Citadel Care Center-Kankakee
900 West River Place, Kankakee, IL 60901 · Kankakee County · 107 certified beds · avg 92 residents/day · certified since Jan 1, 1967
Part of chain: CITADEL HEALTHCARE (14 facilities, chain avg rating 3.2★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★★☆4/5 · CMS overall rating: 4/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Actual harm, one-off · Jan 12, 2024 · F-0697
The facility did not provide safe and appropriate pain management for a resident who needed it.
Why it matters: Untreated pain causes needless suffering and can lead to depression, poor sleep, and declining health.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Jan 31, 2024 (Deficient, Provider has date of correction)
All citations in the current public record (23)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Nov 22, 2024 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Nov 22, 2024 | F · Potential for harm, facility-wide | The facility's quality committee — the internal group responsible for finding and fixing care problems — did not have the required members or did not meet at least every three months. |
| Nov 22, 2024 | D · Potential for harm, one-off | The facility did not treat residents with respect and dignity, or did not let them keep and use their own personal belongings. |
| Nov 22, 2024 | D · Potential for harm, one-off | The facility did not give residents proper notice about what Medicare or Medicaid covers, or about charges the resident might owe for services that aren't covered. |
| Nov 22, 2024 | D · Potential for harm, one-off | The facility did not give residents (and their representatives and the ombudsman, a state advocate for residents) proper advance notice before a transfer or discharge, including information about their right to appeal. |
| Nov 22, 2024 | D · Potential for harm, one-off | The facility did not give the resident or their representative written notice of how long it would hold the resident's bed during a hospital stay or approved leave. |
| Nov 22, 2024 | D · Potential for harm, one-off | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. |
| Nov 22, 2024 | D · Potential for harm, one-off | The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline. |
| Nov 22, 2024 | D · Potential for harm, one-off | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. |
| Jan 31, 2024 | D · Potential for harm, one-off | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint |
| Jan 12, 2024 | ▲ G · Actual harm, one-off | The facility did not provide safe and appropriate pain management for a resident who needed it. |
| Jan 12, 2024 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Jan 12, 2024 | E · Potential for harm, repeated | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. |
| Jan 12, 2024 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Jan 12, 2024 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. |
| Jan 12, 2024 | D · Potential for harm, one-off | The facility did not make reasonable adjustments to fit each resident's individual needs and preferences — things like call buttons within reach, preferred wake-up times, or accessible room setups. |
| Jan 12, 2024 | D · Potential for harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. |
| Jan 12, 2024 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Apr 6, 2023 | E · Potential for harm, repeated | The facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. |
| Apr 6, 2023 | E · Potential for harm, repeated | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. |
| Apr 6, 2023 | E · Potential for harm, repeated | The facility did not prepare and serve food in a form that meets each resident's individual needs — for example, chopped, pureed, or softened food for residents with chewing or swallowing problems. |
| Apr 6, 2023 | D · Potential for harm, one-off | The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline. |
| Apr 6, 2023 | D · Potential for harm, one-off | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
Inspection trend by year
Citations from standard inspections stayed about the same across the last two inspection cycles (8 → 9).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 5 | 0 | E |
| 2024 | 18 | 1 | G ▲ |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
No fines or payment denials in the published 3-year window.
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Illinois avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 2.29 | 2.99 | 3.95 | bottom 22% in Illinois; bottom 2% in the U.S. |
| Registered Nurse hours | 0.28 | 0.63 | 0.69 | bottom 13% in Illinois; bottom 8% in the U.S. |
| Weekend total nurse staffing | 2.09 | 2.67 | 3.50 | bottom 26% in Illinois; bottom 2% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.34 | 0.56 | 0.48 | bottom 29% in Illinois; bottom 40% in the U.S. |
| Total nursing staff turnover (%) | 33.7 | 44.5 | 45.8 | top 22% in Illinois; top 21% in the U.S. |
| RN turnover (%) | 25.0 | 41.8 | 42.9 | top 23% in Illinois; top 20% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.23, RN 0.40, weekend 2.95. Staffing rating: 2/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 2/5 · long-stay residents: 4/5 · short-stay residents: 1/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Graf, Marcella | Individual | Direct Ownership Interest | NOT APPLICABLE | 12/15/2023 |
| Gross, Shoshana | Individual | Direct Ownership Interest | NOT APPLICABLE | 12/15/2023 |
| Kohen, Yakov | Individual | Direct Ownership Interest | NOT APPLICABLE | 12/15/2023 |
| Kroll, Gabriel | Individual | Direct Ownership Interest | NOT APPLICABLE | 12/15/2023 |
| Nagel, Steven | Individual | Direct Ownership Interest | NOT APPLICABLE | 12/15/2023 |
| Ollman, Jonathan | Individual | Direct Ownership Interest | NOT APPLICABLE | 04/01/2023 |
| Proctor, Katherine | Individual | Direct Ownership Interest | NOT APPLICABLE | 12/15/2023 |
| Teller, Ilana | Individual | Direct Ownership Interest | NOT APPLICABLE | 12/15/2023 |
| Aaron, Jonathan | Individual | Operational/Managerial Control | NOT APPLICABLE | 12/15/2023 |
| Adams Carr, Macaela | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/31/2024 |
| Adams Carr, Macaela | Individual | ADP of the SNF | NOT APPLICABLE | 03/31/2024 |
| Berger, Menachem | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 04/07/2025 |
| Graf, Marcella | Individual | Operational/Managerial Control | NOT APPLICABLE | 12/15/2023 |
| Graf, Marcella | Individual | ADP of the SNF | NOT APPLICABLE | 12/15/2023 |
| Israel, Benjamin | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 04/07/2025 |
| Robin, Jason | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/01/2024 |
| Robin, Jason | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2024 |
| Stern, Todd | Individual | Individual Is an Owner, Partner or Trustee of Any ADP of the SNF | NOT APPLICABLE | 04/07/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "How do you assess and manage residents' pain, especially for those who have trouble communicating?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "How does your quality committee work, and can you share an example of a problem it identified and fixed?"
- "How do you train staff to treat residents with dignity, and how do you protect residents' personal belongings?"
- "Before any service that isn't covered by Medicare or Medicaid, how will you notify us and get our agreement?"
- "If you ever planned to discharge or transfer my family member, how much written notice would we receive and how could we appeal?"
- "If my family member goes to the hospital, how long will you hold their bed, and will we get that in writing?"
- "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Miller Health Care Center | 0.5 mi | Kankakee, IL | ★★☆☆☆ | 2/5 | |
| Arc at Kankakee | 0.5 mi | Kankakee, IL | ★★★☆☆ | 3/5 | |
| Citadel of Bourbonnais,the | 2.2 mi | Bourbonnais, IL | ★★★☆☆ | 4/5 | |
| Arc at Bradley | 2.3 mi | Bradley, IL | ★☆☆☆☆ | 2/5 | |
| Momence Meadows Nursing & Rehab | 11.5 mi | Momence, IL | ★☆☆☆☆ | 2/5 | abuse |
| La Bella at Clifton | 13.7 mi | Clifton, IL | ★☆☆☆☆ | 2/5 | |
| Aperion Care Wilmington | 18.0 mi | Wilmington, IL | ★☆☆☆☆ | 1/5 | abuse |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 145043.