QUARTERLY REPORT
October - December 2014
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: | Tillers Nursing and Rehab Center |
| FACILITY ADDRESS: | 4390 Route 71 |
| FACILITY CITY, STATE, ZIP: | Oswego, IL 60543 |
| DOCKET NUMBER: | NH 14-S0397 |
| LICENSEE INFO: | The Tillers Nursing and Rehabilitation Center, INC |
| LICENSEE ADDRESS: | 4390 Route 71 |
| LICENSEE CITY, STATE, ZIP: | Oswego, IL 60543 |
| Survey Date – 8/1/14 | |
| Type B violation for violating one or more sections: 300.1210a), 300.1210d)5), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)5) and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Iona Glos SLC |
| FACILITY ADDRESS: | 50 South Fairbank St. |
| FACILITY CITY, STATE, ZIP: | Addison, IL 60101 |
| DOCKET NUMBER: | NH 14-S0398 |
| LICENSEE INFO: | Ray Graham Association for people with disabilities |
| LICENSEE ADDRESS: | 901 Warrenville Road, Suite 500 |
| LICENSEE CITY, STATE, ZIP: | Lisle, IL 60532 |
| Survey Date – 8/8/14 | |
| Type A violation for violating one or more sections: 350.620a), 350.1210, 350.1220j), 350.1230d)1), 350.1230d)2), 350.1230d)3), and 350.3240a). For a total fine of $12,500.00 | |
| FACILITY NAME: | Stockton Healthcare and Rehab |
| FACILITY ADDRESS: | 501 Front St. |
| FACILITY CITY, STATE, ZIP: | Stockton, IL 61085 |
| DOCKET NUMBER: | NH 14-S0399 |
| LICENSEE INFO: | Stockton Healthcare and Rehab Center, Inc. |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Suite 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 9/2/14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210b)3), 300.1210d)6), 300.1220b)3), 300.3240a), 300.3240b), and 300.3240f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Mason Point |
| FACILITY ADDRESS: | One Masonic Way |
| FACILITY CITY, STATE, ZIP: | Sullivan, IL 61951 |
| DOCKET NUMBER: | NH 14-C0405 |
| LICENSEE INFO: | Peterson Health Care VII, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Drive |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 8/11/14 | |
| Type B violation for violating one or more sections: 300.1210a), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)6) and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Nature Trail Health Care Center |
| FACILITY ADDRESS: | 1001 South 34th St. |
| FACILITY CITY, STATE, ZIP: | Mount Vernon, IL 62864 |
| DOCKET NUMBER: | NH 14-C0404 |
| LICENSEE INFO: | SSC Mount Vernon Operating Co., LLC |
| LICENSEE ADDRESS: | 208 South Lasalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 8/19/14 | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210d)A), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Aperion Care Plum Grove |
| FACILITY ADDRESS: | 24 South Plum Grove Road |
| FACILITY CITY, STATE, ZIP: | Palatine, IL 60067 |
| DOCKET NUMBER: | NH 14-S0400 |
| NH 14-C0403 | |
| LICENSEE INFO: | Plum Grove Nursing and Rehab, LLC |
| LICENSEE ADDRESS: | 8131 N. Monticello |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 8/25/14 | |
| Type B violation for violating one or more sections: 300.1210b)5), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210b)5), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Champaign Nursing Home |
| FACILITY ADDRESS: | 500 S Art Bartell Dr. |
| FACILITY CITY, STATE, ZIP: | Urbana, IL 61802 |
| DOCKET NUMBER: | NH 14-C0336 |
| LICENSEE INFO: | Champaign County Board |
| LICENSEE ADDRESS: | 1776 E Washington St |
| LICENSEE CITY, STATE, ZIP: | Urbana, IL 61802 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Timber Point Healthcare Center |
| FACILITY ADDRESS: | 205 East Spring St. |
| FACILITY CITY, STATE, ZIP: | Camp Point, IL 61554 |
| DOCKET NUMBER: | NH 13-S-0216 |
| LICENSEE INFO: | Timber Point Healthcare Center, INC |
| LICENSEE ADDRESS: | 2201 Main St |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60202 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Brother James Court |
| FACILITY ADDRESS: | 2508 St James Road |
| FACILITY CITY, STATE, ZIP: | Springfield, IL 62707 |
| DOCKET NUMBER: | NH 14-S0412 |
| LICENSEE INFO: | Brother James Court |
| LICENSEE ADDRESS: | 1214 S 8th St |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 8/21/14 | |
| Type A violation for violating one or more sections: 350.620a), 350.1210, 350.1220j), and 350.3240a). For a total fine of $10,000. | |
| FACILITY NAME: | Caseyville Nursing and Rehab Center |
| FACILITY ADDRESS: | 601 West Lincoln Ave |
| FACILITY CITY, STATE, ZIP: | Caseyville, IL 62232 |
| DOCKET NUMBER: | NH 12-S0252 |
| LICENSEE INFO: | Caseyville Nursing and Rehab Center, INC |
| LICENSEE ADDRESS: | 30 South Wacker Dr., Suite 2900 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Renaissance at South Shore |
| FACILITY ADDRESS: | 2425 East 71st St |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60649 |
| DOCKET NUMBER: | NH 14-G0279 |
| LICENSEE INFO: | Renaissance at South Shore, INC |
| LICENSEE ADDRESS: | 191 North Wacher Dr., Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Leroy Manor |
| FACILITY ADDRESS: | 509 South Buck Road, PO Box 149 |
| FACILITY CITY, STATE, ZIP: | Leroy, IL 61752 |
| DOCKET NUMBER: | NH 13-C-0195 |
| LICENSEE INFO: | UDI #4, LLC |
| LICENSEE ADDRESS: | 285 South Farnham St |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | P A Peterson Center for Health |
| FACILITY ADDRESS: | 1311 Parkview Ave |
| FACILITY CITY, STATE, ZIP: | Rockford, IL 61107 |
| DOCKET NUMBER: | NH 14-S0254 |
| LICENSEE INFO: | Lutheran Social Services for Illinois |
| LICENSEE ADDRESS: | 1001 ZE. Touhy Ave., Suite 50 |
| LICENSEE CITY, STATE, ZIP: | Des Plaines, IL 60018 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Thomas Herbstritt |
| FACILITY ADDRESS: | 4003 N. Rt 1 & 17, PO Box 260 |
| FACILITY CITY, STATE, ZIP: | Momence, IL 60954 |
| DOCKET NUMBER: | NH 14-C0431 |
| LICENSEE INFO: | Good Shepherd Manor, INC |
| LICENSEE ADDRESS: | 4129 N Rt 1 & 17, PO Box 260 |
| LICENSEE CITY, STATE, ZIP: | Momence, IL 60954 |
| Survey Date – 8/21/14 | |
| Type A violation for violating one or more sections: 350.620a), 350.1210, 350.1220j), 350.1230d), and 350.3240a). For a total fine of $6,250.00 | |
| FACILITY NAME: | Asta Care Center of Colfax |
| FACILITY ADDRESS: | 402 South Harrison |
| FACILITY CITY, STATE, ZIP: | Colfax, IL 61728 |
| DOCKET NUMBER: | NH 14-S0425 |
| NH 14-C0426 | |
| LICENSEE INFO: | Asta Care Center of Colfax, INC |
| LICENSEE ADDRESS: | 134 n McLean Blvd |
| LICENSEE CITY, STATE, ZIP: | Elgin, IL 60123 |
| Survey Date – 9/9/14 | |
| Type A violation for violating one or more sections: 300.510e), 300.610a), 300.1210b), 300.1210d)3), 300.1220b)2), 300.3240a), 300.3240b), and 300.3240f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $25,000.00 | |
| Type A violation for violating one or more sections: 300.510e), 300.610a), 300.1010h), 300.1210b), 300.1210d)3), 300.1220b)2), 300.1220b)3) 300.3240a), and 300.3240d). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), 300.3240a), and 300.3240d). For a total fine of $25,000.00 | |
| Type B Violation of an occurrence for violating one or more of the following sections of the code: 300.1230k). No fine. | |
| Type B Violation of an occurrence for violating one or more of the following sections of the code: 300.3260c). No fine. | |
| FACILITY NAME: | Children’s Habilitation Center |
| FACILITY ADDRESS: | 121 West 154th St. |
| FACILITY CITY, STATE, ZIP: | Harvey, IL 60426 |
| DOCKET NUMBER: | NH 14-C0401 |
| LICENSEE INFO: | Children’s Habilitation Center, INC |
| LICENSEE ADDRESS: | 121 West 154th St. |
| LICENSEE CITY, STATE, ZIP: | Harvey, IL 60426 |
| Survey Date – 9-17-14 | |
| Type A violation for violating one or more sections: 390.620a), 390.1040b), 390.1040k)2), 390.1040k)3), and 390.3240a). For a total fine of $10,000.00 | |
| FACILITY NAME: | Arden Courts of Northbrook |
| FACILITY ADDRESS: | 3240 Milwaukee Ave. |
| FACILITY CITY, STATE, ZIP: | Northbrook, IL 60062 |
| DOCKET NUMBER: | NH 14-S0429 |
| LICENSEE INFO: | Arden Courts of Northbrook IL, INC |
| LICENSEE ADDRESS: | 208 S. LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 8/27/14 | |
| Type A violation for violating one or more sections: 330.760a), 330.1120a), and 330.4240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 330.4240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Bryan Manor |
| FACILITY ADDRESS: | 2150 East McCord |
| FACILITY CITY, STATE, ZIP: | Centralia, IL 62801 |
| DOCKET NUMBER: | NH 14-S0443 |
| LICENSEE INFO: | Penta Group, INC |
| LICENSEE ADDRESS: | 623 E. Broadway |
| LICENSEE CITY, STATE, ZIP: | Centralia, IL 62801 |
| Survey Date – 9-26-14 | |
| Type B violation for violating one or more sections: 350.620a), 350.1060e), 350.1080a), and 3501610b). For a total fine of $1,100.00 | |
| FACILITY NAME: | Meridian Village Care Center |
| FACILITY ADDRESS: | 27 Auerback Place |
| FACILITY CITY, STATE, ZIP: | Glen Carbon, IL 62034 |
| DOCKET NUMBER: | NH 14-S0440 |
| LICENSEE INFO: | Meridian Village Association |
| LICENSEE ADDRESS: | 27 Auerbach Place |
| LICENSEE CITY, STATE, ZIP: | Glen Carbon, IL 62034 |
| Survey Date – 9-25-14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | River View Rehab Center |
| FACILITY ADDRESS: | 50 North Jane |
| FACILITY CITY, STATE, ZIP: | Elgin, IL 60123 |
| DOCKET NUMBER: | NH 14-S0439 |
| LICENSEE INFO: | River View Rehab Center, LLC |
| LICENSEE ADDRESS: | 4711 Golf Road, Suite 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 9-11-14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1220b)3), and 300.3240a). For a total fine of $1,100.00 | |
| FACILITY NAME: | Clearbrook Center |
| FACILITY ADDRESS: | 3201 West Campbell St. |
| FACILITY CITY, STATE, ZIP: | Rolling Meadows, IL 60008 |
| DOCKET NUMBER: | NH 14-S0452 |
| LICENSEE INFO: | Clearbrook |
| LICENSEE ADDRESS: | 1835 West Central Road |
| LICENSEE CITY, STATE, ZIP: | Arlington Heights, IL 60005 |
| Survey Date – 9-9-14 | |
| Type B violation for violating one or more sections: 350.620a), 350.1210, 3450.1230d), and 350.3240a). For a total fine of $750.00 | |
| FACILITY NAME: | Aperion Care Plum Grove |
| FACILITY ADDRESS: | 24 South Plum Grove Road |
| FACILITY CITY, STATE, ZIP: | Palatine, IL 60067 |
| DOCKET NUMBER: | NH 14-S0445 |
| NH 14-C0446 | |
| LICENSEE INFO: | Plum Grove Nursing and Rehab |
| LICENSEE ADDRESS: | 8131 North Monticello |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 8-25-14 | |
| Type B violation for violating one or more sections: 300.1210b)5), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)6), 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Alden Wentworth Rehab and HHC |
| FACILITY ADDRESS: | 201 West 69th St. |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60621 |
| DOCKET NUMBER: | NH 12-C-0142 |
| LICENSEE INFO: | Alden-Wentworth Rehabilitation and Heath Care Center, INC |
| LICENSEE ADDRESS: | 4200 Peterson Ave., Suite 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Ridge Terrace |
| FACILITY ADDRESS: | 2911 Highland View Dr. |
| FACILITY CITY, STATE, ZIP: | Freeport, IL 61032 |
| DOCKET NUMBER: | NH 12-S015 |
| LICENSEE INFO: | Frances House INC |
| LICENSEE ADDRESS: | 285 South Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Prairie View Care Center- Lewistown |
| FACILITY ADDRESS: | 175 East Sycamore |
| FACILITY CITY, STATE, ZIP: | Lewistown, IL 61542 |
| DOCKET NUMBER: | NH 14-S0449 |
| LICENSEE INFO: | Prairie View Care Center of Lewistown, INC. |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Suite 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 8-27-14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1010h), 300.1210d)6), 300.3240a), and 300.3240f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| Type B violation for violating one or more sections: 300.1210a), 300.1210b)4), 300.1210d)2), 300.1210d)5), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210d)5), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| Type B violation for violating one or more sections of the code: 300.625. No fine. | |
| FACILITY NAME: | Dobson Plaza |
| FACILITY ADDRESS: | 120 Dodge Ave |
| FACILITY CITY, STATE, ZIP: | Evanston, IL 60202 |
| DOCKET NUMBER: | NH 14-C0436 |
| LICENSEE INFO: | Dobson Plaza Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 191 North Wacker Drive, Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 9-3-14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Imboden Creek Living Center |
| FACILITY ADDRESS: | 180 West Imboden |
| FACILITY CITY, STATE, ZIP: | Decatur, IL 62521 |
| DOCKET NUMBER: | NH 14-C0402 |
| LICENSEE INFO: | Living Center, Inc |
| LICENSEE ADDRESS: | 20 South Side Country Club |
| LICENSEE CITY, STATE, ZIP: | Decatur, IL 62521 |
| Survey Date – 9-4-14 | |
| Type A violation for violating one or more sections: 300.1210b), 300.1210d)6), 300.1220b)3), 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Lafayette Terrace |
| FACILITY ADDRESS: | 826 West Lafayette |
| FACILITY CITY, STATE, ZIP: | Jacksonville, IL 62650 |
| DOCKET NUMBER: | NH 14-S0455 |
| LICENSEE INFO: | Community Living Options, Inc |
| LICENSEE ADDRESS: | 285 South Farnham St. |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| Survey Date – 9-3-14 | |
| Type B violation for violating one or more sections: 350.1210b), 350.1060e), 350.1230d), 350.1230d)2), and 350.3240a). For a total fine of $500.00 | |
| FACILITY NAME: | Symphony of Crestwood |
| FACILITY ADDRESS: | 14255 South Cicero Ave. |
| FACILITY CITY, STATE, ZIP: | Crestwood, IL 60445 |
| DOCKET NUMBER: | NH 14-C0454 |
| LICENSEE INFO: | Symphony of Crestwood, LLC |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 9-26-14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1010h), 300.1210a), 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Fairview Nursing Plaza |
| FACILITY ADDRESS: | 321 Arnold Ave. |
| FACILITY CITY, STATE, ZIP: | Rockford, IL |
| DOCKET NUMBER: | NH 10-S0353 |
| LICENSEE INFO: | Fairview Nursing Plaza, Inc |
| LICENSEE ADDRESS: | 2201 Main St. |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60202 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Lena Living Center |
| FACILITY ADDRESS: | 1010 South Logan St. |
| FACILITY CITY, STATE, ZIP: | Lena, IL 61048 |
| DOCKET NUMBER: | NH 14-C0466 |
| LICENSEE INFO: | Lena Living Center, LLC |
| LICENSEE ADDRESS: | One IBM Plaza, Suite 3000 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60611 |
| Survey Date – 9/19/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1010i), 300.1210d)3), 300.1210d)6), 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 following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), 300.3240a), and 300.3240d). For a total fine of $2,200.00 | |
| FACILITY NAME: | Nathan Health Care Center |
| FACILITY ADDRESS: | 5050 Summit Ave |
| FACILITY CITY, STATE, ZIP: | East St. Louis, IL 62205 |
| DOCKET NUMBER: | NH 14-C0461 |
| LICENSEE INFO: | Nathan Health Care Center, LLC |
| LICENSEE ADDRESS: | 5050 Summit Ave |
| LICENSEE CITY, STATE, ZIP: | East St. Louis, IL 62205 |
| Survey Date – 10-7-14 | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210d)2), 300.1210d)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 following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Havana Health Care Center |
| FACILITY ADDRESS: | 609 North Harpham St. |
| FACILITY CITY, STATE, ZIP: | Havana, IL 62644 |
| DOCKET NUMBER: | NH 14-C0453 |
| LICENSEE INFO: | Petersen Health Quality, LLC |
| LICENSEE ADDRESS: | 830 W. Trailcreek Dr |
| LICENSEE CITY, STATE, ZIP: | Peopria, IL 61614 |
| Survey Date – 10/14/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Prairie View Care Center-Lewistown |
| FACILITY ADDRESS: | 175 east Sycamore |
| FACILITY CITY, STATE, ZIP: | Lewistown, IL 61542 |
| DOCKET NUMBER: | NH 14-S0449 |
| LICENSEE INFO: | Prairie View Care Center of Lewistown, Inc |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Suite 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 8/27/14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), 300.1210d)6), 300.3240a), and 300.3240f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). For a total fine of $25,000.00 | |
| Type B violation for violating one or more sections: 300.1210a), 300.1210b)4), 300.1210c), 300.1210d)2), 300.1210d)5), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)5), 300.1210d)6) and 300.3240a). For a total fine of $2,200.00 | |
| Type B violation for an occurrence for violating one or more of the following sections of the code: 300.625. No fine. | |
| FACILITY NAME: | Dobson Plaza |
| FACILITY ADDRESS: | 120 Dodge Ave |
| FACILITY CITY, STATE, ZIP: | Evanston, IL 60202 |
| DOCKET NUMBER: | NH 14-C0436 |
| LICENSEE INFO: | Dobson Plaza Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 191 North Wacker Dr., Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 9/3/14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Imboden Creek Living Center |
| FACILITY ADDRESS: | 180 West Imboden |
| FACILITY CITY, STATE, ZIP: | Decatur, IL 62521 |
| DOCKET NUMBER: | NH 14-C0402 |
| LICENSEE INFO: | Living Center, Inc |
| LICENSEE ADDRESS: | 20 South Side Country Club |
| LICENSEE CITY, STATE, ZIP: | Decatur, Il 62521 |
| Survey Date – 9-4-14 | |
| Type A violation for violating one or more sections: 300.1210b), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Lakewood Nursing and Rehab Center |
| FACILITY ADDRESS: | 14716 South Eastern Ave. |
| FACILITY CITY, STATE, ZIP: | Plainfield, IL 60544 |
| DOCKET NUMBER: | NH 14-C-0133 |
| LICENSEE INFO: | Lakewood Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 2201 Main St. |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60202 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Regency Rehab Center |
| FACILITY ADDRESS: | 6631 Milwaukee Ave |
| FACILITY CITY, STATE, ZIP: | Niles, IL 60714 |
| DOCKET NUMBER: | NH 14-S0427 |
| NH 14-C0428 | |
| LICENSEE INFO: | Regency Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 6840 N. Lincoln Ave |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 9/24/14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Presence Villa Franciscan |
| FACILITY ADDRESS: | 210 North Springfield Ave |
| FACILITY CITY, STATE, ZIP: | Joliet, IL 60435 |
| DOCKET NUMBER: | NH 14-C0471 |
| LICENSEE INFO: | Presence Life Connections |
| LICENSEE ADDRESS: | 9223 West Saint Francis |
| LICENSEE CITY, STATE, ZIP: | Frankfort, IL 60423 |
| Survey Date – 10-7-14 | |
| Type B violation for violating one or more sections: 300.1010h), 300.1210d)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 following sections of the Code with a high risk designation: 300.1210d)5), 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Lexington of Streamwood |
| FACILITY ADDRESS: | 815 East Irving Park Road |
| FACILITY CITY, STATE, ZIP: | Streamwood, IL 60107 |
| DOCKET NUMBER: | NH 14-S0469 |
| LICENSEE INFO: | Lexington Health Care Center of Streamwood, Inc |
| LICENSEE ADDRESS: | 665 West North Ave |
| LICENSEE CITY, STATE, ZIP: | Lombard, IL 60148 |
| Survey Date – 10-2-14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Presence Villa Franciscan |
| FACILITY ADDRESS: | 210 North Springfield Ave. |
| FACILITY CITY, STATE, ZIP: | Joliet, IL 60435 |
| DOCKET NUMBER: | NH 14-C0472 |
| LICENSEE INFO: | Presence Life Connections |
| LICENSEE ADDRESS: | 9223 West Saint Francis Road |
| LICENSEE CITY, STATE, ZIP: | Frankfort, IL 60423 |
| Survey Date – 10-17-14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Fairview Nursing Plaza (Forest City Rehab and Nursing Center) |
| FACILITY ADDRESS: | 321 Arnold Ave. |
| FACILITY CITY, STATE, ZIP: | Rockford, IL 61108 |
| DOCKET NUMBER: | NH 14-G130 |
| LICENSEE INFO: | Forest City Rehab and Nursing Center LLC |
| LICENSEE ADDRESS: | 4711 Golf Road Suite 200 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | The Gove of LaGrange Park |
| FACILITY ADDRESS: | 701 North LaGrange Road |
| FACILITY CITY, STATE, ZIP: | LaGrange Park, IL 60526 |
| DOCKET NUMBER: | NH 14-G134 |
| LICENSEE INFO: | Grove of LaGrange Park, LLC |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | The Grove of Evanston |
| FACILITY ADDRESS: | 500 Asbury St |
| FACILITY CITY, STATE, ZIP: | Evanston, IL 60202 |
| DOCKET NUMBER: | NH 14-S0100 |
| LICENSEE INFO: | Grove of Evanston, LLC |
| LICENSEE ADDRESS: | 191 North Wacker Dr, Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | St James Wellness Rehab Villas |
| FACILITY ADDRESS: | 1251 East Richton Road |
| FACILITY CITY, STATE, ZIP: | Crete, IL 60417 |
| DOCKET NUMBER: | NH 14-C0234 |
| LICENSEE INFO: | St James Wellness Rehab and Villas, LLC |
| LICENSEE ADDRESS: | 2201 Main St. |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60202 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Sutton House |
| FACILITY ADDRESS: | 4241 Lincolnshire Dr. |
| FACILITY CITY, STATE, ZIP: | Mount Vernon, IL 62864 |
| DOCKET NUMBER: | NH 14-S0475 |
| LICENSEE INFO: | TDL Group, Inc |
| LICENSEE ADDRESS: | 11340 Arcadia Lake Road |
| LICENSEE CITY, STATE, ZIP: | Marion, IL 62959 |
| Survey Date – 9-16-14 | |
| Type A violation for violating one or more sections: 350.620a), 350.1060j), 350.1210, 350.3240a), and 350.3240f). For a total fine of $6,250.00 | |
| FACILITY NAME: | The Lutheran Home |
| FACILITY ADDRESS: | 6901 North Galena Road |
| FACILITY CITY, STATE, ZIP: | Peoria, IL 61614 |
| DOCKET NUMBER: | NH 14-C0479 |
| LICENSEE INFO: | Lutheran Hillside Village, Inc |
| LICENSEE ADDRESS: | 6901 North Galena Road |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 10-10-14 | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Oakton Pavillion |
| FACILITY ADDRESS: | 1660 Oakton Place |
| FACILITY CITY, STATE, ZIP: | Des Plaines, IL 60018 |
| DOCKET NUMBER: | NH 14-C0477 |
| LICENSEE INFO: | Oakton Pavillion, Inc |
| LICENSEE ADDRESS: | 120 South Riverside Plz, Suite 1200 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 8-13-14 | |
| Type A violation for violating one or more sections: 300.1210b) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Heartland of Decatur |
| FACILITY ADDRESS: | 444 West Harrison St |
| FACILITY CITY, STATE, ZIP: | Decatur, IL 62526 |
| DOCKET NUMBER: | NH 14-S0491 |
| LICENSEE INFO: | Heartland of Decatur IL, LLC |
| LICENSEE ADDRESS: | 208 South LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 10/22/14 | |
| Type B violation for violating one or more sections: 300.1210a), 300.1210b), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Fair Oaks Rehab and HCC |
| FACILITY ADDRESS: | 1515 Blackhawk |
| FACILITY CITY, STATE, ZIP: | South Beloit, IL 61080 |
| DOCKET NUMBER: | NH 14-S0489 |
| LICENSEE INFO: | Fair Oaks Rehab and Health Care Center, LLC |
| LICENSEE ADDRESS: | 412 East Lawrence |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 10/10/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210c), 300.1210d)5) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Country Health |
| FACILITY ADDRESS: | 2304 C R 3000 N |
| FACILITY CITY, STATE, ZIP: | Gifford, IL 61847 |
| DOCKET NUMBER: | NH 14-S0492 |
| LICENSEE INFO: | Country Health, Inc |
| LICENSEE ADDRESS: | RR 1 |
| LICENSEE CITY, STATE, ZIP: | Gifford, IL 61847 |
| Survey Date – 10/17/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)6) and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Asta Care Center of Rockford |
| FACILITY ADDRESS: | 707 West Riverside Blvd |
| FACILITY CITY, STATE, ZIP: | Rockford, IL 61103 |
| DOCKET NUMBER: | NH 14-S0462 |
| NH 14-C0463 | |
| LICENSEE INFO: | Asta Care Center of Rockford, LLC |
| LICENSEE ADDRESS: | 134 North McLean Blvd |
| LICENSEE CITY, STATE, ZIP: | Elgin, IL 60123 |
| Survey Date – 9/29/14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)5), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.00 | |
| Type B violation for violating one or more sections: 300.4000a), 300.4000g), 300.4010a), 300.4010b), 300.4010d), 300.4020a), 300.4030k), 300.4040a)4), and 300.4080. No fine. | |
| FACILITY NAME: | Midwest Rehab and Respiratory |
| FACILITY ADDRESS: | 727 North 17th St. |
| FACILITY CITY, STATE, ZIP: | Belleville, IL 62226 |
| DOCKET NUMBER: | NH 14-C0486 |
| LICENSEE INFO: | Midwest Rehab and Respiratory Center, LLC |
| LICENSEE ADDRESS: | 8170 McCormick Blvd, Suite 219 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| Survey Date – 10/16/14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Winchester House |
| FACILITY ADDRESS: | 1125 North Milwaukee Ave |
| FACILITY CITY, STATE, ZIP: | Libertyville, IL 60048 |
| DOCKET NUMBER: | NH 14-S0484 |
| LICENSEE INFO: | County of Lake |
| LICENSEE ADDRESS: | 18 North County St |
| LICENSEE CITY, STATE, ZIP: | Waukegan, IL 60085 |
| Survey Date – 10/16/14 | |
| Type A violation for violating one or more sections: 300.1210b), 300.3240a), 300.3240c), 300.3240d), and 300.3240e). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.3240a), 300.3240d), and 300.3240e). For a total fine of $25,000.00 | |
| FACILITY NAME: | Arden Courts of Hazel Crest |
| FACILITY ADDRESS: | 3701 West 183rd St. |
| FACILITY CITY, STATE, ZIP: | Hazel Crest, IL 60429 |
| DOCKET NUMBER: | NH 14-S0473 |
| NH 14-C0474 | |
| LICENSEE INFO: | Arden Courts of Hazel Crest II, LLC |
| LICENSEE ADDRESS: | 208 South LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 10/23/14 | |
| Type A violation for violating one or more sections: 330.1110a), 330.1110d), 330.1110f), 330.1155a), 330.1710d), 330.1710e), 330.4220f), and 330.4240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 330.4240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Prairie Care Center of Lewistown |
| FACILITY ADDRESS: | 175 East Sycamore |
| FACILITY CITY, STATE, ZIP: | Lewistown, IL 61542 |
| DOCKET NUMBER: | NH 14-C0450 |
| LICENSEE INFO: | Prairie View Care Center of Lewistown, Inc |
| LICENSEE ADDRESS: | 5750 Old Orchard Road, Suite 420 |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60077 |
| Survey Date – 9-17-14 | |
| Type A violation for violating one or more sections: 300.510e), 300.610a), 300.1210b), 300.1210d)6), 300.3240a), 300.3240d), and 300.3240f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), 300.3240a), and 300.3240d). For a total fine of $25,000.00 | |
| FACILITY NAME: | Sharon Health Care Center Pines |
| FACILITY ADDRESS: | 3614 North Rochelle |
| FACILITY CITY, STATE, ZIP: | Peoria, IL 61604 |
| DOCKET NUMBER: | NH 14-C0485 |
| LICENSEE INFO: | Sharon Health Care Pines, Inc |
| LICENSEE ADDRESS: | 465 Central Ave, Suite 100 |
| LICENSEE CITY, STATE, ZIP: | Northfield, IL 60093 |
| Survey Date – 10-16-14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)6), 300.3240a), and 300.3240b). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation:300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | The Arthur Home |
| FACILITY ADDRESS: | 423 Eberhardt Dr. |
| FACILITY CITY, STATE, ZIP: | Arthur, IL 61911 |
| DOCKET NUMBER: | NH 14-S0493 |
| LICENSEE INFO: | Community Retirement Inc |
| LICENSEE ADDRESS: | 423 Eberhardt Dr. |
| LICENSEE CITY, STATE, ZIP: | Arthur, IL 61911 |
| Survey Date – 10-9-14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Monmence Meadows Nursing and Rehab |
| FACILITY ADDRESS: | 500 South Walnut St. |
| FACILITY CITY, STATE, ZIP: | Monmence, IL 60954 |
| DOCKET NUMBER: | NH 14-C0499 |
| LICENSEE INFO: | Monmence Meadows Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 150 Fencle Lane |
| LICENSEE CITY, STATE, ZIP: | Hillside, IL 60162 |
| Survey Date – 10/28/14 | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210b)5), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Palm Terrace of Mattoon |
| FACILITY ADDRESS: | 1000 Palm Ave. |
| FACILITY CITY, STATE, ZIP: | Mattoon, IL 61938 |
| DOCKET NUMBER: | NH 14-C0464 |
| LICENSEE INFO: | Petersen Management Company, LLC |
| LICENSEE ADDRESS: | 830 West Trailcreek Dr. |
| LICENSEE CITY, STATE, ZIP: | Peoria, IL 61614 |
| Survey Date – 10-3-14 | |
| Type B violation for violating one or more sections: 300.680a), 300.680c), 300.682a), 300.682b), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.680a), 300.680c), and 300.3240a). For a total fine of $2,200.00 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240f). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.1210d)6). For a total fine of $2,200.00 | |
| Type Administrative Warning of an occurrence for violating one or more of sections 300.1230k). No fine. | |
| FACILITY NAME: | Friendship Skilled Nursing and Rehab |
| FACILITY ADDRESS: | 826 North High St. |
| FACILITY CITY, STATE, ZIP: | Carlinville, IL 62626 |
| DOCKET NUMBER: | NH 14-C0503 |
| LICENSEE INFO: | Covenant Care Midwest, Inc |
| LICENSEE ADDRESS: | 208 South LaSalle St., Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 10-21-14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Applewood Rehab Center |
| FACILITY ADDRESS: | 21020 Kostner Ave. |
| FACILITY CITY, STATE, ZIP: | Matteson, IL 60443 |
| DOCKET NUMBER: | NH 14-S0504 |
| NH 14-C0505 | |
| LICENSEE INFO: | Applewood Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 6840 N. Lincoln Ave |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 9-25-14 | |
| Type B violation for violating one or more sections: 300.1210a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210s)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Lake Shore Health Care and Rehab |
| FACILITY ADDRESS: | 7200 North Sheridan Road |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60626 |
| DOCKET NUMBER: | NH 14-C-0077 |
| NH 14-S-0050 | |
| LICENSEE INFO: | Lake Shore Healthcare and Rehab Center, LLC |
| LICENSEE ADDRESS: | 4600 W Toughy Ave #200 |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Christian Nursing Home |
| FACILITY ADDRESS: | 1507 7th St |
| FACILITY CITY, STATE, ZIP: | Lincoln, IL 62656 |
| DOCKET NUMBER: | NH 14-C-0023 |
| NH 14-S-0053 | |
| LICENSEE INFO: | Christian Homes, Inc |
| LICENSEE ADDRESS: | 200 N Postville Dr |
| LICENSEE CITY, STATE, ZIP: | Lincoln, IL 62656 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Symphony of Crestwood |
| FACILITY ADDRESS: | 14255 South Cicero Ave |
| FACILITY CITY, STATE, ZIP: | Crestwood, IL 60445 |
| DOCKET NUMBER: | NH 14-G327 |
| LICENSEE INFO: | Symphony of Crestwood, LLC |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr. |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Alden Village North |
| FACILITY ADDRESS: | 7464 N Sheridan Road |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60626 |
| DOCKET NUMBER: | NH 11-G122 |
| LICENSEE INFO: | Alden Village North, Inc |
| LICENSEE ADDRESS: | 4200 W Peterson Ave, Suite 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Mattoon Rehab and HCC |
| FACILITY ADDRESS: | 2121 South 9th St |
| FACILITY CITY, STATE, ZIP: | Mattoon, IL 61938 |
| DOCKET NUMBER: | NH 14-S0502 |
| LICENSEE INFO: | Mattoon Manor, LLC |
| LICENSEE ADDRESS: | 412 East Lawrence |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 10/29/14 | |
| Type A violation for violating one or more sections: 300.610a), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)6), 300.3240a). For a total fine of $25,000.00 | |
| FACILITY NAME: | Jackson Square Skilled Nursing and Living |
| FACILITY ADDRESS: | 5130 West Jackson Blvd. |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60644 |
| DOCKET NUMBER: | NH 14-C0510 |
| LICENSEE INFO: | Jackson Corp |
| LICENSEE ADDRESS: | 191 N. Wacker Dr., Suite 1800 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60606 |
| Survey Date – 10/28/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Neighbors Rehab Center |
| FACILITY ADDRESS: | 811 W. 2nd St. |
| FACILITY CITY, STATE, ZIP: | Byron, IL 61010 |
| DOCKET NUMBER: | NH 14-C0509 |
| LICENSEE INFO: | Neighbors Rehabilitation Center, LLC |
| LICENSEE ADDRESS: | 6840 North Lincoln Ave |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 10/27/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.696a), 300.1020a), 300.1020b), 300.1020c), 300.1210b), 300.1210d)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.696a), 30.1210b), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Momence Meadows Nursing and Rehab |
| FACILITY ADDRESS: | 500 South Walnut St. |
| FACILITY CITY, STATE, ZIP: | Momence, IL 60954 |
| DOCKET NUMBER: | NH 14-C0508 |
| LICENSEE INFO: | Momence Meadows Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 150 Fencle Lane |
| LICENSEE CITY, STATE, ZIP: | Hillside, IL 60162 |
| Survey Date – 11/6/14 | |
| Type B violation for violating one or more sections: 300.1210a), 30.1210b)5), 300.1210d)6), 300.2420j), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Aperion Care Decatur |
| FACILITY ADDRESS: | 2650 North Monroe |
| FACILITY CITY, STATE, ZIP: | Decatur, IL 62526 |
| DOCKET NUMBER: | NH 14-C-0342 |
| LICENSEE INFO: | Lincoln Rehab Center, LLC |
| LICENSEE ADDRESS: | 8131 Monticello Ave. |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Evenglow Lodge |
| FACILITY ADDRESS: | 215 East Washington St. |
| FACILITY CITY, STATE, ZIP: | Pontiac, IL 61764 |
| DOCKET NUMBER: | NH 14-S0522 |
| LICENSEE INFO: | Evenglow Lodge |
| LICENSEE ADDRESS: | 109 N. Mill St. |
| LICENSEE CITY, STATE, ZIP: | Pontiac, IL 61764 |
| Survey Date – 10/24/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Heritage Health - Elgin |
| FACILITY ADDRESS: | 355 Raymond St |
| FACILITY CITY, STATE, ZIP: | Elgin, IL 60120 |
| DOCKET NUMBER: | NH 14-S0523 |
| LICENSEE INFO: | Heritage Manor-Elgin, LLC |
| LICENSEE ADDRESS: | 115 W. Jefferson St., Suite 400 |
| LICENSEE CITY, STATE, ZIP: | Bloomington, IL 61701 |
| Survey Date – 11/25/14 | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210d)6), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Lexington of Orland Park |
| FACILITY ADDRESS: | 14601 South John Humphrey Dr |
| FACILITY CITY, STATE, ZIP: | Orland Park, IL 60462 |
| DOCKET NUMBER: | NH 14-C0527 |
| LICENSEE INFO: | Lexington Health Care Center of Orland Park, Inc |
| LICENSEE CITY, STATE, ZIP: | Lombard, IL 60148 |
| Survey Date – 11/12/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Ellner Terrace |
| FACILITY ADDRESS: | 801 Market St. |
| FACILITY CITY, STATE, ZIP: | Evansville, IL 62242 |
| DOCKET NUMBER: | NH 14-C0210 |
| NH 14-S0225 | |
| LICENSEE INFO: | Progressive Housing, Inc |
| LICENSEE ADDRESS: | 3615 Park Dr, Suite 100 |
| LICENSEE CITY, STATE, ZIP: | Olympia Field, IL 60461 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Capitol Healthcare and Rehab Center |
| FACILITY ADDRESS: | 555 West Carpenter St. |
| FACILITY CITY, STATE, ZIP: | Springfield, IL 62702 |
| DOCKET NUMBER: | NH 14-S0525 |
| LICENSEE INFO: | Capitol Healthcare and Rehab Centre, LLC |
| LICENSEE ADDRESS: | 4600 West Touhy Ave., Suite 200 |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| Survey Date – 10/31/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)5), 300.1220b)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)5), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Concord Nursing and Rehab |
| FACILITY ADDRESS: | 9401 South Ridgeland Ave |
| FACILITY CITY, STATE, ZIP: | Oak Lawn, IL 60453 |
| DOCKET NUMBER: | NH 13-C-509 |
| LICENSEE INFO: | Concord Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 8131 N Monticello |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Lake Shore Healthcare and Rehab |
| FACILITY ADDRESS: | 7200 North Sheridan Road |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60626 |
| DOCKET NUMBER: | NH 14-S-98 |
| LICENSEE INFO: | Lake Shore Healthcare and Rehab Centre, LLC |
| LICENSEE ADDRESS: | 4600 W. Touhy Ave, #200 |
| LICENSEE CITY, STATE, ZIP: | Lincolnwood, IL 60712 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Aperion Care Bridgeport |
| FACILITY ADDRESS: | 900 East Corporation St |
| FACILITY CITY, STATE, ZIP: | Bridgeport, IL 62417 |
| DOCKET NUMBER: | NH 14-S-0237 |
| LICENSEE INFO: | Aperion Care Bridgeport, LLC |
| LICENSEE ADDRESS: | 8131 Monticello Ave |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | The British Home |
| FACILITY ADDRESS: | 8700 West 31st St. |
| FACILITY CITY, STATE, ZIP: | Brookfield, IL 60513 |
| DOCKET NUMBER: | NH 14-C0516 |
| LICENSEE INFO: | The British Home for Retired Men and Women |
| LICENSEE ADDRESS: | 31st & McCormick Ave |
| LICENSEE CITY, STATE, ZIP: | Brookfield, IL 60513 |
| Survey Date – 11/17/14 | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Helia Healthcare of Benton |
| FACILITY ADDRESS: | 1310 Mark Franklin Louis St. |
| FACILITY CITY, STATE, ZIP: | Benton, IL 62812 |
| DOCKET NUMBER: | NH 14-C0515 |
| LICENSEE INFO: | Helia Healthcare of Benton, LLC |
| LICENSEE ADDRESS: | 600 South Second St., Suite 103 |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62704 |
| Survey Date – 10/16/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Lexington of Schaumburg |
| FACILITY ADDRESS: | 675 South Roselle Road |
| FACILITY CITY, STATE, ZIP: | Schaumburg, IL 60193 |
| DOCKET NUMBER: | NH 14-C0513 |
| LICENSEE INFO: | Lexington Health Care Center of Schaumburg |
| LICENSEE ADDRESS: | 665 West North Ave |
| LICENSEE CITY, STATE, ZIP: | Lombard, IL 60148 |
| Survey Date – 11/7/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b)5), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)6), 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Washington Christian Village |
| FACILITY ADDRESS: | 1201 Newcastle Road |
| FACILITY CITY, STATE, ZIP: | Washington, IL 61571 |
| DOCKET NUMBER: | NH 14-C0514 |
| LICENSEE INFO: | Christian Homes, Inc. |
| LICENSEE ADDRESS: | 200 North Postville Road |
| LICENSEE CITY, STATE, ZIP: | Lincoln, IL 62656 |
| Survey Date – 11/13/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)1), 300.1620a), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b) and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Seymour Terrace |
| FACILITY ADDRESS: | 1504 16th St |
| FACILITY CITY, STATE, ZIP: | North Chicago, IL 60064 |
| DOCKET NUMBER: | NH 11-S370 |
| LICENSEE INFO: | Frances House, Inc |
| LICENSEE ADDRESS: | 285 South Farnham St |
| LICENSEE CITY, STATE, ZIP: | Galesburg, IL 61401 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Lakefront Nursing and Rehab Center |
| FACILITY ADDRESS: | 7618 North Sheridan Road |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60626 |
| DOCKET NUMBER: | NH 14-S275 |
| LICENSEE INFO: | Lakefront Nursing and Rehab Centre, LLC |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Heritage Health Care |
| FACILITY ADDRESS: | 207 Wood Lane, PO Box 278 |
| FACILITY CITY, STATE, ZIP: | Hutsonville, IL 62433 |
| DOCKET NUMBER: | NH -14-S-364 |
| LICENSEE INFO: | Five Star Management, Inc |
| LICENSEE ADDRESS: | 207 Wood Lane |
| LICENSEE CITY, STATE, ZIP: | Hutsonville, IL 62433 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Alden Long Grove Rehab and HCC |
| FACILITY ADDRESS: | Box 2308, RFD Old Hicks Road |
| FACILITY CITY, STATE, ZIP: | Long Grove, IL 60047 |
| DOCKET NUMBER: | NH 14-C0529 |
| LICENSEE INFO: | Alden Long Grove Rehab and HCC, Inc |
| LICENSEE ADDRESS: | 4200 West Petersen Ave, Suite 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| Survey Date – 11/19/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Aperion Care Bridgeport |
| FACILITY ADDRESS: | 900 East Corporation St |
| FACILITY CITY, STATE, ZIP: | Bridgeport, IL 62417 |
| DOCKET NUMBER: | NH 14-S-0237 |
| LICENSEE INFO: | Aperion Care Bridgeport, Inc |
| LICENSEE ADDRESS: | 8131 Monticello Ave |
| LICENSEE CITY, STATE, ZIP: | Skokie, IL 60076 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Alden Princeton Rehab HCC |
| FACILITY ADDRESS: | 255 West 69th St |
| FACILITY CITY, STATE, ZIP: | Chicago, IL 60621 |
| DOCKET NUMBER: | NH 14-G368 |
| LICENSEE INFO: | Alden- Princeton Rehab and HCC, Inc |
| LICENSEE ADDRESS: | 4200 W. Petersen Ave, Suite 140 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60646 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Chateau Nursing and Rehab Center |
| FACILITY ADDRESS: | 7050 Madison St |
| FACILITY CITY, STATE, ZIP: | Willowbrook, IL 60521 |
| DOCKET NUMBER: | NH 13-S-0466 |
| LICENSEE INFO: | Chateau Nursing and Rehab Center, LLC |
| LICENSEE ADDRESS: | 2201 North Main St |
| LICENSEE CITY, STATE, ZIP: | Evanston, IL 60202 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Evenglow Lodge |
| FACILITY ADDRESS: | 215 East Washington |
| FACILITY CITY, STATE, ZIP: | Pontiac, IL 61764 |
| DOCKET NUMBER: | NH 14-S0522 |
| LICENSEE INFO: | Evenglow Lodge |
| LICENSEE ADDRESS: | 109 N. Mill St |
| LICENSEE CITY, STATE, ZIP: | Pontiac, Il 61764 |
| Survey Date – 10/24/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Villa at Evergreen Park |
| FACILITY ADDRESS: | 10124 South Kedzie |
| FACILITY CITY, STATE, ZIP: | Evergreen Park, IL 60805 |
| DOCKET NUMBER: | NH 14-G185 |
| LICENSEE INFO: | Evergreen Living and Rehab Center, LLC |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn. | |
| FACILITY NAME: | Breese Nursing Home |
| FACILITY ADDRESS: | 1155 North First St |
| FACILITY CITY, STATE, ZIP: | Breese, IL 62230 |
| DOCKET NUMBER: | NH 14-S0535 |
| LICENSEE INFO: | Caring First, Inc |
| LICENSEE ADDRESS: | 12 Wolf Creek Dr., Suite 100 |
| LICENSEE CITY, STATE, ZIP: | Belleville, IL 62226 |
| Survey Date – 12/3/14 | |
| Type B violation for violating one or more sections: 300.1210a), 300.1210b), 300.1210c), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.120b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Symphony of Crestwood |
| FACILITY ADDRESS: | 14255 South Cicero Ave |
| FACILITY CITY, STATE, ZIP: | Crestwood, IL 60445 |
| DOCKET NUMBER: | NH 14-C0532 |
| LICENSEE INFO: | Symphony Crestwood, LLC |
| LICENSEE ADDRESS: | 801 Adlai Stevenson Dr |
| LICENSEE CITY, STATE, ZIP: | Springfield, IL 62703 |
| Survey Date – 11/18/14 | |
| Type B violation for violating one or more sections: 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210b), 300.1210d)6), and 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Lexington of Schaumburg |
| FACILITY ADDRESS: | 675 South Roselle Road |
| FACILITY CITY, STATE, ZIP: | Schaumburg, IL 60193 |
| DOCKET NUMBER: | NH 14-S0536 |
| LICENSEE INFO: | Lexington Health Care Center of Schaumburg, Inc |
| LICENSEE ADDRESS: | 665 West North Ave |
| LICENSEE CITY, STATE, ZIP: | Lombard, IL 60148 |
| Survey Date -12/2/14 | |
| Type B violation for violating one or more sections: 300.610a), 300.1210d)1), 300.1610a)1), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.3240a). For a total fine of $2,200.00 | |
| FACILITY NAME: | Highland Health Care Center |
| FACILITY ADDRESS: | 1450 26th St |
| FACILITY CITY, STATE, ZIP: | Highland, IL 62249 |
| DOCKET NUMBER: | NH 14-S0524 |
| LICENSEE INFO: | Covenant Care Midwest, Inc |
| LICENSEE ADDRESS: | 208 South LaSalle, Suite 814 |
| LICENSEE CITY, STATE, ZIP: | Chicago, IL 60604 |
| Survey Date – 11/5/14 | |
| Type A violation for violating one or more sections: 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the following sections of the Code with a high risk designation: 300.1210d)6), 300.3240a). For a total fine of $25,000.00 | |
| Type A violation for violating one or more sections: 300.680a), 300.682a), 300.682a)2), 300.1220b)3), and 300.3240a). For a total fine of $12,500.00. | |
Illinois Department of Public Health
535 West Jefferson St.
Springfield, Illinois 62761
Phone 217-782-4977
Fax 217-782-3987
TTY 800-547-0466
Questions or Comments
535 West Jefferson St.
Springfield, Illinois 62761
Phone 217-782-4977
Fax 217-782-3987
TTY 800-547-0466
Questions or Comments