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Nursing Home Violations for First Quarter of 2022


ILLINOIS, June 7 - The facilities listed below were cited with type "AA" or "A" violations of the Nursing Home Care Act and processed between January and March of 2022. An "AA" violation is cited when there is a condition or occurrence at the facility that proximately caused a resident's death. An "A" violation pertains to a condition in which there is a substantial probability that death or serious mental or physical harm will result or has resulted.


The following facilities were cited for an "AA" violation:


Bria of Forest Edge, a 218-bed skilled care facility at 8001 S. Western Ave. in Chicago, was fined $50,000 for failing to provide safety intervention and supervision for two patients.


Heartland of Galesburg, a 60-bed skilled care facility at 280 E. Losey St. in McLeansboro, was fined $50,000 for failing to identify and assess the medical justification for catheter use and a failing to identify and monitor symptoms of a urinary tract infection.


Hillsboro Rehab & HCC, a 121-bed skilled care facility at 1300 E. Tremont St. in Hillsboro, was fined $25,000 for failing to implement infection control measures to prevent the spread of COVID-19.


New Athens Home for the Aged, a 37-bed skilled care facility at 203 South Johnson St. in New Athens, was fined $50,000 for failing to implement infection control measures to prevent the spread of COVID-19.


Richland Nursing & Rehab, 157-bed skilled care facility at 900 E. Scott St. in Olney, was fined $50,000 for failing to provide supervision during meal service to a resident with dementia.


The following facilities were cited for an "A" violation.


AHVA Care of Winfield, 138-bed skilled care facility located at 28W141 Liberty St. in Winfield, was fined $25,000 for failing to follow standard infection control practices.


Aperion Care DeKalb, a 119-bed skilled care facility at 1212 S. Second St., was fined $12,500 for failing to follow the Control of Communicable Diseases Code, ensuring that staff were properly wearing N-95 masks, and failing to ensure trash disposal was handled in a way that prevents cross contamination.


Aperion Care Forest Park, a 232-bed skilled care facility located at 8200 W. Roosevelt Road in Forest Park, was fined $25,000 for failure to immediately notify the physician of critical laboratory results.


Aperion Care Lakeshore, a 313-bed skilled care facility at 7200 N. Sheridan Road in Chicago, was fined $25,000 for failing to perform a comprehensive skin assessment and to prevent the development of a pressure ulcer.


Aperion Care Peoria Heights, a 110-bed skilled care facility at 1629 Gardner Lane in Peoria Heights, was fined $25,000 for failing to take all necessary steps to ensure the safety of residents while results are pending for criminal history background checks.



$25,000 for failing to assess fall risks and failing to prevent falls for three patients.


Arcadia Care Auburn was also fined $25,000 for failing to provide adequate wound treatment and providing timely updates about wound deterioration to a physician.


Arcadia Care Clifton, a 99-bed skilled care facility at 1190 E. 2900 North Road in Clifton, was fined $25,000 for failing to supervise a resident with known sexual behaviors to ensure protection of sexual abuse of another resident.


Ascension Nazarethville Place, a 68-bed skilled care facility at 300 N. River Road in Des Plaines, was fined $25,000 for failing to follow policy and procedures for wearing personal protective equipment (PPE) as well as universal mask usage and hand hygiene, per the Centers for Disease Control and Prevention guidelines.


Avantara Evergreen Park, a 242-bed skilled care facility at 10124 S. Kedzie Ave. in Evergreen Park, was fined $25,000 for failing to follow a physician's orders for use of specialized respiratory equipment.


Belhaven Nursing & Rehab Center, a 221-bed skilled care facility at 11401 S. Oakley Ave. in Chicago, was fined $25,000 for failing to follow a resident's care plan.


Belhaven Nursing & Rehab Center was also fined $25,000 for failing to monitor, supervise, and prevent a cognitively impaired and total care dependent individual from serious injury.


Beverly Farm Foundation, a 300-bed facility for care of developmentally disabled individuals at 6301 Humbert Road in Godfrey, was fined $12,500 for failing to ensure that policies and procedures were followed to prevent neglect and abuse.


Bria of Belleville, a 94-bed skilled care facility at 150 N. 27th St. in Belleville, was fined $25,000 for failing to monitor a resident's medical condition after hospital discharge.


Bria of Palos Hills, a 170-bed skilled care facility at 10426 S. Roberts Road in Palos Hills, was fined $25,000 for failing to transcribe treatment orders and failing to follow a physician's treatment orders for wound care.


Bria of Palos Hills was also fined $12,500 for failing to ensure that a newly admitted resident was prescribed anti-seizure medication at a therapeutic level.


Bria of Westmont, a 215-bed skilled care facility at 6501 S. Cass Ave. in Westmont, was fined $25,000 for failing to monitor a patient's dialysis catheter access site.


Briar Place Nursing, a 144-bed skilled care facility at 6800 Joliet Road in Indian Head Park, was fined a total of $50,000 failing to follow its discharge and transfer policy by not communicating with the appropriate person at the receiving facility, failing to forward medical record documentation and discharge paperwork, and failing to ensure the receiving facility could meet the medical and psychosocial needs of the patient.


Champaign Urbana Nursing and Rehab, a 213-bed skilled care facility at 302 W. Burwash Ave. in Savoy, was fined $25,000 for failing to prevent the verbal and physical abuse of a resident.


Charter Senior Living Poplar Creek, a 118-bed facility at 2150 W. Golf Road in Hoffman Estates, was fined $25,000 for failing to test vaccinated and unvaccinated staff during a COVID-19 outbreak and also failing to ensure staff wore proper PPE during the outbreak.


Chicago Ridge Skilled Nursing Facility, a 231-bed skilled care facility at 10602 Southwest Highway in Chicago Ridge, was fined $25,000, failing to ensure supervision and monitoring of a resident with a cognitive impairment and swallowing difficulties were implemented.


The Citadel of Northbrook, a 158-skilled care facility at 3300 Milwaukee Ave. in Northbrook, was fined $2,200 for failing to transfer a resident using a mechanical lift.


City View Multicare Center, a 337-bed skilled care facility at 5825 W. Cermak Road in Cicero, was fined $25,000 for failing to call 911 in a timely manner during a medical emergency and failing to have a system in place to detect when a resident has unauthorized medication or contraband in their possession.


Countryside Nursing & Rehab Center, a 100-bed skilled care facility at 1635 E. 154th St. in Dolton, was fined $25,000 for failing to follow their medication administration practice to ensure medications are swallowed.


Elmwood Nursing & Rehab Center, a 91-bed skilled care facility at 152 Wilma Drive in Maryville, was fined $25,000 for failing to complete the required Targeted COVID-19 Training for Frontline Nursing and Management Staff.


Gardenview Manor, a 213-bed skilled care facility at 14792 Catlin-Tilton Road in Danville, was fined $25,000 for failing to recognize an emergent change in a resident's condition and failing to provide timely medical evaluation, care, and intervention.


Generations at Elmwood Park, a 245-bed skilled care facility at 7733 W. Grand Ave. in Elmwood Park, was fined $25,000 for failing to provide supervision and assistance were provided to prevent a fall of a resident.


Generations at Oakton Pavillion, a 294-bed skilled care facility at 1660 Oakton Place in Des Plaines, was fined $25,000 for failing to provide a resident with assistance during transfer and failing to prevent a fall.


Generations at Peoria, a 144-bed facility at 5600 Glen Drive in Peoria, was fined $25,000 for failing to recognize and take immediate action for a critical change in a resident's condition.


Granite Nursing & Rehab Center, an 86-bed skilled care facility at 3500 Century Drive in Granite City, was fined $25,000 for failing to document falls and assess and monitor and implement safety measures of residents.


The Grove of Berwyn, a 145-bed skilled care facility at 3601 S. Harlem Ave. in Berwyn, was fined $25,000 for failing to ensure that residents were free from neglect by failing to prevent pressure ulcers.


The Grove of Elmhurst, a 176-bed skilled care facility at 127 W. Diversey Ave. in Elmhurst, was fined $25,000 for failing to notify the physician and seek medical care for a resident in rapidly declining condition.


Hallmark Healthcare of Pekin, a 71-bed skilled care facility at 2501Allentown Road in Pekin, was fined $25,000 for failing to prevent a resident from falling off a bed.



Helia Healthcare of Belleville, a 122-bed skilled care facility at 40 N. 64th St. in Belleville, was fined $25,000 for failing to provide adequate monitoring during capping/weaning off of a ventilator for a resident.


Helia Healthcare of Olney, a 118-bed skilled care facility at 410 E. Mack Ave. in Olney, was fined $25,000 for failing to prevent the elopement of a resident.


Heritage Health Bloomington, an 88-bed skilled care facility at 700 E. Walnut St. in Bloomington, was fined $25,000 for failing to follow its infection control policy to prevent the spread of COVID-19.


Heritage Health Mt. Zion, a 71-bed skilled care facility at 1225 Woodland Drive in Mt. Zion, was fined $25,000 for failing to provide emergency medical equipment airway breathing for a patient.


Hope Creek Nursing & Rehab, a 245-bed skilled care facility at 4343 Kennedy Drive in East Moline, was fined $50,000 for failing to implement fall interventions to prevent a fall and for failing to implement proper COVID-19 quarantine measures.


Inverness Health & Rehab, a 142-bed skilled care facility at 1800 Colonial Parkway in Inverness, was fined $25,000 for failing to respond in a timely manner to a resident's complaint about pain and for failing to have and individualized plan to prevent a resident's fall.


Loft Rehabilitation & Nursing, a 92-bed skilled care facility at 700 N. Main St. in Eureka, was fined $25,000 for failing to accurately transcribe a prescription for anti-coagulation medication and failing to ensure the resident received the medication.



Mar Ka Nursing Home, a 76-bed skilled care facility at 201 S. 10th St. in Mascoutah, was fined $25,000 for failing to identify residents at risk of falls and implement effective fall prevention measures and failing to provide safe transfers.


Meadows, a 99-bed facility at 3250 S. Plum Grove Road in Rolling Meadows, was fined $10,000 for failing to immediately contact law enforcement after a resident allegedly suffered abuse and was allegedly pushed and injured by a staff member.


Mount Vernon Countryside Manor, a 59-bed skilled care facility at 606 East Illinois 15 in Mt Vernon, was fined $25,000 for failing to provide adequate supervision during an episode of agitation that resulted in a fall.


Mount Vernon Countryside Manor was also fined $25,000 for failing to provide adequate assistance to a resident during transfer resulting in an injury to the resident.


PA Peterson at the Citadel, a 129-bed skilled care facility at 1311 Parkview Ave. in Rockford, was fined $25,000 for failing to ensure a patient was properly identified prior to administering medication to prevent a significant medication error.

Park Pointe Healthcare & Rehab, a 142-bed skilled care facility at 1223 Edgewater Drive in Morris, was fined $25,000 for failing to ensure the safety of a resident who was known to wander.


The Pearl of Naperville, a 118-bed skilled care facility at 200 W. Martin Ave. in Naperville, was fined $25,000 for failing to ensure that a resident was turned safely in bed.


Piatt County Nursing Home, a 100-bed skilled care facility at 1111 N. State St. in Monticello, was fined $25,000 for failing to provide safe supervision for two residents, resulting in falls for both residents.


Pleasant Meadows Senior Living, a 109-bed skilled care facility at 400 W. Washington Ave. in Chrisman, was fined $25,000 for failing to provide safe supervision for a resident, resulting in a traumatic fall.


Rochelle Gardens Care Center, a 74-bed skilled care facility at 1021 Caron Road in Rochelle, was fined $25,000 for failing to protect a resident from physical abuse and failing to incorporate the Identified Offender Report and Recommendation into the offender's care plan.


Sheridan Village Nursing & Rehab, a 128-bed skilled care facility at 5838 N. Sheridan Road in Chicago, was fined $25,000 for failing to provide supervision for a resident, resulting in an elopement.


Sheridan Village Nursing & Rehab was also fined $25,000 for failing to ensure that weekly wound assessments were documented and failing to ensure proper care for two residents with pressure ulcers.


Smith Village, a 93-bed skilled care facility at 2320 W. 113th Place in Chicago, was fined $25,000 for failing to implement policies to minimize patients falls and or injuries, resulting in the fall of a patient.


South Suburban Rehab Center, a 259-bed skilled care facility at 19000 S. Halsted St. in Homewood, was fined $25,000 for failing to provide washcloths and towels to clean a resident.


Southgate Health Care Center, a 106-bed skilled care facility at 900 E. Ninth St. in Metropolis, was fined $25,000 for failing to implement fall interventions and preventing the falls of two residents.


Sparta Terrace, a 16-bed facility at 1501 Melmar Drive in Sparta, was fined $6,250 for failing to correct earlier findings, including performing neurological checks after a head injury and failing to inform the registered nurse when a resident was out of medication.


Symphony at 87th Street, a 210-bed skilled care facility at 2940 W. 87th St. in Chicago, was fined $25,000 for failing to implement fall interventions and preventing the falls of three residents.


Symphony of Bronzeville, a 302-bed skilled care facility at 3400 S. Indiana Ave. in Chicago, was fined $25,000 for failing to provide clinical interventions for pain and failing to address fracture pain for a resident.


Symphony Palos Park, a 129-bed skilled care facility at 12220 S. Will Cook Road in Palos Park, was fined $25,000 for failing to implement safe supervision and fall interventions, resulting in the fall of two residents.


Tri-State Village Nursing & Rehab, a 56-bed skilled care at 2500 E. 175th St. in Lansing, was fined $25,000 for failing to have effective interventions in place to monitor a resident's mental change of condition and failing to notify the physician of the change.


Vandalia Rehab & Health Care, a 59-bed skilled care facility at 1500 W. St. Louis Ave. in Vandalia, was fined $25,000 for failing to maintain resident dignity, and failing to maintain personal hygiene and cleanliness for more than 10 patients.


The Vines at Countryside, a 41-bed facility at 971 Bode Road in Elgin, was fined $25,000 for failing to ensure that residents were transferred in a safe manner to prevent injury.


Warren Barr Liberman, a 240-bed skilled care facility at 9700 Gross Point Road in Skokie, was fined $25,500 for failing to monitor and prevent a confused resident with known exit-seeking behaviors from wandering out of the facility.


Warren Barr North Shore, a 215-bed skilled care facility at 2773 Skokie Valley Road in Highland Park, was fined $25,000 for failing to provide adequate care and services to a patient with an indwelling catheter.


Washington Senior Living, a 122-bed skilled care facility at 1201 Newcastle Road in Washington, was fined $50,000, for failing to perform therapy recommended range of motion exercises and to place a therapy recommended hand device for a patient.


Westmont Manor Health & Rehab, a 149-bed skilled care facility at 512 East Ogden Ave. in Westmont, was fined $25,000 for failing to follow policies and care plan interventions to ensure residents at high risk of falls were being monitored in order to prevent falls.


Willow Rose Rehab & Health, a 98-bed skilled care facility at 410 Fletcher St. in Jerseyville, was fined $25,000 for failing to implement progressive interventions to prevent falls and failed to notify a physician and obtain treatment orders for a patient who had a fall.