QUARTERLY REPORT

FACILITY NAME: Alden Trails
FACILITY ADDRESS: 273 Army Trail Road
Bloomingdale, IL 60108

DOCKET #: NH 12-S0289
NAME. OF OWNER:
OR LICENSEE: Alden Trails, Inc.
ADDRESS: 4200 West Peterson Ave., Ste 140
Chicago, IL 60646

Re: Survey of 5-9-12 On July 20, 2012, sent Notice of Type “A” Violation relating to the area of nursing, Notice of Conditional License and Notice of Fine Assessment of $6,250. A hearing has been requested.

FACILITY NAME: Alden Village North
FACILITY ADDRESS: 7464 North Sheridan Road
Chicago, IL 60626

DOCKET #: NH 11-C0183
NAME. OF OWNER:
OR LICENSEE: Alden Village North, Inc.
ADDRESS: 4200 West Peterson Ave., Ste 140
Chicago, IL 60646

Re: Survey of 4-28-11 By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Applewood Rehabilitation Center
FACILITY ADDRESS: 21020 Kostner Ave.
Matteson, IL 60443

DOCKET #: NH 12-S0287
NAME. OF OWNER:
OR LICENSEE: Applewood Rehabilitation Center, LLC.
ADDRESS: 6840 North Lincoln Ave.
Lincolnwood, IL 60712

Re: Survey of 5-18-12 On July 18, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Arden Courts of Glen Ellyn
FACILITY ADDRESS: 2 South 706 Park Blvd.
Glen Ellyn, IL 60137

DOCKET #: NH 12-S0344
NAME. OF OWNER:
OR LICENSEE: Arden Courts of Glen Ellyn, IL, LLC
ADDRESS: 208 South LaSalle St., Ste 814
Chicago, IL 60604

Re: Survey of 7-19-12 On August 28, 2012, sent Notice of Type “Repeat B” Violations relating to the area of policy & procedure, Notice of Conditional Licensure and Notice of Fine Assessment of $2,200.

FACILITY NAME: The Arthur Home
FACILITY ADDRESS: 423 Eberhardt Dr
Arthur, IL 61911

DOCKET #: NH 12-S0013
NAME. OF OWNER:
OR LICENSEE: Community Retirement Inc.
ADDRESS: 423 Eberhardt Dr
Arthur, IL 61911

Re: Survey of 12-13-11 By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Aurora Rehabilitation and Living Center
FACILITY ADDRESS: 1601 North Farnsworth Ave.
Aurora, IL 60505

DOCKET #: NH 12-C0318
NAME. OF OWNER:
OR LICENSEE: Aurora Manor, Inc.
ADDRESS: 161 North Clark St., Ste 4200
Chicago, IL 60601

Re: Survey of 6-18-12 On July 31, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Avenue Care Nursing and Rehabilitation Center
FACILITY ADDRESS: 4505 South Drexel Blvd
Chicago, IL 60653

DOCKET #: NH 12-C0306
NAME. OF OWNER:
OR LICENSEE: Avenue Care Nursing and Rehabilitation Center, LLC.
ADDRESS: 2201 West Main
Evanston, IL 60202

Re: Survey of 5-31-12 On July 26, 2012, sent Notice of Type “B” Violation relating to the area of policy & procedure and Notice of Fine Assessment of $1,100.

FACILITY NAME: Balmoral Home
FACILITY ADDRESS: 2055 West Balmoral Ave.
Chicago, IL 60625

DOCKET #: NH 12-S0127
NAME. OF OWNER:
OR LICENSEE: Balmoral Home, Inc.
ADDRESS: 6500 North Hamlin
Lincolnwood, IL 60712

Re: Survey of 1-27-12 By Final Order, Violation Amended and Fine Assessment Affirmed.

FACILITY NAME: Batavia Rehabilitation and Healthcare Center
FACILITY ADDRESS: 520 Fabyan Parkway
Batavia, IL 60510

DOCKET #: NH 12-S0363
NAME. OF OWNER:
OR LICENSEE: Petersen Health Operations, LLC
ADDRESS: 830 West Trailcreek Dr
Peoria, IL 61614

Re: Survey of 7-24-12 On September 5, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $2,200.

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

DOCKET #: NH 12-C0356
NAME. OF OWNER:
OR LICENSEE: Bellwood Nursing Center, LLC
ADDRESS: 5750 Old Orchard Rd, Ste 420
Skokie, IL 60077

Re: Survey of 6-19-12 On September 13, 2012 sent Notice of Type “A” & “B” Violations relating to the areas of policy & procedure and nursing, Notice of Conditional License and Notice of Fine Assessment of $31,500.

FACILITY NAME: Briarbrook Place
FACILITY ADDRESS: 228 Briarbrook Dr
East Peoria, IL 61611

DOCKET #: NH 12-C0347
NAME. OF OWNER:
OR LICENSEE: Progressive Housing, Inc.
ADDRESS: 3615 Park Dr, Ste 100
Olympia Fields, IL 60461

Re: Survey of 6-28-12 On August 28, 2012, sent Notice of Type “A” Violation relating to the area of policy & procedure, Notice of Conditional License and Notice of Fine Assessment of $5000.

FACILITY NAME: Brookside Manor
FACILITY ADDRESS: 1740 West McCord
Centralia, IL 62801

DOCKET #: NH 12-S0290
NAME. OF OWNER:
OR LICENSEE: Brookside Nursing Home, Inc.
ADDRESS: 525 South Macon St.
Moweaqua, IL 62550

Re: Survey of 6-6-12 On July 20, 2012, sent Notice of Type “A” Violation relating to the area of policy & procedure, Notice of Conditional License and Notice of Fine Assessment of $10,000.

FACILITY NAME: Burnsides Community Health Center
FACILITY ADDRESS: 410 North Second St., PO Box 219
Marshall, IL 62441

DOCKET #: NH 12-S0373
NAME. OF OWNER:
OR LICENSEE: Burnsides Nursing Home, NFP
ADDRESS: 410 N Second St.
Marshall, IL 62441

Re: Survey of 7-27-12 On September 18, 2012, sent Notice of Type “A” & “B” Violations relating to the areas of policy & procedure and nursing, Notice of Conditional License, and Notice of Fine Assessment of $13,600. A hearing has been requested.

FACILITY NAME: Carole Lane Terrace
FACILITY ADDRESS: 1641 Carole Lane
Sauk Village, IL 60411

DOCKET #: NH 10-C0344
NAME. OF OWNER:
OR LICENSEE: Pioneer Concepts, Inc.
ADDRESS: 285 South Farnham St.
Galesburg, IL 61401

Re: Survey of 10-26-10 By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Casey Health Care Center
FACILITY ADDRESS: 100 Northeast 15th
Casey, IL 62420

DOCKET #: NH 12-C0355
NAME. OF OWNER:
OR LICENSEE: Petersen Health Care II, Inc
ADDRESS: 830 West Trailcreek Dr
Peoria, IL 61614

Re: Survey of 7-31-12 On September 5, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $2,200.

FACILITY NAME: Central Baptist Village
FACILITY ADDRESS: 4747 North Canfield Ave.
Norridge, IL 60706

DOCKET #: NH 12-S0362
NAME. OF OWNER:
OR LICENSEE: Central Baptist Village
ADDRESS: 4747 North Canfield Ave.
Norridge, IL 60706

Re: Survey of 8-14-12 On September 5, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Chateau Nursing and Rehabilitation Center
FACILITY ADDRESS: 7050 Madison St.
Willowbrook, IL 60521

DOCKET #: NH 12-S0384
NAME. OF OWNER:
OR LICENSEE: Chateau Nursing and Rehabilitation Center, LLC
ADDRESS: 2201 Main St.
Evanston, IL 60202

Re: Survey of 8-15-12 On September 11, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100. A hearing has been requested.

FACILITY NAME: Chestnut Manor
FACILITY ADDRESS: 1404 South 14th St.
Herrin, IL 62948

DOCKET #: NH 12-S0271
NAME. OF OWNER:
OR LICENSEE: New Way Developers, Inc.
ADDRESS: 105 South Commercial, PO Box 972
Harrisburg, IL 62946

Re: Survey of 4-19-12 On July 2, 2012, sent Notice of Type “A” Violation relating to the area of policy and procedure and Notice of Fine Assessment of $6,250. A hearing has been requested.

FACILITY NAME: Chestnut Manor
FACILITY ADDRESS: 1404 South 14th St.
Herrin, IL 62948

DOCKET #: NH 12-S0277
NAME. OF OWNER:
OR LICENSEE: New Way Developers, Inc.
ADDRESS: 105 South Commercial, PO Box 972
Harrisburg, IL 62946

Re: Survey of 5-23-12 On July 6, 2012, sent Notice of Type “A” Violation relating to the area of policy & procedure and Notice of Fine Assessment of $6,250.

FACILITY NAME: Chestnut Manor
FACILITY ADDRESS: 1404 South 14th St.
Herrin, IL 62948

DOCKET #: NH 12-C0361
NAME. OF OWNER:
OR LICENSEE: New Way Developers, Inc
ADDRESS: 105 South Commercial, PO Box 972
Harrisburg, IL 62946

Re: Survey of 7-31-12 On September 12, 2012, sent Notice of Type “A” Violation relating to the area of policy & procedure, Notice of Conditional License and Notice of Fine Assessment of $6,250.

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

DOCKET #: NH 12-S0296
NAME. OF OWNER:
OR LICENSEE: Claridge Operations, LLC.
ADDRESS: 325 North Wells, 9th FL
Chicago, IL 60610

Re: Survey of 6-14-12 On July 20, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Colonial Plaza
FACILITY ADDRESS: 618 West Goodner
Nashville, IL 62263

DOCKET #: NH 12-C0369
NAME. OF OWNER:
OR LICENSEE: Developmental Management, Inc
ADDRESS: 15755 Nixon Rd
Nashville, IL 62863

Re: Survey of 7-25-12 On September 13, 2012, sent Notice of Type “A” Violation relating to the area of policy & procedure and Notice of Fine Assessment of $6,000.

FACILITY NAME: Columbia Rehabilitation and Nursing Center
FACILITY ADDRESS: 253 Bradington Dr
Columbia, IL 62236

DOCKET #: NH 12-C0367
NAME. OF OWNER:
OR LICENSEE: Columbia Rehabilitation and Nursing Center, LLC
ADDRESS: 8170 McCormick Blvd, Ste 219
Skokie, IL 60076

Re: Survey of 8-7-12 On September 5, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Coventry Living Center
FACILITY ADDRESS: 612 West St. Mary’s St.
Sterling, IL 61081

DOCKET #: NH 06-C0277
NAME. OF OWNER:
OR LICENSEE: Coventry Living Center
ADDRESS: 330 North Wabash Ste 1700
Chicago, IL 60611

Re: Survey of 6-29-06 By Final Order, Violation, Fine Assessment and Notice of Conditional License Affirmed.

FACILITY NAME: Danville Care Center
FACILITY ADDRESS: 1701 North Bowman
Danville, IL 61832

DOCKET #: NH 12-C0380
NAME. OF OWNER:
OR LICENSEE: Danville Care Center, Ltd
ADDRESS: 5750 Old Orchard Rd, Ste 420
Skokie, IL 60077

Re: Survey of 8-8-12 On September 6, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Daystar Care Center
FACILITY ADDRESS: 2001 Cedar St.
Cairo, IL 62914

DOCKET #: NH 12-C0308
NAME. OF OWNER:
OR LICENSEE: Community Health and Emergency Services, Inc.
ADDRESS: 13245 Kessler Rd, Box 233
Cairo, IL 62914

Re: Survey of 6-21-12 On July 26, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Decatur Rehabilitation and Healthcare Center
FACILITY ADDRESS: 136 South Dipper Lane
Decatur, IL 62522

DOCKET #: NH 12-S0388
NAME. OF OWNER:
OR LICENSEE: Petersen Health Operations, LLC
ADDRESS: 830 West Trailcreek Dr.
Peoria, IL 61614

Re: Survey of 8-15-12 On September 13, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100. A hearing has been requested.

FACILITY NAME: Deerbrook Care Centre
FACILITY ADDRESS: 306 North Larkin Ave.
Joliet, IL 60435

DOCKET #: NH 12-C0286
NAME. OF OWNER:
OR LICENSEE: Symphony Deerbrook, LLC.
ADDRESS: 801 Adlai Stevenson Dr.
Springfield, IL 62703

Re: Survey of 6-14-12 On July 18, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Effingham Terrace
FACILITY ADDRESS: 1101 South 3rd St.
Effingham, IL 62401

DOCKET #: NH 12-S0259
NAME. OF OWNER:
OR LICENSEE: Community Living Options, Inc.
ADDRESS: 285 South Farnham St.
Galesburg, IL 61401

Re: Survey of 4-26-12 On July 6, 2012, sent Notice of Type “A” Violation relating to the area of policy & procedure, Notice of Conditional License and Notice of Fine Assessment of $6,250. A hearing has been requested.

FACILITY NAME: Fairview Care Center of Joliet
FACILITY ADDRESS: 222 North Hammes Ave.
Joliet, IL 60435

DOCKET #: NH 11-C0224
NAME. OF OWNER:
OR LICENSEE: Fairview Care Center of Joliet, LLC.
ADDRESS: 8131 North Monticello
Skokie, IL 60076

Re: Survey of 7-18-11 By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Fondulac Rehabilitation and Healthcare Center
FACILITY ADDRESS: 901 Illini Dr
East Peoria, IL 61611

DOCKET #: NH 12-S0316
NAME. OF OWNER:
OR LICENSEE: Petersen Health Operations, LLC.
ADDRESS: 830 West Trailcreek Dr
Peoria, IL 61614

Re: Survey of 7-3-12 On August 3, 2012, sent Notice of Type “A” Violation relating to the area of nursing, Notice of Conditional License and Notice of Fine Assessment of $10,000.

FACILITY NAME: Good Samaritan Home
FACILITY ADDRESS: 2130 Harrison St
Quincy, IL 62301

DOCKET #: NH 12-S0314
NAME. OF OWNER:
OR LICENSEE: Good Samaritan Home of Quincy
ADDRESS: 2130 Harrison St
Quincy, IL 62301

Re: Survey of 7-16-12 On July 31, 2012, sent Notice of Type “A” Violation relating to the area of nursing, Notice of Conditional License and Notice of Fine Assessment of $12,500.

FACILITY NAME: Granite Nursing and Rehabilitation Center
FACILITY ADDRESS: 3500 Century Dr
Granite City, IL 62040

DOCKET #: NH 12-C0360
NAME. OF OWNER:
OR LICENSEE: Granite Nursing and Rehabilitation Center, LLC
ADDRESS: 801 Adlai Stevenson Dr
Springfield, IL 62703

Re: Survey of 7-30-12 On September 5, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: The Grove of Evanston
FACILITY ADDRESS: 500 Asbury St
Evanston, IL 60202

DOCKET #: NH 12-S0350
NAME. OF OWNER:
OR LICENSEE: Grove of Evanston, LLC
ADDRESS: 191 North Wacker Dr, Ste 1800
Chicago, IL 60606

Re: Survey of 7-26-12 On September 5, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100. A hearing has been requested.

FACILITY NAME: Helia Healthcare of Carbondale
FACILITY ADDRESS: 500 Lewis Lane
Carbondale, IL 62901

DOCKET #: NH 12-C0340
NAME. OF OWNER:
OR LICENSEE: Helia Healthcare of Carbondale, LLC
ADDRESS: 600 South Second St
Springfield, IL 62704

Re: Survey of 7-20-12 On August 21, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Helia Healthcare of Greenville
FACILITY ADDRESS: 400 East Hillview Ave.
Greenville, IL 62246

DOCKET #: NH 12-S0285
NAME. OF OWNER:
OR LICENSEE: Bridgemark of Greenville, LLC.
ADDRESS: 600 South 2nd St
Springfield, IL 62704

Re: Survey 6-8-12 On July 18, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Heritage Health - Carlinville
FACILITY ADDRESS: 1200 University Ave.
Carlinville, IL 62626

DOCKET #: NH 12-S0305
NAME. OF OWNER:
OR LICENSEE: Heritage Manor – Carlinville, LLC.
ADDRESS: 115 West Jefferson St, Ste 4004
Bloomington, IL 61701

Re: Survey of 5-31-12 On July 27, 2012, sent Notice of Type “A” Violation relating to the area of policy & procedure, Notice of Conditional License and Notice of Fine Assessment of $8,000.

FACILITY NAME: Heritage Health - Carlinville
FACILITY ADDRESS: 1200 University Ave.
Carlinville, IL 62626

DOCKET #: NH 12-C0321
NAME. OF OWNER:
OR LICENSEE: Heritage Manor – Carlinville, LLC.
ADDRESS: 115 West Jefferson St, Ste 4004
Bloomington, IL 61701

Re: Survey of 7-17-12 On August 8, 2012, sent Notice of Type “A” Violation relating to the area of policy & procedure, Notice of Conditional License and Notice of Fine Assessment of $8000. A hearing has been requested.

FACILITY NAME: Highview In The Woodlands
FACILITY ADDRESS: 1000 Falcon Point Place
Rockton, IL 61072

DOCKET #: NH 12-S0374
NAME. OF OWNER:
OR LICENSEE: Highview Retirement Home Association
ADDRESS: 800 N Church St
Rockford, IL 61103

Re: Survey of 8-16-12 On September 18, 2012, sent Notice of Type “A” Violation relating to the area of policy & procedure, Notice of Conditional License and Notice of Fine Assessment of $12,500. A hearing has been requested.

FACILITY NAME: Hilltop Skilled Nursing and Rehabilitation
FACILITY ADDRESS: 910 West Polk St
Charleston, IL 61920

DOCKET #: NH 12-S0352
NAME. OF OWNER:
OR LICENSEE: Covenant Care Hilltop, LLC
ADDRESS: 208 South LaSalle St, Ste 814
Chicago, IL 60604

Re: Survey of 7-27-12 On September 10, 2012, sent Notice of Type “RPT B” Violation relating to the area of policy & procedure, Notice of Conditional License and Notice of Fine Assessment of $550.

FACILITY NAME: Holy Family Villa
FACILITY ADDRESS: 12220 South Will Cook Rd
Palos Park, IL 60464

DOCKET #: NH 12-S0088
NAME. OF OWNER:
OR LICENSEE: Holy Family Villa
ADDRESS: 721 North LaSalle St
Chicago, IL 60654

Re: Survey of 1-3-12 By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Illini Heritage Rehabilitation and Healthcare
FACILITY ADDRESS: 1315 Curt Dr, PO Box 6179
Champaign, IL 61820

DOCKET #: NH 12-S0288
NAME. OF OWNER:
OR LICENSEE: Petersen Health Care – Illini, LLC.
ADDRESS: 830 W Trailcreek Dr
Peoria, IL 61614

Re: Survey of 5-30-12 On July 27, 2012, sent Notice of Type “A” Violation relating to the area of nursing, Notice of Conditional License and Notice of Fine Assessment of $6,250. A hearing has been requested.

FACILITY NAME: Lake Cook Terrace Nursing Center
FACILITY ADDRESS: ; 263 Skokie Blvd
Northbrook, IL 60062

DOCKET #: NH 12-C0215
NAME. OF OWNER:
OR LICENSEE: GAF Lake Cook Terrace, Inc
ADDRESS: 465 Central Ave., Ste 100
Northfield, IL 60093

 Re: Survey of 4-19-12 By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Lake Shore Healthcare and Rehabilitation
FACILITY ADDRESS: 7200 North Sheridan Road
Chicago, IL 60626

DOCKET #: NH 12-S0074
NAME. OF OWNER:
OR LICENSEE: Lake Shore Healthcare and Rehabilitation Centre, LLC.
ADDRESS: 3553 West Peterson Ave., Ste 300
Chicago, IL 60659

Re: Survey of 12-23-11 By Final Order, Violation Amended and Fine Assessment Reduced.

FACILITY NAME: Lena Living Center
FACILITY ADDRESS: 1010 South Lagan St
Lena, IL 61048

DOCKET #: NH 11-S0274
NAME. OF OWNER:
OR LICENSEE: Lena Living Center, LLC.
ADDRESS: One IBM Plaza, Ste 3000
Chicago, IL 60611

Re: Survey of 9-7-12 By Final Order, Violation Reduced, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Leroy Manor
FACILITY ADDRESS: 509 South Buck Rd, PO Box 149
Leroy, IL 61752

DOCKET #: NH 12-S0345
NAME. OF OWNER:
OR LICENSEE: UDI #4, LLC.
ADDRESS: 285 South Farnham St
Galesburg, IL 61401

Re: Survey of 7-19-12 On August 24, 2012, sent Notice of Type ”B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Lexington of Elmhurst
FACILITY ADDRESS: 420 West Butterfield Rd
Elmhurst, IL 60126

DOCKET #: NH 12-S0311
NAME. OF OWNER:
OR LICENSEE: Lexington Health Care Center of Elmhurst, Inc.
ADDRESS: 665 West North Ave.
Lombard, IL 60148

Re: Survey of 7-3-12 On July 30, 2012, sent Notice of Type “B” Violation relating to the area of policy & procedure and Notice of Fine Assessment of $2,200.

FACILITY NAME: Manorcare of Libertyville
FACILITY ADDRESS: 1500 South Milwaukee Ave.
Libertyville, IL 60048

DOCKET #: NH 12-S0341
NAME. OF OWNER:
OR LICENSEE: Manor Care of Libertyville, IL, LLC
ADDRESS: 208 South LaSalle St, Ste 814
Chicago, IL 60604

Re: Survey of 6-29-12 On August 21, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Fine Assessment of $1,100.

FACILITY NAME: Mather Pavilion
FACILITY ADDRESS: 820 Foster St
Evanston, IL 60201

DOCKET #: NH 12-S0280
NAME. OF OWNER:
OR LICENSEE: Mather Health Care, Inc.
ADDRESS: 1603 Orrington Ave., Ste 1800
Evanston, IL 60201

Re: Survey of 5-24-12 On July 6, 2012, sent Notice of Type “B” Violation relating to the area of policy & procedure and Notice of Fine Assessment of $1,100. A hearing has been requested.

FACILITY NAME: Meadowbrook Manor
FACILITY ADDRESS: 431 West Remington Blvd
Bolingbrook, IL 60440

DOCKET #: NH 12-C0121
NAME. OF OWNER:
OR LICENSEE: Butterfield, Health Care, Inc.
ADDRESS: 161 North Clark St, Ste 4200
Chicago, IL 60601

Re: Survey of 2-23-12 By Final Order, Violation Affirmed, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Meadowbrook Manor
FACILITY ADDRESS: 431 West Remington Blvd
Bolingbrook, IL 60440

DOCKET #: NH 12-S0338
NAME. OF OWNER:
OR LICENSEE: Butterfield Health Care, Inc.
ADDRESS: 161 North Clark St, Ste 4200
Chicago, IL 60601

Re: Survey of 5-25-12 On August 21, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Medina Nursing Center
FACILITY ADDRESS: 402 South Center St
Durand, IL 61024

DOCKET #: NH 12-S0317
NAME. OF OWNER:
OR LICENSEE: Medina Nursing Center, Inc.
ADDRESS: Center St
Durand, IL 61024

Re: Survey of 6-28-12 On July 31, 2012, sent Notice of Type “B” Violation relating to the area of policy & procedure and Notice of Fine Assessment of $1,100.

FACILITY NAME: Montebello Healthcare Center
FACILITY ADDRESS: 1599 Keokuk St
Hamilton, IL 62341

DOCKET #: NH 12-S0333
NAME. OF OWNER:
OR LICENSEE: SSC Hamilton Operating Company, LLC
ADDRESS: 208 South LaSalle St, Ste 814
Chicago, IL 60604

Re: Survey of 7-9-12 On August 21, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $2,200. A hearing has been requested.

FACILITY NAME: North Adams Home
FACILITY ADDRESS: 2259 E. 1100th St
Mendon, IL 62351

DOCKET #: NH 12-C0035
NAME. OF OWNER:
OR LICENSEE: North Adams Home, Inc
ADDRESS: 237 N 6th St, Ste 200
Quincy, IL 62301

Re: Survey of 1-5-12 By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Norwood Crossing
FACILITY ADDRESS: 6016 North Nina Ave.
Chicago, IL 60631

DOCKET #: NH 12-S0180
NAME. OF OWNER:
OR LICENSEE: Norwood Crossing Association
ADDRESS: 6016 North Nina Ave.
Chicago, IL 60631

Re: Survey of 4-4-12 By Final Order, Violation Amended, Fine Assessment Affirmed and Notice of Conditional License Withdrawn.

FACILITY NAME: Oak Park Healthcare Center
FACILITY ADDRESS: 625 North Harlem
Oak Park, IL 60302

DOCKET #: NH 12-C0293
NAME. OF OWNER:
OR LICENSEE: Oak Park Healthcare Center, LLC.
ADDRESS: 8320 Skokie Blvd
Skokie, IL 60077

Re: Survey of 5-18-12 On July 20, 2012, sent Notice of Type “A” Violation relating to the area of nursing, Notice of Conditional License and Notice of Fine Assessment of $10,000. A hearing has been requested.

FACILITY NAME: Our Place
FACILITY ADDRESS: 301 North 13th St, PO Box 1240
Murphysboro, IL 62966

DOCKET #: NH 11-S0388
NAME. OF OWNER:
OR LICENSEE: Developmental Planning and Services, Inc.
ADDRESS: 20258 Broadway, PO Box 2369
Mt Vernon, IL 62864

Re: Survey of 11-4-11 By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Our Place
FACILITY ADDRESS: 301 N 13th St, PO Box 1240
Murphysboro, IL 62966

DOCKET #: NH 12-S0186
NAME. OF OWNER:
OR LICENSEE: Developmental Planning and Services, Inc
ADDRESS: 20258 Broadway, PO Box 2369
Mt Vernon, IL 62864

Re: Survey of 3-22-12 By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: PA Peterson Center for Health
FACILITY ADDRESS: 1311 Parkview Ave.
Rockford, IL 61107

DOCKET #: NH 12-S0346
NAME. OF OWNER:
OR LICENSEE: Petersen Health Care II, Inc.
ADDRESS: 830 West Trailcreek Dr
Peoria, IL 61614

Re: Survey of 7-24-12 On August 24, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Patterson House
FACILITY ADDRESS: 307 E. Jefferson
Sullivan, IL 61951

DOCKET #: NH 12-C0368
NAME. OF OWNER:
OR LICENSEE: Patterson House, Inc
ADDRESS: 110 Southbrooke Court
Decatur, IL 62521

Re: Survey of 7-24-12 On September 18, 2012, sent Notice of Type “A” Violation relating to policy & procedure, Notice of Conditional License and Notice of Fine Assessment of $6,250. A hearing has been requested.

FACILITY NAME: Plaza Nursing and Rehab Center
FACILITY ADDRESS: 3249 W 147th St
Midlothian, IL 60445

DOCKET #: NH 12-S0393
NAME. OF OWNER:
OR LICENSEE: Plaza Nursing and Rehab Center, LLC
ADDRESS: 320 Skokie Blvd
Skokie, IL 60077

Re: Survey of 8-15-12 On September 18, 2012, sent Notice of Type “B” Violation relating to the area of policy & procedure and Notice of Fine Assessment of $2,200.

FACILITY NAME: Prairieview Lutheran Home
FACILITY ADDRESS: PO Box 4, Corner of North & 4th
Danforth, IL 60930

DOCKET #: NH 12-C0335
NAME. OF OWNER:
OR LICENSEE: Lutheran Home for Aged Development Corp.
ADDRESS: 403 North 4th St, PO Box 4
Danforth, IL 60930

Re: Survey of 7-13-12 On August 24, 2012, sent Notice of Type “A” Violation relating to the area of nursing, Notice of Conditional License and Notice of Fine Assessment of $12,500. A hearing has been requested.

FACILITY NAME: Regency Nursing Care Residence
FACILITY ADDRESS: 2120 West Washington
Springfield, IL 62702

DOCKET #: NH 12-C0304
NAME. OF OWNER:
OR LICENSEE: Parentech, LLC.
ADDRESS: 109 South 7th St
Springfield, IL 62701

Re: Survey of 6-22-12 On July 26, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: River Bluff Nursing Home
FACILITY ADDRESS: 4401 North Main St
Rockford, IL 61103

DOCKET #: NH 12-C0094
NAME. OF OWNER:
OR LICENSEE: Winnebago Count
ADDRESS: 404 Elm St, Rm 504
Rockford, IL 61101

Re: Survey of 2-15-12 By Final Order, Violation Amended and Fine Assessment Withdrawn.

FACILITY NAME: Rosewood Care Center of Northbrook
FACILITY ADDRESS: 4101 Lake Cook Rd
Northbrook, IL 60062

DOCKET #: NH 12-C0112
NAME. OF OWNER:
OR LICENSEE: Bravo Care of Northbrook, Inc.
ADDRESS: 412 East Lawrence
Springfield, IL 62703

Re: Survey of 2-7-12 By Final Order, Violation Amended and Fine Assessment Reduced.

FACILITY NAME: Rosewood Care Center Swansea
FACILITY ADDRESS: 100 Rosewood Village Dr
Swansea, IL 62226

DOCKET #: NH 12-S0358
NAME. OF OWNER:
OR LICENSEE: Rosewood Care Center, Inc of Swansea
ADDRESS: 412 East Lawrence
Springfield, IL 62703

Re: Survey of 7-3-12 On September 5, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100. A hearing has been requested.

FACILITY NAME: Sandwich Rehabilitation and Health Care Center
FACILITY ADDRESS: 902 East Arnold St
Sandwich, IL 60548

DOCKET #: NH 12-C0019
NAME. OF OWNER:
OR LICENSEE: Petersen Health Operations, LLC.
ADDRESS: 830 West Trailcreek Dr
Peoria, IL 61614

Re: Survey of 12-8-11  By Final Order, Violation Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Shabbona Healthcare Center
FACILITY ADDRESS: 409 West Comanche Ave.
Shabbona, IL 60550

DOCKET #: NH 12-C0312
NAME. OF OWNER:
OR LICENSEE: Shabbona Healthcare Center, Inc.
ADDRESS: 7434 North Skokie Blvd
Skokie, IL 60077

Re: Survey of 6-25-12 On July 31, 2012, sent Notice of Type “B” Violation relating to the area of policy & procedure and Notice of Fine Assessment of $1,100.

FACILITY NAME: Shady Oaks West
FACILITY ADDRESS: 16220 Parker Rd
Lockport, IL 60441

DOCKET #: NH 12-C0098
NAME. OF OWNER:
OR LICENSEE: Lutheran Social Services of Illinois
ADDRESS: 1001 East Touhy Ave., Ste #50
Des Plaines, IL 60018

Re: Survey of 1-19-12 By Final Order, Violation Amended, Fine Assessment Affirmed and Notice of Conditional License Withdrawn.

FACILITY NAME: Shady Oaks West
FACILITY ADDRESS: 16220 Parker Rd
Lockport, IL 60441

DOCKET #: NH 12-S0348
NAME. OF OWNER:
OR LICENSEE: Lutheran Social Services of Illinois
ADDRESS: 1001 East Touhy Ave., Ste 50
Des Plaines, IL 60018

Re: Survey of 6-20-12 On August 24, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Sheltering Oak
FACILITY ADDRESS: PO Box 367
Island Lake, IL 60042

DOCKET #: NH 12-S0359
NAME. OF OWNER:
OR LICENSEE: Sheltering Oak, Inc
ADDRESS: 5412 South Rte 31, Ste #3
Crystal Lake, IL 60012

Re: Survey of 7-25-12 On September 5, 2012, sent Notice of Type “B” Violations relating to the area of policy & procedure and Notice of Fine Assessment of $3,300.

FACILITY NAME: Stearns Nursing and Rehabilitation Center
FACILITY ADDRESS: 3900 Stearns Ave.
Granite City, IL 62040

DOCKET #: NH 12-C0366
NAME. OF OWNER:
OR LICENSEE: Stearns Nursing and Rehabilitation Center, LLC
ADDRESS: 801 Adlai Stevenson Dr
Springfield, IL 62703

Re: Survey of 8-7-12 On September 13, 2012, sent Notice of Type “A” Violation relating to the area of policy & procedure, Notice of Conditional License and Notice of Fine Assessment of $10,000.

FACILITY NAME: Taylorville Care Center
FACILITY ADDRESS: 600 South Houston
Taylorville, IL 62568

DOCKET #: NH 12-S0309
NAME. OF OWNER:
OR LICENSEE: Taylorville Care Center, Inc.
ADDRESS: 935 South Mill
Nashville, IL 62263

Re: Survey of 6-29-12 On July 25, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Transitions Nursing and Rehabilitation Center
FACILITY ADDRESS: 1000 Dixon Ave.
Rock Falls, IL 61071

DOCKET #: NH 12-S0320
NAME. OF OWNER:
OR LICENSEE: Colonial Acres Health Care Center, Inc.
ADDRESS: 1625 South 6th St
Springfield, IL 62703

Re: Survey of 7-13-12 On August 3, 2012, sent Notice of Type “B” Violation relating to the area of policy & procedure and Notice of Fine Assessment of $1,100.

FACILITY NAME: Turner Manor
FACILITY ADDRESS: PO Box 303, 901 Oglesby Rd
Harrisburg, IL 62946

DOCKET #: NH 12-C0294
NAME. OF OWNER:
OR LICENSEE: Turner Manor, Inc.
ADDRESS: 105 South Commercial St, PO Box 972
Harrisburg, IL 62946

Re: Survey of 5-17-12 On July 20, 2012, sent Notice of Type “B” Violation relating to the area of policy & procedure and Notice of Fine Assessment of $750.

FACILITY NAME: Vermilion Manor Nursing Home
FACILITY ADDRESS: 14792 Catlin-Tilton Rd
Danville, IL 61834

DOCKET #: NH 12-C0313
NAME. OF OWNER:
OR LICENSEE: Vermilion County
ADDRESS: 6 North Vermilion
Danville, IL 61832

Re: Survey of 6-8-12 On July 31, 2012, sent Notice of Type “B” Violation relating to the area of policy & procedure and Notice of Fine Assessment of $1,100.

FACILITY NAME: Villa Health Care East
FACILITY ADDRESS: 100 Marian Parkway, PO Box 109
Sherman, IL 62684

DOCKET #: NH 12-S0385
NAME. OF OWNER:
OR LICENSEE: Villa Health Care, Inc
ADDRESS: 313 Saratoga Chase
Sherman, IL 62684

Re: Survey of 8-17-12 On September 13, 2012, sent Notice of Type “B” Violation relating to the area of nursing and Notice of Fine Assessment of $1,100.

FACILITY NAME: Westminster Village
FACILITY ADDRESS: 2025 E. Lincoln St
Bloomington, IL 61701

DOCKET #: NH 12-C0386
NAME. OF OWNER:
OR LICENSEE: Westminster Village, Inc
ADDRESS: 2025 E. Lincoln St
Bloomington, IL 61701

Re: Survey of 8-8-12 On September 18, 2012, sent Notice of Type “A” Violation relating to the area of policy & procedure, Notice of Conditional License and Notice of Fine Assessment of $12,500. A hearing has been requested.