Illinois ›Freeport

The Citadel at Saint Joseph Village

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659 East Jefferson Street, Freeport, IL 61032 (opens Google Maps) · Stephenson County · (815) 232-6181· 124 certified beds · avg 91 residents/day · certified since Mar 14, 1997 · Medicare and Medicaid certified

Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →

2/5
Health inspection rating (on-site)
inspected Mar 5, 2026
6
Serious findings on record
most recent Sep 2, 2025
$125,824
Fines, last 3 years
2.72
Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

New to these records? How to read an inspection report →

Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 1/5 · how star ratings work →

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 quality measures from resident assessments and claims.

Most serious findings (actual harm or immediate jeopardy)

▲ Actual harm, isolated · Sep 2, 2025 · F-0689 · triggered by a complaint

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Sep 8, 2025 (Deficient, Provider has date of correction)

▲ Actual harm, isolated · Mar 18, 2025 · F-0689 · triggered by a complaint

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Mar 8, 2025 (Past Non-Compliance)

▲ Actual harm, isolated · Dec 11, 2024 · F-0694

The facility did not safely and appropriately administer IV fluids (fluids given through a vein) for residents who needed them.

Why it matters: Improper IV care can cause infections, dehydration, or dangerous fluid imbalances.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Dec 18, 2024 (Deficient, Provider has date of correction)

▲ Actual harm, isolated · Sep 13, 2024 · F-0689 · triggered by a complaint

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Sep 24, 2024 (Deficient, Provider has date of correction)

▲ Actual harm, isolated · Aug 1, 2024 · F-0689 · triggered by a complaint

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Aug 9, 2024 (Deficient, Provider has date of correction)

▲ Actual harm, isolated · Feb 8, 2024 · F-0686

The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.

Why it matters: Bedsores are painful, can become deeply infected, and in serious cases can be life-threatening.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Mar 13, 2024 (Deficient, Provider has date of correction)

Inspection findings in the public record

Showing the latest 3 of 53 inspection findings. Open the full record below to read every finding.

  1. D · Potential for more than minimal harm, isolated

    The facility did not make sure a transfer or discharge met the resident's needs and preferences, or did not properly prepare the resident to leave safely. · from a complaint F-0627

  2. D · Potential for more than minimal harm, isolated

    The facility did not provide each resident with a nourishing, tasty, well-balanced diet that meets their daily nutritional and special dietary needs. · from a complaint F-0800

  3. E · Potential for more than minimal harm, pattern

    The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · from a complaint F-0755

View all 53 inspection findingsShow only the latest 3 findings

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.

DateSeverityWhat the facility was cited for
Apr 22, 2026D · Potential for more than minimal harm, isolatedThe facility did not make sure a transfer or discharge met the resident's needs and preferences, or did not properly prepare the resident to leave safely. · from a complaint · F-0627
Apr 22, 2026D · Potential for more than minimal harm, isolatedThe facility did not provide each resident with a nourishing, tasty, well-balanced diet that meets their daily nutritional and special dietary needs. · from a complaint · F-0800
Mar 12, 2026E · Potential for more than minimal harm, patternThe facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · from a complaint · F-0755
Mar 5, 2026F · Potential for more than minimal harm, widespreadThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
Mar 5, 2026E · Potential for more than minimal harm, patternThe 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. · F-0550
Mar 5, 2026E · Potential for more than minimal harm, patternThe facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time. · F-0759
Mar 5, 2026E · Potential for more than minimal harm, patternThe 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. · F-0805
Mar 5, 2026E · Potential for more than minimal harm, patternThe facility did not serve meals and snacks at times that fit residents' needs, preferences, and requests, or did not offer nourishing alternatives for residents who want to eat outside scheduled meal times. · F-0809
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe 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. · F-0558
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · F-0684
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe 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. · F-0690
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes. · F-0693
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe facility did not safely and appropriately administer IV fluids (fluids given through a vein) for residents who needed them. · F-0694
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe 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. · F-0695
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · F-0761
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe 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. · F-0880
Dec 6, 2025E · Potential for more than minimal harm, patternThe facility did not provide food that accounts for each resident's allergies, intolerances, and personal preferences, or did not offer appealing alternatives. · from a complaint · F-0806
Sep 2, 2025▲ G · Actual harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Jul 21, 2025D · Potential for more than minimal harm, isolatedThe 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. · from a complaint · F-0550
Jul 21, 2025D · Potential for more than minimal harm, isolatedThe 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. · from a complaint · F-0677
Jul 21, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint · F-0684
Jun 13, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint · F-0684
Jun 10, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · from a complaint · F-0755
May 28, 2025E · Potential for more than minimal harm, patternThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint · F-0684
May 28, 2025D · Potential for more than minimal harm, isolatedThe facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint · F-0609
May 28, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · from a complaint · F-0686
May 28, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · from a complaint · F-0755
Mar 18, 2025▲ G · Actual harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Dec 11, 2024▲ G · Actual harm, isolatedThe facility did not safely and appropriately administer IV fluids (fluids given through a vein) for residents who needed them. · F-0694
Dec 11, 2024E · Potential for more than minimal harm, patternThe 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. · F-0805
Dec 11, 2024E · Potential for more than minimal harm, patternThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
Dec 11, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0550
Dec 11, 2024D · Potential for more than minimal harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689
Dec 11, 2024D · Potential for more than minimal harm, isolatedThe facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time. · F-0759
Dec 11, 2024D · Potential for more than minimal harm, isolatedThe facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · F-0760
Sep 13, 2024▲ G · Actual harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Sep 13, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide the right treatment and services for residents with dementia or signs of dementia. Dementia care requires specific approaches, training, and patience. · from a complaint · F-0744
Aug 1, 2024▲ G · Actual harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Aug 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint · F-0684
May 21, 2024D · Potential for more than minimal harm, isolatedThe facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand. · from a complaint · F-0552
Apr 23, 2024D · Potential for more than minimal harm, isolatedThe facility did not treat residents with respect and dignity, or did not let them keep and use their own personal belongings. · from a complaint · F-0557
Feb 8, 2024▲ G · Actual harm, isolatedThe facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · F-0686
Feb 8, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0550
Feb 8, 2024D · Potential for more than minimal harm, isolatedThe facility did not properly plan a resident's discharge to meet the resident's goals and needs after leaving. · from a complaint · F-0660
Feb 8, 2024D · Potential for more than minimal harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689
Feb 8, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0690
Feb 8, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0695
Feb 8, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. · F-0755
Feb 8, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0880
Nov 9, 2023D · Potential for more than minimal harm, isolatedThe facility did not educate residents and staff about COVID-19 vaccination, offer the vaccine to those eligible after that education, or properly document everyone's vaccination status. · from a complaint · F-0887
Nov 1, 2023D · Potential for more than minimal harm, isolatedThe facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint · F-0610
Oct 10, 2023D · Potential for more than minimal harm, isolatedThe facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · from a complaint · F-0760

Inspection trend by year

Citations from standard inspections increased between the last two inspection cycles (7 → 14).

Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01
All citationsSerious citations (G–L)
2023
All citations: 3
Serious citations (G–L): 0
2024
All citations: 21
Serious citations (G–L): 4
2025
All citations: 12
Serious citations (G–L): 2
2026
All citations: 17
Serious citations (G–L): 0

All bars start at zero. Exact values and supporting details remain below.

YearCitationsSerious (G–L)Worst severity that year
202330D
2024214G ▲
2025122G ▲
2026170F

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)

How to file a complaint about care →

6 fines totaling $125,824, plus 1 Medicare payment denial period.

Every penalty CMS publishes for this facility in the 3-year window is listed —none excluded. The count and the dollar total come from two different CMS datasets and agree for this facility. Penalties older than the window are dropped by CMS before publication, not by us.

DateTypeAmount / length
Sep 2, 2025Fine$15,015
Mar 18, 2025Fine$14,731
Dec 11, 2024Fine$15,004
Sep 13, 2024Fine$12,581
Aug 1, 2024Fine$12,248
Feb 8, 2024Fine$56,245
Feb 8, 2024Payment Denial4 days from Mar 9, 2024

Nurse staffing (from payroll records, adjusted for how much care residents need)

What these staffing numbers mean →

Nurse time, in contextAdjusted hours per resident per day · Source: CMS, 2026-08-01
This facilityIllinois averageU.S. average
Total nurse staffing (hours per resident per day)
This facility: 2.72
Illinois average: 2.99
U.S. average: 3.95
Registered Nurse hours
This facility: 0.37
Illinois average: 0.63
U.S. average: 0.69
Weekend total nurse staffing
This facility: 2.42
Illinois average: 2.67
U.S. average: 3.50

All bars start at zero. Exact values and supporting details remain below.

MeasureThis facilityIllinois avgU.S. avgWhere it stands
Total nurse staffing (hours per resident per day)2.722.993.95top 46% in Illinois; bottom 7% in the U.S.
Registered Nurse hours0.370.630.69bottom 28% in Illinois; bottom 18% in the U.S.
Weekend total nurse staffing2.422.673.50top 48% in Illinois; bottom 7% in the U.S.
Weekend RN hours (not acuity-adjusted)0.240.560.48bottom 13% in Illinois; bottom 19% in the U.S.
Total nursing staff turnover (%)64.944.545.8bottom 8% in Illinois; bottom 10% in the U.S.
RN turnover (%)73.341.842.9bottom 8% in Illinois; bottom 9% in the U.S.

Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — 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 3.26, RN 0.45, weekend 2.89.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.26 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 1/5.

Quality measures: assessments & claims

Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.

Quality measures rating: 4/5 · long-stay residents: 5/5 · short-stay residents: 3/5

Costs & payment

Price evidence · separate from quality

No verified facility-specific private-pay price is available in our data for The Citadel at Saint Joseph Village. CMS inspection and staffing records do not tell us what this home will charge you.

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Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.

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Who owns this facility

How to read ownership records →

Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →

For profit - Corporation

Owner / managerTypeRoleStakeSince
Ownership Data Not Available

All 1 owning or managing party CMS has on file are shown — none excluded.

Questions to ask on your visit

Full visit checklist →

Print visit checklist

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

  • "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
  • "Who on your staff manages IV therapy, and what training and monitoring is in place?"
  • "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
  • "Before a resident is discharged or transferred, how do you make sure the new place can actually meet their needs?"
  • "Can I see a sample menu, and how do you handle special diets like low-sodium or diabetic meals?"
  • "How does your pharmacist review residents' medications, and how quickly can you fill new or urgent prescriptions?"
  • "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
  • "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"

Also worth asking anywhere

  • "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
  • "Can I see the plan of correction for the findings in your most recent state inspection?"
  • "CMS reports 65% total nursing staff turnover here — who on the care team has been with you longest?"
  • "Can I visit again unannounced, at a mealtime or on a weekend?"

Nearby facilities (within 20 miles)

FacilityDistanceCityOverallInspectionFlags
Stephenson Nursing Center1.9 miFreeport, IL★★★☆☆3/5
Pearl Pointe Nursing Rehab & Care3.3 miFreeport, IL★☆☆☆☆1/5
Manor Court of Freeport5.4 miFreeport, IL★★☆☆☆2/5
Serenity Estates of Lena12.8 miLena, IL★★★☆☆4/5
Medina Nursing Center17.6 miDurand, IL★★☆☆☆2/5abuse
Allure of Pinecrest18.9 miMount Morris, IL★★☆☆☆2/5

Compare this facility with the 3 closest →

All facilities in Freeport →

Facility data as of CMS processing date 2026-08-01. CCN 145935.

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