01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-07-03 | 4 | 2025-07-03 | 3 |
| Cycle 2 | 2024-09-13 | 9 | 2024-09-13 | 4 |
| Cycle 3 | 2023-08-31 | 9 | 2023-08-31 | 3 |
CMS CCN 1461782026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Victorian Village Hlth & Well
12525 W Renaissance Circle · Homer Glen, IL 60491 · Will County
Certified beds50CMS provider file
Recent citation rows32current CMS citation release
Penalty rows0current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
32 rows in the current release
1 rows carry G–L scope/severity codes; 0 carry J–L. 7 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-03-26 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2026-03-27 · complaint2025-07-03 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2025-07-042025-07-03 · HEALTHF0808Severity E · pattern; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2025-07-042025-07-03 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2025-07-042025-07-03 · FIREK0321Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Correction field: Deficient, Provider has date of correction · 2025-07-162025-07-03 · FIREK0341Severity E · pattern; potential for more than minimal harm
Smoke Deficiencies
Install a fire alarm system that can be heard throughout the facility.
Correction field: Deficient, Provider has date of correction · 2025-07-162025-07-03 · FIREK0920Severity E · pattern; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Correction field: Deficient, Provider has date of correction · 2025-07-162025-06-05 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2025-06-06 · complaint2025-06-05 · HEALTHF0628Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Correction field: Deficient, Provider has date of correction · 2025-06-06 · complaint2024-09-13 · FIREE0026Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Establish roles under a Waiver declared by secretary.
Correction field: Deficient, Provider has date of correction · 2024-09-192024-09-13 · HEALTHF0658Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Correction field: Deficient, Provider has date of correction · 2024-09-142024-09-13 · HEALTHF0677Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Correction field: Deficient, Provider has date of correction · 2024-09-142024-09-13 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2024-09-142024-09-13 · HEALTHF0760Severity D · isolated; potential for more than minimal harm
Pharmacy Service Deficiencies
Ensure that residents are free from significant medication errors.
Correction field: Deficient, Provider has date of correction · 2024-09-142024-09-13 · HEALTHF0812Severity F · widespread; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-09-142024-09-13 · HEALTHF0880Severity D · isolated; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-09-142024-09-13 · HEALTHF0887Severity F · widespread; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2024-09-142024-09-13 · FIREK0911Severity D · isolated; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Meet requirements for the installation and maintenance of electrical systems.
Correction field: Deficient, Provider has date of correction · 2024-09-192024-09-13 · FIREK0923Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Have proper medical gas storage and administration areas.
Correction field: Deficient, Provider has date of correction · 2024-09-192024-09-13 · FIREK0926Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk.
Correction field: Deficient, Provider has date of correction · 2024-09-192023-08-31 · HEALTHF0558Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Reasonably accommodate the needs and preferences of each resident.
Correction field: Deficient, Provider has date of correction · 2023-09-012023-08-31 · HEALTHF0583Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Keep residents' personal and medical records private and confidential.
Correction field: Deficient, Provider has date of correction · 2023-09-012023-08-31 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2023-09-012023-08-31 · HEALTHF0690Severity D · isolated; potential for more than minimal harm
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.
Correction field: Deficient, Provider has date of correction · 2023-09-0103 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOMEOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 01/26/2015
- BREEMS, TIMIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/2024
- DEGRAFF, DAVEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/2024
- FEENSTRA, THEODOREIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/02/2022
- KATS, STEVENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/2026
- KOLDENHOVEN, ARNOLDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/2024
- LEO, GARYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/2024
- PETROELJE, ROBIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/2024
- VAN ESSEN, DARRENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/02/2022
- VAN SOLKEMA, KEVINIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/2026
- VOSS, DAVIDIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/02/2022
- WOO, ERICIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/2024
- YONKER, KYLEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/02/2022
- OTTE, LARRYIndividual · CORPORATE OFFICERNOT APPLICABLE · since 10/01/2025
- KRIEPS, JAMIEIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/01/2024
- MULKI, M GHAITHIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/01/2024
- ZANDSTRA, JOHANNAIndividual · OPERATIONAL/MANAGERIAL CONTROLNOT APPLICABLE · since 04/01/2024
- REST HAVEN ILLIANA CHRISTIAN CONVALESCENT HOMEOrganization · ADP OF THE SNFNOT APPLICABLE · since 01/26/2015
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours5.25per resident day
RN hours2.01per resident day
Weekend nurse hours4.68per resident day
Staff turnover31.6%CMS reported field
06 / LOCAL RECORDS
Open the Illinois ledger →Other published facilities nearby
No second facility in the same city met the directory rule.