Monday, May 23, 2011

2011 State of Illinois: 1st Quarter Report, Nursing Home Violators

2011 1st Quarter Report, Nursing Home Violators

QUARTERLY REPORT
January - March 2011

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 Illinois Department of Healthcare and Family Services, or the Secretary of the U.S. Department of Health and Human Services for violations in relation to patient care, pursuant to Titles XVIII and XIX of the Social Security Act.

FACILITY NAME: Albany Care
FACILITY ADDRESS: 901 Maple Avenue
Evanston, Illinois 60202

DOCKET #: NH 11-C0034
NAME OF OWNER OR LICENSEE: Albany Care, Inc.
ADDRESS: 2201 Main Street
Evanston, Illinois 60202

On February 18, 2011, sent Type “A” Notice of Violation relating to the area of policy and procedure and Notice of Fine Assessment of $12,500. A hearing has been requested.

FACILITY NAME: Alden Terrace of McHenry
FACILITY ADDRESS: 803 Royal Drive
McHenry, Illinois 60050

DOCKET #: NH 11-S0019
NAME OF OWNER OR LICENSEE: Alden Terrace of McHenry Rehab and HCC, Inc.
ADDRESS: 4200 W. Peterson Ave., Ste 140
Chicago, Illinois 60646

On February 14, 2011, sent Notice of Type “A” Violation relating to the area of policy and procedure and Notice of Fine Assessment of $12,500.

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

DOCKET #: NH 09-C0056
NAME OF OWNER OR LICENSEE: Alden Village North, Inc.
ADDRESS: 4200 W. Peterson Ave., Ste. 140
Chicago, Illinois 60646

By Final Order, Violations Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

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

DOCKET #: NH 09-C0223
NAME OF OWNER OR LICENSEE: Alden Village North, Inc.
ADDRESS: 4200 W. Peterson Ave., Ste 140
Chicago, Illinois 60646

By Final Order, Violations Affirmed, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

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

DOCKET #: NH 11-o0059
NAME OF OWNER OR LICENSEE: Alden Village North, Inc.
ADDRESS: 4200 W. Peterson Ave., Ste. 140
Chicago, Illinois 60646

On March 3, 2011, sent Notice of License Revocation.

FACILITY NAME: All American Nursing Home
FACILITY ADDRESS: 5448 North Broadway Street
Chicago, Illinois 60640

DOCKET #: NH 11-C0026
NAME OF OWNER OR LICENSEE: Zikainum, Inc.
ADDRESS: 10 S. Wacker Drive, 40th FL
Chicago, Illinois 60606

On February 18, 2011, sent Notice of Type “A” Violations relating to the area of policy and procedure and Notice of Fine Assessment of $12,500. A hearing has been requested.

FACILITY NAME: Arden Courts of Hazel Crest
FACILITY ADDRESS: 1701 West 183rd Street
Hazel Crest, Illinois 60429

DOCKET #: NH 11-S0010
NAME OF OWNER OR LICENSEE: Arden Courts of Hazel Crest IL, L.L.C.
ADDRESS: 208 S. LaSalle Street, Ste.814
Chicago, Illinois 60604

On January 31, 2011, sent Notice of Type ”RPT B” Violation relating to the area of policy and procedure and Notice of Fine Assessment of $1000. A hearing has been requested.

FACILITY NAME: Arthur Home, The
FACILITY ADDRESS: 423 Eberhardt Drive
Arthur, Illinois 61911

DOCKET #: NH 10-C0351
NAME OF OWNER OR LICENSEE: Community Retirement, Inc.
ADDRESS: 506 South Pine
Arthur, Illinois 61911

On January 13, 2011, sent Notice of Type “A” Violation relating to the area of policy and procedure and Notice of Fine Assessment of $10,000. A hearing has been requested.

FACILITY NAME: Central Plaza Residential Home
FACILITY ADDRESS: 321- 27 North Central
Chicago, Illinois 60644

DOCKET #: NH 09-C0162
NAME OF OWNER OR LICENSEE: B & D Hotel Corporation
ADDRESS: 465 Central Avenue, Ste., 100
Northfield, Illinois 60093

By Final Order, Violations Amended, Fine Assessment Reduced and Notice of Conditional License Withdrawn.

FACILITY NAME: Columbus Manor Residential Care Home
FACILITY ADDRESS: 5107-21 West Jackson Boulevard Chicago, Illinois 60644

DOCKET #: NH 10-o0127
NAME OF OWNER OR LICENSEE: Columbus Manor Residential Care Home, Inc.
ADDRESS: 5107 West Jackson Boulevard
Chicago, Illinois 60644

By Final Order, Notice of License Revocation Affirmed.

FACILITY NAME: Fox River Pavilion
FACILITY ADDRESS: 400 East New York Street
Aurora, Illinois 60505

DOCKET #: NH 10-o0062
NAME OF OWNER OR LICENSEE: Fox River Pavilion, Limited Partnership
ADDRESS: 5750 Old Orchard Road, Ste. 420
Skokie, Illinois 60077

By Final Order, Violations Dismissed, Fine Assessment Dismissed and Notice of License Revocation Affirmed.

FACILITY NAME: Hearthstone Manor
FACILITY ADDRESS: 920 N. Seminary Ave., P.O. Box 520
Woodstock, Illinois 60098

DOCKET #: NH 10-S0360
NAME OF OWNER OR LICENSEE: Woodstock Christian Life Services
ADDRESS: 318 Christian Way
Woodstock, Illinois 60098

On January 4, 2011, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $12,500. A hearing has been requested.

FACILITY NAME: Heritage Nursing Center
FACILITY ADDRESS: 1315 Curt Drive, P.O. Box 3179
Champaign, Illinois 61820

DOCKET #: NH 11-C0082
NAME OF OWNER OR LICENSEE: Heritage Nursing Care, Inc.
ADDRESS: 10 South Wacker Drive, 40th FL
Chicago, Illinois 60606

On March 31, 2011, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $5,000. A hearing has been requested.

FACILITY NAME: Independence Place
FACILITY ADDRESS: 1705 South Park Avenue
Herrin, Illinois 62948

DOCKET #: NH 10-C0355
NAME OF OWNER OR LICENSEE: Independence Place, Inc.
ADDRESS: 15755 Nixon Road
Nashville, Illinois 62263

On January 3, 2011, sent Notice of Type “B” Violations relating to the area of policy and procedure Notice of Fine Assessment of $4,000.

FACILITY NAME: Lakeside Home II
FACILITY ADDRESS: 6330 N. Sheridan Road
Chicago, 60660

DOCKET #: NH 11-S0051
NAME OF OWNER OR LICENSEE: Lakeside Home II, L.L.C.
ADDRESS: 6330 N. Sheridan Road
Chicago, Illinois 60660

On March 29, 2011, sent Notice of Type “RPT B” Violation relating to the area of nursing and Notice of Fine Assessment of $2,000.
FACILITY NAME: Lebanon Care Center
FACILITY ADDRESS: 1201 North Alton
Lebanon, Illinois 62254

DOCKET #: NH 11-S0057
NAME OF OWNER OR LICENSEE: Petersen Health Network, LLC
ADDRESS: 830 West Trailcreek Drive
Peoria, Illinois 61614

On March 18, 2011, sent Notice of Type “RPT B” Violation relating to the area of policy and procedure and Notice of Fine Assessment of $500. A hearing has been requested.

FACILITY NAME: Lincoln Manor
FACILITY ADDRESS: 2650 North Monroe Street
Decatur, Illinois 62526

DOCKET #: NH 10-C0035
NAME OF OWNER OR LICENSEE: Lincoln Manor, Inc.
ADDRESS: 225 North Water, Ste. 200, Box 1760
Decatur, Illinois 62525

By Final Order, Violation Affirmed, Fine Assessment Affirmed and Notice of Conditional License Affirmed.

FACILITY NAME: Litchfield Care Center
FACILITY ADDRESS: 1024 East Tyler
Litchfield, Illinois 62056

DOCKET #: NH 11-S0067
NAME OF OWNER OR LICENSEE: Litchfield Care Center, LLC
ADRESS: 8320 Skokie Blvd., Ste 100
Skokie, Illinois 60077

On March 18, 2011, sent Notice of Type “RPT B” Violation relating to the area of policy and procedure and Notice of Fine Assessment of $500. A hearing has been requested.
FACILITY NAME: North Logan Healthcare Center
FACILITY ADDRESS: 801 North Logan Avenue
Danville, Illinois 61832

DOCKET #: NH 11-S0036
NAME OF OWNER OR LICENSEE: North Logan Health Care Center Investors, L.L.C.
ADDRESS: 8170 N. McCormick Blvd., Ste. 219
Skokie, Illinois 60076

On February18, 2011, sent Notice of Type “RPT B” Violation relating to the area policy and procedure and Notice of Fine Assessment of $500. A hearing has been requested.

FACILITY NAME: Northwoods Care Centre
FACILITY ADDRESS: 2250 Pearl Street
Belvidere, Illinois 61008

DOCKET #: NH 11-S0013
NAME OF OWNER OR LICENSEE: Northwoods Care Centre, LP
ADDRESS: 801 Skokie Blvd., Ste. 100
Northbrook, Illinois 60062

On January 31, 2011, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $8,000. A hearing has been requested.

FACILITY NAME: Rockford Nursing & Rehab Center
FACILITY ADDRESS: 1920 North Main Street
Rockford, Illinois 61103

DOCKET #: NH 10-C0356
NAME OF OWNER OR LICENSEE: Rockford Nursing & Rehabilitation Center, LLC
ADDRESS: 8320 Skokie Boulevard
Skokie, Illinois 60077

On February 10, 2011, sent Notice of Type “A” Violation relating to the area of policy and procedure and Notice of Fine Assessment of $12,500. A hearing has been requested.

FACILITY NAME: Rosewood Care Ctr-Edwardsville
FACILITY ADDRESS: 6277 Center Grove Road
Edwardsville, Illinois 62025

DOCKET #: NH 05-C0274
NAME OF OWNER OR LICENSEE: Bravo Care of Edwardsville, Inc.
ADDRESS: 412 East Lawrence
Springfield, Illinois 62703

By Final Order, Violations Amended, Fine Assessment Reduced and Notice of Conditional License Affirmed.

FACILITY NAME: St. Ann’s Healthcare Center
FACILITY ADDRESS: 770 State Street
Chester, Illinois 62233

DOCKET #: NH 11-S0033
NAME OF OWNER OR LICENSEE: St. Ann’s Healthcare Center, Inc.
ADDRESS: 770 State Street
Chester, Illinois 62233

On February 18, 2011, sent Notice of Type ”A” Violation relating to the area of nursing and Notice of Fine Assessment of $6,250. A hearing has been requested.

FACILITY NAME: Squire’s Sheltered Care Home
FACILITY ADDRESS: 2601 North California
Chicago, Illinois 60647

DOCKET #: NH 11-S0021
NAME OF OWNER OR LICENSEE: Fellowship House, Inc.
ADDRESS: 2601 North California Avenue
Chicago, Illinois 60647

On February 14, 2011, sent Notice of Type “A” Violations relating to the area of policy and procedure and Notice of Fine Assessment of $500.

FACILITY NAME: Three Springs Lodge Nursing Home
FACILITY ADDRESS: 161 Three Springs Road
Chester, Illinois 62233

DOCKET #: NH 11-S0083
NAME OF OWNER OR LICENSEE: Three Springs Lodge Nursing Home, Inc.
ADDRESS: 1001 East Main Street, Bldg. 4
Carbondale, Illinois 62901

On March 30, 2011, sent Notice of Type “A” Violation relating to the area of policy and procedure and Notice of Fine Assessment of $10,000. A hearing has been requested.

FACILITY NAME: Torrence Place
FACILITY ADDRESS: 2601 223rd Street
Sauk Village, Illinois 60411

DOCKET #: NH 11-C0017
NAME OF OWNER OR LICENSEE: Pioneer Concepts, Inc.
ADDRESS: 285 South Farnham Street
Galesburg, Illinois 61401

On February 18, 2011, sent Notice of Type “A” Violations relating to the area of policy and procedure and Notice of Fine Assessment of $10,000. A hearing has been requested.

FACILITY NAME: Virgil Calvert N & Rehab Center
FACILITY ADDRESS: 5050 Summit Avenue
East Saint Louis, Illinois 62205

DOCKET #: NH 11-o0025
NAME OF OWNER OR LICENSEE: Virgil Calvert Nursing & Rehabilitation Center
ADDRESS: 30 South Wacker Dr., Ste. 2900
Chicago, Illinois 60606

On March 10, 2011, sent Notice of Type “RPT A” Violation relating to the area of policy and procedure and Notice of Fine Assessment of $12,500. A hearing has been requested.

FACILITY NAME: Waterfront Terrace
FACILITY ADDRESS: 7750 South Shore Drive
Chicago, Illinois 60649

DOCKET #: NH 11-C0012
NAME OF OWNER OR LICENSEE: Waterfront Terrace, Inc.
ADDRESS: 191 North Wacker Drive, Ste.1800
Chicago, Illinois 60606

On February 25, 2011, sent Notice of Type “A" & "B” Violations relating to the area of nursing and Notice of Fine Assessment of $26,100. A hearing has been requested.

FACILITY NAME: Wincrest Nursing Center Corporation
FACILITY ADDRESS: 6326 North Winthrop Avenue
Chicago, Illinois 60660

DOCKET #: NH 11-S0020
NAME OF OWNER OR LICENSEE: Wincrest Nursing Center Corporation
ADDRESS: 5940 W. Touhy Avenue
Niles, Illinois 60714

On February 14, 2011, sent Notice of Type “A” Violation relating to the area of nursing and Notice of Fine Assessment of $8,000.

Illinois Department of Public Health
535 West Jefferson Street
Springfield, Illinois 62761
Phone 217-782-4977
Fax 217-782-3987
TTY 800-547-0466
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