Hickory Vlg Nrsg & Rhb

Nursing home · 9246 SOUTH ROBERTS ROAD, Hickory Hills, IL 60457 · Cook County

3★Medicare overall

52cited deficiencies

6harm or jeopardy level

9penalties

Prices

No private-pay rate was reported to HFSRB for this facility, and Illinois publishes no facility websites, so we show none. Ask the facility directly.

Facility

Type: Nursing home
Capacity: 74
State license: 145866
Medicare CCN: 145866
Licensed entity: HICKORY VILLAGE NURSING AND REHABILITATION CENTER LLC
Chain: WISSATI IRREVOCABLE TRUST
Ownership: For profit - Limited Liability company
Phone: (708) 598-4040
Nurse staffing: 2.67 hours per resident per day; 27.9% nursing staff turnover
Medicare ratings: Inspections 3★ · Staffing 2★ · Quality 3★
Official record: Illinois Department of Public Health nursing home pages
Official record: Medicare Care Compare

Other public records for this operator

Penalties

Feb 7, 2025 — IDPH fine (Nursing Home Care Act) ($25,000)
Jan 14, 2025 — Fine ($131,763)
Jan 14, 2025 — Payment Denial · payment denial 1 days
Jan 14, 2025 — IDPH fine (Nursing Home Care Act) ($25,000)
May 16, 2024 — IDPH fine (Nursing Home Care Act) ($500)
Jan 25, 2024 — Fine ($79,590)
Jan 25, 2024 — IDPH fine (Nursing Home Care Act) ($2,200)
Nov 2, 2023 — IDPH fine (Nursing Home Care Act) ($2,200)
Nov 2, 2023 — Fine ($139,319)

Inspection findings

Jun 17, 2025 Health · 1 finding
- Not serious Scope/severity F Complaint
  F0921 Environmental Deficiencies
  
  Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
  
  Corrected Jul 2, 2025 · CMS health inspection
Mar 21, 2025 Health · 5 findings
- Not serious Scope/severity D
  F0568 Resident Rights Deficiencies
  
  Properly hold, secure, and manage each resident's personal money which is deposited with the nursing home.
  
  Corrected Apr 8, 2025 · CMS health inspection
- Not serious Scope/severity D
  F0644 Resident Assessment and Care Planning Deficiencies
  
  Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
  
  Corrected Apr 8, 2025 · CMS health inspection
- Not serious Scope/severity E
  K0271 Egress Deficiencies
  
  Have exits that are accessible at all times.
  
  Corrected Mar 21, 2025 · CMS fire safety
- Not serious Scope/severity F
  K0353 Smoke Deficiencies
  
  Inspect, test, and maintain automatic sprinkler systems.
  
  Corrected Jun 10, 2025 · CMS fire safety
- Not serious Scope/severity F
  K0363 Smoke Deficiencies
  
  Install corridor and hallway doors that block smoke.
  
  Corrected Apr 11, 2025 · CMS fire safety
Feb 7, 2025 Health · 2 findings
- Serious Scope/severity J Complaint
  F0689 Quality of Life and Care Deficiencies
  
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  
  Corrected Feb 8, 2025 · CMS health inspection
- Serious Scope/severity A
  Type A Illinois Nursing Home Care Act violation
  
  Type A: substantial probability of death or serious harm, or actual harm (1-129). Sections of the Illinois Administrative Code cited: 300.610a), 300.1210b), 300.1210c), and 300.1210d)3)6). 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 300.1210d)6).
  
  Statement of deficiencies (PDF)
Jan 14, 2025 Health · 3 findings
- Not serious Scope/severity D Complaint
  F0580 Resident Rights Deficiencies
  
  Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
  
  Corrected Jan 31, 2025 · CMS health inspection
- Serious Scope/severity G Complaint
  F0689 Quality of Life and Care Deficiencies
  
  Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  
  Corrected Jan 31, 2025 · CMS health inspection
- Serious Scope/severity A
  Type A Illinois Nursing Home Care Act violation
  
  Type A: substantial probability of death or serious harm, or actual harm (1-129). Sections of the Illinois Administrative Code cited: 300.610a), 300.1210b), 300.1210c), and 300.1210d)6). 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 300.1210d)6).
  
  Statement of deficiencies (PDF)
Dec 19, 2024 Health · 1 finding
- Not serious Scope/severity D Complaint
  F0600 Freedom from Abuse, Neglect, and Exploitation Deficiencies
  
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  
  Corrected Dec 30, 2024 · CMS health inspection
Sep 25, 2024 Health · 4 findings
- Not serious Scope/severity D Complaint
  F0600 Freedom from Abuse, Neglect, and Exploitation Deficiencies
  
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  
  Corrected Oct 22, 2024 · CMS health inspection
- Not serious Scope/severity D Complaint
  F0609 Freedom from Abuse, Neglect, and Exploitation Deficiencies
  
  Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
  
  Corrected Oct 15, 2024 · CMS health inspection
- Not serious Scope/severity D Complaint
  F0656 Resident Assessment and Care Planning Deficiencies
  
  Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
  
  Corrected Oct 15, 2024 · CMS health inspection
- Not serious Scope/severity D Complaint
  F0741 Quality of Life and Care Deficiencies
  
  Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.
  
  Corrected Oct 15, 2024 · CMS health inspection
Jul 19, 2024 Health · 1 finding
- Not serious Scope/severity D Complaint
  F0600 Freedom from Abuse, Neglect, and Exploitation Deficiencies
  
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  
  Corrected Aug 7, 2024 · CMS health inspection
May 16, 2024 Health · 15 findings
- Not serious Scope/severity D
  F0759 Pharmacy Service Deficiencies
  
  Ensure medication error rates are not 5 percent or greater.
  
  Corrected Jun 7, 2024 · CMS health inspection
- Not serious Scope/severity F
  F0812 Nutrition and Dietary Deficiencies
  
  Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  
  Corrected Jun 7, 2024 · CMS health inspection
- Not serious Scope/severity F
  F0882 Infection Control Deficiencies
  
  Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
  
  Corrected Jun 7, 2024 · CMS health inspection
- Not serious Scope/severity F
  K0222 Egress Deficiencies
  
  Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
  
  Corrected Jun 7, 2024 · CMS fire safety
- Not serious Scope/severity E
  K0321 Smoke Deficiencies
  
  Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
  
  Corrected Jun 7, 2024 · CMS fire safety
- Not serious Scope/severity E
  K0324 Smoke Deficiencies
  
  Provide properly protected cooking facilities.
  
  Corrected Jun 7, 2024 · CMS fire safety
- Not serious Scope/severity F
  K0345 Smoke Deficiencies
  
  Have approved installation, maintenance and testing program for fire alarm systems.
  
  Corrected Aug 9, 2024 · CMS fire safety
- Not serious Scope/severity F
  K0353 Smoke Deficiencies
  
  Inspect, test, and maintain automatic sprinkler systems.
  
  Corrected Jun 7, 2024 · CMS fire safety
- Not serious Scope/severity F
  K0355 Smoke Deficiencies
  
  Properly select, install, inspect, or maintain portable fire extinguishes.
  
  Corrected Jun 7, 2024 · CMS fire safety
- Not serious Scope/severity E
  K0362 Smoke Deficiencies
  
  Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
  
  Corrected Jun 7, 2024 · CMS fire safety
- Not serious Scope/severity F
  K0712 Miscellaneous Deficiencies
  
  Have simulated fire drills held at unexpected times.
  
  Corrected Jun 7, 2024 · CMS fire safety
- Not serious Scope/severity F
  K0914 Gas, Vacuum, and Electrical Systems Deficiencies
  
  Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
  
  Corrected Jun 7, 2024 · CMS fire safety
- Not serious Scope/severity F
  K0918 Gas, Vacuum, and Electrical Systems Deficiencies
  
  Have generator or other power source capable of supplying service within 10 seconds.
  
  Corrected Aug 2, 2024 · CMS fire safety
- Not serious Scope/severity F
  K0923 Gas, Vacuum, and Electrical Systems Deficiencies
  
  Have proper medical gas storage and administration areas.
  
  Corrected Jun 7, 2024 · CMS fire safety
- Not serious Scope/severity C
  Type C Illinois Nursing Home Care Act violation
  
  Type C: less than minimal harm (1-132). Sections of the Illinois Administrative Code cited: 300.615e), 300.615f), and 300.615g). This instance in accordance with 300.282f) and j) of the Code is assessed a fine due to the violation of the sections of the Code with a high-risk designation: 300.615e), 300.615f), and 300.615g).
  
  Statement of deficiencies (PDF)
Jan 25, 2024 Health · 2 findings
- Serious Scope/severity J Complaint
  F0600 Freedom from Abuse, Neglect, and Exploitation Deficiencies
  
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  
  Corrected Feb 7, 2024 · CMS health inspection
- Not serious Scope/severity B
  Type B Illinois Nursing Home Care Act violation
  
  Type B: more likely than not to cause more than minimal harm (1-130). Sections of the Illinois Administrative Code cited: 300.610a), 300.1210b), and 300.3210t). 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).
  
  Statement of deficiencies (PDF)
Nov 2, 2023 Health · 5 findings
- Serious Scope/severity J Complaint
  F0600 Freedom from Abuse, Neglect, and Exploitation Deficiencies
  
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  
  Corrected Nov 27, 2023 · CMS health inspection
- Not serious Scope/severity D Complaint
  F0609 Freedom from Abuse, Neglect, and Exploitation Deficiencies
  
  Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
  
  Corrected Nov 27, 2023 · CMS health inspection
- Not serious Scope/severity D Complaint
  F0684 Quality of Life and Care Deficiencies
  
  Provide appropriate treatment and care according to orders, resident’s preferences and goals.
  
  Corrected Nov 27, 2023 · CMS health inspection
- Not serious Scope/severity E Complaint
  F0921 Environmental Deficiencies
  
  Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
  
  Corrected Nov 27, 2023 · CMS health inspection
- Not serious Scope/severity B
  Type B Illinois Nursing Home Care Act violation
  
  Type B: more likely than not to cause more than minimal harm (1-130). Sections of the Illinois Administrative Code cited: 300.610a), 300.1210b), 300.3210t) 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 se vctions of the Code with a high-risk designation: 300.3240e).
  
  Statement of deficiencies (PDF)
Apr 28, 2023 Fire Safety · 13 findings
- Not serious Scope/severity F
  E0007 Emergency Preparedness Deficiencies
  
  Address patient/client population and determine types of services needed.
  
  Corrected Jun 1, 2023 · CMS fire safety
- Not serious Scope/severity D
  F0692 Quality of Life and Care Deficiencies
  
  Provide enough food/fluids to maintain a resident's health.
  
  Corrected May 19, 2023 · CMS health inspection
- Not serious Scope/severity F
  F0812 Nutrition and Dietary Deficiencies
  
  Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
  
  Corrected May 19, 2023 · CMS health inspection
- Not serious Scope/severity F
  F0880 Infection Control Deficiencies
  
  Provide and implement an infection prevention and control program.
  
  Corrected May 19, 2023 · CMS health inspection
- Not serious Scope/severity E
  K0222 Egress Deficiencies
  
  Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
  
  Corrected May 24, 2023 · CMS fire safety
- Not serious Scope/severity E
  K0324 Smoke Deficiencies
  
  Provide properly protected cooking facilities.
  
  Corrected Jun 16, 2023 · CMS fire safety
- Not serious Scope/severity F
  K0345 Smoke Deficiencies
  
  Have approved installation, maintenance and testing program for fire alarm systems.
  
  Corrected May 26, 2023 · CMS fire safety
- Not serious Scope/severity F
  K0353 Smoke Deficiencies
  
  Inspect, test, and maintain automatic sprinkler systems.
  
  Corrected Jun 6, 2023 · CMS fire safety
- Not serious Scope/severity E
  K0355 Smoke Deficiencies
  
  Properly select, install, inspect, or maintain portable fire extinguishes.
  
  Corrected May 26, 2023 · CMS fire safety
- Not serious Scope/severity F
  K0374 Smoke Deficiencies
  
  Install smoke barrier doors that can resist smoke for at least 20 minutes.
  
  Corrected May 26, 2023 · CMS fire safety
- Not serious Scope/severity C
  K0712 Miscellaneous Deficiencies
  
  Have simulated fire drills held at unexpected times.
  
  Corrected Jun 2, 2023 · CMS fire safety
- Not serious Scope/severity F
  K0918 Gas, Vacuum, and Electrical Systems Deficiencies
  
  Have generator or other power source capable of supplying service within 10 seconds.
  
  Corrected Jun 16, 2023 · CMS fire safety
- Not serious Scope/severity E
  K0923 Gas, Vacuum, and Electrical Systems Deficiencies
  
  Have proper medical gas storage and administration areas.
  
  Corrected May 26, 2023 · CMS fire safety

Owners and managers (as published by CMS)

DAVEY, JENNIFER — operational/managerial control, NOT APPLICABLE, since 07/01/2022
DAVEY, JENNIFER — adp of the snf, NOT APPLICABLE, since 07/01/2022
GAUTAM, SAGUN — operational/managerial control, NOT APPLICABLE, since 07/01/2022
GAUTAM, SAGUN — adp of the snf, NOT APPLICABLE, since 07/01/2022
GRASSO, ALBERT — trustee of the snf, NOT APPLICABLE, since 07/01/2022
LIPSHITZ, RITA — adp of the snf, NOT APPLICABLE, since 07/01/2022
LIPSHITZ, RITA — direct ownership interest, NOT APPLICABLE, since 07/01/2022
MASHIACH, RHONDA — direct ownership interest, NOT APPLICABLE, since 07/01/2022
MASHIACH, RHONDA — adp of the snf, NOT APPLICABLE, since 07/01/2022
MASHIACH, YAACOV — direct ownership interest, NOT APPLICABLE, since 07/01/2022
MASHIACH, YAACOV — adp of the snf, NOT APPLICABLE, since 07/01/2022
MASHIACH, YAACOV — operational/managerial control, NOT APPLICABLE, since 07/01/2022
MASHIACH, YECHIEL — operational/managerial control, NOT APPLICABLE, since 07/01/2022
MASHIACH, YECHIEL — direct ownership interest, NOT APPLICABLE, since 07/01/2022
MASHIACH, YECHIEL — adp of the snf, NOT APPLICABLE, since 07/01/2022
MIRETZKY, STEVEN — trustee of the snf, NOT APPLICABLE, since 07/01/2022
JADE FINANCIAL SERVICES LLC — adp of the snf, NOT APPLICABLE, since 07/01/2022
MIDLAND STATES BANCORP INC — 5% or greater security interest, NOT APPLICABLE, since 12/11/2024
WISSATI IRREVOCABLE TRUST — direct ownership interest, NOT APPLICABLE, since 07/01/2022

Sources: CMS's list of certified Illinois nursing homes, IDPH's quarterly nursing home violation reports and the rates facilities reported to HFSRB and CMS Care Compare (nursing homes). “Harm or jeopardy level” is CMS scope/severity G–L. About this data.