
| FACILITY ADDRESS: | 1700 White St. |
| FACILITY CITY, STATE, ZIP: | Mount Vernon, IL 62864 |
| DOCKET NUMBER: | NH 15-C0125 |
| LICENSEE INFO: | Petersen Management Company, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Drive |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61814 |
| Survey Date – 2/18/15 | |
| Type A violation for violating one or more sections of the code: 300.610a), 300.1210b), 300.1210d)6) and 300.3240a) . The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: | Moweaqua NRSG & retirement CTR |
| FACILITY ADDRESS: | Maple and Macon Streets |
| FACILITY CITY, STATE, ZIP: | Moweaqua, IL 62550 |
| DOCKET NUMBER: | NH 15-C0127 |
| LICENSEE INFO: | Moweaqua Nursing Ventures LLC |
| LICENSEE ADDRESS: | 480 S. Meadowbrook Road |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62707 |
| Survey Date – 3/30/15 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1610a)10, 300.1830b), 300.3210g), 300.3240a), and 300.3240b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Pleasant View Rehab & HCC |
| FACILITY ADDRESS: | 500 North Jackson St. |
| FACILITY CITY, STATE, ZIP: | Morrison, IL 61270 |
| DOCKET NUMBER: | NH 15-S0128 |
| LICENSEE INFO: | Petersen Health Operations III, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Drive |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 2/26/15 | |
| Type B violation for violating one or more sections: 300.610a), 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) and300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Forest City Rehab & NRSG CTR |
| FACILITY ADDRESS: | 321 Arnold Ave. |
| FACILITY CITY, STATE, ZIP: | Rockford, IL. 61108 |
| DOCKET NUMBER: | NH 15-S0129 |
| LICENSEE INFO: | Forest City Rehab and nursing center |
| LICENSEE ADDRESS: | 4711 Golf Road, Ste 200 |
| LICENSEE CITY, STATE, ZIP: Skokie, IL 60076 | |
| Survey Date – 1/22/15 | |
| Type B violation for violating one or more sections: 300.625c). | |
| FACILITY NAME: | Meadows Mennonite Home |
| FACILITY ADDRESS: | 24588 Church St. |
| FACILITY CITY, STATE, ZIP: | Chenoa, IL 61726 |
| DOCKET NUMBER: | NH 15-C0132 |
| LICENSEE INFO: | Meadows Mennonite Retirement Community Association Inc |
| LICENSEE ADDRESS: | 24588 Church St. |
| LICENSEE CITY, STATE, ZIP: | Chenoa, IL 61726 |
| Survey Date – 3/17/15 | |
| Type B violation for violating one or more sections: 300.690b), 300.690c). | |
| FACILITY NAME: | Brookdale Burr Ridge |
| FACILITY ADDRESS: | 6801 Highgrove Blvd |
| FACILITY CITY, STATE, ZIP: | Burr Ridge, IL 60527 |
| DOCKET NUMBER: | NH 15-S0124 |
| LICENSEE INFO: | S-H OPCO Burr Ridge, LLC |
| LICENSEE ADDRESS: | 208 S. LaSalle St, Ste 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 3/4/15 | |
| Type B violation for violating one or more sections: 300.2030e)f)h)i). No fine. | |
Illinois Department of Public Health
535 West Jefferson St.
Springfield, Illinois 62761
Phone 217-782-4977
Fax 217-782-3987
TTY 800-547-0466
Questions or Comments
535 West Jefferson St.
Springfield, Illinois 62761
Phone 217-782-4977
Fax 217-782-3987
TTY 800-547-0466
Questions or Comments