1st Quarter Report January-March 2016

FACILITY NAME: Alden Des Plaines Rehab & HC
FACILITY ADDRESS: 1221 East Golf Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60016

DOCKET NUMBER: NH 16-C0023

LICENSEE INFO: Des Plaines Rehabilitation and Health Care Center, Inc
LICENSEE ADDRESS: 4200 West Peterson Ave
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 12/22/2015

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

FACILITY NAME: Alden Estates of Orland Park
FACILITY ADDRESS: 16450 South 97^th Avenue
FACILITY CITY, STATE, ZIP: Orland Park, IL 60462

DOCKET NUMBER: NH 15-C0413

LICENSEE INFO: Alden-Orland Park Rehabilitation and Health Care Center, Inc.
LICENSEE ADDRESS: 4200 W. Peterson Ave, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 08/05/2015

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Alden Village Health Facility
FACILITY ADDRESS: 267 East Lake Street
FACILITY CITY, STATE, ZIP: Bloomingdale, IL 60108

DOCKET NUMBER: NH 16-S0040

LICENSEE INFO: Alden Village Health Facility for Children and Young Adults
LICENSEE ADDRESS: 4200 W. Peterson Avenue, Ste 140
LICENSEE CITY, STATE, ZIP: Chicago, IL 60646
Survey Date – 11/20/2015

Type B violation for violating one or more sections: 350.3240. No fine

FACILITY NAME: Aperion Care Colfax
FACILITY ADDRESS: 402 South Harrison
FACILITY CITY, STATE, ZIP: Colfax, IL 61728

DOCKET NUMBER: NH 16-C0056

LICENSEE INFO: Aperion Care Colfax, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/31/2015

Type B violation for violating one or more sections: 300.1230k). No fine

FACILITY NAME: Aperion Care Colfax
FACILITY ADDRESS: 402 South Harrison
FACILITY CITY, STATE, ZIP: Colfax, IL 61728

DOCKET NUMBER: NH 16-S0129

LICENSEE INFO: Aperion Care Colfax, LLC
LICENSEE ADDRESS: 801 Adlai Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 03/15/2016

Type B violation for violating one or more sections: 300.670k)1)2)3). No fine

Type B violation for violating one or more sections: 300.696a)c)6). No fine

Type B violation for violating one or more sections: 300.1210d)1). No fine

Type B violation for violating one or more sections: 300.1220a)1)2). No fine

Type B violation for violating one or more sections: 300.2210b)2). No fine

Type B violation for violating one or more sections: 300.3260c). No fine

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

DOCKET NUMBER: NH 16-C0109

LICENSEE INFO: International Nursing & Rehab Center, LLC
LICENSEE ADDRESS: 8131 N. Monticello
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 01/26/2016

Type B violation for violating one or more sections: 300.690B). No fine

FACILITY NAME: Arba Care Ctr of Bloomington
FACILITY ADDRESS: 1509 N. Calhoun Street
FACILITY CITY, STATE, ZIP: Bloomington, IL 61701

DOCKET NUMBER: NH 16-S0002

LICENSEE INFO: Arba Care Center of Bloomington, LLC
LICENSEE ADDRESS: 134 N. McLean Blvd
LICENSEE CITY, STATE, ZIP: Elgin, IL 60123
Survey Date – 11/30/2015

Type B violation for violating one or more sections: 300.3100d)2). No fine

FACILITY NAME: Arden Courts of Glen Ellyn
FACILITY ADDRESS: 2 South 706 Park Boulevard
FACILITY CITY, STATE, ZIP: Glen Ellyn, IL 60137

DOCKET NUMBER: NH 16-S0043

LICENSEE INFO: Arden Courts of Glen Ellyn IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/08/2015

Type B violation for violating one or more sections: 330.7103)F). No fine

Type B violation for violating one or more sections: 330.780a), 330.780b), and 330.780c). No fine

Type B violation for violating one or more sections: 330.4240f). No fine

Type B violation for violating one or more sections:330.1155b), 330.1155c), and 330.1155e)1)2)3). No fine

Type B violation for violating one or more sections: 330.765a), 330.765b), and 330.765c). No fine

Type B violation for violating one or more sections: 330.1710f)1). No fine

Type B violation for violating one or more sections: 330.911. No fine

Administrative Warning for violating the following section of the Code: 330.720e)1)2)3). No fine

Administrative Warning for violating the following section of the Code: 330.1950c), 330.19501)A)B)C), 330.19502)A), 330.1950i), 330.1950g), and 330.19501)A). No fine

Administrative Warning for violating the following section of the Code:330.1510a)4). No fine

FACILITY NAME: Aria Post Acute Care
FACILITY ADDRESS: 4600 North Frontage Road
FACILITY CITY, STATE, ZIP: Hillside, IL 60162

DOCKET NUMBER: NH 16-C0074

LICENSEE INFO: Symphony Aria, LLC
LICENSEE ADDRESS: 801 Adlia Stevenson Drive
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/04/2016

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

FACILITY NAME: Asbury Gardens Nrsg & Rehab
FACILITY ADDRESS: 212 Airport Road
FACILITY CITY, STATE, ZIP: North Aurora, IL 60542

DOCKET NUMBER: NH 16-C0004

LICENSEE INFO: Asbury Pavilion Nursing & Rehabilitation Center, LLC
LICENSEE ADDRESS: 8170 McCormick Blvd, Ste 104
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 12/03/2015

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.610c)4), 300.1210a), 300.1210b)3), 300.1210d)6) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210d)6) and 300.3240a). A fine of $25,000.00.

FACILITY NAME: Auburn Rehab & HCC
FACILITY ADDRESS: 304 Maple Avenue
FACILITY CITY, STATE, ZIP: Auburn, IL 62615

DOCKET NUMBER: NH 16-S0076

LICENSEE INFO: Auburn Nursing and Rehabilitation Center. L.L.C.
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/22/2016

Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210a), 300.1210d)5), and 300.3240a). No fine

Type B violation for violating one or more sections: 300.610a), 300.1210d)6), 300.3240a) No fine

FACILITY NAME: Ballard Respiratory and Rehab
FACILITY ADDRESS: 9300 Ballard Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60016

DOCKET NUMBER: NH 16-S0008

LICENSEE INFO: Ballard Respiratory and Rehabilitation Center, LLC
LICENSEE ADDRESS: 55 W. Monroe Street, Ste 2400
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 10/26/2015

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

FACILITY NAME: Ballard Respiratory and Rehab
FACILITY ADDRESS: 9300 Ballard Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60016

DOCKET NUMBER: NH 16-C0009

LICENSEE INFO: Ballard Respiratory and Rehabilitation Center, LLC
LICENSEE ADDRESS: 55 W. Monroe St., Ste 2400
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 11/25/2015

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

FACILITY NAME: Ballard Respiratory and Rehab
FACILITY ADDRESS: 9300 Ballard Road
FACILITY CITY, STATE, ZIP: Des Plaines, IL 60016

DOCKET NUMBER: NH 16-C0093

LICENSEE INFO: Ballard Respiratory and Rehabilitation Center, LLC
LICENSEE ADDRESS: 55 W. Monroe Street. Ste 2400
LICENSEE CITY, STATE, ZIP: Chicago, IL 60603
Survey Date – 01/07/2016

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

FACILITY NAME: Bement Health Care Center
FACILITY ADDRESS: 601 North Morgan
FACILITY CITY, STATE, ZIP: Bement, IL 61813

DOCKET NUMBER: NH 16-S0128

LICENSEE INFO: Petersen Health Quality, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 03/10/2016

Type B violation for violating one or more sections: 300.615a)e). No fine

Type B violation for violating one or more sections: 300.626c). No fine

FACILITY NAME: Bridgeway Senior Living
FACILITY ADDRESS: 111 East Washington Street
FACILITY CITY, STATE, ZIP: Bensenville, IL 60106

DOCKET NUMBER: NH 16-S0032

LICENSEE INFO: Bridgeway Senior Living, LLC
LICENSEE ADDRESS: 5750 Old Orchard Rd, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 11/20/2015

Type B violation for violating one or more sections 300.625. No fine

FACILITY NAME: Bryan Manor
FACILITY ADDRESS: 2150 East McCord
FACILITY CITY, STATE, ZIP: Centralia, IL 62801

DOCKET NUMBER: NH 16-S0073

LICENSEE INFO: Penta Group, Inc.
LICENSEE ADDRESS: 623 E. Broadway
LICENSEE CITY, STATE, ZIP: Centralia, IL 62801
Survey Date – 01/21/2016

Type B violation for violating one or more sections: 350.620a), and 350.1210. No fine

FACILITY NAME: Casey Health Care Center
FACILITY ADDRESS: 100 North East 15^th
FACILITY CITY, STATE, ZIP: Casey, IL 62420

DOCKET NUMBER: NH 16-S0046

LICENSEE INFO: Petersen Management Company, LLC
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 01/08/2016

Type B violation for violating one or more sections: 300.163a)b)c)d)e)f)g)h)i), and 300.7000a)b). No fine

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

DOCKET NUMBER: NH 16-S0078

LICENSEE INFO: Christian Homes, Inc.
LICENSEE ADDRESS: 200 N. Postville Drive
LICENSEE CITY, STATE, ZIP: Lincoln, IL 62656
Survey Date – 01/28/2016

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

FACILITY NAME: Clark-Lindsey Village
FACILITY ADDRESS: 101 West Windsor Road
FACILITY CITY, STATE, ZIP: Urbana, IL 61801

DOCKET NUMBER: NH 16-S0031

LICENSEE INFO: Clark-Lindsey Village, Inc.
LICENSEE ADDRESS: 1729 Georgetown Drive
LICENSEE CITY, STATE, ZIP: Champaign, IL 61821
Survey Date – 12/18/2015

Type B violation for violating one or more sections: 300.840. No fine.

Type B violation for violating one or more sections: 300.2100. No fine.

Type B violation for violating one or more sections:330.2000. No fine

FACILITY NAME: Clayberg, The
FACILITY ADDRESS: East Monroe Street
FACILITY CITY, STATE, ZIP: Cuba, IL 61427

DOCKET NUMBER: NH 16-C0138

LICENSEE INFO: Fulton County
LICENSEE ADDRESS: 100 N. Main Street
LICENSEE CITY, STATE, ZIP: Lewistown, IL 61542
Survey Date – 02/23/2016

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

FACILITY NAME: Concordia Village Care Center
FACILITY ADDRESS: 4101 West Iles Avenue
FACILITY CITY, STATE, ZIP: Springfield, IL 62711

DOCKET NUMBER: NH 16-C0079

LICENSEE INFO: Lutheran Senior Services
LICENSEE ADDRESS: 208 So. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 01/19/2016

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

FACILITY NAME: Danville Care Center
FACILITY ADDRESS: 1700 North Bowman
FACILITY CITY, STATE, ZIP: Danville, IL 61832

DOCKET NUMBER: NH 16-C0108

LICENSEE INFO: Danville Care Center, LTD
LICENSEE ADDRESS: 5750 Old Orchard Road, Ste 420
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 02/25/2016

Type B violation for violating one or more sections: 300.690b)c). No fine

FACILITY NAME: Daystar Nursing & Rehab Center
FACILITY ADDRESS: 2001 Cedar Street
FACILITY CITY, STATE, ZIP: Cairo, IL 62914

DOCKET NUMBER: NH 16-C0007

LICENSEE INFO: Daystar Nursing and Rehabilitation Center, LLC
LICENSEE ADDRESS: 8170 McCormick Blvd, Ste 219
LICENSEE CITY, STATE, ZIP: Skokie, IL 60078
Survey Date – 12/11/2015

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

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

DOCKET NUMBER: NH 16-C0077

LICENSEE INFO: Petersen Health & Wellness, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 01/21/2016

Type B violation for violating one or more sections: 300.610, 300.1010h), 300.1210b), 300.1210d)5), 300.3240a). No fine

FACILITY NAME: Elm Brook Healthcare & Rehab
FACILITY ADDRESS: 127 West Diversey Avenue
FACILITY CITY, STATE, ZIP: Elmhurst, IL 60126

DOCKET NUMBER: NH 16-S0117

LICENSEE INFO: Elmbrook Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 7040 North Ridgeway Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 02/24/2016

Type B violation for violating one or more sections: 300.2040b). No fine

FACILITY NAME: Elmwood Care
FACILITY ADDRESS: 7733 West Grand Avenue
FACILITY CITY, STATE, ZIP: Elmwood Park. O: 60707

DOCKET NUMBER: NH 16-S0069

LICENSEE INFO: Elmwood Care, Inc.
LICENSEE ADDRESS: 6840 N. Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 01/21/2016

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

FACILITY NAME: Forest City Rehab & Nrsg Ctr.
FACILITY ADDRESS: 321 Arnold Avenue
FACILITY CITY, STATE, ZIP: Rockford, IL 61108

DOCKET NUMBER: NH 16-C0020

LICENSEE INFO: Forest City Rehab and Nursing Center, LLC
LICENSEE ADDRESS: 4711 Golf Rd, Ste 200
LICENSEE CITY, STATE, ZIP: Skokie, IL 60076
Survey Date – 12/16/2015

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

Administrative Warning for violating the following section of the Code: 300.690b) and 300.690c).

FACILITY NAME: Genesis Senior Living
FACILITY ADDRESS: 309 NW 9^th Avenue
FACILITY CITY, STATE, ZIP: Aledo, IL 61231

DOCKET NUMBER: NH 16-S0110

LICENSEE INFO: Genesis Senior Living, Aledo
LICENSEE ADDRESS: 801 Illini Drive
LICENSEE CITY, STATE, ZIP: Silvis, IL 61282
Survey Date – 02/18/2016

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

Administrative Warning for violating the following section of the Code: 300.1230k). No fine.

FACILITY NAME: Good Samaritan - Flanagan
FACILITY ADDRESS: 205 North Adams Street
FACILITY CITY, STATE, ZIP: Flanagan, IL 61740

DOCKET NUMBER: NH 16-S0082

LICENSEE INFO: Good Samaritan Home of Flanagan Illinois
LICENSEE ADDRESS: 205 North Adams Street
LICENSEE CITY, STATE, ZIP: Flanagan, IL 61740
Survey Date – 01/21/2016

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

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

DOCKET NUMBER: NH 16-C0005

LICENSEE INFO: The Greek American Rehabilitation and Care Centre, Inc
LICENSEE ADDRESS: 220 North First Street
LICENSEE CITY, STATE, ZIP: Wheeling, IL 60090
Survey Date – 12/09/2015

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)5), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b)5), 300.1210d)6) and 300.3240a). A fine of $2.200.00

FACILITY NAME: Grove at the Lake, The
FACILITY ADDRESS: 2534 Elim Avenue
FACILITY CITY, STATE, ZIP: Zion, IL 60099

DOCKET NUMBER: NH 16-S0122

LICENSEE INFO: Grove at the Lake Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 7040 North Ridgeway Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 02/18/2016

Type B violation for violating one or more sections: 300.1210b)3). No fine

FACILITY NAME: Grove of LaGrange Park, The
FACILITY ADDRESS: 701 North LaGrange Park
FACILITY CITY, STATE, ZIP: LaGrange Park, IL 60526

DOCKET NUMBER: NH 16-S0086

LICENSEE INFO: LaGrange Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 7040 North Ridgeway Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 02/18/2016

Type B violation for violating one or more sections: 300.1210a), 300.1210d)(a)2), 300.1810c)2), 300.1810c)3), and 300.1820c)3). No fine

Administrative Warning for violating the following section of the Code: 300.2100. No fine

FACILITY NAME: Grove of Northbrook, The
FACILITY ADDRESS: 263 Skokie Boulevard
FACILITY CITY, STATE, ZIP: Northbrook, IL 60062

DOCKET NUMBER: NH 16-S0096

LICENSEE INFO: Northbrook Skilled Nursing Facility, LLC
LICENSEE ADDRESS: 7040 North Ridgeway Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 02/18/2016

Type B violation for violating one or more sections: 300.1620a. No fine

Type B violation for violating one or more sections: 300.3220f) and 300.696a). No fine

Type C violation for violating one or more sections: 300.2040b and 300.2090a)b). No fine

Type C violation for violating one or more sections: 300.2210b)1)3)9 and 300.2930c)4). No fine

Type C violation for violating one or more sections: 300.1210d)4). No fine

FACILITY NAME: Heartland of Decatur
FACILITY ADDRESS: 444 West Harrison Street
FACILITY CITY, STATE, ZIP: Decatur, IL 62526

DOCKET NUMBER: NH 16-C0123

LICENSEE INFO: Heartland of Decatur IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 01/30/2016

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1010h), 300.1210b), 300.1210d)1), 300.1210d)2), 300.1210d)3), 300.1610a)1), 300.1610d) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.00

FACILITY NAME: Helia Healthcare of Champaign
FACILITY ADDRESS: 1915 S. Mattis Street
FACILITY CITY, STATE, ZIP: Champaign, IL 61821

DOCKET NUMBER: NH 16-S0131

LICENSEE INFO: Helia Healthcare of Champaign, LLC
LICENSEE ADDRESS: 118 W. Edwards Street, Ste 200
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 02/19/2016

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

FACILITY NAME: Helia Healthcare of Energy-DD
FACILITY ADDRESS: 210 East College
FACILITY CITY, STATE, ZIP: Energy, IL 62933

DOCKET NUMBER: NH 16-C0107

LICENSEE INFO: Helia Healthcare of Energy, L.L.C.
LICENSEE ADDRESS: 600 South 2^nd Street
LICENSEE CITY, STATE, ZIP: Springfield, IL 62704
Survey Date – 02/02/2016

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.2040b), 300.2040g), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation 300.1210b), and 300.3240a). A fine of $2,200.00.

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

DOCKET NUMBER: NH 16-S0072

LICENSEE INFO: Heritage Manor – Mt. Zion, LLC
LICENSEE ADDRESS: 115 W. Jefferson Street, Ste 400
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 01/22/2016

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.1210b)5), 300.1210d)6), 300.1220b)2), 300.1220b)7) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b)5), 300.1210d)6) and 300.3240a). A fine of $25,000.00.

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

DOCKET NUMBER: NH 16-S0047

LICENSEE INFO: Heritage Manor – Normal, LLC
LICENSEE ADDRESS: 115 W. Jefferson Street, Ste 401
LICENSEE CITY, STATE, ZIP: Bloomington, IL 61701
Survey Date – 01/07/2016

Type B violation for violating one or more sections: 300.615e) and 300.615f). No fine

Type B violation for violating one or more sections:300.626c) and 300.627c). No fine

Type B violation for violating one or more sections: 300.7040e). No fine

Administrative Warning for violating the following section of the Code: 300.7050e)f). No fine

Administrative Warning for violating the following section of the Code: 300.7020b)1)8). No fine

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

DOCKET NUMBER: NH 15-S0397

LICENSEE INFO: Hillsboro Rehabilitation and Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 08/19/2015

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Holland Terrace
FACILITY ADDRESS: 15175 State Street
FACILITY CITY, STATE, ZIP: South Holland, IL 60473

DOCKET NUMBER: NH 16-S0081

LICENSEE INFO: Pioneer Concepts, Inc.
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 01/26/2016

Type B violation for violating one or more of the following sections of the Code: 350.620a), 350.1010e), 350.1060a), 350.1210, and 350.3240a). A fine of $550.00

FACILITY NAME: Hope Creek Care Center
FACILITY ADDRESS: 4343 Kennedy Drive
FACILITY CITY, STATE, ZIP: East Moline, IL 61244

DOCKET NUMBER: NH 16-S0097

LICENSEE INFO: Rock Island County
LICENSEE ADDRESS: 1504 Third Avenue
LICENSEE CITY, STATE, ZIP: Rock Island, IL 61201
Survey Date – 01/27/2016

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

FACILITY NAME: Illini Heritage Rehab & HC
FACILITY ADDRESS: 1315 Curt Drive
FACILITY CITY, STATE, ZIP: Champaign, IL 61820

DOCKET NUMBER: NH 16-S0113

LICENSEE INFO: Petersen Health Care – Illini, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 02/25/2016

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

FACILITY NAME: Integrity HC of Godfrey
FACILITY ADDRESS: 1623-29 W. Delmar Avenue
FACILITY CITY, STATE, ZIP: Godfrey, IL 62035

DOCKET NUMBER: NH 16-C0042

LICENSEE INFO: Godfrey Healthcare & Rehabilitation Center, LLC
LICENSEE ADDRESS: 8170 N. McCormick Blvd, Ste 219
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 12/30/2015

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

FACILITY NAME: Lexington of Orland Park
FACILITY ADDRESS: 14601 South John Humphrey Dr.
FACILITY CITY, STATE, ZIP: Orland Park, IL 60462

DOCKET NUMBER: NH 16-C0018

LICENSEE INFO: Lexington Health Care Center of Orland Park, Inc.
LICENSEE ADDRESS: 665 West North Avenue
LICENSEE CITY, STATE, ZIP: Lombard, IL 60148
Survey Date – 12/07/2015

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

FACILITY NAME: Lexington of Wheeling
FACILITY ADDRESS: 730 West Hintz Road
FACILITY CITY, STATE, ZIP: Wheeling, IL 60090

DOCKET NUMBER: NH 16-S0045

LICENSEE INFO: Lexington Health Care Center of Wheeling, Inc.
LICENSEE ADDRESS: 665 W. North Avenue
LICENSEE CITY, STATE, ZIP: Lombard, IL 60148
Survey Date – 01/14/2016

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

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.615e). No fine

FACILITY NAME: Life’s Journey Mattoon
FACILITY ADDRESS: 300 Lerna Road South
FACILITY CITY, STATE, ZIP: Mattoon, IL 61938

DOCKET NUMBER: NH 15-S0539

LICENSEE INFO: MAS Senior Living, LLC
LICENSEE ADDRESS: 70 W. Madison St., Ste. 3500
LICENSEE CITY, STATE, ZIP: Chicago, IL 60602
Survey Date – 12/18/2015

Type B violation for violating one or more sections:330.710a), 330.780a), and 330.110a)f). No fine

Type B violation for violating one or more sections: 330.1930, 330.2000, 750.160a), 750.800e) and 330.3970f). No fine

Administrative Warning for violating the following section of the Code:330.1120a). No fine

FACILITY NAME: Lutheran Home, The
FACILITY ADDRESS: 6901 North Galena Road
FACILITY CITY, STATE, ZIP: Peoria, IL 61614

DOCKET NUMBER: NH 16-C0067

LICENSEE INFO: Lutheran Hillside Village, Inc.
LICENSEE ADDRESS: 6901 N. Galena Road
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 12/23/2015

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

FACILITY NAME: Lutheran Home, The
FACILITY ADDRESS: 6901 North Galena Road
FACILITY CITY, STATE, ZIP: Peoria, IL 61614

DOCKET NUMBER: NH 16-C0102

LICENSEE INFO: Lutheran Hillside Village, Inc.
LICENSEE ADDRESS: 6901 N. Galena Road
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 01/25/2016

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

FACILITY NAME: Magnolia Manor Shelter Care H
FACILITY ADDRESS: 1100 Grant
FACILITY CITY, STATE, ZIP: Eldorado, IL 62930

DOCKET NUMBER: NH 16-C0090

LICENSEE INFO: John Zink
LICENSEE ADDRESS: 150 South Route 45, P. O. Box 250
LICENSEE CITY, STATE, ZIP: Louisville, IL 62858
Survey Date – 02/18/2016

Type B violation for violating one or more sections: 330.780a), 330.780b), 330.780c), 330.4240d) and 330.4240f). No fine

FACILITY NAME: Manorcare of Palos Hts East
FACILITY ADDRESS: 7850 W. College Drive
FACILITY CITY, STATE, ZIP: Palos Heights, IL 60463

DOCKET NUMBER: NH 16-S0003

LICENSEE INFO: Manor Care of Palos Heights, IL., LLC
LICENSEE ADDRESS: 208 S. LaSalle St. Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 11/17/2015

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

FACILITY NAME: Manorcare of Westmont
FACILITY ADDRESS: 512 East Ogden Avenue
FACILITY CITY, STATE, ZIP: Westmont, IL 60559

DOCKET NUMBER: NH 16-S0017

LICENSEE INFO: Manor Care of Westmont, IL, LLC
LICENSEE ADDRESS: 208 S. LaSalle Street, Ste 814
LICENSEE CITY, STATE, ZIP: Chicago, IL 60604
Survey Date – 12/11/2015

Type B violation for violating one or more sections:300.625m)n). No fine

FACILITY NAME: Marigold Rehabilitation HCC
FACILITY ADDRESS: 275 East Carl Sandberg Drive
FACILITY CITY, STATE, ZIP: Galesburg, IL 61401

DOCKET NUMBER: NH 16-C0030

LICENSEE INFO: Petersen Health Network, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Dr.
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 12/02/2015

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

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

DOCKET NUMBER: NH 16-C0053

LICENSEE INFO: Mattoon Manor, LLC
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 12/29/2015

Type B violation for violating one or more sections: 300.610a), 300.1010h), 300.1210b), and 300.3240a). No fine

FACILITY NAME: Mid America Care Center
FACILITY ADDRESS: 4920 North Kenmore Avenue
FACILITY CITY, STATE, ZIP: Chicago, IL 60640

DOCKET NUMBER: NH 16-S0026

LICENSEE INFO: Mid America Care Center, L.L.C.
LICENSEE ADDRESS: 4600 W. Touhy Avenue, Ste 200
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 12/10/2015

Type B violation for violating one or more sections: 300.610a), 300.1210a), 300.1210b), 300.1220b)3), 300.1620a), 300.1630d), and 300.3240a). No fines

Type B violation for violating one or more sections: 300.625j), 300.625k), and 300.625l. No fine

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

DOCKET NUMBER: NH 16-S0088

LICENSEE INFO: Moweaqua Rehabilitation & Health Care Center, LLC
LICENSEE ADDRESS: 412 E. Lawrence Avenue
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 02/11/2016

Type B violation for violating one or more sections: 300.615e). No fine

FACILITY NAME: Parkway Manor
FACILITY ADDRESS: 3116 Williamson County PKWY
FACILITY CITY, STATE, ZIP: Marion, IL 62959

DOCKET NUMBER: NH 16-S0124

LICENSEE INFO: UDI #1, LLC
LICENSEE ADDRESS: 285 South Farnham Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 02/09/2016

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.696a), 300.696c)2), 300.696c)7), 300.1210b), 300.1210c)3) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.696, 300.1210b) and 300.3240a). A fine of $2,200.00.

FACILITY NAME: Piper City Rehab & Living Ctr
FACILITY ADDRESS: 600 South Maple Street
FACILITY CITY, STATE, ZIP: Piper City, IL 60959

DOCKET NUMBER: NH 16-S0127

LICENSEE INFO: Midwest Health Operations, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 02/10/2016

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

FACILITY NAME: Pleasant View & HCC
FACILITY ADDRESS: 500 North Jackson Street
FACILITY CITY, STATE, ZIP: Morrison, IL 61270

DOCKET NUMBER: NH 16-S0083

LICENSEE INFO: Petersen Health Operations III, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 01/29/2016

Type B violation for violating one or more sections: 300.661 and 300.615e). No fine

Administrative Warning for violating the following section of the Code: 300.3130C04) and 300.3130C05). No fine.

FACILITY NAME: Plymouth Place
FACILITY ADDRESS: 315 North LaGrange Road
FACILITY CITY, STATE, ZIP: LaGrange Park, IL 60526

DOCKET NUMBER: NH 16-C0034

LICENSEE INFO: Plymouth Place, Inc.
LICENSEE ADDRESS: 315 N. LaGrange Rd.
LICENSEE CITY, STATE, ZIP: LaGrange, IL 60526
Survey Date – 12/14/2015

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b), 300.1210d)3), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b) and 300.3240a). A fine of $2,200.

FACILITY NAME: Presence Cor Mariae Center
FACILITY ADDRESS: 3330 Maria Linden Drive
FACILITY CITY, STATE, ZIP: Rockford, IL 61114

DOCKET NUMBER: NH 16-S0011

LICENSEE INFO: Presence Life Connections
LICENSEE ADDRESS: 9223 West Saint Francis Road
LICENSEE CITY, STATE, ZIP: Frankfort, IL 60423
Survey Date – 11/19/2015

Type A violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1010h), 300.1210b)4), 300.1210d)1), 300.1210d)2), 300.1610a), 300.1630b) and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b)and 300.3240a). A fine of $25,000.00.

FACILITY NAME: Presence Cor Mariae Center
FACILITY ADDRESS: 3330 Maria Linden Drive
FACILITY CITY, STATE, ZIP: Rockford, IL 61114

DOCKET NUMBER: NH 16-S0011

LICENSEE INFO: Presence Life Connections
LICENSEE ADDRESS: 9223 West Saint Francis Road
LICENSEE CITY, STATE, ZIP: Frankfort, IL 60423
Survey Date – 11/19/2015

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Presence Pine View Care Center
FACILITY ADDRESS: 611 Allen Lane
FACILITY CITY, STATE, ZIP: St. Charles, IL 60174

DOCKET NUMBER: NH 15-S0415

LICENSEE INFO: Presence Life Connections
LICENSEE ADDRESS: 9223 West Saint Francis Road
LICENSEE CITY, STATE, ZIP: Frankfort, IL 60423
Survey Date – 08/21/2015

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Providence Palos Heights
FACILITY ADDRESS: 13259 South Central Avenue
FACILITY CITY, STATE, ZIP: Palos Heights, IL 60463

DOCKET NUMBER: NH 16-C0070

LICENSEE INFO: Providence Operations, LLC
LICENSEE ADDRESS: 18601 N. Creek Drive, Ste A
LICENSEE CITY, STATE, ZIP: Tinley Park, IL 60477
Survey Date – 01/08/2016

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

FACILITY NAME: Regency Rehabilitation Center
FACILITY ADDRESS: 6631 Milwaukee Avenue
FACILITY CITY, STATE, ZIP: Niles, IL 60714

DOCKET NUMBER: NH 16-C0035

LICENSEE INFO: Regency Rehabilitation Center, LLC
LICENSEE ADDRESS: 6840 N. Lincoln Avenue
LICENSEE CITY, STATE, ZIP: Lincolnwood, IL 60712
Survey Date – 12/16/2015

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.1210a), 300.1210b), 300.1210d)6), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation: 300.1210b), 300.1210d)6) and 300.3240a). A fine of $2,200.

FACILITY NAME: Rosewood Care Ctr of Rockford
FACILITY ADDRESS: 1660 S. Mulford Road
FACILITY CITY, STATE, ZIP: Rockford, IL 61108

DOCKET NUMBER: NH 16-S0055

LICENSEE INFO: Bravo Care of Rockford, Inc.
LICENSEE ADDRESS: 412 E. Lawrence
LICENSEE CITY, STATE, ZIP: Springfield, IL 62703
Survey Date – 01/06/2016

Type B violation for violating one or more sections: 300.615e), and 300.1030d). No fine

FACILITY NAME: Sandwich Rehab & HCC
FACILITY ADDRESS: 902 East Arnold Street
FACILITY CITY, STATE, ZIP: Sandwich, IL 60548

DOCKET NUMBER: NH 16-S0104

LICENSEE INFO: Petersen Health Business, LLC
LICENSEE ADDRESS: 830 W. Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 01/22/2016

Type B violation of an occurrence for violating one or more of the following sections of the Code: 300.610a), 300.1210a), 300.1210b), 300.2040b), 300.2040g), and 300.3240a). The fine was doubled in this instance in accordance with 300.282i) and j) of the Code due to the violation of the sections of the Code with a high risk designation 300.1210b), and 300.3240a). A fine of $2,200.00.

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

DOCKET NUMBER: NH 16-C0021

LICENSEE INFO: Sharon Health Care Elms, Inc.
LICENSEE ADDRESS: 465 Central Avenue, Ste 100
LICENSEE CITY, STATE, ZIP: Northfield, IL 60093
Survey Date – 12/17/2015

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

FACILITY NAME: South Lawn Sheltered Care
FACILITY ADDRESS: 512 South Franklin
FACILITY CITY, STATE, ZIP: Bunker Hill, IL 62014

DOCKET NUMBER: NH 16-S0012

LICENSEE INFO: South Lawn Sheltered Care, Inc.
LICENSEE ADDRESS: R.R. #1 Route 159, P.O. Box H
LICENSEE CITY, STATE, ZIP: Bunker Hill, IL 62014
Survey Date – 12/09/2015

Type B violation for violating one or more sections: 330.725. No fine

Type B violation for violating one or more sections: 330.920. No fine

FACILITY NAME: South Lawn Sheltered Care
FACILITY ADDRESS: 512 South Franklin
FACILITY CITY, STATE, ZIP: Bunker Hill, IL 62014

DOCKET NUMBER: NH 16-C0133

LICENSEE INFO: South Lawn Sheltered Care, Inc.
LICENSEE ADDRESS: R.R. 1 Route 159
LICENSEE CITY, STATE, ZIP: Bunker Hill, IL 62014
Survey Date – 01/24/2016

Type B violation for violating one or more sections: 330.3060g). No fine

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

DOCKET NUMBER: NH 16-C0075

LICENSEE INFO: SV Care, LLC
LICENSEE ADDRESS: 1S433 Summitt Avenue, Ste 204
LICENSEE CITY, STATE, ZIP: Oakbrook Terrace, IL 60181
Survey Date – 01/14/2016

Type B violation for violating one or more sections: 300.625a), 300.625b), 300.625c)2), 300.625j), and 300.625n). No fine.

Type B violation for violating one or more sections: 300.626c), and 300.626e). No fine

FACILITY NAME: St. Paul’s Home
FACILITY ADDRESS: 1021 West E. Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62220

DOCKET NUMBER: NH 16-S0060

LICENSEE INFO: St. Paul’s Home
LICENSEE ADDRESS: 23 Public Square # 300
LICENSEE CITY, STATE, ZIP: Belleville, IL 62220
Survey Date – 12/22/2015

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

FACILITY NAME: St. Paul’s Home
FACILITY ADDRESS: 1021 West E. Street
FACILITY CITY, STATE, ZIP: Belleville, IL 62220

DOCKET NUMBER: NH 16-S0060

LICENSEE INFO: St. Paul’s Home
LICENSEE ADDRESS: 23 Public Square #300
LICENSEE CITY, STATE, ZIP: Belleville, IL 62220
Survey Date – 12/22/2015

FINAL ORDER – Violation Amended/Affirmed, Fine Assessment Reduced and/or Notice of Conditional License Withdrawn.

FACILITY NAME: Stevens House
FACILITY ADDRESS: 2182 Windish Drive
FACILITY CITY, STATE, ZIP: Galesburg, IL 61401

DOCKET NUMBER: NH 16-S0054

LICENSEE INFO: Community Living Options, Inc.
LICENSEE ADDRESS: 285 South Farnharm Street
LICENSEE CITY, STATE, ZIP: Galesburg, IL 61401
Survey Date – 12/15/2015

Type A violation of an occurrence for violating one or more of the following sections of the Code: 350.620a), 350.1060e), 350.1210 and 350.3240a). A fine of $6250.00.

FACILITY NAME: The Elms
FACILITY ADDRESS: 1212 Madelyn Avenue
FACILITY CITY, STATE, ZIP: Macomb, IL 61455

DOCKET NUMBER: NH 16-S0066

LICENSEE INFO: McDonough County
LICENSEE ADDRESS: One Courthouse Square, No. 7
LICENSEE CITY, STATE, ZIP: Macomb, IL 61455
Survey Date – 01/12/2016

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

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

DOCKET NUMBER: NH 16-C0089

LICENSEE INFO: Tower Hill Rehabilitation, LLC
LICENSEE ADDRESS: 7434 Skokie Blvd
LICENSEE CITY, STATE, ZIP: Skokie, IL 60077
Survey Date – 01/13/2016

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

FACILITY NAME: Tuscola Health Care Center
FACILITY ADDRESS: 1203 Egyptian Trail
FACILITY CITY, STATE, ZIP: Tuscola, IL 61953

DOCKET NUMBER: NH 16-S0100

LICENSEE INFO: Petersen Health Enterprises, L.L.C.
LICENSEE ADDRESS: 830 West Trailcreek Drive
LICENSEE CITY, STATE, ZIP: Peoria, IL 61614
Survey Date – 02/18/2016

Type B violation for violating one or more sections: 300.670a), 300.670c)1), and 300.670c)3). No fine

Administrative Warning for violating the following section of the Code: 300.1230. No fine

FACILITY NAME: Waverly Place of Stockton
FACILITY ADDRESS: 501 Front Street
FACILITY CITY, STATE, ZIP: Stockton, IL 61085

DOCKET NUMBER: NH 16-S0058

LICENSEE INFO: Waverly Place of Stockton, LLC
LICENSEE ADDRESS: 2711 W. Howard Street
LICENSEE CITY, STATE, ZIP: Chicago, IL 60645
Survey Date – 01/20/2016

Type B violation for violating one or more sections: 300.2900d)2). No fine

FACILITY NAME: Wesley Village
FACILITY ADDRESS: 1200 East Grant Street
FACILITY CITY, STATE, ZIP: Macomb, IL 61455

DOCKET NUMBER: NH 16-S0071

LICENSEE INFO: Wesley Village, Incorporated
LICENSEE ADDRESS: 1200 East Grant Street
LICENSEE CITY, STATE, ZIP: Macomb, IL 61455
Survey Date – 01/19/2016

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

Type B violation of an occurrence for violating the following section of the Code: 300.670). No fine.

Administrative Warning for violating the following section of the Code: 300.615). No fine