Pa Peterson at the Citadel
Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.
based on 99 Google reviews
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Quality Concerns Identified
Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.
- Low overall rating (2/5 stars)
- Low staffing rating (1/5 stars)
- Above-median deficiencies (15 vs median 11.0)
- High staff turnover (51%)
- High RN turnover (63%)
Below average in IL · Below recommended RN staffing · Above average staffing · Below chain average · $21,212 in fines
What this means for your family
While the facility's physical and occupational therapy programs are frequently praised, the recurring reports of neglect, poor hygiene, and unresponsive staff are significant red flags. If you are considering this facility, we strongly recommend conducting an unannounced visit to check the cleanliness of the rooms and asking management specifically about their current nurse-to-patient ratios and call-light response protocols.
Google Reviews
Google Reviews
99 reviews on Google“PA Peterson at the Citadel receives highly polarized feedback, with many families reporting severe neglect, unsanitary conditions, and chronic understaffing. While some patients praise the physical and occupational therapy teams and specific individual nurses, these positive experiences are frequently overshadowed by reports of unresponsive call lights, poor food quality, and facility maintenance issues.”
Quality Themes
Tap a score for detailsStrengths
- Effective physical and occupational therapy
- Select dedicated and compassionate nursing staff
- Helpful social services support
- Successful short-term rehabilitation outcomes
Concerns
- Unresponsive call lights and delayed patient care (mentioned by 12 reviewers)
- Poor food quality, temperature, and nutritional appropriateness (mentioned by 9 reviewers)
- Unsanitary facility conditions (urine smells, mold, pests) (mentioned by 8 reviewers)
- Chronic understaffing and high staff turnover (mentioned by 7 reviewers)
- Rude or unprofessional front desk and administrative staff (mentioned by 6 reviewers)
Rating Trends
Tap a year to see what changed
Distribution · 100 analyzed
How They Respond to Reviews
This facility rarely responds to reviews.
Questions for Your Tour
- 1Given the current staffing levels, what specific protocols are in place to ensure that call lights are answered promptly and resident needs are met in a timely manner?
- 2I understand that maintaining a clean environment is a priority; could you walk me through your daily housekeeping and sanitation schedule to address concerns regarding facility cleanliness?
- 3Could you share how you are currently working to improve the dining experience and ensure that the food served meets the nutritional and temperature preferences of the residents?
- 4With the facility's focus on rehabilitation, how do you ensure consistent communication between the therapy team and the nursing staff to support a resident's progress?
- 5What steps is the administration taking to improve staff retention and ensure that residents have consistent, familiar faces providing their daily care?
- 6In the event of a medical emergency, what is the specific chain of command and communication process to notify family members immediately?
Personalized based on this facility's data
Key Review Excerpts
“They fast tracked my care, I was doing sometype of physical or occupational therapy upwards of two or three times a day, every day. The staff was wonderful, caring, professional.”
“The girls there on the men too let him do that they give him a sense of duty when he would act out they were kind and loving and when he had a fall I was contacted and they stood by the whole time.”
“They would let his colostomy bag burst and leave him lie in the waste for hours and it got into his wounds and infected them causing sepsis.”
Staffing
Staffing Hours
per resident/day · Medicare 2026Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 17 measures
8
measures
9
measures
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents vaccinated for the flu
Residents on antipsychotic medication
Residents vaccinated for pneumonia
Residents whose walking got worse
Residents who lost too much weight
Short-stay residents vaccinated for the flu
Short-stay residents vaccinated for pneumonia
Short-stay residents newly given antipsychotics
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
This facility shows concerning patterns with frequent family complaints driving inspections, particularly around medication management, daily care assistance, and infection control. Half of the 67 deficiencies were triggered by complaints, indicating ongoing resident and family concerns about care quality. Issues with medication services and basic care appear repeatedly across multiple surveys, suggesting persistent problems despite reported corrections by the facility.
Mar 2, 2026Complaint1
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Dec 2, 2025Complaint1
Pharmacy Service Deficiencies
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Nov 24, 2025Complaint1
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
May 21, 2025Routine12
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
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.
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Infection Control Deficiencies
Develop and implement policies and procedures for flu and pneumonia vaccinations.
May 21, 2025Complaint1
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Dec 13, 2024Complaint1
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Federal Penalties
Fine
Jul 10, 2024
$21,212
Ownership & Operations
Who Operates This Facility
Pa Peterson at the Citadel
for profit
Chain Affiliation
Citadel Healthcare
13 facilities nationwide
Chain avg rating: 3.1/5 · Rank 10 of 13
Ownership & Management
Owners
Kohen, Tsipporah
Owner
Key personnel
Contact
Get in Touch
Contact this facility directly and verify the details that matter most to your family.
References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
99 reviews from families & visitors
Medicare data downloads
Original nursing home datasets
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Safer Alternatives Nearby
Based on current clinical data, we identified 6 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.
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