Skilled nursing facility · CMS certification number 146178
VICTORIAN VILLAGE HLTH & WELL
HOMER GLEN, Illinois · Medicare
Certified beds, as filed in Care Compare: 50
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
In Care Compare’s provider information: Penalties: 0 · Fines: 0 · Fines, total amount: $0.00 · Payment denials: 0. Every penalty on file ↓
For this facility: the citable document with full history — $295 · an email when this record changes — $99/month
Finances, as filed
From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.
Cost report for January 1, 2024 to December 31, 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on September 15, 2025.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,388,718 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $890,980 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $10,497,738 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $11,405,001 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$907,263 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$907,263 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$907,263 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 54 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 19,764 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicare (Title XVIII) patient days | 9,127 | CMS-2540-10 worksheet S300001 line 800 column 400 |
| Other-payer patient days | 8,670 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 17,797 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicare discharges | 459 | CMS-2540-10 worksheet S300001 line 800 column 900 |
| Other-payer discharges | 76 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 535 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 19.88 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 33.27 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1439560, read from the public cost report file SNF10FY2024.zip.
Fiscal year 2023, ended December 31, 2023
Cost report for January 1, 2023 to December 31, 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 20, 2024.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $11,141,998 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,373,743 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,768,255 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $10,131,298 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$363,043 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$363,043 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$363,043 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,525 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 497 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.07 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 35.26 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1392589, read from the public cost report file SNF10FY2023.zip.
Fiscal year 2022, ended December 31, 2022
Cost report for January 1, 2022 to December 31, 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 9, 2023.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,894,211 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,525,491 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,368,720 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,710,571 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$341,851 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Net income after other income | −$341,851 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$341,851 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,989 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 503 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.52 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 33.78 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1364103, read from the public cost report file SNF10FY2022.zip.
Fiscal year 2021, ended December 31, 2021
Cost report for January 1, 2021 to December 31, 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on September 16, 2022.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,772,609 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,550,019 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,222,590 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $9,645,251 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$422,661 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $19,220 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$403,441 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$403,441 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,775 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 554 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 20.83 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 30.28 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1331908, read from the public cost report file SNF10FY2021.zip.
Fiscal year 2020, ended December 31, 2020
Cost report for January 1, 2020 to December 31, 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on November 16, 2021.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,367,475 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $945,509 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,421,966 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,832,785 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$410,819 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $578,599 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $167,780 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $167,780 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,367 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 455 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 23.28 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 35.97 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1304538, read from the public cost report file SNF10FY2020.zip.
Fiscal year 2019, ended December 31, 2019
Cost report for January 1, 2019 to December 31, 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on November 17, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,816,941 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,767,259 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $9,049,682 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,890,321 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $159,361 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $66,408 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $225,769 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $225,769 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 17,434 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 646 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 19.08 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 26.99 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1273820, read from the public cost report file SNF10FY2019.zip.
Fiscal year 2018, ended December 31, 2018
Cost report for January 1, 2018 to December 31, 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on December 24, 2020.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $10,323,211 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,946,033 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $8,377,178 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $8,746,892 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$369,714 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,280 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$368,434 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$368,434 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,555 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 796 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 17.3 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 20.8 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1277434, read from the public cost report file SNF10FY2018.zip.
Fiscal year 2017, ended December 31, 2017
Cost report for January 1, 2017 to December 31, 2017 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 21, 2018.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $9,470,892 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $1,507,667 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,963,225 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,964,406 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$1,181 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,909 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $728 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $728 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,338 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 590 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 17.45 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 27.69 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1207898, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended December 31, 2016
Cost report for January 1, 2016 to December 31, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on September 8, 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $7,649,442 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $118,202 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $7,531,240 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $7,555,706 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$24,466 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | −$16,943 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$41,409 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$50,133 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 16,810 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 601 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.49 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 27.97 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1175499, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended December 31, 2015
Cost report for May 1, 2015 to December 31, 2015 — a reporting period of 244 days, not a full year, on form CMS-2540-10, settled, processed by CMS on September 30, 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $4,144,246 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $25,369 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $4,118,877 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $4,148,883 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$30,006 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,847 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$27,159 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$40,209 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 50 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 9,601 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 252 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 22.46 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, all patients, in days | 38.1 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1143117, read from the public cost report file SNF10FY2015.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
Care Compare
As filed in the CMS file dated September 1, 2026 (Care Compare ownership).
| Owner or manager | Role | Type | Ownership percentage | Association |
|---|---|---|---|---|
| REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME | 5% OR GREATER DIRECT OWNERSHIP INTEREST | Organization | 100% | since 01/26/2015 |
| KRIEPS, JAMIE | ADP OF THE SNF | Individual | NOT APPLICABLE | since 02/07/2025 |
| MULKI, M GHAITH | ADP OF THE SNF | Individual | NOT APPLICABLE | since 04/01/2024 |
| REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME | ADP OF THE SNF | Organization | NOT APPLICABLE | since 01/26/2015 |
| BREEMS, TIM | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/01/2024 |
| DEGRAFF, DAVE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/01/2024 |
| FEENSTRA, THEODORE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/02/2022 |
| KATS, STEVEN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/01/2026 |
| KOLDENHOVEN, ARNOLD | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/01/2024 |
| LEO, GARY | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/01/2024 |
| PETROELJE, ROB | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/01/2024 |
| VAN ESSEN, DARREN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/02/2022 |
| VAN SOLKEMA, KEVIN | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/01/2026 |
| VOSS, DAVID | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/02/2022 |
| WOO, ERIC | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/01/2024 |
| YONKER, KYLE | CORPORATE DIRECTOR | Individual | NOT APPLICABLE | since 04/02/2022 |
| OTTE, LARRY | CORPORATE OFFICER | Individual | NOT APPLICABLE | since 10/01/2025 |
| KRIEPS, JAMIE | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/01/2024 |
| MULKI, M GHAITH | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/01/2024 |
| ZANDSTRA, JOHANNA | OPERATIONAL/MANAGERIAL CONTROL | Individual | NOT APPLICABLE | since 04/01/2024 |
Medicare enrollment
As filed in the CMS file dated August 1, 2026 (Medicare enrollment ownership), under the enrollment of REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME (enrollment ID O20150415001911).
CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; where the private equity, real estate investment trust or holding company field below has not been filed under the current cycle, it reads “Paused by CMS”.
| Owner | Individual or organization | Role | Ownership percentage | Association date | Described in the filing as |
|---|---|---|---|---|---|
| REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST | 100 | 1/26/2015 | Private equity company: No Real estate investment trust: No Holding company: No |
| JAMIE L KRIEPS | Individual | ADP OF THE SNF | Not stated in the filing | 2/7/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| M GHAITH MULKI | Individual | ADP OF THE SNF | Not stated in the filing | 4/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME | Organization | ADP OF THE SNF | Not stated in the filing | 1/26/2015 | Private equity company: No Real estate investment trust: No Holding company: No |
| ARNOLD KOLDENHOVEN | Individual | CORPORATE DIRECTOR | 0 | 4/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DARREN VAN ESSEN | Individual | CORPORATE DIRECTOR | 0 | 4/2/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DAVE DEGRAFF | Individual | CORPORATE DIRECTOR | 0 | 4/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| DAVID VOSS | Individual | CORPORATE DIRECTOR | 0 | 4/2/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ERIC M WOO | Individual | CORPORATE DIRECTOR | 0 | 4/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| GARY W LEO | Individual | CORPORATE DIRECTOR | 0 | 4/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KEVIN VAN SOLKEMA | Individual | CORPORATE DIRECTOR | 0 | 4/1/2026 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| KYLE YONKER | Individual | CORPORATE DIRECTOR | 0 | 4/2/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| ROB PETROELJE | Individual | CORPORATE DIRECTOR | 0 | 4/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| STEVEN KATS | Individual | CORPORATE DIRECTOR | 0 | 4/1/2026 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| THEODORE EARLE FEENSTRA | Individual | CORPORATE DIRECTOR | 0 | 4/2/2022 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| TIM BREEMS | Individual | CORPORATE DIRECTOR | 0 | 4/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| LARRY JAY OTTE | Individual | CORPORATE OFFICER | 0 | 10/1/2025 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JAMIE L KRIEPS | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 4/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| JOHANNA ZANDSTRA | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 4/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
| M GHAITH MULKI | Individual | OPERATIONAL/MANAGERIAL CONTROL | Not stated in the filing | 4/1/2024 | Private equity company: Paused by CMS Real estate investment trust: Paused by CMS Holding company: Paused by CMS |
Changes in ownership
- August 1, 2026: KENNETH ALAN HOVING no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: PATRICIA L JABAAY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: KAREN HUIZENGA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: BARRY VANDERGENUGTEN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: EDWARD DAMSTRA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: PAUL BUIKEMA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: KEVIN VAN SOLKEMA (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2026; associated with this enrollment since April 1, 2026. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: STEVEN KATS (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2026; associated with this enrollment since April 1, 2026. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: LARRY JAY OTTE (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on August 1, 2026; associated with this enrollment since October 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- April 1, 2025: WILLIAM ZANDSTRA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: EMILY MCMASTER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: SHERYL HAMMER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: BARRY VANDERGENUGTEN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: ROGER BOEREMA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JACOB J GROENEWOLD no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: PAUL KATS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JACKIE TERPSTRA no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JOHANNA ZANDSTRA no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: DAVE DEGRAFF (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: ROB PETROELJE (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: ARNOLD KOLDENHOVEN (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: GARY W LEO (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: TIM BREEMS (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: M GHAITH MULKI (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: M GHAITH MULKI (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: ERIC M WOO (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: BARRY VANDERGENUGTEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since May 31, 2001. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JAMIE L KRIEPS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since February 7, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JAMIE L KRIEPS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JOHANNA ZANDSTRA (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 26, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
Recent changes on this record
- August 1, 2026: KENNETH ALAN HOVING no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: PATRICIA L JABAAY no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: KAREN HUIZENGA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: BARRY VANDERGENUGTEN no longer appears as OPERATIONAL/MANAGERIAL CONTROL in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: EDWARD DAMSTRA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: PAUL BUIKEMA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: KEVIN VAN SOLKEMA (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2026; associated with this enrollment since April 1, 2026. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: STEVEN KATS (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on August 1, 2026; associated with this enrollment since April 1, 2026. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- August 1, 2026: LARRY JAY OTTE (CORPORATE OFFICER) first listed in CMS’s Medicare enrollment ownership file on August 1, 2026; associated with this enrollment since October 1, 2025. Skilled_Nursing_Facility_All_Owners_:_2026-08-01.csv
- September 15, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. SNF10FY2024.zip
- April 1, 2025: WILLIAM ZANDSTRA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: EMILY MCMASTER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: SHERYL HAMMER no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: BARRY VANDERGENUGTEN no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: ROGER BOEREMA no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JACOB J GROENEWOLD no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: PAUL KATS no longer appears as CORPORATE DIRECTOR in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JACKIE TERPSTRA no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JOHANNA ZANDSTRA no longer appears as W-2 MANAGING EMPLOYEE in the Medicare enrollment ownership file. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: DAVE DEGRAFF (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: ROB PETROELJE (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: ARNOLD KOLDENHOVEN (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: GARY W LEO (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: TIM BREEMS (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: M GHAITH MULKI (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: M GHAITH MULKI (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: ERIC M WOO (CORPORATE DIRECTOR) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: BARRY VANDERGENUGTEN (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since May 31, 2001. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JAMIE L KRIEPS (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since February 7, 2025. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JAMIE L KRIEPS (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: JOHANNA ZANDSTRA (OPERATIONAL/MANAGERIAL CONTROL) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since April 1, 2024. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- April 1, 2025: REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME (ADP OF THE SNF) first listed in CMS’s Medicare enrollment ownership file on April 1, 2025; associated with this enrollment since January 26, 2015. Skilled_Nursing_Facility_All_Owners_:_2025-04-01.csv
- August 20, 2024: A cost report was filed for fiscal year 2023, on form CMS-2540-10. SNF10FY2023.zip
- September 9, 2023: A cost report was filed for fiscal year 2022, on form CMS-2540-10. SNF10FY2022.zip
- September 16, 2022: A cost report was filed for fiscal year 2021, on form CMS-2540-10. SNF10FY2021.zip
- November 16, 2021: A cost report was filed for fiscal year 2020, on form CMS-2540-10. SNF10FY2020.zip
- December 24, 2020: A cost report was filed for fiscal year 2018, on form CMS-2540-10. SNF10FY2018.zip
- November 17, 2020: A cost report was filed for fiscal year 2019, on form CMS-2540-10. SNF10FY2019.zip
- August 21, 2018: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- September 8, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
Inspections
| Inspection cycle | Health inspection | Fire safety inspection | Health deficiencies | Fire safety deficiencies |
|---|---|---|---|---|
| 1 | July 3, 2025 | July 3, 2025 | 4 | 3 |
| 2 | September 13, 2024 | September 13, 2024 | 9 | 4 |
| 3 | August 31, 2023 | August 31, 2023 | 9 | 3 |
From the Care Compare inspection summary file NH_SurveySummary_Sep2026_2.csv, processed on September 1, 2026.
Deficiencies cited
22 deficiencies on file, newest inspection first
| Inspection date | Inspection type | Tag | Category | What was cited | Scope and severity | Complaint | Corrected | Correction date |
|---|---|---|---|---|---|---|---|---|
| March 26, 2026 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | Yes | Deficient, Provider has date of correction | March 27, 2026 |
| July 3, 2025 | Health | F 0689 | Quality of Life and Care Deficiencies | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | No | Deficient, Provider has date of correction | July 4, 2025 |
| July 3, 2025 | Health | F 0808 | Nutrition and Dietary Deficiencies | Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | E | No | Deficient, Provider has date of correction | July 4, 2025 |
| July 3, 2025 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | E | No | Deficient, Provider has date of correction | July 4, 2025 |
| June 5, 2025 | Health | F 0583 | Resident Rights Deficiencies | Keep residents' personal and medical records private and confidential. | D | Yes | Deficient, Provider has date of correction | June 6, 2025 |
| June 5, 2025 | Health | F 0628 | Resident Rights Deficiencies | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | Yes | Deficient, Provider has date of correction | June 6, 2025 |
| September 13, 2024 | Health | F 0658 | Resident Assessment and Care Planning Deficiencies | Ensure services provided by the nursing facility meet professional standards of quality. | D | No | Deficient, Provider has date of correction | September 14, 2024 |
| September 13, 2024 | Health | F 0677 | Quality of Life and Care Deficiencies | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | No | Deficient, Provider has date of correction | September 14, 2024 |
| September 13, 2024 | Health | F 0690 | Quality of Life and Care Deficiencies | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | No | Deficient, Provider has date of correction | September 14, 2024 |
| September 13, 2024 | Health | F 0760 | Pharmacy Service Deficiencies | Ensure that residents are free from significant medication errors. | D | No | Deficient, Provider has date of correction | September 14, 2024 |
| September 13, 2024 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | September 14, 2024 |
| September 13, 2024 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | September 14, 2024 |
| September 13, 2024 | Health | F 0887 | Infection Control Deficiencies | Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status. | F | No | Deficient, Provider has date of correction | September 14, 2024 |
| August 31, 2023 | Health | F 0558 | Resident Rights Deficiencies | Reasonably accommodate the needs and preferences of each resident. | D | No | Deficient, Provider has date of correction | September 1, 2023 |
| August 31, 2023 | Health | F 0583 | Resident Rights Deficiencies | Keep residents' personal and medical records private and confidential. | D | No | Deficient, Provider has date of correction | September 1, 2023 |
| August 31, 2023 | Health | F 0688 | Quality of Life and Care Deficiencies | Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason. | D | No | Deficient, Provider has date of correction | September 1, 2023 |
| August 31, 2023 | Health | F 0690 | Quality of Life and Care Deficiencies | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | No | Deficient, Provider has date of correction | September 1, 2023 |
| August 31, 2023 | Health | F 0695 | Quality of Life and Care Deficiencies | Provide safe and appropriate respiratory care for a resident when needed. | D | No | Deficient, Provider has date of correction | September 1, 2023 |
| August 31, 2023 | Health | F 0808 | Nutrition and Dietary Deficiencies | Ensure therapeutic diets are prescribed by the attending physician and may be delegated to a registered or licensed dietitian, to the extent allowed by State law. | E | No | Deficient, Provider has date of correction | September 1, 2023 |
| August 31, 2023 | Health | F 0812 | Nutrition and Dietary Deficiencies | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | F | No | Deficient, Provider has date of correction | September 1, 2023 |
| August 31, 2023 | Health | F 0880 | Infection Control Deficiencies | Provide and implement an infection prevention and control program. | D | No | Deficient, Provider has date of correction | September 1, 2023 |
| August 31, 2023 | Health | F 0925 | Environmental Deficiencies | Make sure there is a pest control program to prevent/deal with mice, insects, or other pests. | E | No | Deficient, Provider has date of correction | September 1, 2023 |
From the Care Compare health citations file NH_HealthCitations_Sep2026_2.csv, processed on September 1, 2026.
Penalties
No penalty on file for this facility in CMS’s Care Compare penalties data.
Care Compare provider information
| Field | As filed |
|---|---|
| Provider Type | Medicare |
| Ownership Type | Non profit - Corporation |
| Legal Business Name | REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOME |
| Date First Approved to Provide Medicare and Medicaid Services | 2015-05-01 |
| Provider Resides in Hospital | N |
| Continuing Care Retirement Community | N |
| Urban | Y |
| County/Parish | Will |
| Telephone Number | 7085905050 |
| Provider Changed Ownership in Last 12 Months | N |
| With a Resident and Family Council | Resident |
| Automatic Sprinkler Systems in All Required Areas | Yes |
| Number of Certified Beds | 50 |
| Average Number of Residents per Day | 52.2 |
| Overall Rating | 5 |
| Health Inspection Rating | 4 |
| QM Rating | 3 |
| Long-Stay QM Rating | 3 |
| Short-Stay QM Rating | 3 |
| Processing Date | 2026-09-01 |
From the Care Compare Provider Information file NH_ProviderInfo_Sep2026_3.csv, processed on September 1, 2026.
Get an email when this record changes
One email a day naming what moved on VICTORIAN VILLAGE HLTH & WELL: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On September 15, 2025: A cost report was filed for fiscal year 2024, on form CMS-2540-10. That is one line of the alert.
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The citable document for VICTORIAN VILLAGE HLTH & WELL
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in Illinois at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
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Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 146178.