2022 1st Quarterly Report

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: Abington of Glenview Nursing
FACILITY ADDRESS: 3901 Glenview Road
FACILITY CITY, STATE, ZIP: Glenview, IL 60025

DOCKET NUMBER: NH 22-C0035

LICENSEE INFO: Abington of Glenview Nursing & Rehab Center, LLC
LICENSEE ADDRESS: 180 N. LaSalle St., Ste 3300
LICENSEE CITY, STATE, ZIP: Chicago, IL 60601
Survey Date – 11/23/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), and 300.1210d)2)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)5). A fine of $2,200.00

FACILITY NAME: Accolade Healthcare Danville
FACILITY ADDRESS: 801 North Logan Avenue
FACILITY CITY, STATE, ZIP: Danville, IL 61832

DOCKET NUMBER: NH 21-S0873

LICENSEE INFO: Accolade Healthcare of Danville, LLC
LICENSEE ADDRESS: 2501 Chatham Road, Ste R
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 10/25/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)5), 300.1210c), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Adloff Place
FACILITY ADDRESS: 50 Adloff Lane
FACILITY CITY, STATE, ZIP: Springfield, IL 62703

DOCKET NUMBER: NH 22-S0168

LICENSEE INFO: Home and Environments for Living and Programs, Inc.
LICENSEE ADDRESS: 208 South LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 01/21/2022

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.620b)6), 350.1070), 350.3240a), and 350.3240a). A fine of $550.00

Type B violation for violating one or more of the following sections of the Code: 350.1060a), 350.1060d), and 350.1060 j). A fine of $550.00

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1840b), 350.1840e), and 350.1850). A fine of $550.00

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1440a)2), 350.1440e), and 350.1450c). A fine of $550.00

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1230a)6), and 350.1410a). A fine of $550.00

Total Fine: $2,750.00

FACILITY NAME: AHVA Care of Winfield
FACILITY ADDRESS: 28W141 Liberty Street
FACILITY CITY, STATE, ZIP: Winfield, IL 60190

DOCKET NUMBER: NH 22-C0166

LICENSEE INFO: AHVA Care of Winfield, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 01/20/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.3240a). A fine of $25,000.00

FACILITY NAME: Alden Estates of Skokie
FACILITY ADDRESS: 4626 Old Orchard Road
FACILITY CITY, STATE, ZIP: Skokie, IL 60076

DOCKET NUMBER: NH 22-C0107

LICENSEE INFO: Alden Estates of Skokie, Inc.
LICENSEE ADDRESS: 4200 W. Peterson, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 12/30/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Alden Poplar Creek Rehab & HCC
FACILITY ADDRESS: 1545 Barrington Road
FACILITY CITY, STATE, ZIP: Hoffman Estates, IL 60169

DOCKET NUMBER: NH 22-S0065

LICENSEE INFO: Alden-Poplar Creek Rehabilitation and Health Care Center
LICENSEE ADDRESS: 4200 W. Peterson Ave., Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 12/17/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)3)5), and 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5). A fine of $2,200.00

FACILITY NAME: Alden Poplar Creek Rehab & HCC
FACILITY ADDRESS: 1545 Barrington Road
FACILITY CITY, STATE, ZIP: Hoffman Estates, IL 60169

DOCKET NUMBER: NH 22-S0144

LICENSEE INFO: Alden Poplar Creek Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave., Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 01/19/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210d)2), and 300.1210d)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)5). A fine of $2,200.00

FACILITY NAME: Alden Town Manor Rehab & HCC
FACILITY ADDRESS: 6120 West Ogden
FACILITY CITY, STATE, ZIP: Cicero, IL 60804

DOCKET NUMBER: NH 22-C0138

LICENSEE INFO: Alden Town Manor Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave., Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 01/11/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)5), and 300.1210c). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Alhambra Rehab & Healthcare
FACILITY ADDRESS: 417 East Main St., P.O. Box 208
FACILITY CITY, STATE, ZIP: Alhambra, IL 62001

DOCKET NUMBER: NH 21-C0937

LICENSEE INFO: Alhambra Rehab & Healthcare, LLC
LICENSEE ADDRESS: 215 E. Locust Street
LICENSEE CITY, STATE, ZIP: Harrisburg, IL 62946
Survey Date – 12/14/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)5) and 300.1210c). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Alpine Fireside Health Center
FACILITY ADDRESS: 3650 North Alpine Road
FACILITY CITY, STATE, ZIP: Rockford, IL 61114

DOCKET NUMBER: NH 22-S0129

LICENSEE INFO: Alpine Fireside Health Center, Ltd
LICENSEE ADDRESS: 3650 N. Alpine Road
LICENSEE CITY, STATE, ZIP: Rockford, IL 61114
Survey Date – 01/11/2022

FACILITY NAME: Ambassador Nsg & Rehab Center
FACILITY ADDRESS: 4900 N. Bernard
FACILITY CITY, STATE, ZIP: Chicago, IL 60625

DOCKET NUMBER: NH 21-S0934

LICENSEE INFO: Ambassador Nursing and Rehabilitation II, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 11/10/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a) and 300.1210b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), and 300.1210d)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5). A fine of $2,200.00

Total Fine: $4,400.00

FACILITY NAME: Ambassador Nsg & Rehab Center
FACILITY ADDRESS: 4900 N. Bernard
FACILITY CITY, STATE, ZIP: Chicago, IL 60625

DOCKET NUMBER: NH 22-C0070

LICENSEE INFO: Ambassador Nursing and Rehabilitation II, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 12/17/2021

FACILITY NAME: Aperion Care DeKalb
FACILITY ADDRESS: 1212 South Second Street
FACILITY CITY, STATE, ZIP: DeKalb, IL 60115

DOCKET NUMBER: NH 22-S0101

LICENSEE INFO: Aperion Care DeKalb, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 01/13/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1020a) and 300.1020b). A fine of $12,500.00

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.615e) and 300.615f). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.615e) and 300.615f). A fine of $500.00

Total Fine: $13,000.00

FACILITY NAME: Aperion Care Forest Park
FACILITY ADDRESS: 8200 West Roosevelt Road
FACILITY CITY, STATE, ZIP: Forest Park, IL 60130

DOCKET NUMBER: NH 21-C0901

LICENSEE INFO: Berkshire Nursing & Rehab Center, LLC
LICENSEE ADDRESS: 208 So, LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/16/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), 300.1210c), 300.1210d)2)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.1210d)3)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)5). A fine of $25,000.00

Total Fine: $50,000.00

FACILITY NAME: Aperion Care Forest Park
FACILITY ADDRESS: 8200 West Roosevelt Road
FACILITY CITY, STATE, ZIP: Forest Park, IL 60130

DOCKET NUMBER: NH 22-C0128

LICENSEE INFO: Berkshire Nursing & Rehab Center, LLC
LICENSEE ADDRESS: 208 So. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 01/26/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)4), 300.1210c), and 300.1210d)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

FACILITY NAME: Aperion Care Jacksonville
FACILITY ADDRESS: 1021 North Church Street
FACILITY CITY, STATE, ZIP: Jacksonville, IL 62650

DOCKET NUMBER: NH 22-S0004

LICENSEE INFO: North Church Nursing & Rehab, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/06/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210c), and 300.1210d)2)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210c), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

Total Fine: $4,400.00

FACILITY NAME: Aperion Care Lakeshore
FACILITY ADDRESS: 7200 North Sheridan Road
FACILITY CITY, STATE, ZIP: Chicago, IL 60626

DOCKET NUMBER: NH 21-C0926

LICENSEE INFO: Lakeshore OPCO, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/22/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d)3)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)5). A fine of $25,000.00

FACILITY NAME: Aperion Care Peoria Heights
FACILITY ADDRESS: 1629 Gardner Lane
FACILITY CITY, STATE, ZIP: Peoria Heights, IL 61616

DOCKET NUMBER: NH 22-C0011

LICENSEE INFO: Aperion Care Peoria Heights, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/24/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.625a), 300.625b), 300.625k), 300.625n), 300.1210a), 300.1210b), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.625a), 300.625b), 300.625k), 300.625n), 300.1210b), and 300.1210d)6). A fine of $25,000.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b), and 300.1210d)3)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

Total Fine: $27,200.00

FACILITY NAME: Aperion Care Peoria Heights
FACILITY ADDRESS: 1629 Gardner Lane
FACILITY CITY, STATE, ZIP: Peoria Heights, IL 61616

DOCKET NUMBER: NH 22-C0029

LICENSEE INFO: Aperion Care Peoria Heights, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/15/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)4)5), 300.1210c), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Aperion Care West Ridge
FACILITY ADDRESS: 6450 N. Ridge Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60626

DOCKET NUMBER: NH 22-C0019

LICENSEE INFO: Aperion Care West Ridge, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/24/2021

FACILITY NAME: Aperion Care Westchester
FACILITY ADDRESS: 2901 South Wolf Road
FACILITY CITY, STATE, ZIP: Westchester, IL 60154

DOCKET NUMBER: NH 22-S0079

LICENSEE INFO: Aperion Care Westchester, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/20/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Aperion Care Wilmington
FACILITY ADDRESS: 555 West Kahler
FACILITY CITY, STATE, ZIP: Wilmington, IL 60481

DOCKET NUMBER: NH 21-S0875

LICENSEE INFO: Island City Rehabilitation Center, LLC
LICENSEE ADDRESS: 208 So. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/10/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b) and 300.1210d)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Arcadia Care Auburn
FACILITY ADDRESS: 304 Maple Avenue
FACILITY CITY, STATE, ZIP: Auburn, IL 62615

DOCKET NUMBER: NH 22-C0013

LICENSEE INFO: Arcadia Care Auburn, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/10/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b)5), 300.1210d)6), and 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Arcadia Care Auburn
FACILITY ADDRESS: 304 Maple Avenue
FACILITY CITY, STATE, ZIP: Auburn, IL 62615

DOCKET NUMBER: NH 22-C0014

LICENSEE INFO: Arcadia Care Auburn, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/23/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210c), and 300.1210d)1)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

FACILITY NAME: Arcadia Care Auburn
FACILITY ADDRESS: 304 Maple Avenue
FACILITY CITY, STATE, ZIP: Auburn, IL 62615

DOCKET NUMBER: NH 22-C0119

LICENSEE INFO: Arcadia Care Auburn, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 01/20/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)5, and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1010g)4), 300.1210a), 300.1210b), 300.1210d)3), and 300.2040b)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $2,200.00

Total Fine: $4,400.00

FACILITY NAME: Arcadia Care Bloomington
FACILITY ADDRESS: 1509 North Calhoun Street
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701

DOCKET NUMBER: NH 22-S0123

LICENSEE INFO: Arcadia Care Bloomington, LLC
LICENSEE ADDRESS: 4655 W. Chase Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 01/06/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.690a), 300.690b), 300.690c), 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 sections of the Code with a high risk designation: 300.690, 300.1210b), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Arcadia Care Clifton
FACILITY ADDRESS: 1190 E. 2900 North Road
FACILITY CITY, STATE, ZIP: Clifton, IL 60927

DOCKET NUMBER: NH 22-C0010

LICENSEE INFO: Clifton Operations, LLC
LICENSEE ADDRESS: 4655 W. Chase Ave
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 11/18/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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 sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Arcadia Care Danville
FACILITY ADDRESS: 1701 North Bowman
FACILITY CITY, STATE, ZIP: Danville, IL 61832

DOCKET NUMBER: NH 22-S0023

LICENSEE INFO: Danville Operations, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/08/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Arcadia Care Morris
FACILITY ADDRESS: 1095 Twilight Drive
FACILITY CITY, STATE, ZIP: Morris, IL 60450

DOCKET NUMBER: NH 22-C0089

LICENSEE INFO: Morris SNF Management, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/29/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210c)3), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Arden Courts (South Holland)
FACILITY ADDRESS: 2045 East 170^th Street
FACILITY CITY, STATE, ZIP: South Holland, IL 60473

DOCKET NUMBER: NH 21-S0868

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 – 11/06/2021

Type C violation of an occurrence for violating one or more of the following sections of the Code: 330.780b) and 330.780c). This instance in accordance with 330.282f) i) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 330.780). A fine of $500.00

FACILITY NAME: Asbury Court Nursing & Rehab
FACILITY ADDRESS: 1750 Elmhurst Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60018

DOCKET NUMBER: NH 21-C0820

LICENSEE INFO: Asbury Court Nursing & Rehabilitation, LLC
LICENSEE ADDRESS: 7040 N. Ridgeway
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/26/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a)b), 300.1210d)2)3)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5). A fine of $2,200.00

FACILITY NAME: Ascension Nazarethville Place
FACILITY ADDRESS: 300 North River Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60016

DOCKET NUMBER: NH 21-C0907

LICENSEE INFO: Presence Senior Services - Chicagoland
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/25/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)2)6)7), 300.1020a), and 300.1210b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.696 and 300.1210b). A fine of $25,000.00

FACILITY NAME: Ascension Resurrection Place
FACILITY ADDRESS: 1001 North Greenwood Avenue
FACILITY CITY, STATE, ZIP: Park Ridge, IL 60068

DOCKET NUMBER: NH 21-S0872

LICENSEE INFO: Presence Senior Services, Chicagoland
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 11/01/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210c) and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Austin Oasis, The
FACILITY ADDRESS: 901 South Austin Boulevard
FACILITY CITY, STATE, ZIP: Chicago, IL 60644

DOCKET NUMBER: NH 22-C0016

LICENSEE INFO: The Austin Oasis, LLC
LICENSEE ADDRESS: 4711 Golf Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 12/09/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.3240g). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Avantara Evergreen Park
FACILITY ADDRESS: 10124 South Kedzie
FACILITY CITY, STATE, ZIP: Evergreen Park, IL 60805

DOCKET NUMBER: NH 21-C0920

LICENSEE INFO: Evergreen Living & Rehab Center, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/27/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)2), 300.12202)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 sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Barry Community Care Center
FACILITY ADDRESS: 1313 Pratt Street
FACILITY CITY, STATE, ZIP: Barry, IL 62312

DOCKET NUMBER: NH 21-S0944

LICENSEE INFO: Barry Community Care Center, Inc.
LICENSEE ADDRESS: 1313 Pratt Street
LICENSEE CITY, STATE, ZIP: Barry, IL 62312
Survey Date – 11/18/2021

FACILITY NAME: Belhaven Nursing & Rehab Center
FACILITY ADDRESS: 11401 South Oakley Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60643

DOCKET NUMBER: NH 22-C0094

LICENSEE INFO: Belhaven Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 12/13/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), 300.1210d)3), and 300.1210d)5), and 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)5). A fine of $25,000.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)1)2)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

Total Fine: $27,200.00

FACILITY NAME: Belhaven Nursing & Rehab Ctr
FACILITY ADDRESS: 11401 South Oakley Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60643

DOCKET NUMBER: NH 22-C0145

LICENSEE INFO: Belhaven Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 01/07/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Bella Terra LaGrange
FACILITY ADDRESS: 4735 Willow Springs Road
FACILITY CITY, STATE, ZIP: LaGrange, IL 60525

DOCKET NUMBER: NH 21-S0925

LICENSEE INFO: Willow Springs Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 11/05/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.3240a) and 300.3240c). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Bella Terra Schaumburg
FACILITY ADDRESS: 675 S. Roselle Road
FACILITY CITY, STATE, ZIP: Schaumburg, IL 60193

DOCKET NUMBER: NH 21-S0910

LICENSEE INFO: Schaumburg Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton St
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 11/02/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240e). A fine of $2,200.00

FACILITY NAME: Beverly Farm Foundation
FACILITY ADDRESS: 6301 Humbert Road
FACILITY CITY, STATE, ZIP: Godfrey, IL 62035

DOCKET NUMBER: NH 21-S0916

LICENSEE INFO: Beverly Farm Foundation
LICENSEE ADDRESS: 190 South LaSalle St., Ste 3700
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 10/29/2021

Type Repeat A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) and 350.3240a). A fine of $12,500.00

FACILITY NAME: Bria of Belleville
FACILITY ADDRESS: 150 North 27^th Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62226

DOCKET NUMBER: NH 22-C0109

LICENSEE INFO: Belleville Healthcare & Rehabilitation Center, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Ste 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 12/17/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

FACILITY NAME: Bria of Forest Edge
FACILITY ADDRESS: 8001 South Western Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60620

DOCKET NUMBER: NH 21-C0833

LICENSEE INFO: Forest Edge Healthcare & Rehabilitation Center, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 10/26/2021

Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b)4)5), 300.1210c) 300.1210d)1)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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $50,000.00

FACILITY NAME: Bria of Palos Hills
FACILITY ADDRESS: 10426 South Roberts
FACILITY CITY, STATE, ZIP: Palos Hills, IL 60465

DOCKET NUMBER: NH 21-C0879

LICENSEE INFO: Palos Hills Healthcare, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 10/29/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)5, 300.1210c) and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Bria of Palos Hills
FACILITY ADDRESS: 10426 South Roberts
FACILITY CITY, STATE, ZIP: Palos Hills, IL 60465

DOCKET NUMBER: NH 21-C0902

LICENSEE INFO: Palos Hills Healthcare, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 11/23/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210c), 300.1210d)2)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Bria of Palos Hills
FACILITY ADDRESS: 10426 South Roberts
FACILITY CITY, STATE, ZIP: Palos Hills, IL 60465

DOCKET NUMBER: NH 21-C0908

LICENSEE INFO: Palos Hills Healthcare, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 11/10/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a) and 300.1210a). A fine of $12,500.00

FACILITY NAME: Bria of Palos Hills
FACILITY ADDRESS: 10426 South Roberts
FACILITY CITY, STATE, ZIP: Palos Hills, IL 60465

DOCKET NUMBER: NH 22-C0124

LICENSEE INFO: Palos Hills Healthcare, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 01/03/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210d)3), and 300.1220b)3). A fine of $1,100.00

FACILITY NAME: Bria of Westmont
FACILITY ADDRESS: 6501 S. Cass Ave
FACILITY CITY, STATE, ZIP: Westmont, IL 60559

DOCKET NUMBER: NH 21-C0933

LICENSEE INFO: Westmont Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 11/18/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), 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 sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Briar Place Nursing
FACILITY ADDRESS: 6800 West Joliet
FACILITY CITY, STATE, ZIP: Indian Head Park, IL 60525

DOCKET NUMBER: NH 22-C0102

LICENSEE INFO: Briar Place Nursing, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/21/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)6), 300.1840d), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.696a), 300.696c), 300.1020a), 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 sections of the Code with a high-risk designation: 300.696, 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

Total Fine: $50,000.00

FACILITY NAME: Briarbrook Place
FACILITY ADDRESS: 228 Briarbrook Drive
FACILITY CITY, STATE, ZIP: East Peoria, IL 61611

DOCKET NUMBER: NH 22-C0106

LICENSEE INFO: Progressive Housing, Inc.
LICENSEE ADDRESS: 20180 Governors Dr., Ste 300
LICENSEE CITY, STATE, ZIP: Olympia Fields, IL 60461
Survey Date – 12/21/2021

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.3240a) and 350.3240f). A fine of $550.00

FACILITY NAME: Brother James Court
FACILITY ADDRESS: 2508 St. James Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62707

DOCKET NUMBER: NH 22-S0092

LICENSEE INFO: Brother James Court
LICENSEE ADDRESS: 1215 S. 4^th Street
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/17/2021

Type B violation for violating one or more of the following sections of the Code: 350.700b), 350.700c), 350.1060a), 350.1060b), 350.1060e), 350.1210, and 350.3240a). A fine of $750.00

FACILITY NAME: Bryan Manor
FACILITY ADDRESS: 2150 East McCord P.O. Box 568
FACILITY CITY, STATE, ZIP: Centralia, IL 62801

DOCKET NUMBER: NH 22-S0130

LICENSEE INFO: Penta Group, Inc.
LICENSEE ADDRESS: 523 E. Broadway
LICENSEE CITY, STATE, ZIP: Centralia, IL 62801
Survey Date – 01/18/2022

Type B violation for violating one or more of the following sections of the Code: 350.610). A fine of $1,100.00

FACILITY NAME: Champaign Urbana Nrsg & Rehab
FACILITY ADDRESS: 302 Burwash Avenue
FACILITY CITY, STATE, ZIP: Savoy, IL 61874

DOCKET NUMBER: NH 22-C0057

LICENSEE INFO: Champaign Urbana Nursing and Rehab, LP
LICENSEE ADDRESS: 5750 Ola Orchard Rd., Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 12/06/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210d)3), 300.1210d)6), and 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

Total Fine: $27,200.00

FACILITY NAME: Charter Sr. Lvg Poplar Creek
FACILITY ADDRESS: 2150 West Golf Road
FACILITY CITY, STATE, ZIP: Hoffman Estates, IL 60169

DOCKET NUMBER: NH 22-C0173

LICENSEE INFO: S-H OPCO Hoffman Estates, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/19/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 330.790a). The fine was doubled in this instance in accordance with 330.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 330.790. A fine of $25,000.00

FACILITY NAME: Chicago Ridge SNF
FACILITY ADDRESS: 10602 Southwest Highway
FACILITY CITY, STATE, ZIP: Chicago Ridge, IL 60415

DOCKET NUMBER: NH 22-C0074

LICENSEE INFO: Chicago Ridge SNF, LLC
LICENSEE ADDRESS: 3531 Howard St., Ste 1006
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 12/15/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210c). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

FACILITY NAME: Christian Buehler Mem Home
FACILITY ADDRESS: 3415 North Sheridan Road
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 21-S0917

LICENSEE INFO: Christian Buehler Memorial
LICENSEE ADDRESS: 3415 North Sheridan Road
LICENSEE CITY, STATE, ZIP: Peoria, IL 61604
Survey Date – 12/01/2021

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.686b)4), 300.686c), 300.686d), and 300.686f)2)3)A)B)C)D)E)F)G)H)I)5)9)A)B)12). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.686. A fine of $500.00

FACILITY NAME: Christian Nursing Home
FACILITY ADDRESS: 1507 7^th Street
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 22-S0037

LICENSEE INFO: Christian Homes, Inc.
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/02/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Christian Nursing Home
FACILITY ADDRESS: 1507 7^th Street
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 22-C0116

LICENSEE INFO: Christian Homes, Inc.
LICENSEE ADDRESS: 208 S. LaSalle Street., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 01/12/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Citadel of Northbrook, The
FACILITY ADDRESS: 3300 Milwaukee Avenue
FACILITY CITY, STATE, ZIP: Northbrook, IL 60062

DOCKET NUMBER: NH 22-S0153

LICENSEE INFO: Citadel of Northbrook, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 01/19/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b) and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: City View Multicare Center
FACILITY ADDRESS: 5825 West Cermak Road
FACILITY CITY, STATE, ZIP: Cicero, IL 60804

DOCKET NUMBER: NH 21-C0906

LICENSEE INFO: City View Multicare Center, LLC
LICENSEE ADDRESS: 240 Fencl lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 11/24/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1030a)4), 300.1210a), 300.1210b), 300.1210c), 300.1210d)3)6), 300.1410a), 300.14010g), 300.1630a), and 300.1650a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Countryside Nrsg & Rehab Ctr
FACILITY ADDRESS: 1635 East 154^th Street
FACILITY CITY, STATE, ZIP: Dolton, IL 60419

DOCKET NUMBER: NH 22-S0033

LICENSEE INFO: Countryside Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 W. Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 12/03/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1)3), and 300.4040a)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

FACILITY NAME: Crestwood Terrace
FACILITY ADDRESS: 13301 South Central Avenue
FACILITY CITY, STATE, ZIP: Crestwood, IL 60418

DOCKET NUMBER: NH 22-C0111

LICENSEE INFO: Laureate Crestwood Operations, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 01/04/2022

FACILITY NAME: Crossroads Care Ctr Woodstock
FACILITY ADDRESS: 309 McHenry Avenue
FACILITY CITY, STATE, ZIP: Woodstock, IL 60098

DOCKET NUMBER: NH 21-S0931

LICENSEE INFO: Crossroads Care Center of Woodstock, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/08/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210d)6), and 300.1220b)9). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Crystal Pines Rehab & HCC
FACILITY ADDRESS: 335 North Illinois Street
FACILITY CITY, STATE, ZIP: Crystal Lake, IL 60014

DOCKET NUMBER: NH 22-S0001

LICENSEE INFO: Crystal Pines Rehabilitation and Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 11/18/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010g)4) and 300.1210b)4). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Doctors Nursing & Rehab Center
FACILITY ADDRESS: 1201 Hawthorn Road
FACILITY CITY, STATE, ZIP: Salem, IL 62881

DOCKET NUMBER: NH 22-S0099

LICENSEE INFO: Helia Healthcare of Salem, LLC
LICENSEE ADDRESS: 600 S. Second Street, Suite 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 01/11/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), and 300.1210b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Eastview Terrace
FACILITY ADDRESS: 100 Eastview Place
FACILITY CITY, STATE, ZIP: Sullivan, IL 61951

DOCKET NUMBER: NH 22-S0069

LICENSEE INFO: Eastview HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 12/23/2021

Type B violation of an occurrence for violating one or more of the following 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 sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Elevate Care Country Club Hill
FACILITY ADDRESS: 18300 South Lavergne
FACILITY CITY, STATE, ZIP: Country Club Hills, IL 60478

DOCKET NUMBER: NH 21-C0929

LICENSEE INFO: Elevate Care County Club Hills, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/19/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), and 300.1210d)3)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Elmwood Nursing & Rehab Center
FACILITY ADDRESS: 152 Wilma Drive
FACILITY CITY, STATE, ZIP: Maryville, IL 62062

DOCKET NUMBER: NH 22-S0071

LICENSEE INFO: Elmwood Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2202 Main Street, Ste 180
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 12/15/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210c), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000,00

FACILITY NAME: Elmwood Nursing & Rehab Center
FACILITY ADDRESS: 152 Wilma Drive
FACILITY CITY, STATE, ZIP: Maryville, IL 62062

DOCKET NUMBER: NH 22-C0072

LICENSEE INFO: Elmwood Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2202 Main Street., Ste 180
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 12/23/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210c), and 300.1210d)3)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Elmwood Terrace Healthcare Ctr
FACILITY ADDRESS: 1017 West Galena
FACILITY CITY, STATE, ZIP: Aurora, IL 60506

DOCKET NUMBER: NH 21-S0947

LICENSEE INFO: Elmwood Terrace Healthcare Center, Inc.
LICENSEE ADDRESS: 2201 Main Street, Ste 180
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 11/12/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)4)5), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Flanagan Rehabilitation & HCC
FACILITY ADDRESS: 201 East Falcon Highway
FACILITY CITY, STATE, ZIP: Flanagan, IL 61740

DOCKET NUMBER: NH 22-C0075

LICENSEE INFO: Flanagan HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 01/05/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.710a) and 330.710c)2). A fine of $1,100.00

FACILITY NAME: Gardenview Manor
FACILITY ADDRESS: 14792 Catlin-Tilton Road
FACILITY CITY, STATE, ZIP: Danville, IL 61834

DOCKET NUMBER: NH 21-C0911

LICENSEE INFO: Gardenview Manor, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd., Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 11/05/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), and 300.1210d)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

FACILITY NAME: Gardenview Manor
FACILITY ADDRESS: 14792 Catlin Tilton Road
FACILITY CITY, STATE, ZIP: Danville, IL 61834

DOCKET NUMBER: NH 22-S0021

LICENSEE INFO: Gardenview Manor, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 11/24/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.3240a). A fine of $2,200.00

FACILITY NAME: Generations at Applewood
FACILITY ADDRESS: 21020 Kostner Avenue
FACILITY CITY, STATE, ZIP: Matteson, IL 60443

DOCKET NUMBER: NH 22-S0147

LICENSEE INFO: Generations at Applewood, LLC
LICENSEE ADDRESS: 6840 N. Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 01/05/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.3210f) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.3240a). A fine of $2,200.00

FACILITY NAME: Generations at Elmwood Park
FACILITY ADDRESS: 7733 West Grand Avenue
FACILITY CITY, STATE, ZIP: Elmwood Park, IL 60707

DOCKET NUMBER: NH 22-C0096

LICENSEE INFO: Generations at Elmwood Park, Inc.
LICENSEE ADDRESS: 6840 N. Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 01/13/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210c) and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Generations Oakton Pavillion
FACILITY ADDRESS: 1660 Oakton Place
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60018

DOCKET NUMBER: NH 22-C0132

LICENSEE INFO: Generations at Oakton Pavillion, LLC
LICENSEE ADDRESS: 6840 N. Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 01/10/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4, 300.1210b)5), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Generations at Peoria
FACILITY ADDRESS: 5600 N. Glen Elm Drive
FACILITY CITY, STATE, ZIP: Peoria, IL 61614

DOCKET NUMBER: NH 22-C0054

LICENSEE INFO: Generations at Peoria, LLC
LICENSEE ADDRESS: 6840 N. Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 11/30/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696b), 300.696c)5), 300.1010h), 300.1030a)5), and 300.1210d)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.696. A fine of $25,000.00

FACILITY NAME: Generations at Rock Island
FACILITY ADDRESS: 2545 25^th Street
FACILITY CITY, STATE, ZIP: Rock Island, IL 61201

DOCKET NUMBER: NH 21-C0938 & NH 21-S0939

LICENSEE INFO: Generations at Rock Island, LLC
LICENSEE ADDRESS: 6840 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 11/10/2021

Total Fine: $4,400.00

FACILITY NAME: Gilman Healthcare Center
FACILITY ADDRESS: 1390 South Cresent Street
FACILITY CITY, STATE, ZIP: Gilman, IL 60938

DOCKET NUMBER: NH 21-S0892

LICENSEE INFO: Gilman Healthcare Center, LLC
LICENSEE ADDRESS: 4711 Golf Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 11/01/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210c), and 300.1210d2)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Good Samaritan Home
FACILITY ADDRESS: 2130 Harrison Street
FACILITY CITY, STATE, ZIP: Quincy, IL 62301

DOCKET NUMBER: NH 21-C0895

LICENSEE INFO: The Good Samaritan Home of Quincy
LICENSEE ADDRESS: 2130 Harrison Street
LICENSEE CITY, STATE, ZIP: Quincy, IL 62301
Survey Date – 11/05/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)3)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5). A fine of $2,200.00

FACILITY NAME: Granite Nsg & Rehab Center
FACILITY ADDRESS: 3500 Century Drive
FACILITY CITY, STATE, ZIP: Granite City, IL 62040

DOCKET NUMBER: NH 21-S0914

LICENSEE INFO: Granite Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 901 S. 2^nd Street, Ste 201
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 11/10/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)5), 300.1210d)4)6), 300.1810c), 300.1810f)1), and 300.1820c)3)4). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Grove of Berwyn, The
FACILITY ADDRESS: 3601 South Harlem Avenue
FACILITY CITY, STATE, ZIP: Berwyn, IL 60402

DOCKET NUMBER: NH 21-C0922

LICENSEE INFO: Berwyn Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 11/20/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d2)3)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)5), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Grove of Berwyn, The
FACILITY ADDRESS: 3601 South Harlem Avenue
FACILITY CITY, STATE, ZIP: Berwyn. IL 60402

DOCKET NUMBER: NH 22-C0034

LICENSEE INFO: Berwyn Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/19/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Grove of Berwyn, The
FACILITY ADDRESS: 3601 South Harlem Avenue
FACILITY CITY, STATE, ZIP: Berwyn. IL 60402

DOCKET NUMBER: NH 22-C0115

LICENSEE INFO: Berwyn Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/13/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)4), and 300.1210d)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Grove of Elmhurst, The
FACILITY ADDRESS: 127 West Diversey Avenue
FACILITY CITY, STATE, ZIP: Elmhurst, IL 60126

DOCKET NUMBER: NH 21-C0880

LICENSEE INFO: Elmbrook Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 11/01/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010g)3), 300.1010h), 300.1210a), 300.1210b), 300.1210d)2)5), and 300.3220f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5). A fine of $2,200.00

FACILITY NAME: Grove of Elmhurst, The
FACILITY ADDRESS: 127 West Diversey Avenue
FACILITY CITY, STATE, ZIP: Elmhurst, IL 60126

DOCKET NUMBER: NH 21-C0893

LICENSEE INFO: Elmbrook Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/27/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696d), 300.1010h), 300.1210a), 300.1210b), 300.1210d)3), and 300.1220b)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.696 and 300.1210b). A fine of $25,000.00

FACILITY NAME: Hallmark Healthcare of Pekin
FACILITY ADDRESS: 2501 Allentown Road
FACILITY CITY, STATE, ZIP: Pekin, IL 61554

DOCKET NUMBER: NH 22-C0058

LICENSEE INFO: Hallmark Healthcare of Pekin, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/30/2021

FACILITY NAME: Hamilton Memorial Rehab & HCC
FACILITY ADDRESS: 609 South Marshall Avenue
FACILITY CITY, STATE, ZIP: McLeansboro, IL 62859

DOCKET NUMBER: NH 22-C0131

LICENSEE INFO: Hamilton Memorial Nursing and Rehabilitation, LLC
LICENSEE ADDRESS: 412 East Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/18/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210d)3), and 300.1210d)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210d)5). A fine of $25,000.00

FACILITY NAME: Heartland of Galesburg
FACILITY ADDRESS: 280 East Losey Street
FACILITY CITY, STATE, ZIP: Galesburg, IL 61401

DOCKET NUMBER: NH 21-C0897

LICENSEE INFO: Heartland of Galesburg IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/12/2021

Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b)3), 300.1210c)3), 300.1220b)2) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $50,000.00

FACILITY NAME: Helia Healthcare of Belleville
FACILITY ADDRESS: 40 North 64^th Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62223

DOCKET NUMBER: NH 22-C0002

LICENSEE INFO: Helia Healthcare of Belleville, LLC
LICENSEE ADDRESS: 600 S. Second Street, Suite 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 12/15/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210d)3)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Helia Healthcare of Olney
FACILITY ADDRESS: 410 East Mack
FACILITY CITY, STATE, ZIP: Olney, IL 62450

DOCKET NUMBER: NH 21-C0818

LICENSEE INFO: Helia Healthcare of Olney, LLC
LICENSEE ADDRESS: 118 W. Edwards St., Ste 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 10/28/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210c), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Heritage Health Beardstown
FACILITY ADDRESS: 8306 St. Lukes Drive
FACILITY CITY, STATE, ZIP: Beardstown, IL 62618

DOCKET NUMBER: NH 22-S0080

LICENSEE INFO: Heritage Manor Beardstown South, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Suite 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 12/13/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1220d)2), 300.3240a), 300.3240b), 300.3240c), 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 sections of the Code with a high risk designation: 300.1210b), 300.3240a), and 300.3240e). A fine of $2,200.00

FACILITY NAME: Heritage Health Bloomington
FACILITY ADDRESS: 700 E. Walnut Street
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701

DOCKET NUMBER: NH 21-S0948

LICENSEE INFO: Heritage Manor Bloomington, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Ste 400
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 11/23/2021

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.661. This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.661. A fine of $500.00

FACILITY NAME: Heritage Health Bloomington
FACILITY ADDRESS: 700 E. Walnut Street
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701

DOCKET NUMBER: NH 22-C0020 & NH 22-S0083

LICENSEE INFO: Heritage Manor – Bloomington, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Ste 400
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 12/23/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b), 300.1210d)6), and 303.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Heritage Health Bloomington
FACILITY ADDRESS: 700 E. Walnut Street
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701

DOCKET NUMBER: NH 22-C0036

LICENSEE INFO: Heritage Manor Bloomington, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Ste 400
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 12/20/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)7), 300.1010h), 300.1210b), and 300.1210d)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.696 and 300.1210b). A fine of $25,000.00

FACILITY NAME: Heritage Health Hoopeston
FACILITY ADDRESS: 423 North Dixie Highway
FACILITY CITY, STATE, ZIP: Hoopeston, IL 60942

DOCKET NUMBER: NH 21-S0943

LICENSEE INFO: Hoopeston Retirement Village Foundation, Inc.
LICENSEE ADDRESS: 115 W. Jefferson Street, Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 11/20/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)5), 300.1210c), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Heritage Health Mt. Zion
FACILITY ADDRESS: 1225 Woodland Drive
FACILITY CITY, STATE, ZIP: Mt. Zion, IL 62549

DOCKET NUMBER: NH 21-S0884

LICENSEE INFO: Heritage Manor – Mt Zion, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Ste 400
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 10/25/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1030b), 300.1210b), 300.2420a)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 sections of the Code with a high-risk designation: 300.1210b), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Heritage Health Mt Zion
FACILITY ADDRESS: 1225 Woodland Drive
FACILITY CITY, STATE, ZIP: Mt. Zion, IL 62549

DOCKET NUMBER: NH 22-S0133

LICENSEE INFO: Heritage Manor – Mt. Zion, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Ste 400
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 01/18/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b) and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Highland Health Care Center
FACILITY ADDRESS: 1450 26^th Street
FACILITY CITY, STATE, ZIP: Highland, IL 62249

DOCKET NUMBER: NH 21-C0915

LICENSEE INFO: Highland Care and Rehabilitation Center, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/03/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610c)4), 300.1210d)6), and 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210d)6). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b)4), and 300.1210d)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

Total Fine: $4,400.00

FACILITY NAME: Hillsboro Rehab & HCC
FACILITY ADDRESS: 1300 East Tremont Street
FACILITY CITY, STATE, ZIP: Hillsboro, IL 62049

DOCKET NUMBER: NH 21-C0936

LICENSEE INFO: Hillsboro Rehabilitation and Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/03/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Hillsboro Rehab & HCC
FACILITY ADDRESS: 1300 East Tremont Street
FACILITY CITY, STATE, ZIP: Hillsboro, IL 62049

DOCKET NUMBER: NH 22-S0114

LICENSEE INFO: Hillsboro Rehabilitation and Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/13/2022

Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)6)7), 300.1020a), 300.1020b), 300.1020c), 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 sections of the Code with a high risk designation: 300.696, 300.1210b), and 300.3240a). A fine of $50,000.00

FACILITY NAME: Hillside Rehab & Care Center
FACILITY ADDRESS: 1308 Game Farm Road
FACILITY CITY, STATE, ZIP: Yorkville, IL 60560

DOCKET NUMBER: NH 21-S0862

LICENSEE INFO: Helia Healthcare of Yorkville, LLC
LICENSEE ADDRESS: 118 W. Edwards St., Ste 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 10/28/2021

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4), 300.1210d)3), 300.2040b)2), 300.2040d), and 300.2040e). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $500.00

FACILITY NAME: Hope Creek Nursing & Rehab
FACILITY ADDRESS: 4343 Kennedy Drive
FACILITY CITY, STATE, ZIP: East Moline, IL 61244

DOCKET NUMBER: NH 22-C0137

LICENSEE INFO: Hope Creek Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 5683 N. Lincoln Ave
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659
Survey Date – 01/12/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b) and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.696a), 300.696b), and 300.696c)6)7). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.696. A fine of $25,000.00

Total Fine: $50,000.00

FACILITY NAME: Illini Heritage Rehab & HC
FACILITY ADDRESS: 1315 Curt Drive, Suite B
FACILITY CITY, STATE, ZIP: Champaign, IL 61821

DOCKET NUMBER: NH 22-S0122

LICENSEE INFO: Petersen Health Care- Illini, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 12/29/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.1210d)6), and 300.1220b)2)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Inverness Health & Rehab
FACILITY ADDRESS: 1800 Colonial Parkway
FACILITY CITY, STATE, ZIP: Inverness, IL 60067

DOCKET NUMBER: NH 22-C0007

LICENSEE INFO: Inverness NH, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/09/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)4)5), 300.1210c), 300.1210d)3)6), and 300.1450). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: King Bruwaert House
FACILITY ADDRESS: 6101 County Line Road
FACILITY CITY, STATE, ZIP: Burr Ridge, IL 60527

DOCKET NUMBER: NH 22-C0097

LICENSEE INFO: King Bruwaert House
LICENSEE ADDRESS: 2215 York Road, Suite 550
LICENSEE CITY, STATE, ZIP: Oak Brook, IL 60523
Survey Date – 12/30/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)6), 300.1220b)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $2,200.00

FACILITY NAME: Landmark of Richton Park
FACILITY ADDRESS: 22660 South Cicero Avenue
FACILITY CITY, STATE, ZIP: Richton Park, IL 60471

DOCKET NUMBER: NH 22-C0120 & NH 22-S0121

LICENSEE INFO: Landmark of Richton Park Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 5683 N. Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659
Survey Date – 12/28/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210d)5), and 300.1220b)2)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5). A fine of $2,200.00

Total Fine: $6,600.00

FACILITY NAME: Landmark of Richton Park
FACILITY ADDRESS: 22660 South Cicero Ave
FACILITY CITY, STATE, ZIP: Richton Park, IL 60471

DOCKET NUMBER: NH 22-C0156 & NH 22-S0157

LICENSEE INFO: Landmark of Richton Park Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 5683 N. Lincoln Ave
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659
Survey Date – 01/19/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b) and 300.1220b)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)3)5), and 300.1220b)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)5). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)3), and 300.1220b)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $2,200.00

Total Fine: $8,800.00

FACILITY NAME: Lemont Nrsg & Rehab Center
FACILITY ADDRESS: 12450 Walker Road
FACILITY CITY, STATE, ZIP: Lemomt, IL 60539

DOCKET NUMBER: NH 22-C0103

LICENSEE INFO: Lemond Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 01/13/2022

FACILITY NAME: Loft Rehabilitation & Nursing
FACILITY ADDRESS: 700 N. Main Street
FACILITY CITY, STATE, ZIP: Eureka, IL 61530

DOCKET NUMBER: NH 21-C0935

LICENSEE INFO: The Loft Rehabilitation & Nursing, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 11/08/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)1)2), and 300.3220f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

FACILITY NAME: Loft Rehabilitation & Nursing
FACILITY ADDRESS: 700 N. Main Street
FACILITY CITY, STATE, ZIP: Eureka, IL 61530

DOCKET NUMBER: NH 22-S0044

LICENSEE INFO: The Loft Rehabilitation & Nursing, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 12/21/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1830b), 300.1830c), 300.3210f), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.3240a). A fine of $25,000.00

FACILITY NAME: Loft Rehab & Nursing of Normal
FACILITY ADDRESS: 510 Broadway
FACILITY CITY, STATE, ZIP: Normal, IL 61761

DOCKET NUMBER: NH 22-C0047

LICENSEE INFO: The Loft Rehabilitation and Nursing of Normal, LLC
LICENSEE ADDRESS: 191 N. Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 12/14/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210d)1), 300.1220b)2), 300.1610a)1), and 300.1630d). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Manor Court of Maryville
FACILITY ADDRESS: 6955 State Route 162
FACILITY CITY, STATE, ZIP: Maryville, IL 62062

DOCKET NUMBER: NH 22-S0169

LICENSEE INFO: UDI #2, LLC
LICENSEE ADDRESS: 285 S. Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 01/06/2022

FACILITY NAME: Manor Court of Rochelle
FACILITY ADDRESS: 2203 Flagg Road
FACILITY CITY, STATE, ZIP: Rochelle, IL 61068

DOCKET NUMBER: NH 22-S0027

LICENSEE INFO: Residential Alternatives of Illinois, Inc.
LICENSEE ADDRESS: 285 South Farnham St
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 12/17/2021

FACILITY NAME: Mar Ka Nursing Home
FACILITY ADDRESS: 201 South 10^th Street
FACILITY CITY, STATE, ZIP: Mascoutah, IL 62258

DOCKET NUMBER: NH 21-C0877

LICENSEE INFO: Community Care Center of Mascoutah, Inc.
LICENSEE ADDRESS: 858 Sunnyhill Lane
LICENSEE CITY, STATE, ZIP: Columbia, IL 62236
Survey Date – 11/03/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.610c)4)F), 300.1210d)6), and 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Meadowbrook Skld Nsg & Rehab
FACILITY ADDRESS: 320 South 2^nd Street
FACILITY CITY, STATE, ZIP: Grayville, IL 62844

DOCKET NUMBER: NH 21-C0852

LICENSEE INFO: Meadowbrook Skilled Nursing and Rehab, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/10/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.3130c)3)4)5). A fine of $1,100.00

FACILITY NAME: Meadows
FACILITY ADDRESS: 3250 South Plum Grove Road
FACILITY CITY, STATE, ZIP: Rolling Meadows, IL 60008

DOCKET NUMBER: NH 22-C0041

LICENSEE INFO: Meadows Sheltered Care, Inc.
LICENSEE ADDRESS: 3250 S. Plum Grove Road
LICENSEE CITY, STATE, ZIP: Rolling Meadows, IL 60008
Survey Date – 12/02/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.750b)1), 350.1210, 350.1230b), 350.1230d)1), 350.3240a), 350.3240d), and 350.3240e). A fine of $10,000.00

FACILITY NAME: Mercy Rehab and Care Center
FACILITY ADDRESS: 100 Rosewood Village Drive
FACILITY CITY, STATE, ZIP: Swansea, IL 62226

DOCKET NUMBER: NH 22-C0052

LICENSEE INFO: Mercy Rehab and Care Center, Inc.
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/28/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210d)2)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Michaelsen Health Care Center
FACILITY ADDRESS: 831 North Batavia Avenue
FACILITY CITY, STATE, ZIP: Batavia, IL 60510

DOCKET NUMBER: NH 22-S0110

LICENSEE INFO: Covenant Health Care Center, Inc.
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/16/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)7), and 300.1020a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.696). A fine of $2,200.00

FACILITY NAME: Midway Neurological/ Rehab Center
FACILITY ADDRESS: 8540 South Harlem Avenue
FACILITY CITY, STATE, ZIP: Bridgeview, IL 60455

DOCKET NUMBER: NH 22-C0032

LICENSEE INFO: Midway Neurological and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 12/10/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1220b)3), 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 sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210a), and 300.1210d)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

Total Fine: $4,400.00

FACILITY NAME: Montgomery Nursing & Rehab Ctr
FACILITY ADDRESS: State Route 127, P.O. Box 309
FACILITY CITY, STATE, ZIP: Hillsboro, IL 62049

DOCKET NUMBER: NH 22-C0091

LICENSEE INFO: Helia Healthcare of Hillsboro, LLC
LICENSEE ADDRESS: 600 S. Second Street, Suite 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 12/28/2021

FACILITY NAME: Mount Vernon Countryside Manor
FACILITY ADDRESS: 606 East IL Highway 15
FACILITY CITY, STATE, ZIP: Mount Vernon, IL 62864

DOCKET NUMBER: NH 21-C0887

LICENSEE INFO: Palladian Mt. Vernon SNF, LLC
LICENSEE ADDRESS: 600 S. Second St., Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 11/09/2021

FACILITY NAME: Mount Vernon Countryside Manor
FACILITY ADDRESS: 606 East IL Highway 15
FACILITY CITY, STATE, ZIP: Mount Vernon, IL 62864

DOCKET NUMBER: NH 22-S0154

LICENSEE INFO: Palladian Mt. Vernon SNF, LLC
LICENSEE ADDRESS: 600 S. Second St., Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 01/19/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)5), 300.1210c), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: New Athens Home for the Aged
FACILITY ADDRESS: 203 South Johnson Street
FACILITY CITY, STATE, ZIP: New Athens, IL 62264

DOCKET NUMBER: NH 22-C0068

LICENSEE INFO: New Athens Home for the Aged
LICENSEE ADDRESS: 203 South Johnson Street
LICENSEE CITY, STATE, ZIP: New Athens, IL 62264
Survey Date – 12/14/2021

Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.696a), 300.696c)6), 300.1020a), 300.1020b), 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 sections of the Code with a high risk designation: 300.696, 300.1210b), and 300.3240a). A fine of $50,000.00

FACILITY NAME: Oak Brook Care
FACILITY ADDRESS: 2013 Midwest Road
FACILITY CITY, STATE, ZIP: Oak Brook, IL 60523

DOCKET NUMBER: NH 22-S0050 & NH 22-C0051

LICENSEE INFO: Oakbrook Healthcare Centre, Ltd
LICENSEE ADDRESS: 5061 N. Pulaski Rd
LICENSEE CITY, STATE, ZIP: Chicago, IL 60630
Survey Date – 12/06/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210c), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Oak Crest
FACILITY ADDRESS: 2944 Greenwood Acres Drive
FACILITY CITY, STATE, ZIP: DeKalb, IL 60115

DOCKET NUMBER: NH 22-S0046

LICENSEE INFO: DeKalb Area Retirement Center
LICENSEE ADDRESS: 2944 Greenwood Acres Drive
LICENSEE CITY, STATE, ZIP: DeKalb, IL 60115
Survey Date – 12/10/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210d)5), and 300.1220b)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210d)5). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210d)6), and 300.1220b)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210d)6). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1220b)6), 300.1640a), and 300.1650a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210d)5). A fine of $1,100.00

Total Fine: $5,500.00

FACILITY NAME: PA Peterson at the Citadel
FACILITY ADDRESS: 1311 Parkview Avenue
FACILITY CITY, STATE, ZIP: Rockford, IL 61107

DOCKET NUMBER: NH 22-C0017

LICENSEE INFO: PA Peterson at the Citadel, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 12/02/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)1), 300.1210d)2), 300.1620a), 300.1630c), and 300.3210o). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

FACILITY NAME: Palos Heights Rehabilitation
FACILITY ADDRESS: 13259 South Central Avenue
FACILITY CITY, STATE, ZIP: Crestwood, IL 60418

DOCKET NUMBER: NH 22-S0135

LICENSEE INFO: Palos Heights Rehabilitation, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 12/30/2021

FACILITY NAME: Park Place of Belvidere
FACILITY ADDRESS: 1701 5^th Avenue
FACILITY CITY, STATE, ZIP: Belvidere, IL 61008

DOCKET NUMBER: NH 21-C0851

LICENSEE INFO: The Gardens of Belvidere, LLC
LICENSEE ADDRESS: 8150 Central Park
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 10/27/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.625i), 300.625k), and 300.625l). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.625k), and 300.625l). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1620c), 300.3240a), 300.3240b), 300.3240c), 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 sections of the Code with a high risk designation: 300.1210b), 300.3240a), and 300.3240b). A fine $2,200.00

Total Fine: $4,400.00

FACILITY NAME: Park Pointe Healthcare & Rehab
FACILITY ADDRESS: 1223 Edgewater Drive
FACILITY CITY, STATE, ZIP: Morris, IL 60450

DOCKET NUMBER: NH 22-C0009

LICENSEE INFO: Park Pointe Healthcare & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2525 Cabot Dr., Ste 204
LICENSEE CITY, STATE, ZIP: Lisle, IL 60532
Survey Date – 12/01/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)6), 300.2900d)2), and 300.3100d)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), 300.2900d)2), and 300.3100d)2). A fine of $25,000.00

FACILITY NAME: Pearl of Hillside, The
FACILITY ADDRESS: 4600 N. Frontage Road
FACILITY CITY, STATE, ZIP: Hillside, IL 60162

DOCKET NUMBER: NH 22-C0012

LICENSEE INFO: Pearl of Hillside, LLC
LICENSEE ADDRESS: 4711 Golf Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 11/19/2021

FACILITY NAME: Pearl of Naperville, The
FACILITY ADDRESS: 200 W. Martin Avenue
FACILITY CITY, STATE, ZIP: Naperville, IL 60540

DOCKET NUMBER: NH 22-S0015

LICENSEE INFO: Pearl of Naperville, LLC
LICENSEE ADDRESS: 4711 Golf Road, Suite 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 12/10/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610c)4)F), 300.1210b), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Piatt County Nursing Home
FACILITY ADDRESS: 1111 N. State St., P.O. Box 410
FACILITY CITY, STATE, ZIP: Monticello, IL 61856

DOCKET NUMBER: NH 22-S0060

LICENSEE INFO: Piatt County
LICENSEE ADDRESS: 101 W. Washington, Room 107
LICENSEE CITY, STATE, ZIP: Monticello, IL 61856
Survey Date – 12/22/2021

Type A violation of an occurrence for violating one or more of the following 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 sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Pittsfield Manor
FACILITY ADDRESS: 610 Lowry Street
FACILITY CITY, STATE, ZIP: Pittsfield, IL 62363

DOCKET NUMBER: NH 22-S0118

LICENSEE INFO: UDI #9, LLC
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 01/06/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610c)4), 300.1210a), 300.1210b), 300.1210d)6), and 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Pleasant Meadows Senior Living
FACILITY ADDRESS: 400 West Washington
FACILITY CITY, STATE, ZIP: Chrisman, IL 61924

DOCKET NUMBER: NH 21-S0904

LICENSEE INFO: Pleasant Meadows Senior Living, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 11/15/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), and 300.1210)d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Pleasant Meadows Senior Living
FACILITY ADDRESS: 400 West Washington
FACILITY CITY, STATE, ZIP: Chrisman, IL 61924

DOCKET NUMBER: NH 22-S0066

LICENSEE INFO: Pleasant Meadows Senior Living, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 12/28/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b) and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Prairie Manor Nrsg & Rehab Ctr
FACILITY ADDRESS: 345 Dixie Highway
FACILITY CITY, STATE, ZIP: Chicago Heights, IL 60411

DOCKET NUMBER: NH 22-C0117

LICENSEE INFO: Prairie Manor Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 West Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 12/30/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a)4)A)B)F), 300.1210b), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Prairie Oasis
FACILITY ADDRESS: 16000 Wabash Avenue
FACILITY CITY, STATE, ZIP: South Holland, IL 60473

DOCKET NUMBER: NH 21-S0940

LICENSEE INFO: Prairie Oasis, LLC
LICENSEE ADDRESS: 4711 Golf Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 11/24/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1220b)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Total Fine: $4,400.00

FACILITY NAME: Prairieview Lutheran Home
FACILITY ADDRESS: P.O. Box 4, Corner of North & 4^th
FACILITY CITY, STATE, ZIP: Danforth, IL 60930

DOCKET NUMBER: NH 22-S0100

LICENSEE INFO: Lutheran Home for the Aged Development Corp.
LICENSEE ADDRESS: 403 N. 4^th Street, P.O. Box 4
LICENSEE CITY, STATE, ZIP: Danforth, IL 60930
Survey Date – 12/27/2021

FACILITY NAME: Promedica Skilled Nursing Hom
FACILITY ADDRESS: 940 Maple Avenue
FACILITY CITY, STATE, ZIP: Homewood, IL 60430

DOCKET NUMBER: NH 22-C0039

LICENSEE INFO: Manor Care of Homewood IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street. Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/28/2021

FACILITY NAME: Richland Nursing & Rehab
FACILITY ADDRESS: 900 East Scott Street
FACILITY CITY, STATE, ZIP: Olney, IL 62450

DOCKET NUMBER: NH 21-S0772

LICENSEE INFO: Helia Richland Healthcare, LLC
LICENSEE ADDRESS: 600 S. 2^nd Street, Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 11/17/2021

Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210d)6) 300.2040e), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $50,000.00

FACILITY NAME: River Crossing of Rockford
FACILITY ADDRESS: 1660 South Mulford Road
FACILITY CITY, STATE, ZIP: Rockford, IL 61108

DOCKET NUMBER: NH 21-C0919

LICENSEE INFO: Rockford NH, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 11/02/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)6), and 300.3210o). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

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

DOCKET NUMBER: NH 21-C0861

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 10/28/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.625k), 300.625n), 300.1210a), 300.1210b), 300.1210d)6), and 300.3210t). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.625k), 300.625n), 300.1210b), and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Rushville Nursing & Rehab Ctr
FACILITY ADDRESS: 135 South Morgan Street
FACILITY CITY, STATE, ZIP: Rushville, IL 62681

DOCKET NUMBER: NH 21-S0932

LICENSEE INFO: Rushville Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 11/08/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b) and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Sharon Health Care Pines
FACILITY ADDRESS: 3614 North Rochelle
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 22-S0018

LICENSEE INFO: Sharon Health Care Pines, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 11/23/2021

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.690c). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.690. A fine of $500.00

FACILITY NAME: Sheridan Village Nrsg & Rhb
FACILITY ADDRESS: 5838 North Sheridan Road
FACILITY CITY, STATE, ZIP: Chicago, IL 60660

DOCKET NUMBER: NH 21-S0898

LICENSEE INFO: Sheridan Village Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 5009 Oakton St
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 10/26/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)3)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Sheridan Village Nrsg & Rhb
FACILITY ADDRESS: 5838 North Sheridan Road
FACILITY CITY, STATE, ZIP: Chicago, IL 60660

DOCKET NUMBER: NH 22-C0038

LICENSEE INFO: Sheridan Village Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 5009 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 12/02/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)2)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5). A fine of $2,200.00

FACILITY NAME: Sheridan Village Nrsg & Rhb
FACILITY ADDRESS: 5838 North Sheridan Road
FACILITY CITY, STATE, ZIP: Chicago, IL 60660

DOCKET NUMBER: NH 22-C0146

LICENSEE INFO: Sheridan Village Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 5009 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 01/06/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)2)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)5). A fine of $25,000.00

FACILITY NAME: Smith Village
FACILITY ADDRESS: 2320 West 113^th Place
FACILITY CITY, STATE, ZIP: Chicago, IL 60643

DOCKET NUMBER: NH 22-S0185

LICENSEE INFO: The Washington and Jane Smith Community-Beverly
LICENSEE ADDRESS: 208 S. LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 01/21/2022

FACILITY NAME: South Suburban Rehab Center
FACILITY ADDRESS: 19000 South Halsted Street
FACILITY CITY, STATE, ZIP: Homewood, IL 60430

DOCKET NUMBER: NH 21-C0890

LICENSEE INFO: South Suburban Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 West Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 11/04/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a) and 300.1210b)4)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)4)A)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 sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

Total Fine: $4,400.00

FACILITY NAME: South Suburban Rehab Center
FACILITY ADDRESS: 19000 South Halsted Street
FACILITY CITY, STATE, ZIP: Homewood, IL 60430

DOCKET NUMBER: NH 21-S0891 & NH 21-C0909

LICENSEE INFO: South Suburban Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 West Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 10/27/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)6), and 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b) and 300.1210d)4). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

Total Fine: $27,200.00

FACILITY NAME: South Suburban Rehab Center
FACILITY ADDRESS: 19000 South Halsted Street
FACILITY CITY, STATE, ZIP: Homewood, IL 60430

DOCKET NUMBER: NH 22-C0063 & NH 22-S0064

LICENSEE INFO: South Suburban Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 West Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 12/13/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210c), 300.1210d)6), and 300.1220b)3). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

Total Fine: $4,400.00

FACILITY NAME: Southgate Health Care Center
FACILITY ADDRESS: 900 E. Ninth Street., P.O. Box 843
FACILITY CITY, STATE, ZIP: Metropolis, IL 62960

DOCKET NUMBER: NH 22-C0090

LICENSEE INFO: Southgate Health Care, Inc.
LICENSEE ADDRESS: 900 E. 9^th Street
LICENSEE CITY, STATE, ZIP: Metropolis, IL 62960
Survey Date – 12/22/2021

FACILITY NAME: Sparta Terrace
FACILITY ADDRESS: 1501 Melmar
FACILITY CITY, STATE, ZIP: Sparta, IL 62286

DOCKET NUMBER: NH 21-S0941

LICENSEE INFO: Progressive Housing, Inc.
LICENSEE ADDRESS: 20180 Governors Dr., Ste 300
LICENSEE CITY, STATE, ZIP: Olympia Fields, IL 60461
Survey Date – 11/12/2021

Type Repeat A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a), 350.1230b)7), 350.1230d)1)2), and 350.3240a). A fine of $6,250.00

FACILITY NAME: St. Anthony’s Nsg & Rehab Ctr
FACILITY ADDRESS: 767 30^th Street
FACILITY CITY, STATE, ZIP: Rock Island, IL 61201

DOCKET NUMBER: NH 21-S0866

LICENSEE INFO: St. Anthony’s Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 150 N. Riverside Pl, Ste 3000
LICENSEE CITY, STATE, ZIP: Chicago, IL 60601
Survey Date – 10/28/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.2090a), 300.2090b), and 300.2100). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b). A fine of $2,200.00

FACILITY NAME: Symphony at 87^th Street
FACILITY ADDRESS: 2940 West 87^th Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60652

DOCKET NUMBER: NH 21-C0878

LICENSEE INFO: Symphony Beverly, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 11/01/2021

FACILITY NAME: Symphony at 87^th Street
FACILITY ADDRESS: 2940 West 87^th Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60652

DOCKET NUMBER: NH 22-S0022

LICENSEE INFO: Symphony Beverly, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/10/2021

FACILITY NAME: Symphony of Bronzeville
FACILITY ADDRESS: 3400 South Indiana
FACILITY CITY, STATE, ZIP: Chicago, IL 60616

DOCKET NUMBER: NH 21-S0918

LICENSEE INFO: Symphony Bronzeville Park, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 11/12/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210d)3)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Symphony of Bronzeville
FACILITY ADDRESS: 3400 South Indiana
FACILITY CITY, STATE, ZIP: Chicago, IL 60616

DOCKET NUMBER: NH 22-C0030

LICENSEE INFO: Symphony Bronzeville Park, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/21/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210d)3)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210d)6) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Symphony Palos Park
FACILITY ADDRESS: 12220 South Will Cook Road
FACILITY CITY, STATE, ZIP: Palos Park, IL 60464

DOCKET NUMBER: NH 21-S0853

LICENSEE INFO: Holy Family Villa
LICENSEE ADDRESS: 721 N. LaSalle St., 5^th FL
LICENSEE CITY, STATE, ZIP: Chicago, IL 60654
Survey Date – 11/02/2021

FACILITY NAME: Symphony Palos Park
FACILITY ADDRESS: 12220 S. Will Cook Road
FACILITY CITY, STATE, ZIP: Palos Park, IL 60464

DOCKET NUMBER: NH 22-C0112 & NH 22-S0113

LICENSEE INFO: Sym Palos Park SNF Healthcare, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/20/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)5), 300.1210c), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Toulan Rehab & Health Care Ctr
FACILITY ADDRESS: 17 East, P.O. Box 249
FACILITY CITY, STATE, ZIP: Toulon, IL 61483

DOCKET NUMBER: NH 22-S0043

LICENSEE INFO: Petersen Management Company, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 12/15/2021

FACILITY NAME: Tri-State Village Nrsg & Rhb
FACILITY ADDRESS: 2500 East 175^th Street
FACILITY CITY, STATE, ZIP: Lansing, IL 60438

DOCKET NUMBER: NH 21-S0905

LICENSEE INFO: Tri-State Village Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/26/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210d)3)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 sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: University Nsg & Rehab Center
FACILITY ADDRESS: 1095 University Drive
FACILITY CITY, STATE, ZIP: Edwardsville, IL 62025

DOCKET NUMBER: NH 21-C0844

LICENSEE INFO: University Care Center, LLC
LICENSEE ADDRESS: 111 North Ottawa Street
LICENSEE CITY, STATE, ZIP: Joliet, IL 60432
Survey Date – 10/29/2021

FACILITY NAME: University Nsg & Rehab Center
FACILITY ADDRESS: 1095 University Drive
FACILITY CITY, STATE, ZIP: Edwardsville, IL 62025

DOCKET NUMBER: NH 21-C0912

LICENSEE INFO: University Care Center, LLC
LICENSEE ADDRESS: 111 North Ottawa Street
LICENSEE CITY, STATE, ZIP: Joliet, IL 60432
Survey Date – 11/17/2021

FACILITY NAME: Vandalia Rehab & Health Care C
FACILITY ADDRESS: 1500 West St. Louis Avenue
FACILITY CITY, STATE, ZIP: Vandalia, IL 62471

DOCKET NUMBER: NH 22-C0084

LICENSEE INFO: Vandalia HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 12/23/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)3), 300.1210b)4), 300.1210d)4)A),B),C), 300.1220b)7), 300.1230e), 300.1230f), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1230, and 300.3240a). A fine of $25,000.00

FACILITY NAME: Villa South Holland, The
FACILITY ADDRESS: 16300 Wausau Street
FACILITY CITY, STATE, ZIP: South Holland, IL 60473

DOCKET NUMBER: NH 21-S0913

LICENSEE INFO: The Villa at South Holland, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 11/05/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)4 and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Vines at Countryside, The
FACILITY ADDRESS: 971 Bode Road
FACILITY CITY, STATE, ZIP: Elgin, IL 60120

DOCKET NUMBER: NH 21-S0945

LICENSEE INFO: The Vines Senior Homes, LLC
LICENSEE ADDRESS: 13N315 Brindlewood Lane
LICENSEE CITY, STATE, ZIP: Elgin, IL 60124
Survey Date – 11/05/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 330.720b) and 330.4240a). The fine was doubled in this instance in accordance with 330.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 330.4240a). A fine of $25,000.00

FACILITY NAME: Warren Barr Liberman
FACILITY ADDRESS: 9700 Gross Point Road
FACILITY CITY, STATE, ZIP: Skokie, IL 60076

DOCKET NUMBER: NH 22-C0049 & NH 22-S0095

LICENSEE INFO: Lieberman Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakston St
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 12/06/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)6), and 300.1220b)3)8). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.2900d)2) and 300.3100d)2). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.2900d)2) and 300.3100d)2). A fine of $500.00

Total Fine: $25,500.00

FACILITY NAME: Warren Barr North Shore
FACILITY ADDRESS: 2773 Skokie Valley Road
FACILITY CITY, STATE, ZIP: Highland Park, IL 60035

DOCKET NUMBER: NH 22-C0088

LICENSEE INFO: Warren Barr North Shore, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/06/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b)3), 300.1210c)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $25,000.00

FACILITY NAME: Washington Senior Living
FACILITY ADDRESS: 1201 Newcastle Road
FACILITY CITY, STATE, ZIP: Washington, IL 61571

DOCKET NUMBER: NH 21-C0886

LICENSEE INFO: Washington Senior Living, LLC
LICENSEE ADDRESS: 1275 Milwaukee Ave, Ste 300
LICENSEE CITY, STATE, ZIP: Glenview, IL 60025
Survey Date – 11/08/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)2), 300.1210c) and 300.1210d)2). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b). A fine of $25,000.00

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210c) and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.1210d)6). A fine of $25,000.00

Total Fine: $50,000.00

FACILITY NAME: Watseka Rehab & Hlth Care Ctr
FACILITY ADDRESS: 715 East Raymond Road
FACILITY CITY, STATE, ZIP: Watseka, IL 60970

DOCKET NUMBER: NH 22-C0031

LICENSEE INFO: Watseka HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 12/14/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210c), and 300.1230f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1230). A fine of $2,200.00

FACILITY NAME: Wesley Place
FACILITY ADDRESS: 1415 West Foster Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 22-C0098

LICENSEE INFO: Chicagoland Methodist Senior Services
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/23/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)2), and 300.1210d)5). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)5). A fine of $2,200.00

FACILITY NAME: Westminster Village
FACILITY ADDRESS: 2025 East Lincoln Street
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701

DOCKET NUMBER: NH 21-S0950

LICENSEE INFO: Westminster Village, Inc.
LICENSEE ADDRESS: 2025 E. Lincoln Street
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 12/09/2021

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4)5), and 300.1210d)6). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). A fine of $2,200.00

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.686b)1)2)3)4). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high risk designation: 300.686. A fine of $500.00

Total Fine: $2,700.00

FACILITY NAME: Westmont Manor Hlth & Rhb
FACILITY ADDRESS: 512 East Ogden Avenue
FACILITY CITY, STATE, ZIP: Westmont, IL 60559

DOCKET NUMBER: NH 21-C0881

LICENSEE INFO: Westmont Manor HRC, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 10/27/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Willow Rose Rehab & Health
FACILITY ADDRESS: 410 Fletcher
FACILITY CITY, STATE, ZIP: Jerseyville, IL 62052

DOCKET NUMBER: NH 21-C0900

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 11/02/2021

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d3)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

2022 1st Quarterly Report

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2022 1st Quarterly Report

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