2022 4th 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: Accolade Paxton Senior Living
FACILITY ADDRESS: 450 Fulton Street
FACILITY CITY, STATE, ZIP: Paxton, IL 60957

DOCKET NUMBER: NH 22-C0790

LICENSEE INFO: Accolade Healthcare of Paxton Senior Living, LLC
LICENSEE ADDRESS: 1900 E. Golf Rd, Ste 950A
LICENSEE CITY, STATE, ZIP: Schaumburg, IL 60173
Survey Date – 08/03/2022

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: Accolade Paxton Senior Living
FACILITY ADDRESS: 450 Fulton Street
FACILITY CITY, STATE, ZIP: Paxton, IL 60957

DOCKET NUMBER: NH 22-S0791

LICENSEE INFO: Accolade Healthcare of Paxton Senior Living, LLC
LICENSEE ADDRESS: 1900 E. Golf Rd, Ste 950A
LICENSEE CITY, STATE, ZIP: Schaumburg, IL 60173
Survey Date – 08/16/2022

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), 300.1210d)6), 300.1220b)2), 300.1220c), 300.3100d)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), 300.3100d)2), 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: 300.610a), 300.1210b)5), 300.1210c), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

Total Fine: $50,000.00

FACILITY NAME: Accolade Paxton Senior Living
FACILITY ADDRESS: 450 Fulton Street
FACILITY CITY, STATE, ZIP: Paxton, IL 60957

DOCKET NUMBER: NH 22-S0859

LICENSEE INFO: Accolade Healthcare of Paxton Senior Living, LLC
LICENSEE ADDRESS: 1900 E. Golf Rd, Ste 950A
LICENSEE CITY, STATE, ZIP: Schaumburg, IL 60173
Survey Date – 09/20/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), 300.1210c)3), 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: 300.1210b) and 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Alden Debes Rehab & HCC
FACILITY ADDRESS: 550 S. Mulford Avenue
FACILITY CITY, STATE, ZIP: Rockford, IL 61108

DOCKET NUMBER: NH 22-S0804

LICENSEE INFO: Alden Alma Nelson Manor, Inc.
LICENSEE ADDRESS: 4200 West Peterson Ave., #140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 09/09/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)2)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

FACILITY NAME: Alden Lakeland Rehab & HCC
FACILITY ADDRESS: 820 West Lawrence
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 22-S0862

LICENSEE INFO: Alden Lakeland Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave., Suite 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 08/25/2022

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 $25,000.00

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

DOCKET NUMBER: NH 22-CS0788

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 – 07/28/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b) and 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: 300.1210b) and 300.1210d)6). 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-C0945

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 – 09/21/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), 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 $2,200.00

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

Total Fine: $4,400.00

FACILITY NAME: Alden Valley Ridge Rehab & HCC
FACILITY ADDRESS: 275 East Army Trail Road
FACILITY CITY, STATE, ZIP: Bloomingdale, IL 60108

DOCKET NUMBER: NH 22-C0933

LICENSEE INFO: Alden Valley Ridge Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave., Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 09/12/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 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: Allure of Sterling
FACILITY ADDRESS: 612 West St. Mary’s Street
FACILITY CITY, STATE, ZIP: Sterling, IL 61081

DOCKET NUMBER: NH 22-S0863

LICENSEE INFO: Allure of Sterling, LLC
LICENSEE ADDRESS: 2711 W. Howard Street
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645
Survey Date – 08/31/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.690b), 300.690c), 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: 300.690, 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: 300.615e), and 300.615f). 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: 300.615e), and 300.615f). A fine of $500.00

Total Fine: $2,700.00

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

DOCKET NUMBER: NH 22-C0734

LICENSEE INFO: Alpine Fireside Health Center, Ltd
LICENSEE ADDRESS: 3650 N. Alpine Road
LICENSEE CITY, STATE, ZIP: Rockford, IL 61114
Survey Date – 08/03/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.710c)3)A). A fine of $1,100.00

FACILITY NAME: Amberwood Care Centre
FACILITY ADDRESS: 2313 North Rockton Avenue
FACILITY CITY, STATE, ZIP: Rockford, IL 61103

DOCKET NUMBER: NH 22-S1134

LICENSEE INFO: AMBD Property, LLC
LICENSEE ADDRESS: 6201 W. Howard St., Ste 201
LICENSEE CITY, STATE, ZIP: Niles, IL 60714
Survey Date – 10/12/2022

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

FACILITY NAME: Aperion Care Bradley
FACILITY ADDRESS: 650 North Kenzie
FACILITY CITY, STATE, ZIP: Bradley, IL 60915

DOCKET NUMBER: NH 22-C0783

LICENSEE INFO: Aperion Care Bradley, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/08/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)1)3), 300.1220b)2), 300.1630d), 300.1650a), 300.1650d)1)and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Aperion Care Capitol
FACILITY ADDRESS: 555 West Carpenter Road
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 22-C0997

LICENSEE INFO: Aperion Care Capitol, LLC
LICENSEE ADDRESS: 4655 W. Chase Ave
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/07/2022

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 300.1620a). 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 DeKalb
FACILITY ADDRESS: 1212 South Second Street
FACILITY CITY, STATE, ZIP: DeKalb, IL 60115

DOCKET NUMBER: NH 22-S0793

LICENSEE INFO: Aperion Care DeKalb, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/04/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)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: Aperion Care DeKalb
FACILITY ADDRESS: 1212 South Second Street
FACILITY CITY, STATE, ZIP: DeKalb, IL 60115

DOCKET NUMBER: NH 22-C0962

LICENSEE INFO: Aperion Care DeKalb, LLC
LICENSEE ADDRESS: 4655 W. Chase Ave
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 09/30/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 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 Elgin
FACILITY ADDRESS: 134 N. McLean Blvd
FACILITY CITY, STATE, ZIP: Elgin, IL 60123

DOCKET NUMBER: NH 22-S0646

LICENSEE INFO: Aperion Care Elgin, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/31/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b)4), 300.1210c)3), 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). A fine of $2,200.00

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

DOCKET NUMBER: NH 22-CS0980

LICENSEE INFO: Berkshire Nursing & Rehab Center, LLC
LICENSEE ADDRESS: 4655 W. Chase Ave
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/05/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.3210t). 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: 300.1210b). 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)2)5), 300.1810e), and 300.1810h). 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: Aperion Care Highwood
FACILITY ADDRESS: 50 Pleasant Avenue
FACILITY CITY, STATE, ZIP: Highwood, IL 60040

DOCKET NUMBER: NH 22-S0982

LICENSEE INFO: Highland Park Nursing and Rehab Center, LLC
LICENSEE ADDRESS: 4655 W. Chase Ave
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/05/2022

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.615e). 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). A fine of $500.00

FACILITY NAME: Aperion Care International
FACILITY ADDRESS: 4815 South Western Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60609

DOCKET NUMBER: NH 22-CS0837

LICENSEE INFO: International Nursing & Rehab Center, LLC
LICENSEE ADDRESS: 208 So LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/03/2022

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

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

DOCKET NUMBER: NH 22-C0834

LICENSEE INFO: Lakeshore OPCO, LLC
LICENSEE ADDRESS: 208 S. LaSalle Ste., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/23/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)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: Aperion Care Marseilles
FACILITY ADDRESS: 578 West Commercial Street
FACILITY CITY, STATE, ZIP: Marseilles, IL 61341

DOCKET NUMBER: NH 22-C0826

LICENSEE INFO: Aperion Care Marseilles, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/23/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)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: Aperion Care Morton Villa
FACILITY ADDRESS: 190 East Queenwood Road
FACILITY CITY, STATE, ZIP: Morton, IL 61550

DOCKET NUMBER: NH 22-C0747

LICENSEE INFO: Aperion Care Morton Villa, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/03/2022

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

DOCKET NUMBER: NH 22-CS0951

LICENSEE INFO: Aperion Care Peoria Heights, LLC
LICENSEE ADDRESS: 4655 W. Chase Ave
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 09/21/2022

Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1620a), 300.1630b), 300.1630c), 300.1630d), 300.1630e), and 300.3220f. 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), 300.1030a)4), 300.1030b), 300.1030c), and 3001220b)7)8). A fine of $1,100.00

Total Fine: $26,100.00

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

DOCKET NUMBER: NH 22-C0789

LICENSEE INFO: Aperion Care West Ridge, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/09/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1), 300.1220b)3), and 300.1810g). 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: Aperion Care Westchester
FACILITY ADDRESS: 2901 South Wolf Road
FACILITY CITY, STATE, ZIP: Westchester, IL 60154

DOCKET NUMBER: NH 22-S0876

LICENSEE INFO: Aperion Care Westchester, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/04/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)2), 300.1210c)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

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

Total Fine: $4,400.00

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

DOCKET NUMBER: NH 22-C1041

LICENSEE INFO: Arcadia Care Auburn, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/20/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)5), 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 $25,000.00

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

DOCKET NUMBER: NH 22-S0813

LICENSEE INFO: Arcadia Care Bloomington, LLC
LICENSEE ADDRESS: 4655 W. Chase Ave
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 08/03/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)6), and 300.3240a). 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: Arcadia Care Morris
FACILITY ADDRESS: 1095 Twilight Drive
FACILITY CITY, STATE, ZIP: Morris, IL 60450

DOCKET NUMBER: NH 22-C0905

LICENSEE INFO: Arcadia Care Morris, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/16/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 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 $2,200.00

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

DOCKET NUMBER: NH 22-C0948

LICENSEE INFO: Arcadia Care Morris, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/09/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 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 $25,000.00

FACILITY NAME: Arcola Health Care Center
FACILITY ADDRESS: 422 East 4^th South Street
FACILITY CITY, STATE, ZIP: Arcola, IL 61910

DOCKET NUMBER: NH 22-S0949

LICENSEE INFO: Arcola HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/22/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 $2,200.00

FACILITY NAME: Ascension Saint Joseph Village
FACILITY ADDRESS: 659 East Jefferson Street
FACILITY CITY, STATE, ZIP: Freeport, IL 61032

DOCKET NUMBER: NH 22-C0928

LICENSEE INFO: Presence Life Connections
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/06/2022

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

DOCKET NUMBER: NH 22-S0935

LICENSEE INFO: The Austin Oasis, LLC
LICENSEE ADDRESS: 4711 Golf Rd, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 09/15/2022

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)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: Avantara Park Ridge
FACILITY ADDRESS: 1601 North Western Avenue
FACILITY CITY, STATE, ZIP: Park Ridge, IL 60068

DOCKET NUMBER: NH 22-C0776

LICENSEE INFO: Avantara Park Ridge, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/10/2022

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: Avenues at Springfield
FACILITY ADDRESS: 525 S. Martin Luther King Drive
FACILITY CITY, STATE, ZIP: Springfield, IL 62703

DOCKET NUMBER: NH 22-S0885

LICENSEE INFO: Avenues at Arcadia Springfield, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/31/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b), 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 $2,200.00

FACILITY NAME: Beacon Care and Rehabilitation
FACILITY ADDRESS: 4538 North Beacon Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 22-C0936

LICENSEE INFO: Beacon Care and Rehabilitation Center, LLC
LICENSEE ADDRESS: 600 South Second Street, Ste 404
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 09/20/2022

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)3)5), and 300.1010h). 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: Belhaven Nursing & Rehab Ctr
FACILITY ADDRESS: 11401 South Oakley Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60643

DOCKET NUMBER: NH 22-C0760

LICENSEE INFO: Belhaven Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 07/28/2022

Type A 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)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: 300.690, 300.1210b), and 300.1210d)6). A fine of $25,000.00

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

DOCKET NUMBER: NH 22-S1054

LICENSEE INFO: Belhaven Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 10/06/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)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: Bella Terra Schaumburg
FACILITY ADDRESS: 675 S. Roselle Road
FACILITY CITY, STATE, ZIP: Schaumburg, IL 60193

DOCKET NUMBER: NH 22-S0976

LICENSEE INFO: Schaumburg Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Dr
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/26/2022

FACILITY NAME: Bella Terra Streamwood
FACILITY ADDRESS: 815 East Irving Park Road
FACILITY CITY, STATE, ZIP: Streamwood, IL 60107

DOCKET NUMBER: NH 22-C0906

LICENSEE INFO: Streamwood Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/12/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)3), 300.1210d)6), 300.1220b)2)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: Bella Terra Streamwood
FACILITY ADDRESS: 815 East Irving Park Road
FACILITY CITY, STATE, ZIP: Streamwood, IL 60107

DOCKET NUMBER: NH 22-S1062

LICENSEE INFO: Streamwood Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Dr.
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/14/2022

FACILITY NAME: Bellefontaine Place
FACILITY ADDRESS: 98 Debra Lane
FACILITY CITY, STATE, ZIP: Waterloo, IL 62298

DOCKET NUMBER: NH 22-S0944

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 09/22/2022

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.760a), 350.760c)8)10), and 350.769c). A fine of $550.00

FACILITY NAME: Belmont Village Geneva Road
FACILITY ADDRESS: 545 Belmont Lane
FACILITY CITY, STATE, ZIP: Carol Stream, IL 60188

DOCKET NUMBER: NH 22-S1031

LICENSEE INFO: Belmont Village Geneva Road Tenant, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/14/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.710a) and 330.710c)3)A)B)C)F). A fine of $1,100.00

FACILITY NAME: Bethany Home
FACILITY ADDRESS: 4950 N. Ashland Ave
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 22-S0765

LICENSEE INFO: Thorek Memorial Hospital
LICENSEE ADDRESS: 850 W. Irving Park Road 306
LICENSEE CITY, STATE, ZIP: Chicago, IL 60613
Survey Date – 08/04/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.340a)4)G)I) and 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: 300.790. A fine of $2,200.00

FACILITY NAME: Bethany Rehab & HCC
FACILITY ADDRESS: 3298 Resources Parkway
FACILITY CITY, STATE, ZIP: DeKalb, IL 60115

DOCKET NUMBER: NH 22-S0880

LICENSEE INFO: Bethany Health, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/31/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010e), 300.1210b), 300.1210d)3)6), and 300.2090b). 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: Bloomington Rehabilitation & HCC
FACILITY ADDRESS: 1925 South Main Street
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701

DOCKET NUMBER: NH 22-S0769

LICENSEE INFO: Petersen Health Operations, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/27/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010c), 300.1010g)1), 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

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)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: $29,400.00

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

DOCKET NUMBER: NH 22-C0903

LICENSEE INFO: Belleville Healthcare & Rehabilitation Center, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Ste 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 08/24/2022

Type AA 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)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 $50,000.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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

Total Fine: $52,200.00

FACILITY NAME: Bria of Chicago Heights
FACILITY ADDRESS: 120 West 26^th Street
FACILITY CITY, STATE, ZIP: So Chicago Hts, IL 60411

DOCKET NUMBER: NH 22-C0990

LICENSEE INFO: MST Health Properties, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/25/2022

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

FACILITY NAME: Bria of Godfrey
FACILITY ADDRESS: 1623 West Delmar
FACILITY CITY, STATE, ZIP: Godfrey, IL 62035

DOCKET NUMBER: NH 22-S0977

LICENSEE INFO: Bria of Godfrey, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/29/2022

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)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: $6,600.00

FACILITY NAME: Bria of Mascoutah
FACILITY ADDRESS: 901 North Tenth Street
FACILITY CITY, STATE, ZIP: Mascoutah, IL 62258

DOCKET NUMBER: NH 22-S0893

LICENSEE INFO: Bria of Mascoutah, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/02/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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 $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 22-S0866

LICENSEE INFO: Palos Hills Healthcare, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 08/25/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)6), and 300.1220b)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)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 22-C0953

LICENSEE INFO: Palos Hills Healthcare, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/27/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 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 $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), 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

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)2), 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). A fine of $25,000.00

Total Fine: $77,200.00

FACILITY NAME: Bria of River Oaks
FACILITY ADDRESS: 14500 South Manistee
FACILITY CITY, STATE, ZIP: Burnham, IL 60633

DOCKET NUMBER: NH 22-C1000

LICENSEE INFO: River Oaks Healthcare & Rehabilitation Center, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60044
Survey Date – 10/13/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.3210t), 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: Bria of Westmont
FACILITY ADDRESS: 6501 S. Cass Ave
FACILITY CITY, STATE, ZIP: Westmont, IL 60559

DOCKET NUMBER: NH 22-C0742

LICENSEE INFO: Westmont Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 08/04/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.1210d)2)4)A)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 Westmont
FACILITY ADDRESS: 6501 S. Cass Ave
FACILITY CITY, STATE, ZIP: Westmont, IL 60559

DOCKET NUMBER: NH 22-C0838

LICENSEE INFO: Westmont Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/19/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 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: Bria of WoodRiver
FACILITY ADDRESS: 393 Edwardsville Road
FACILITY CITY, STATE, ZIP: Wood River, IL 62095

DOCKET NUMBER: NH 22-CS0902

LICENSEE INFO: Bria of Wood River, LLC
LICENSEE ADDRESS: 5151 Church Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/09/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1630d), and 300.1630e). A fine of $12,500.00

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 300.1210d)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

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 300.1810h). 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: $39,700.00

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

DOCKET NUMBER: NH 22-CS1114

LICENSEE INFO: Briar Place Nursing, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/29/2022

FACILITY NAME: Burt Sheltered Care Home
FACILITY ADDRESS: 1414 Milton Road
FACILITY CITY, STATE, ZIP: Alton, IL 62002

DOCKET NUMBER: NH 22-C0801

LICENSEE INFO: Mary Jo Swengrosh
LICENSEE ADDRESS: 1414 Milton Road
LICENSEE CITY, STATE, ZIP: Alton, IL 62002
Survey Date – 07/22/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 330.790a), 330.790c)1)3)7)8)9), 330.790)d)1)2), 330.790)e)1)2)A)B)3)A)B)D)4)5), 330.790)f), 330.790)g), 330.794a)1)2)3), 330.794b)1)2)A)B)C)3)4)A)B)5)6), 330.794c)1)2)3)4)5)6)7), 330.794g), and 330.794h)1)2)3). 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 and 330.794. A fine of $25,000.00

FACILITY NAME: Casey Health Care Center
FACILITY ADDRESS: 100 N.E. 15^th Street
FACILITY CITY, STATE, ZIP: Casey, IL 62420

DOCKET NUMBER: NH 22-S0768

LICENSEE INFO: Casey HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/05/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.3210t). A fine of $1,100.00

FACILITY NAME: Celebrate Senior Living Niles
FACILITY ADDRESS: 7000 North Newark Avenue
FACILITY CITY, STATE, ZIP: Niles, IL 60714

DOCKET NUMBER: NH 22-CS0901

LICENSEE INFO: Elevate Saint Andrew Living Community, LLC
LICENSEE ADDRESS: 8140 McCormick Blvd, Ste 124
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 08/17/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.3240a). 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: Center Home Hispanic Elderly
FACILITY ADDRESS: 1401 North California
FACILITY CITY, STATE, ZIP: Chicago, IL 60622

DOCKET NUMBER: NH 22-C1008

LICENSEE INFO: Center Home Hispanic Elderly, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 09/24/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a) and 300.1210d)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: Champaign Urbana Nrsg & Rehab
FACILITY ADDRESS: 302 Burwash Avenue
FACILITY CITY, STATE, ZIP: Savoy, IL 61874

DOCKET NUMBER: NH 22-C0909

LICENSEE INFO: Champaign Urbana Nursing and Rehab, LP
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/14/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.690a), 300.1210b), 300.1210d)6), 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: 300.690), 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), 300.1210a), 300.1210b), 300.1220b)3), 300.2040b)2), and 300.2050). 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), 300.1010h), 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: 300.2860b)7) and 300.2940g)1). A fine of $1,100.00

Total Fine: $7,700.00

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

DOCKET NUMBER: NH 22-C0910

LICENSEE INFO: Champaign Urbana Nursing and Rehab, LP
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 08/26/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210d)3)5), 300.1220b)3), 300.2040b)2), 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), 300.1210d)5), and300.3240a). A fine of $25,000.00

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

DOCKET NUMBER: NH 22-C0911

LICENSEE INFO: Champaign Urbana Nursing and Rehab, LP
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 08/26/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210c), 300.1210d)2), 300.1210d)3), 300.1210d)5), 300.1220b)3), 300.2040b)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)5), and 300.3240a). A fine of $25,000.00

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

DOCKET NUMBER: NH 22-C0943

LICENSEE INFO: Champaign Urbana Nursing & Rehab, LP
LICENSEE ADDRESS: 5750 Old Orchard Rd, Suite 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/28/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)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

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)3), 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 $25,000.00

Total Fine: $50,000.00

FACILITY NAME: Chateau Nrsg & Rehab Center
FACILITY ADDRESS: 7050 Madison Street
FACILITY CITY, STATE, ZIP: Willowbrook, IL 60521

DOCKET NUMBER: NH 22-S0994

LICENSEE INFO: Chateau Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 09/22/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b) and 300.1210d)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: Children’s Habilitation Ctr
FACILITY ADDRESS: 121 West 154^th Street
FACILITY CITY, STATE, ZIP: Harvey, IL 60426

DOCKET NUMBER: NH 22-C0819

LICENSEE INFO: Children’s Habilitation Center, Inc.
LICENSEE ADDRESS: 121 West 154^th Street
LICENSEE CITY, STATE, ZIP: Harvey, IL 60426
Survey Date – 09/12/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 390.620a), 390.1040k)2). 380.2010h), and 390.3240a). The fine was doubled in this instance in accordance with 390.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 390.1040) and 390.3240. A fine of $1,500.00

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

DOCKET NUMBER: NH 22-C0921

LICENSEE INFO: City View Multicare Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 09/09/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), 300.1210d)3)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: 300.610a), 300.1210a), 300.1210b), 300.1210c), 300.1210d)3)6), 300.1220b)3), 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: 300.1210b), 300.1210d)6), and 300.3240e). A fine of $2,200.00

Total Fine: $27,200.00

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

DOCKET NUMBER: NH 22-CS1012

LICENSEE INFO: City View Multicare Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 10/07/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210d)6), 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), 300.1210d)6), and 300.3240e). A fine of $25,000.00

FACILITY NAME: Claridge Healthcare Center
FACILITY ADDRESS: 700 Jenkisson
FACILITY CITY, STATE, ZIP: Lake Bluff, IL 60044

DOCKET NUMBER: NH 22-C0923

LICENSEE INFO: Claridge Operations, LLC
LICENSEE ADDRESS: 3300 W. Peterson Ave., Ste E
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659
Survey Date – 09/08/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.690b), 300.1010h), 300.1010i), 300.1210a), 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: 300.690, 300.1210b), and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Clark Manor
FACILITY ADDRESS: 7433 North Clark Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60626

DOCKET NUMBER: NH 22-S0744

LICENSEE INFO: Clark Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/03/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1030a)3), 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: Clearbrook Center
FACILITY ADDRESS: 3201 West Campbell Street
FACILITY CITY, STATE, ZIP: Rolling Meadows, IL 60008

DOCKET NUMBER: NH 22-S1013

LICENSEE INFO: Clearbrook
LICENSEE ADDRESS: 1835 West Central Road
LICENSEE CITY, STATE, ZIP: Arlington Heights, IL 60005
Survey Date – 09/19/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.610a) 350.760a), 350.760c)6)7), 350.1210, 350.1223a), 350.2210j)1)2)4)5)6), 350.2660b)3)4), 350.2660c)1)2), 350.2660f)1), and 350.3240a). A fine of $10,000.00

FACILITY NAME: Collinsville Rehab & Health CC
FACILITY ADDRESS: 614 North Summit
FACILITY CITY, STATE, ZIP: Collinsville, IL 62234

DOCKET NUMBER: NH 22-C0958

LICENSEE INFO: Collinsville HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/02/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d)3), 300.1820c)3), 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: 300.1210b). 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-S0887

LICENSEE INFO: Countryside Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 W. Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 09/10/2022

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

FACILITY NAME: Countryview Care Center-Macomb
FACILITY ADDRESS: 400 West Grant Street
FACILITY CITY, STATE, ZIP: Macomb, IL 61455

DOCKET NUMBER: NH 22-C0968

LICENSEE INFO: Petersen Health Properties, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/02/2022

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.660a) and 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: Countryview Care Center Macomb
FACILITY ADDRESS: 400 West Grant Street
FACILITY CITY, STATE, ZIP: Macomb, IL 61455

DOCKET NUMBER: NH 22-C0987

LICENSEE INFO: Petersen Health Properties, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/14/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210c)1)2)3), 300.1210d)5), 300.3220f), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: Countryview Care Center Macomb
FACILITY ADDRESS: 400 West Grant Street
FACILITY CITY, STATE, ZIP: Macomb, IL 61455

DOCKET NUMBER: NH 22-S1044

LICENSEE INFO: Petersen Health Properties, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/21/2022

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)2)3), 300.1210d)5), 300.1220b)1)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 $2,200.00

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.690a), 300.1010h), 300.1210b), 300.1210c)3), 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: 300.690 and 300.1210b). A fine of $2,200.00

Total Fine: $4,400.00

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

DOCKET NUMBER: NH 22-S0825

LICENSEE INFO: Crystal Pines Rehabilitation and Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/24/2022

FACILITY NAME: Davies Square
FACILITY ADDRESS: 1817 Crescent Drive
FACILITY CITY, STATE, ZIP: Pekin, IL 61554

DOCKET NUMBER: NH 22-C0867

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 08/25/2022

Type B violation for violating one or more of the following sections of the Code: 350.620a) and 350.700c). A fine of $550.00

FACILITY NAME: Decatur Rehab & Health Care Ct
FACILITY ADDRESS: 136 South Dipper Lane
FACILITY CITY, STATE, ZIP: Decatur, IL 62522

DOCKET NUMBER: NH 22-CS0739

LICENSEE INFO: Decatur HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/27/2022

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), and 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

Total Fine: $4,400.00

FACILITY NAME: Deerfield Crossing Northbrook
FACILITY ADDRESS: 4101 Lake Cook Road
FACILITY CITY, STATE, ZIP: Northbrook, IL 60062

DOCKET NUMBER: NH 22-S0772

LICENSEE INFO: Northbrook NH, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 07/31/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), 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

FACILITY NAME: Dimensions Living Prospect Hts
FACILITY ADDRESS: 700 East Euclid Avenue
FACILITY CITY, STATE, ZIP: Prospect Heights, IL 60070

DOCKET NUMBER: NH 22-C0984

LICENSEE INFO: S-H OPCO Prospect Heights, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/06/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.710a), 330.1110f), 330.4240a), and 330.4240d). 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), and 330.4240d). A fine of $2,200.00

FACILITY NAME: Dixie Manor Sheltered Care
FACILITY ADDRESS: 15535 Dixie Highway
FACILITY CITY, STATE, ZIP: Harvey, IL 60426

DOCKET NUMBER: NH 22-CS1090

LICENSEE INFO: Dixie Manor Sheltered Care, Inc.
LICENSEE ADDRESS: 15535 Dixie Highway
LICENSEE CITY, STATE, ZIP: Harvey, IL 60426
Survey Date – 10/13/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 330.794b), 330.794c)2), 330.794g), and 330.794h)2). 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: 330.794. A fine of $25,000.00

FACILITY NAME: Dobson Plaza
FACILITY ADDRESS: 120 Dodge Avenue
FACILITY CITY, STATE, ZIP: Evanston, IL 60202

DOCKET NUMBER: NH 22-S0721

LICENSEE INFO: Dobson Plaza Nursing & Rehab Center, LLC
LICENSEE ADDRESS: 191 N. Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 07/21/2022

FACILITY NAME: Effingham Rehab & Health C Ctr
FACILITY ADDRESS: 1610 North Lakewood Drive
FACILITY CITY, STATE, ZIP: Effingham, IL 62401

DOCKET NUMBER: NH 22-CS0803

LICENSEE INFO: Effingham HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/22/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b) and 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 $2,200,00

Total Fine: $27,200.00

FACILITY NAME: Effingham Terrace
FACILITY ADDRESS: 1101 South 3^rd Street
FACILITY CITY, STATE, ZIP: Effingham, IL 62401

DOCKET NUMBER: NH 22-S0843

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 08/02/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a) 350.760a), 350.769g), 350.769h)1)2)3), and 350.1210). A fine of $6,250.00

FACILITY NAME: El Paso Health Care Center
FACILITY ADDRESS: 850 East Second Street
FACILITY CITY, STATE, ZIP: El Paso, IL 61738

DOCKET NUMBER: NH 22-S0947

LICENSEE INFO: El Paso HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/01/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)3), 300.1210d)5), 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)5), and 300.3240a). A fine of $2,200.00

FACILITY NAME: El Paso Health Care Center
FACILITY ADDRESS: 850 East Second Street
FACILITY CITY, STATE, ZIP: El Paso, IL 61738

DOCKET NUMBER: NH 22-C0964

LICENSEE INFO: El Paso HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/19/2022

FACILITY NAME: Eldorado Rehab & Healthcare
FACILITY ADDRESS: 1001 A. Jefferson Street
FACILITY CITY, STATE, ZIP: Eldorado, IL 62930

DOCKET NUMBER: NH 22-S0916

LICENSEE INFO: Eldorado Rehab & Healthcare, LLC
LICENSEE ADDRESS: 215 E. Locust St
LICENSEE CITY, STATE, ZIP: Harrisburg, IL 62946
Survey Date – 09/13/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210d)6), 300.1220b)1)2), 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: 300.1210d)6). A fine of $2,200.00

FACILITY NAME: Elevate Care Abington
FACILITY ADDRESS: 3901 Glenview Road
FACILITY CITY, STATE, ZIP: Glenview, IL 60025

DOCKET NUMBER: NH 22-S0895

LICENSEE INFO: Elevate Care Abington, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/14/2022

FACILITY NAME: Elevate Care Country Club Hill
FACILITY ADDRESS: 18200 South Cicero Avenue
FACILITY CITY, STATE, ZIP: Country Club Hills, IL 60478

DOCKET NUMBER: NH 22-CS0860

LICENSEE INFO: Elevate Care Country Club Hills, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/26/2022

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)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) 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 C 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)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 $500.00

Total Fine: $7,100.00

FACILITY NAME: Elevate Care Country Club Hill
FACILITY ADDRESS: 18200 South Cicero Avenue
FACILITY CITY, STATE, ZIP: Country Club Hills, IL 60478

DOCKET NUMBER: NH 22-C0926

LICENSEE INFO: Elevate Care Country Club Hills, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/14/2022

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

FACILITY NAME: Elevate Care Niles
FACILITY ADDRESS: 8333 West Golf Road
FACILITY CITY, STATE, ZIP: Niles, IL 60714

DOCKET NUMBER: NH 22-S0792

LICENSEE INFO: Elevate Care Niles, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/15/2022

FACILITY NAME: Elevate Care Northbrook
FACILITY ADDRESS: 270 Skokie Blvd
FACILITY CITY, STATE, ZIP: Northbrook, IL 60062

DOCKET NUMBER: NH 22-C0955

LICENSEE INFO: Elevate Care Northbrook, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/04/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c)1)2), 300.1630d), 300.3220f). and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Elmhurst Extended Care Center
FACILITY ADDRESS: 200 East Lake Street
FACILITY CITY, STATE, ZIP: Elmhurst, IL 60126

DOCKET NUMBER: NH 22-C0950

LICENSEE INFO: SBNB, Inc.
LICENSEE ADDRESS: 1701 East Lake Ave., 200
LICENSEE CITY, STATE, ZIP: Glenview, IL 60025
Survey Date – 09/26/2022

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

FACILITY NAME: Fair Havens Senior Living
FACILITY ADDRESS: 1790 South Fairview Avenue
FACILITY CITY, STATE, ZIP: Decatur, IL 62521

DOCKET NUMBER: NH 22-S0915

LICENSEE INFO: Fair Havens Senior Living, LLC
LICENSEE ADDRESS: 1275 Milwaukee Ave., Ste 300
LICENSEE CITY, STATE, ZIP: Glenview, IL 60025
Survey Date – 09/09/2022

FACILITY NAME: Fairhaven Christian Ret Center
FACILITY ADDRESS: 3470 North Alpine Road
FACILITY CITY, STATE, ZIP: Rockford, IL 61114

DOCKET NUMBER: NH 22-C0874

LICENSEE INFO: Fairhaven Christian Retirement Center
LICENSEE ADDRESS: 3470 North Alpine Road
LICENSEE CITY, STATE, ZIP: Rockford, IL 61114
Survey Date – 08/26/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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) and 300.1210d)5). A fine of $2,200.00

FACILITY NAME: Fairmont Care
FACILITY ADDRESS: 5061 North Pulaski Road
FACILITY CITY, STATE, ZIP: Chicago, IL 60630

DOCKET NUMBER: NH 22-S0756

LICENSEE INFO: Fairmont Care Center, Inc.
LICENSEE ADDRESS: 5061 North Pulaski Road
LICENSEE CITY, STATE, ZIP: Chicago, IL 60630
Survey Date – 10/14/2022

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 300.1210b)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 300.1210b)6). A fine of $2,200.00

FACILITY NAME: Farmer City Rehab & Health Cr
FACILITY ADDRESS: 404 Brookview Drive
FACILITY CITY, STATE, ZIP: Farmer City, IL 61842

DOCKET NUMBER: NH 22-S0833

LICENSEE INFO: Peterson Health Care Farmer City, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/09/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b)5), 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: Forest View Rehab & Nrsg Ctr
FACILITY ADDRESS: 535 South Elm
FACILITY CITY, STATE, ZIP: Itasca, IL 60143

DOCKET NUMBER: NH 22-C0884

LICENSEE INFO: Forest View Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 09/06/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1220b)3), 300.3240c), and 300.3240f). A fine of $12,500.00

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

DOCKET NUMBER: NH 22-S0802

LICENSEE INFO: Challenge Unlimited, Inc.
LICENSEE ADDRESS: #4 Emmie L. Kaus Lane
LICENSEE CITY, STATE, ZIP: Alton, IL 62002
Survey Date – 07/21/2022

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

FACILITY NAME: Franklin Grove Living & Rehab
FACILITY ADDRESS: 502 North State Street
FACILITY CITY, STATE, ZIP: Franklin Grove, IL 61031

DOCKET NUMBER: NH 22-C0927

LICENSEE INFO: Franklin Grove Living & Rehabilitation Center, LLC
LICENSEE ADDRESS: 7434 Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/21/2022

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

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

DOCKET NUMBER: NH 22-C0930

LICENSEE INFO: Gardenview Manor, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd., Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 09/14/2022

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)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

Type B 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 $2,200.00

Total Fine: $4,400.00

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

DOCKET NUMBER: NH 22-C1003

LICENSEE INFO: Gardenview Manor, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 10/17/2022

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)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 $25,000.00

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

DOCKET NUMBER: NH 22-S0998

LICENSEE INFO: Generations at Applewood, LLC
LICENSEE ADDRESS: 6840 N. Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 09/22/2022

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.690b) and 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: Generations at Elmwood Park
FACILITY ADDRESS: 7733 West Grand Avenue
FACILITY CITY, STATE, ZIP: Elmwood Park, IL 60707

DOCKET NUMBER: NH 22-C0764

LICENSEE INFO: Generations at Elmwood Park, Inc.
LICENSEE ADDRESS: 6840 N. Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 08/04/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d2)4)A)). 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: Generations at Regency
FACILITY ADDRESS: 6631 Milwaukee Avenue
FACILITY CITY, STATE, ZIP: Niles, IL 60714

DOCKET NUMBER: NH 22-S0917

LICENSEE INFO: Generations at Regency, LLC
LICENSEE ADDRESS: 6840 N. Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/12/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), 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

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), and 300.1210b)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 $2,200.00

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 22-S0806

LICENSEE INFO: Gilman Healthcare Center, LLC
LICENSEE ADDRESS: 4711 Golf Rd, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 09/02/2022

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

DOCKET NUMBER: NH 22-S0912

LICENSEE INFO: The Good Samaritan Home of Quincy
LICENSEE ADDRESS: 2130 Harrison St
LICENSEE CITY, STATE, ZIP: Quincy, IL 62301
Survey Date – 09/08/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696b), 300.696d)6)13), 300696f)2)A)B)4) 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: Granite Nsg & Rehab Center
FACILITY ADDRESS: 3500 Century Drive
FACILITY CITY, STATE, ZIP: Granite City, IL 62040

DOCKET NUMBER: NH 22-S0995

LICENSEE INFO: Granite Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 901 S. 2^nd St., Ste 201
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 10/11/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a) and 300.1210b)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: 300.690a), 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: 300.690, 300.1210b) and 300.1210d)6). A fine of $2,200.00

Total Fine: $6,600.00

FACILITY NAME: Greek American Rehab & Care Ct
FACILITY ADDRESS: 220 North First Street
FACILITY CITY, STATE, ZIP: Wheeling, IL 60090

DOCKET NUMBER: NH 22-C0857

LICENSEE INFO: The Greek American Rehabilitation and Care Centre, Inc.
LICENSEE ADDRESS: 220 North First Street
LICENSEE CITY, STATE, ZIP: Wheeling, IL 60090
Survey Date – 09/02/2022

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

DOCKET NUMBER: NH 22-C0808

LICENSEE INFO: Elmbrook Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/18/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), 300.1210d)6), 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), 300.3100d)2). A fine of $25,000.00

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

DOCKET NUMBER: NH 22-S0879

LICENSEE INFO: Elmbrook Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/25/2022

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

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696b), and 300.696d)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). A fine of $500.00

Total Fine: $2,700.00

FACILITY NAME: Harmony Nursing & Rehab Center
FACILITY ADDRESS: 3919 West Foster Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60625

DOCKET NUMBER: NH 22-S1039

LICENSEE INFO: Harmony Nursing and Rehabilitation Center, Inc.
LICENSEE ADDRESS: 6633 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 10/18/2022

FACILITY NAME: Havana Health Care Center
FACILITY ADDRESS: 609 North Harpham Street
FACILITY CITY, STATE, ZIP: Havana, IL 62644

DOCKET NUMBER: NH 22-C0713

LICENSEE INFO: Havana HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/25/2022

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: Healthbridge of Arlington Hts
FACILITY ADDRESS: 1200 N. Arlington Heights Road
FACILITY CITY, STATE, ZIP: Arlington Hts, IL 60004

DOCKET NUMBER: NH 22-S0888

LICENSEE INFO: Healthbridge of Arlington Heights, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/10/2022

FACILITY NAME: Heartland Senior Living
FACILITY ADDRESS: 101 Trowbridge Road
FACILITY CITY, STATE, ZIP: Neoga, IL 62447

DOCKET NUMBER: NH 22-C0751

LICENSEE INFO: Heartland Senior Living, LLC
LICENSEE ADDRESS: 1275 Milwaukee Ave., Ste 300
LICENSEE CITY, STATE, ZIP: Glenview, IL 60025
Survey Date – 08/05/2022

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

DOCKET NUMBER: NH 22-S0773

LICENSEE INFO: Helia Healthcare of Belleville, LLC
LICENSEE ADDRESS: 600 S. Second Street, Suite 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 07/27/2022

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)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

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), 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), 300.1210b), 300.1210c), 300.1210d)2)4)A), 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: $6,600.00

FACILITY NAME: Helia Healthcare of Newton
FACILITY ADDRESS: 300 S. Scott Street
FACILITY CITY, STATE, ZIP: Newton, IL 62448

DOCKET NUMBER: NH 22-S0856

LICENSEE INFO: Helia Healthcare of Newton, LLC
LICENSEE ADDRESS: 600 S. 2^nd Street, Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 08/24/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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: Helia Southbelt Healthcare
FACILITY ADDRESS: 101 South Belt West
FACILITY CITY, STATE, ZIP: Belleville, IL 62220

DOCKET NUMBER: NH 22-C0840

LICENSEE INFO: Helia Southbelt Healthcare, LLC
LICENSEE ADDRESS: 118 W. Edwards St., Ste 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 08/19/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)1), and 300.1610a)1). 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: Heritage Health Jacksonville
FACILITY ADDRESS: 873 Grove Street
FACILITY CITY, STATE, ZIP: Jacksonville, IL 62650

DOCKET NUMBER: NH 22-S0809

LICENSEE INFO: Barton W. Stone Jacksonville, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 07/26/2022

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), 300.2040b), 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 $25,000.00

FACILITY NAME: Heritage Health Mt Sterling
FACILITY ADDRESS: 435 Camden Road
FACILITY CITY, STATE, ZIP: Mt. Sterling, IL 62353

DOCKET NUMBER: NH 22-S0712

LICENSEE INFO: Heritage Manor Mt Sterling, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 07/25/2022

FACILITY NAME: Heritage Health Mt Sterling
FACILITY ADDRESS: 435 Camden Road
FACILITY CITY, STATE, ZIP: Mt. Sterling, IL 62353

DOCKET NUMBER: NH 22-C0882

LICENSEE INFO: Heritage Manor Mt Sterling, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Ste 400
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 08/30/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.610c)1), 300.620a), 300.1010h), 300.1210a), 300.1210b), 300.1210d)3)6), 300.1220b)3), 300.3300b), and 300.3300j). 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 Normal
FACILITY ADDRESS: 509 N. Adelaide
FACILITY CITY, STATE, ZIP: Normal, IL 61761

DOCKET NUMBER: NH 22-S0937

LICENSEE INFO: Heritage Manor Normal, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 09/21/2022

FACILITY NAME: Heritage Health Normal
FACILITY ADDRESS: 509 N. Adelaide
FACILITY CITY, STATE, ZIP: Normal, IL 61761

DOCKET NUMBER: NH 22-S0966

LICENSEE INFO: Heritage Manor Normal, LLC
LICENSEE ADDRESS: 115 W. Jefferson St., Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 10/02/2022

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 300.3240a). 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: Highland Oaks
FACILITY ADDRESS: 2750 West Highland Avenue
FACILITY CITY, STATE, ZIP: Elgin, IL 60124

DOCKET NUMBER: NH 22-S0766

LICENSEE INFO: The Apostolic Christian Resthaven
LICENSEE ADDRESS: 2750 W. Highland Ave
LICENSEE CITY, STATE, ZIP: Elgin, IL 60124
Survey Date – 08/19/2022

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.696b). 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: 300.696). A fine of $500.00

FACILITY NAME: Highview in the Woodlands
FACILITY ADDRESS: 1000 Falcon Point Place
FACILITY CITY, STATE, ZIP: Rockton, IL 61072

DOCKET NUMBER: NH 22-S1100

LICENSEE INFO: Highview Retirement Home Association
LICENSEE ADDRESS: 800 N. Church Street
LICENSEE CITY, STATE, ZIP: Rockford, IL 61103
Survey Date – 10/05/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.794c). 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: 300.794. A fine of $25,000.00

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

DOCKET NUMBER: NH 22-S0873

LICENSEE INFO: Hillsboro Rehabilitation and Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/25/2022

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 300.3210t). 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: 300.1210b) and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Ignite Medical McHenry
FACILITY ADDRESS: 550 Ridgeview Drive
FACILITY CITY, STATE, ZIP: McHenry, IL 60050

DOCKET NUMBER: NH 22-S0820

LICENSEE INFO: TCO JV, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/21/2022

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.610a) and 300.615e). 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: 300.615e). A fine of $500.00

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

DOCKET NUMBER: NH 22-C0842

LICENSEE INFO: Petersen Health Care Illini, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/10/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696d)4), 300.1210b), 300.1610a)1), and 300.1620a). 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: Integrity HC of Belleville (AKA: Belleville Healthcare Center)
FACILITY ADDRESS: 727 North 17^th Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62226

DOCKET NUMBER: NH 22-C0755

LICENSEE INFO: Belleville Behavioral Health & Nursing Center, LLC
LICENSEE ADDRESS: 600 S. 2^nd Street, Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 08/10/2022

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: Integrity HC of Carbondale
FACILITY ADDRESS: 120 North Tower Road
FACILITY CITY, STATE, ZIP: Carbondale, IL 62901

DOCKET NUMBER: NH 22-C1021

LICENSEE INFO: Carbondale Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 600 South 2^nd Street., Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 10/18/2022

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

FACILITY NAME: Integrity HC of Smithton (AKA Bria of Smithton)
FACILITY ADDRESS: 107 South Lincoln
FACILITY CITY, STATE, ZIP: Smithton, IL 62285

DOCKET NUMBER: NH 22-C0738

LICENSEE INFO: Park Haven Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 600 S. 2^nd Street, Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 07/25/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210c), 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). A fine of $25,000.00

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

DOCKET NUMBER: NH 22-S1018

LICENSEE INFO: Inverness NH, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/14/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.3210t), and 300.3240b). A fine of $1,100.00

FACILITY NAME: Jerseyville Manor
FACILITY ADDRESS: 1251 North State Street
FACILITY CITY, STATE, ZIP: Jerseyville, IL 62052

DOCKET NUMBER: NH 22-C0985

LICENSEE INFO: UDI #11, LLC
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 10/06/2022

FACILITY NAME: Jerseyville Nsg & Rehab Center
FACILITY ADDRESS: 1001 South State Street
FACILITY CITY, STATE, ZIP: Jerseyville, IL 62052

DOCKET NUMBER: NH 22-C0979

LICENSEE INFO: Helia Healthcare of Jerseyville, LLC
LICENSEE ADDRESS: 600 S. Second St., Suite 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 09/29/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210c), 3003210t), 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) and 300.3240e). A fine of $25,000.00

FACILITY NAME: Jerseyville Nsg & Rehab Center
FACILITY ADDRESS: 1001 South State Street
FACILITY CITY, STATE, ZIP: Jerseyville, IL 62052

DOCKET NUMBER: NH 22-C1009

LICENSEE INFO: Helia Healthcare of Jerseyville, LLC
LICENSEE ADDRESS: 600 S. Second Street., Suite 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 10/18/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.3210t), 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: Kensington Place Nrsg & Rehab
FACILITY ADDRESS: 3405 South Michigan Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60616

DOCKET NUMBER: NH 22-S1017

LICENSEE INFO: Kensington Place Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 10/15/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.3210t), 300.3240b), and 300.3240c). A fine of $1,100.00

FACILITY NAME: Kepley House
FACILITY ADDRESS: 408 East Washington
FACILITY CITY, STATE, ZIP: Pittsfield, IL 62363

DOCKET NUMBER: NH 22-S1026

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 10/14/2022

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1060e), 350.1230b)7), and 350.1620d)4)12). A fine of $550.00

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1060e), 350.1230b)7), 350.1610h)1), and 350.1620d)4)C). A fine of $550.00

Total Fine: $1,100.00

FACILITY NAME: Lakeview Rehab & Nrsg Center
FACILITY ADDRESS: 735 West Diversey
FACILITY CITY, STATE, ZIP: Chicago, IL 60614

DOCKET NUMBER: NH 22-S0836

LICENSEE INFO: Lakeview Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 08/24/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.1210d)1)2)6), and 300.1620a). 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: Landmark of Des Plaines Rehab
FACILITY ADDRESS: 9300 Ballard Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60016

DOCKET NUMBER: NH 22-CS0796

LICENSEE INFO: Landmark of Des Plaines Rehabilitation Center, LLC
LICENSEE ADDRESS: 5683 North Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60659
Survey Date – 08/11/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b) and 300.1210b)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 300.1210b)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 300.3210t). 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: 300.1210b). A fine of $2,200.00

Total Fine: $29,400.00

FACILITY NAME: Lawrence Place
FACILITY ADDRESS: 715 South Washington Street
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 22-S0754

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 07/28/2022

Type B violation for violating one or more of the following sections of the Code: 350.1050e)2), 350.1060f), 350.1230b)3), and 350.1620d)3)11)15). A fine of $550,00

FACILITY NAME: Lewis Memorial Christian Vlg
FACILITY ADDRESS: 3400 West Washington
FACILITY CITY, STATE, ZIP: Springfield, IL 62711

DOCKET NUMBER: NH 22-C1038

LICENSEE INFO: Lewis Memorial Christian Village
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/13/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d)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 3001210d)5). A fine of $25,000.00

FACILITY NAME: Loft Rehab & Nursing of Canton
FACILITY ADDRESS: 2081 North Main Street
FACILITY CITY, STATE, ZIP: Canton, IL 61520

DOCKET NUMBER: NH 22-S0954

LICENSEE INFO: The Loft Rehabilitation and Nursing of Canton, LLC
LICENSEE ADDRESS: 55 W. Monroe St., Ste 2400
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 09/23/2022

FACILITY NAME: Loft Rehab of Decatur
FACILITY ADDRESS: 500 West McKinley Avenue
FACILITY CITY, STATE, ZIP: Decatur, IL 62526

DOCKET NUMBER: NH 22-S0946

LICENSEE INFO: The Loft Rehabilitation of Decatur, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 09/14/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d)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: Loft Rehab of Decatur
FACILITY ADDRESS: 500 West McKinley Avenue
FACILITY CITY, STATE, ZIP: Decatur, IL 62526

DOCKET NUMBER: NH 22-S1004

LICENSEE INFO: The Loft Rehabilitation of Decatur, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 09/30/2022

FACILITY NAME: Loft Rehab of Decatur
FACILITY ADDRESS: 500 West McKinley Avenue
FACILITY CITY, STATE, ZIP: Decatur, IL 62526

DOCKET NUMBER: NH 22-C1005

LICENSEE INFO: The Loft Rehabilitation of Decatur, LLC
LICENSEE ADDRESS: 191 N. Wacker Drive, Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/11/2022

FACILITY NAME: Loft Rehab of Rock Springs
FACILITY ADDRESS: 2530 North Monroe Street
FACILITY CITY, STATE, ZIP: Decatur, IL 62526

DOCKET NUMBER: NH 22-S0741

LICENSEE INFO: The Loft Rehabilitation of Rock Springs, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 08/03/2022

FACILITY NAME: Loft Rehab of Rock Springs
FACILITY ADDRESS: 2530 North Monroe Street
FACILITY CITY, STATE, ZIP: Decatur, IL 62526

DOCKET NUMBER: NH 22-C0890

LICENSEE INFO: The Loft Rehabilitation of Rock Springs, LLC
LICENSEE ADDRESS: 191 N. Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 09/07/2022

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.690a), 300.690b) and 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: Lynwood Terrace
FACILITY ADDRESS: 2317 East 207^th Street
FACILITY CITY, STATE, ZIP: Lynwood, IL 60411

DOCKET NUMBER: NH 22-S0986

LICENSEE INFO: Pioneer Concepts, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 09/12/2022

Type B violation for violating one or more of the following sections of the Code: 350.610a), 350.1210b), 350.1230b), 350.1230d)1)2)3), and 350.3240a). A fine of $550.00

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

DOCKET NUMBER: NH 22-CS1007

LICENSEE INFO: UDI #2, LLC
LICENSEE ADDRESS: 285 S. Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 09/27/2022

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

Total Fine: $27,200.00

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

DOCKET NUMBER: NH 22-S0896

LICENSEE INFO: Community Care Center of Mascoutah, Inc.
LICENSEE ADDRESS: 858 Sunnyhill Lane
LICENSEE CITY, STATE, ZIP: Columbia, IL 62236
Survey Date – 08/24/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 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

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)2), 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). 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), 300.680a), 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

Total Fine: $54,400.00

FACILITY NAME: Mattoon Rehab & HCC
FACILITY ADDRESS: 2121 South 9^th Street
FACILITY CITY, STATE, ZIP: Mattoon, IL 61938

DOCKET NUMBER: NH 22-S0877

LICENSEE INFO: Mattoon Manor, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/24/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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

Total Fine: $4,400.00

FACILITY NAME: Mattoon Rehab & HCC
FACILITY ADDRESS: 2121 South 9^th Street
FACILITY CITY, STATE, ZIP: Mattoon, IL 61938

DOCKET NUMBER: NH 22-C0957

LICENSEE INFO: Mattoon Manor, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/01/2022

FACILITY NAME: Mayfield Care and Rehab
FACILITY ADDRESS: 5905 West Washington Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60644

DOCKET NUMBER: NH 22-S0823

LICENSEE INFO: Mayfield Care and Rehabilitation Center, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 08/19/2022

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 300.1220b)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: Mayfield Care and Rehab
FACILITY ADDRESS: 5905 West Washington Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60644

DOCKET NUMBER: NH 22-C1002

LICENSEE INFO: Mayfield Care and Rehabilitation Center, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 10/14/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.615b). 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: 300.615b). A fine of $2,200.00

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

DOCKET NUMBER: NH 22-CS0830

LICENSEE INFO: Midway Neurological and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 08/19/2022

FACILITY NAME: Monmouth Nursing Home
FACILITY ADDRESS: 117 South I Street
FACILITY CITY, STATE, ZIP: Monmouth, IL 61462

DOCKET NUMBER: NH 22-CS0868

LICENSEE INFO: Community Care Center of Monmouth, Inc.
LICENSEE ADDRESS: 117 S. I Street
LICENSEE CITY, STATE, ZIP: Monmouth, IL 61462
Survey Date – 08/25/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.690a), 300.1210b), 300.1210c), 300.1210d)6), 300.3240a), 300.3240b), 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: 300.690, 300.1210b), 300.1210d)6), and300.3240a). A fine of $25,000.00

FACILITY NAME: Monmouth Nursing Home
FACILITY ADDRESS: 117 South I Street
FACILITY CITY, STATE, ZIP: Monmouth, IL 61462

DOCKET NUMBER: NH 22-S1006

LICENSEE INFO: Community Care Center of Monmouth, Inc.
LICENSEE ADDRESS: 117 S. I Street
LICENSEE CITY, STATE, ZIP: Monmouth, IL 61462
Survey Date – 10/07/2022

FACILITY NAME: Montgomery Place
FACILITY ADDRESS: 5550 South Shore Drive
FACILITY CITY, STATE, ZIP: Chicago, IL 60637

DOCKET NUMBER: NH 22-C0864

LICENSEE INFO: Montgomery Place
LICENSEE ADDRESS: 5550 South Shore Drive
LICENSEE CITY, STATE, ZIP: Chicago, IL 60637
Survey Date – 08/24/2022

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)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: 300.1210d)5). A fine of $25,000.00

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-S0828

LICENSEE INFO: Palladian Mt. Vernon SNF, LLC
LICENSEE ADDRESS: 600 S. Second St., Ste 104
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 08/23/2022

Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210c), 300.1210d)2), 300.1210d)6), 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) and 300.1210d)6). A fine of $50,000.00

FACILITY NAME: Moweaqua Rehab & HCC
FACILITY ADDRESS: 525 South Macon Street
FACILITY CITY, STATE, ZIP: Moweaqua, IL 62550

DOCKET NUMBER: NH 22-S0914

LICENSEE INFO: Moweaqua Rehabilitation & Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence Avenue
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/08/2022

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: Moweaqua Rehab & HCC
FACILITY ADDRESS: 525 South Macon Street
FACILITY CITY, STATE, ZIP: Moweaqua, IL 62550

DOCKET NUMBER: NH 22-S1001

LICENSEE INFO: Moweaqua Rehabilitation & Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence Avenue
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/29/2022

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)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 3001210d)5). A fine of $25,000.00

Total Fine: $27,200.00

FACILITY NAME: Mt Vernon Health Care Center
FACILITY ADDRESS: #5 Doctor’s Park Road
FACILITY CITY, STATE, ZIP: Mount Vernon, IL 62864

DOCKET NUMBER: NH 22-S0733

LICENSEE INFO: Petersen Management Company, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/28/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.686b)4), 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: 300.686 and 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)2)5), 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: 300.1210b) 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), 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

Total Fine: $8,800.00

FACILITY NAME: Mulberry Manor
FACILITY ADDRESS: 612 East Davie Street., Box 88
FACILITY CITY, STATE, ZIP: Anna, IL 62906

DOCKET NUMBER: NH 22-C0753

LICENSEE INFO: Mulberry Manor, Inc.
LICENSEE ADDRESS: 158 E. Vienna St., P.O. Box 88
LICENSEE CITY, STATE, ZIP: Anna, IL 62906
Survey Date – 07/22/2022

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1060a), 350.1060g), 350.1210d), 350.1230b), 350.1230d)1), and 350.3240a). A fine of $750.00

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1210)b), and 350.3240a). A fine of $750.00

Total Fine: $1,500.00

FACILITY NAME: Nokomis Rehab & Health Care C
FACILITY ADDRESS: 505 Stevens Street
FACILITY CITY, STATE, ZIP: Nokomis, IL 62075

DOCKET NUMBER: NH 22-C0978

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/29/2022

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

FACILITY NAME: North Aurora Care Center
FACILITY ADDRESS: 310 Banbury Road
FACILITY CITY, STATE, ZIP: North Aurora, IL 60542

DOCKET NUMBER: NH 22-C0871

LICENSEE INFO: North Aurora HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/31/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.810a), 300.1210b), 300.1210d)1), 300.1220a), 300.1230e), and 300.1240a). 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 300.1240). A fine of $2,200.00

FACILITY NAME: Norwood Crossing
FACILITY ADDRESS: 6016 North Nina Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60631

DOCKET NUMBER: NH 22-C0956

LICENSEE INFO: Norwood Crossing Association
LICENSEE ADDRESS: 6016 North Nina Avenue
LICENSEE CITY, STATE, ZIP: Chicago, IL 60631
Survey Date – 08/31/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)5), 300.1210d)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: 300.1210b) and 300.1210d)6). A fine of $25,000.00

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

DOCKET NUMBER: NH 22-S0932

LICENSEE INFO: DeKalb Area Retirement Center
LICENSEE ADDRESS: 2944 Greenwood Acres Drive
LICENSEE CITY, STATE, ZIP: DeKalb, IL 60115
Survey Date – 09/14/2022

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.696b). 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 $500.00

FACILITY NAME: Oak Hill
FACILITY ADDRESS: 623 Hamacher Street
FACILITY CITY, STATE, ZIP: Waterloo, IL 62298

DOCKET NUMBER: NH 22-S1028

LICENSEE INFO: County of Monroe
LICENSEE ADDRESS: 100 South Main Street
LICENSEE CITY, STATE, ZIP: Waterloo, IL 62298
Survey Date – 09/16/2022

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

FACILITY NAME: Oak Lawn Respiratory & Rehab
FACILITY ADDRESS: 9525 South Mayfield
FACILITY CITY, STATE, ZIP: Oaklawn, IL 60453

DOCKET NUMBER: NH 22-CS0898

LICENSEE INFO: Oak Lawn Respiratory and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 09/01/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.3240a), 300.3240b), 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: 300.3240a). 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). A fine of $1,100.00

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)1). 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: $5,500.00

FACILITY NAME: Oak Park Oasis
FACILITY ADDRESS: 625 North Harlem
FACILITY CITY, STATE, ZIP: Oak Park, IL 60302

DOCKET NUMBER: NH 22-C0908

LICENSEE INFO: Oak Park Oasis, LLC
LICENSEE ADDRESS: 4711 Gold Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 08/04/2022

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), 300.2040d), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: Odd Fellow Rebekah Home
FACILITY ADDRESS: 201 Lafayette Avenue, East
FACILITY CITY, STATE, ZIP: Mattoon, IL 61938

DOCKET NUMBER: NH 22-S0870

LICENSEE INFO: Illinois I.OOF Old Folks’ Home, Mattoon, IL
LICENSEE ADDRESS: 201 Lafayette East
LICENSEE CITY, STATE, ZIP: Mattoon, IL 61938
Survey Date – 08/18/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1010i), 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: Our Lady of Angeles Ret Home
FACILITY ADDRESS: 1201 Wyoming Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60435

DOCKET NUMBER: NH 22-S0810

LICENSEE INFO: Our Lady of Angels Retirement Home
LICENSEE ADDRESS: 2801 Black Road, 2nd FL
LICENSEE CITY, STATE, ZIP: Joliet, IL 60435
Survey Date – 08/17/2022

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

DOCKET NUMBER: NH 22-C0965

LICENSEE INFO: Palos Heights Rehabilitation, LLC
LICENSEE ADDRESS: 2201 Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 09/27/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d)3), and 300.1810f)1). 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

Total Fine: $27,200.00

FACILITY NAME: Park Place Christian Community
FACILITY ADDRESS: 1150 Euclid Avenue
FACILITY CITY, STATE, ZIP: Elmhurst, IL 60126

DOCKET NUMBER: NH 22-S0774

LICENSEE INFO: Timothy Place, NFP
LICENSEE ADDRESS: 18601 N. Creek Drive
LICENSEE CITY, STATE, ZIP: Tinley Park, IL 60477
Survey Date – 08/04/2022

FACILITY NAME: Parkshore Estates Nrsg & Rehab
FACILITY ADDRESS: 6125 South Kenwood
FACILITY CITY, STATE, ZIP: Chicago, IL 60637

DOCKET NUMBER: NH 22-C0815

LICENSEE INFO: Parkshore Estates Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 07/22/2022

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

DOCKET NUMBER: NH 22-C0913

LICENSEE INFO: Pearl of Naperville, LLC
LICENSEE ADDRESS: 4711 Golf Road, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 09/12/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)3)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: Pleasant Meadows Senior Living
FACILITY ADDRESS: 400 West Washington
FACILITY CITY, STATE, ZIP: Chrisman, IL 61924

DOCKET NUMBER: NH 22-CS0715

LICENSEE INFO: Pleasant Meadows Senior Living, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 07/29/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)1)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: Pleasant View Rehab & HCC
FACILITY ADDRESS: 500 North Jackson Street
FACILITY CITY, STATE, ZIP: Morrison, IL 61270

DOCKET NUMBER: NH 22-S0807

LICENSEE INFO: Pleasant View HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 07/28/2022

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

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: $26,000.00

FACILITY NAME: Prairie Crossing Lvg & Rehab
FACILITY ADDRESS: 409 West Comanche Avenue
FACILITY CITY, STATE, ZIP: Shabbona, IL 60550

DOCKET NUMBER: NH 22-S0737

LICENSEE INFO: Prairie Crossing Living & Rehabilitation Center, LLC
LICENSEE ADDRESS: 7434 Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 07/27/2022

Type C violation of an occurrence for violating one or more of the following sections of the Code: 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: 300.615f). A fine of $500.00

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

DOCKET NUMBER: NH 22-S0795

LICENSEE INFO: Prairie Manor Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 West Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 08/17/2022

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

DOCKET NUMBER: NH 22-S0924

LICENSEE INFO: Prairie Manor Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 2201 West Main Street
LICENSEE CITY, STATE, ZIP: Evanston, IL 60202
Survey Date – 08/25/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.3210a), 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: 300.1210b). 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 22-C0973

LICENSEE INFO: Prairie Oasis, LLC
LICENSEE ADDRESS: 4711 Golf Rd, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 10/04/2022

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)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: Prairie Rose Health Care Ctr
FACILITY ADDRESS: 900 South Chestnut Street
FACILITY CITY, STATE, ZIP: Pana, IL 62557

DOCKET NUMBER: NH 22-C0897

LICENSEE INFO: SJL Health Systems, Inc.
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/04/2022

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)4)5), 300.1210c)2)3), 300.1210d)5), 300.1220b)1)2), 300.3220f), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: Prairie Rose Health Care Ctr
FACILITY ADDRESS: 900 South Chestnut Street
FACILITY CITY, STATE, ZIP: Pana, IL 62557

DOCKET NUMBER: NH 22-S0989

LICENSEE INFO: SJL Health Systems, Inc.
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/20/2022

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)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: Promedica Skilled Nursing AH
FACILITY ADDRESS: 715 West Central Road
FACILITY CITY, STATE, ZIP: Arlington Hts, IL 60005

DOCKET NUMBER: NH 22-S0992

LICENSEE INFO: Manorcare Health Services, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 10/05/2022

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)1). 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: 300.1210b). A fine of $500.00

Total Fine: $1,000.00

FACILITY NAME: Promedica Skilled Nursing Mo
FACILITY ADDRESS: 833 Sixteenth Ave
FACILITY CITY, STATE, ZIP: Moline, IL 61265

DOCKET NUMBER: NH 22-S0999

LICENSEE INFO: Heartland of Moline IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/28/2022

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 3001210d)6). A fine of $25,000.00

FACILITY NAME: Quincy Healthcare & Sr Living
FACILITY ADDRESS: 1440 North 10^th Street
FACILITY CITY, STATE, ZIP: Quincy, IL 62301

DOCKET NUMBER: NH 22-S0798

LICENSEE INFO: Quincy Healthcare & Senior Living, LLC
LICENSEE ADDRESS: 4711 Golf Rd, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 08/11/2022

FACILITY NAME: Quincy Healthcare & Sr. Living
FACILITY ADDRESS: 1440 North 10^th Street
FACILITY CITY, STATE, ZIP: Quincy, IL 62301

DOCKET NUMBER: NH 22-S0929

LICENSEE INFO: Quincy Healthcare & Senior Living, LLC
LICENSEE ADDRESS: 4711 Golf Rd, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 09/23/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 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: Regency Care
FACILITY ADDRESS: 2120 W. Washington Street
FACILITY CITY, STATE, ZIP: Springfield, IL 62702

DOCKET NUMBER: NH 22-C0832

LICENSEE INFO: Rutledge Regency Operations, LLC
LICENSEE ADDRESS: 202 N. Center Street
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 08/11/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.690a), 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: River Bluff Nursing Home
FACILITY ADDRESS: 4401 North Main Street
FACILITY CITY, STATE, ZIP: Rockford, IL 61103

DOCKET NUMBER: NH 22-C0844

LICENSEE INFO: Winnebago County
LICENSEE ADDRESS: 404 Elm Street, Room 504
LICENSEE CITY, STATE, ZIP: Rockford, IL 61101
Survey Date – 09/26/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 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: River Crossing of Alton
FACILITY ADDRESS: 3490 Humbert Road
FACILITY CITY, STATE, ZIP: Alton, IL 62002

DOCKET NUMBER: NH 22-C0794

LICENSEE INFO: Alton NH, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/10/2022

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)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: Royal Oaks Care Center
FACILITY ADDRESS: 605 East Church Street, Box 600
FACILITY CITY, STATE, ZIP: Kewanee, IL 61443

DOCKET NUMBER: NH 22-S0925

LICENSEE INFO: Royal HCO, LLC
LICENSEE ADDRESS: 833 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/10/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210d)3)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: 300.1210b), and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Salem Village Nursing & Rehab
FACILITY ADDRESS: 1314 Rowell Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60433

DOCKET NUMBER: NH 22-C0931

LICENSEE INFO: Salem Village Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 111 N. Ottawa Street
LICENSEE CITY, STATE, ZIP: Joliet, IL 60432
Survey Date – 09/21/2022

Type AA violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1035e), 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 $50,000.00

FACILITY NAME: Salem Village Nursing & Rehab
FACILITY ADDRESS: 1314 Rowell Avenue
FACILITY CITY, STATE, ZIP: Joliet, IL 60433

DOCKET NUMBER: NH 22-S0941

LICENSEE INFO: Salem Village Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 111 N. Ottawa Street
LICENSEE CITY, STATE, ZIP: Joliet, IL 60432
Survey Date – 10/03/2022

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

FACILITY NAME: Sharon Health Care Elms
FACILITY ADDRESS: 3611 North Rochelle
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 22-S0963

LICENSEE INFO: Sharon Health Care Elms, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 09/15/2022

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

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)5)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: 300.1210b) and 300.1210d)5)6). A fine of $2,200.00

Total Fine: $27,200.00

FACILITY NAME: Sharon Health Care Elms
FACILITY ADDRESS: 3611 North Rochelle
FACILITY CITY, STATE, ZIP: Peoria, IL 61604

DOCKET NUMBER: NH 22-C0991

LICENSEE INFO: Sharon Health Care Elms, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 09/27/2022

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

DOCKET NUMBER: NH 22-S0841

LICENSEE INFO: Sharon Health Care Pines, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 07/28/2022

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

DOCKET NUMBER: NH 22-S0993

LICENSEE INFO: Sharon Health Care Pines, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 09/19/2022

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

DOCKET NUMBER: NH 22-S1055

LICENSEE INFO: Sharon Health Care Pines, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Suite 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 10/06/2022

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

FACILITY NAME: South Elgin Rehab & HCC
FACILITY ADDRESS: 746 West Spring Street
FACILITY CITY, STATE, ZIP: South Elgin, IL 60177

DOCKET NUMBER: NH 22-C0988

LICENSEE INFO: Petersen Health Properties, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/26/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b)4), 300.1210c)2)3), 300.1210d)5), 300.1220a)1)2), 300.1220b)1)2)3)7), 300.3220f), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: South Lawn Sheltered Care
FACILITY ADDRESS: 512 South Franklin
FACILITY CITY, STATE, ZIP: Bunker Hill, IL 62014

DOCKET NUMBER: NH 22-C0726

LICENSEE INFO: South Lawn Sheltered Care, Inc.
LICENSEE ADDRESS: R.R. #1 Route 159, P.O. Box H
LICENSEE CITY, STATE, ZIP: Bunker Hill, IL 62014
Survey Date – 07/20/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 330.790a), 330.790b), and 330.790c)3)4). 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 $2,200.00

FACILITY NAME: Southpoint Nrsg & Rehab Ctr
FACILITY ADDRESS: 1010 West 95^th Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60643

DOCKET NUMBER: NH 22-C0961

LICENSEE INFO: Southpoint Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 240 Fencl Lane
LICENSEE CITY, STATE, ZIP: Hillside, IL 60162
Survey Date – 10/03/2022

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). 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 C violation of an occurrence for violating one or more of the following sections of the Code: 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: 300.3240a) and 300.3240d). A fine of $500.00

Total Fine: $30,000.00

FACILITY NAME: Southview Manor
FACILITY ADDRESS: 3311 South Michigan Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60616

DOCKET NUMBER: NH 22-C0814

LICENSEE INFO: Laureate Southview Operations, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/05/2022

Type A 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), 300.1210d)6), 300.1220b)2)3), 300.3100d)2), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.690, 300.1210b), 300.1210d)6), 300.3100d)2), and 300.3240a). A fine of $25,000.00

FACILITY NAME: Southview Manor
FACILITY ADDRESS: 3311 South Michigan Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60616

DOCKET NUMBER: NH 22-C1027

LICENSEE INFO: Laureate Southview Operations, LLC
LICENSEE ADDRESS: 208 S. LaSalle St., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 09/23/2022

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

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 22-C0878

LICENSEE INFO: St. Anthony’s Rehabilitation and Nursing Center, LLC
LICENSEE ADDRESS: 767 30^th Street
LICENSEE CITY, STATE, ZIP: Rock Island, IL 61201
Survey Date – 08/18/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210c)3), 300.1220b)1)2), 300.1810f)1), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.1210b) 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: 300.610a), 300.1210b)4), 300.1210c)4)A)B)C), 300.1220b)1)2), 300.1230a), 300.3240b)1)2)A)B)C), 300.120e), 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

Total Fine: $50,000.00

FACILITY NAME: St. Clara’s Rehab & Senior Care
FACILITY ADDRESS: 1450 Castle Manor Drive
FACILITY CITY, STATE, ZIP: Lincoln, IL 62656

DOCKET NUMBER: NH 22-S0745

LICENSEE INFO: St. Clara’s Manor
LICENSEE ADDRESS: 1 N. Old State Capitol, Plaza 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62701
Survey Date – 07/28/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.690a), 300.1010h), 300.1010i), 300.1210b), 300.1210c), 300.1210d)6), 300.1220b)2), 300.3240a), and 300.3240b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high-risk designation: 300.690, 300.1210b), 300.1210d)6), and 300.3240a). A fine of $25,000.00

FACILITY NAME: St. Joseph Village of Chicago
FACILITY ADDRESS: 4021 West Belmont Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60641

DOCKET NUMBER: NH 22-S0748

LICENSEE INFO: Franciscan Communities, Inc.
LICENSEE ADDRESS: 208 South LaSalle St., Suite 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 07/29/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 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: St. Paul’s Senior Community
FACILITY ADDRESS: 1021 West E Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62220

DOCKET NUMBER: NH 22-C0722

LICENSEE INFO: St. Paul’s Senior Community, LLC
LICENSEE ADDRESS: 412 E. Lawrence Ave
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 07/22/2022

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)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: Stonebridge Nursing & Rehab
FACILITY ADDRESS: 902 S. McLeansboro Street, Box 968
FACILITY CITY, STATE, ZIP: Benton, IL 62812

DOCKET NUMBER: NH 22-S0881

LICENSEE INFO: Stonebridge Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 215 E. Locust Street
LICENSEE CITY, STATE, ZIP: Harrisburg, IL 62946
Survey Date – 10/20/2022

FACILITY NAME: Swansea Rehab & Hlth Care Ctr
FACILITY ADDRESS: 1405 North Second Street
FACILITY CITY, STATE, ZIP: Swansea, IL 62226

DOCKET NUMBER: NH 22-S0839

LICENSEE INFO: Swansea HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/17/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210c), and 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), 300.1210c), 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: Symphony Chicago West
FACILITY ADDRESS: 5130 West Jackson Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60644

DOCKET NUMBER: NH 22-C0938

LICENSEE INFO: Symphony Jackson Square, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/21/2022

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 300.3210t). 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: 300.1210b) 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), 300.1210b), and 300.1210d)1). 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: $6,600.00

FACILITY NAME: Symphony Encore
FACILITY ADDRESS: 2829 South California Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60608

DOCKET NUMBER: NH 22-S0750

LICENSEE INFO: Symphony of California Gardens, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/05/2022

FACILITY NAME: Symphony Encore
FACILITY ADDRESS: 2829 South California Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60608

DOCKET NUMBER: NH 22-CS0858

LICENSEE INFO: Symphony of California Gardens, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/01/2022

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), 300.3240b), 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),300.1210d)6), and 300.3240e). A fine of $2,200.00

FACILITY NAME: Symphony Encore
FACILITY ADDRESS: 2829 South California Blvd
FACILITY CITY, STATE, ZIP: Chicago, IL 60608

DOCKET NUMBER: NH 22-S0967

LICENSEE INFO: Symphony of California Gardens, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/07/2022

FACILITY NAME: Symphony Lincoln Park
FACILITY ADDRESS: 1366 West Fullerton Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60614

DOCKET NUMBER: NH 22-S0907

LICENSEE INFO: Symphony Lincoln Park, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/08/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300690a), 300.690b), 300.690c), 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), 300.690, and 300.1210d)6). A fine of $25,000.00

FACILITY NAME: Symphony Maple Crest
FACILITY ADDRESS: 4452 Squaw Prairie Road
FACILITY CITY, STATE, ZIP: Belvidere, IL 61008

DOCKET NUMBER: NH 22-S0904

LICENSEE INFO: Symphony Maple Crest, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/18/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b)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 $25,000.00

FACILITY NAME: Symphony Midway
FACILITY ADDRESS: 4437 South Cicero
FACILITY CITY, STATE, ZIP: Chicago, IL 60632

DOCKET NUMBER: NH 22-C0971

LICENSEE INFO: Symphony Midway, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/30/2022

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 3001210d)6). A fine of $25,000.00

FACILITY NAME: Symphony Morgan Park
FACILITY ADDRESS: 10935 S. Halsted Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60628

DOCKET NUMBER: NH 22-C0952

LICENSEE INFO: Symphony Park South, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/07/2022

FACILITY NAME: Symphony Morgan Park
FACILITY ADDRESS: 10935 S. Halsted Street
FACILITY CITY, STATE, ZIP: Chicago, IL 60628

DOCKET NUMBER: NH 22-S1076

LICENSEE INFO: Symphony Park South, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 10/14/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.3210t), 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: 300.1210b). A fine of $25,000.00

FACILITY NAME: Taylor House
FACILITY ADDRESS: 3021 Taylor Avenue
FACILITY CITY, STATE, ZIP: Springfield, IL 62703

DOCKET NUMBER: NH 22-C0767

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 07/22/2022

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1010e), 350.1060e), and 350.1610c)3). A fine of $550.00

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

Total Fine: $1,100.00

FACILITY NAME: Taylor House
FACILITY ADDRESS: 3021 Taylor Avenue
FACILITY CITY, STATE, ZIP: Springfield, IL 62703

DOCKET NUMBER: NH 22-S0892

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 08/25/2022

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1060e), 350.1420a), 350.1430e), 350.1610b), 350.1840b)e), and 350.3240a). A fine of $550.00

FACILITY NAME: Terrace Nursing Home, The
FACILITY ADDRESS: 1615 Sunset Avenue
FACILITY CITY, STATE, ZIP: Waukegan, IL 60087

DOCKET NUMBER: NH 22-S0883

LICENSEE INFO: TN Care, LLC
LICENSEE ADDRESS: 1S443 Summitt Avenue, Ste 204
LICENSEE CITY, STATE, ZIP: Oakbrook Terrace, IL 60181
Survey Date – 09/02/2022

Type C violation of an occurrence for violating one or more of the following sections of the Code: 300.650a), 300.650c), 300.650d), and 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: Thelma Terrace
FACILITY ADDRESS: 1450 Virginia Avenue
FACILITY CITY, STATE, ZIP: Wood River, IL 62095

DOCKET NUMBER: NH 22-S0891

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 07/28/2022

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

FACILITY NAME: Thelma Terrace
FACILITY ADDRESS: 1450 Virginia Avenue
FACILITY CITY, STATE, ZIP: Wood River, IL 62095

DOCKET NUMBER: NH 22-S1060

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 09/22/2022

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

FACILITY NAME: Timbercreek Rehab & Hlth C Ctr
FACILITY ADDRESS: 2220 State Street
FACILITY CITY, STATE, ZIP: Pekin, IL 61554

DOCKET NUMBER: NH 22-S0972

LICENSEE INFO: Petersen Health Operations, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 10/05/2022

FACILITY NAME: Tower Hill Healthcare Center
FACILITY ADDRESS: 759 Kane Street
FACILITY CITY, STATE, ZIP: South Elgin, IL 60177

DOCKET NUMBER: NH 22-S0872

LICENSEE INFO: Tower Hill Rehabilitation, LLC
LICENSEE ADDRESS: 759 Kane Street
LICENSEE CITY, STATE, ZIP: South Elgin, IL 60177
Survey Date – 08/31/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)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

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b), 300.1210d)1), and 300.1620a). 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: Tri-State Village Nrsg & Rhb
FACILITY ADDRESS: 2500 East 175^th Street
FACILITY CITY, STATE, ZIP: Lansing, IL 60438

DOCKET NUMBER: NH 22-C1042

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 – 10/05/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210c), and 300.1210d)2)5)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 3001210d)5)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: 300.610a), 300.1010h), 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: 300.1210b) and 300.1210d)6). A fine of $2,200.00

Total Fine: $27,200.00

FACILITY NAME: Union County Hospital LTC
FACILITY ADDRESS: 521 North Main Street
FACILITY CITY, STATE, ZIP: Anna, IL 62906

DOCKET NUMBER: NH 22-S0762

LICENSEE INFO: Anna Hospital Corporation
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/04/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.696b), 300.696f)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: 300.696). A fine of $25,000.00

FACILITY NAME: University Rehab
FACILITY ADDRESS: 500 South Art Bartell Road
FACILITY CITY, STATE, ZIP: Urbana, IL 61802

DOCKET NUMBER: NH 22-C0811

LICENSEE INFO: University Rehabilitation Center of C-U, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street., Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 08/18/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)3), 300.1220b)2), and 300.2900d)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 300.2900d)2). A fine of $25,000.00

FACILITY NAME: Uptown Care and Rehabilitation
FACILITY ADDRESS: 4920 North Kenmore Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 22-S0775

LICENSEE INFO: Uptown Care and Rehabilitation Center, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/05/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 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: Villa Health Care East
FACILITY ADDRESS: 100 Marian Parkway, P.O. Box 109
FACILITY CITY, STATE, ZIP: Sherman, IL 62684

DOCKET NUMBER: NH 22-S0894

LICENSEE INFO: Villa Health Care, Inc.
LICENSEE ADDRESS: 313 Saratoga Chase
LICENSEE CITY, STATE, ZIP: Sherman, IL 62684
Survey Date – 08/11/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b) and 300.1210d)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: Warren Barr South Loop
FACILITY ADDRESS: 1725 South Wabash Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60616

DOCKET NUMBER: NH 22-C0818

LICENSEE INFO: South Loop Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 09/16/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 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: Washington Senior Living
FACILITY ADDRESS: 1201 Newcastle Road
FACILITY CITY, STATE, ZIP: Washington, IL 61571

DOCKET NUMBER: NH 22-C0865

LICENSEE INFO: Washington Senior Living, LLC
LICENSEE ADDRESS: 1275 Milwaukee Ave., Ste 300
LICENSEE CITY, STATE, ZIP: Glenview, IL 60025
Survey Date – 08/30/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 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: Watseka Rehab & Hlth Care Ctr
FACILITY ADDRESS: 715 East Raymond Road
FACILITY CITY, STATE, ZIP: Watseka, IL 60970

DOCKET NUMBER: NH 22-C0757

LICENSEE INFO: Watseka HCO, LLC
LICENSEE ADDRESS: 830 Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 08/04/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)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 $2,200.00

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

DOCKET NUMBER: NH 22-S0854

LICENSEE INFO: Watseka HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/11/2022

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), 300.3240g), 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: 300.1210b) and 300.1210d)6). A fine of $2,200.00

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

DOCKET NUMBER: NH 22-CS0934

LICENSEE INFO: Watseka HCO, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 09/21/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.1210d)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

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), and 300.4040a)1)2)3)4)5)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). A fine of $2,200.00

Total Fine: $6,600.00

FACILITY NAME: White Hall Nsg & Rehab Center
FACILITY ADDRESS: 620 West Bridgeport Street
FACILITY CITY, STATE, ZIP: White Hall, IL 62092

DOCKET NUMBER: NH 22-S0761

LICENSEE INFO: White Hall Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 901 S. 2^nd Street, Ste 201
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 08/05/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b) and 300.2040b)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

FACILITY NAME: Whitehall of Deerfield
FACILITY ADDRESS: 300 Waukegan Road
FACILITY CITY, STATE, ZIP: Deerfield, IL 60015

DOCKET NUMBER: NH 22-S0805

LICENSEE INFO: Whitehall Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 3450 Oakton Street
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 08/17/2022

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.1210c), and 300.1210d)1). 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 C violation of an occurrence for violating one or more of the following sections of the Code: 300.615e) and 300.615f). 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: 300.615e) and 300.615f). A fine of $500.00

Total Fine: $2,700.00

FACILITY NAME: Willow Crest Nursing Pavilion
FACILITY ADDRESS: 515 North Main Street
FACILITY CITY, STATE, ZIP: Sandwich, IL 60548

DOCKET NUMBER: NH 22-CS1043

LICENSEE INFO: Willow Crest Nursing Pavilion, Ltd
LICENSEE ADDRESS: 191 North Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 09/26/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210b), 300.1210d)3)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the 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: Woodbridge Nursing Pavilion
FACILITY ADDRESS: 2242 North Kedzie
FACILITY CITY, STATE, ZIP: Chicago, IL 60647

DOCKET NUMBER: NH 22-CS0969

LICENSEE INFO: Woodbridge Nursing Pavilion, Ltd
LICENSEE ADDRESS: 191 North Wacker Dr., Ste 1800
LICENSEE CITY, STATE, ZIP: Chicago, IL 60606
Survey Date – 10/12/2022

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 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). A fine of $25,000.00

2022 4th Quarterly Report

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2022 4th Quarterly Report

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