4452 Squaw Prairie Road, Belvidere, IL 61008 · Boone County · (815) 547-6377
86 certified beds, about 69 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 2000
CMS Care Compare ratings, data as of September 1, 2026 · CCN 145990 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on September 25, 2025, inspectors cited 9 health deficiencies (the Illinois average is 12.6, the national average 9.2).
Of 44 health citations since October 2023, 5 were rated as actual harm or immediate jeopardy to residents (2 immediate jeopardy).
CMS lists 4 fines totaling $399,325 in the last three years; the largest was $195,340, and the latest is dated May 26, 2026.
Nurses and nurse aides worked 2.85 hours per resident per day, against 3.45 across Illinois and 3.86 nationally. Registered nurses accounted for 0.40 of those hours.
53.4% of nursing staff left within the year CMS measured (Illinois average 44.5%).
CMS links it to Symphony Care Network, an affiliated group of 7 nursing homes.
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 44 health citations on file.
Inspectors wroteBased on interview and record review the facility failed to ensure call lights were answered in a timely manner for 7 of 7 residents (R1-R7) who require assistance from staff reviewed for activities of daily living in the sample of 7.
Inspectors wroteBased on interview and record review the facility failed to ensure medications were administered as ordered for 1 of 3 residents (R1) reviewed for medication administration in the sample of 7.
Inspectors wroteBased on interview and record review the facility failed to ensure a resident was provided a shower or bed bath. This applies to 1 of 3 residents (R1) reviewed for showers in the sample of 3.
Inspectors wroteBased on interview and record review the facility failed to ensure residents were protected from potential abuse when a non-staff individual, who was not screened, trained or authorized by the facility, was permitted to provide resident care including incontinence care, transfers and assisting residents to change clothes for 4 of 4 residents (R4, R5, R6, and R7) reviewed for abuse in the sample of 8. The Immediate Jeopardy began on 5/10/2026 when V5 (Non-Staff Individual) entered the building and began providing resident care. V1 (Administrator) was notified of Immediate Jeopardy on 5/26/2026 at 8:23 AM. This surveyor confirmed by interview and record review that Immediate Jeopardy was removed on 5/26/2026 but noncompliance remains at Level Two because additional time is needed to evaluate the implementation and effectiveness of the in-service training.
Inspectors wroteBased on observation, interview and record review, the facility failed to prevent cross-contamination of soiled linens for 3 of 7 residents (R4, R5, and R7) reviewed for infection control in the sample of 7.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure a resident was transferred out of bed in a timely manner and failed to provide incontinence care for a resident in a timely manner for 2 of 2 residents (R23, R57) reviewed for activities of daily living in the sample of 35. This failure resulted in R23 crying and voicing feelings of depression.
Inspectors wroteBased on interview and record review, the facility failed to properly cool a pork roast after cooking. This has the potential to affect all residents in the building.
Inspectors wroteBased on observation, interview, and record review, the facility failed to maintain a system for tracking infections, failed to wear personal protective equipment (PPE) into a contact isolation room for 1 resident (R68), failed to wear appropriate PPE for 3 residents (R11,R29,R58) on Enhanced Barrier Precautions, failed to perform hand hygiene and glove changes to prevent cross contamination during incontinence care for 1 resident (R57). These failures have the potential to affect all residents in the building.
Inspectors wroteBased on observation, interview, and record review, the facility failed to offer activities. This applies to 6 of 6 residents (R10,R15,R28,R44,R48,R66) reviewed for activities in the sample of 35.
Inspectors wroteBased on observation, interview and record review, the facility failed to ensure dignity was maintained for 2 of 2 residents (R50, R47) reviewed for dignity in the sample of 35.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure wound care was provided in a manner to prevent cross contamination and failed to apply tubular compression stockings for a resident with swelling. This applies to 2 of 2 residents (R58, R61) reviewed for quality of care in the sample of 35.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a resident's pressure injury dressing was intact for 1 of 1 resident (R29) reviewed for pressure in the sample of 35.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a catheter tubing secure device was in place and did not clean the drainage spout on the catheter after emptying the drainage bag for 2 of 2 residents (R29 & R11) reviewed for catheters in the sample of 35.
Inspectors wroteBased on observation, interview, and record review, the facility failed to administer medications at ordered times. There were 25 opportunities with 3 errors resulting in a 12% medication error rate.
Inspectors wroteBased on interview and record review the facility failed to identify two areas of pressure until becoming unstageable. This failure resulted in one of the wounds requiring debridement and becoming a stage 4 pressure ulcer. This applies to one of three residents (R1) reviewed for pressure in the sample of three.
Inspectors wroteBased on interview and record review the facility failed to administer medications as ordered to a resident newly admitted to the facility. This applies to 1 of 4 residents (R1) reviewed for medication administration in the sample of 6.
Inspectors wroteBased on observation, interview, and record review the facility failed to attain and/or maintain the highest practicable physical, mental, and psychosocial well-being of each resident in the facility, this failure has the potential to affect all 64 residents in the facility. The facility's 671 Application for Medicare and Medicaid dated 11/18/2024 shows, 64 residents in the facility and a Medication Administration error rate of 31.25 percent.
Inspectors wroteBased on observation, interview and record review the facility failed to ensure opened, multi-dose insulin bottles and insulin pens were labeled with expiration dates for 4 of 4 residents (R3, R1, R29, R169) reviewed for medication storage in the sample of 16.
Inspectors wroteBased on observation, interview, and record review the facility failed to wear Personal Protective Equipment (PPE) in a contact isolation room, failed to implement Enhanced Barrier Precautions (EBP) for a resident with a pressure injury, and failed to change gloves during incontinence care in a manner to prevent cross contamination. This failure applies to 4 of 4 residents (R116, R36, R39, R57) reviewed for infection control.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents were provided ADL's (Activities of Daily Living) care in a dignified manner for 1 of 3 residents (R44) reviewed for resident rights in the sample of 64.
Inspectors wroteBased on observation, interview, and record review, the facility failed to provide ADL (Activities of Daily Living) assistance for residents that require staff assistance for incontinence care/toileting for 3 of 16 residents (R21, R1, R40) reviewed for ADLs in the sample of 16.
Inspectors wroteBased on observation, interview and record review the facility failed to complete weekly wound assessments on a resident's pressure injury. The facility failed to ensure pressure treatments and pressure relieving interventions were in place. These failures apply to 2 of 5 residents (R36, R31) reviewed for pressure injuries in the sample of 16.
Inspectors wroteBased on observation, interview and record review the facility failed to ensure a resident, with a history of significant weight loss, received weight loss interventions as ordered. The facility failed to monitor this resident's weights as directed by the dietician. These failures apply to 1 of 3 residents (R21) reviewed for weight loss in the sample of 16.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure oxygen was administered by the nurse, failed to have orders for oxygen, and failed to change oxygen tubing in order to prevent infection for 2 of 4 residents (R116, R31) reviewed for oxygen in the sample of 16.
Inspectors wroteBased on observation, interview and record review the facility failed to administer medications as ordered. There were 32 opportunities with 10 errors resulting in a 31.25% error rate. This failure applies to 3 of 4 residents (R60, R11, R117) observed in the medication pass.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents were transferred in a safe manner for 2 of 3 residents (R1, R2) reviewed for safety in the sample of 5. This failure resulted in R1 sustaining a right femur fracture and R2 sustaining a laceration requiring 21 sutures.
Inspectors wroteBased on observation, interview, and record review the facility failed to monitor temperatures of hot beverages prior to serving to residents, resulting in R1 sustaining full thickness (third degree) and partial thickness (second degree) burns to her thighs. This failure had the potential to affect 50 out of 75 residents residing in the facility that drink hot beverages and resulted in Immediate Jeopardy to their health and safety. The Immediate Jeopardy began on 9/15/24 when R1 sustained burns to her inner thighs from hot coffee. V1 Administrator was informed of the Immediate Jeopardy on 10/1/24 at 3:29 PM. The surveyor confirmed by observation, interview, and record review that the Immediate Jeopardy was removed on 10/2/24 but compliance remains at a Level 2 because additional time is needed to evaluate the implementation and effectiveness of the in-service training.
Inspectors wroteBased on observation, interview and record review the facility failed to provide showers to a resident that needs assistance in activities of daily living (ADL) to 1 of 5 residents (R3) reviewed for ADL care in the sample of 5.
Inspectors wroteBased on observation, interview and record review the facility failed to provide incontinence care in a manner to prevent infection to 1 of 5 residents (R2) reviewed for incontinence care in the sample of 5.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure a resident was free from verbal abuse. This applies to 1 of 8 residents (R1) reviewed for abuse in the sample of 8.
Inspectors wroteBased on interview and record review the facility failed to ensure newly-hired nursing staff received dementia care training and education prior to caring for facility residents. This failure has the potential to affect all 73 residents in the facility.
Inspectors wroteBased on interview and record review the facility failed to supervise a dementia resident to prevent the resident from wandering into rooms of other residents for 1 of 3 residents (R1) reviewed for dementia care in the sample of 5.
Inspectors wroteBased on observation, interview, and record review the facility failed to to provide ADL (Activities of Daily Living) assistance to residents that required assistance with toileting/incontinence care for 3 of 5 residents (R2, R5, R3) reviewed for ADLs in the sample of 5.
Inspectors wroteBased on interview, and record review the facility failed to obtain an x-ray ordered by the physician. This applies to 1 of 3 (R1) residents in the sample of 8. On 2/6/2024 at 10:20 AM, V3 Registered Nurse (RN) said on 12/28/2023 V5 Physician came to round on residents at the facility and saw (R1). V3 said she placed an order for an x-ray on (R1) related to (R1) having a cough. V3 said the facility uses two companies for x-ray. V3 said she does not recall which x-ray company she notified of the x-ray order. V3 said once the company is notified the requisition is printed along with the resident's face sheet and kept at the desk until the x-ray is completed. V3 said there is no log in place to track if an x-ray company is notified or not. V3 said it is passed along in report. [...]
Inspectors wroteBased on observation, interview, and record review the facility failed to serve two scoops of mechanical soft pork to residents requiring a mechanical soft diet. This applies to 4 of 4 (R10, R19, R44, R268) residents reviewed for mechanical soft diets in the sample of 17.
Inspectors wroteBased on observation, interview, and record review the facility failed to provided pureed pork in a pudding-like consistency for residents requiring a pureed diet. This applies to 4 of 4 (R2, R27, R41, R43) residents reviewed for pureed diets in the sample of 17.
Inspectors wroteBased on observation, interview, and record review the facility failed to handle a spatula in a manner to prevent cross-contamination when preparing pureed pork. This applies to 4 of 4 (R2, R27, R41, R43) residents reviewed for pureed diets in the sample of 17.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents were provided privacy during personal care. This applies to 1of 17 residents (R43) reviewed for privacy in the sample of 17.
Inspectors wroteBased on observation, interview, and record review the facility failed to provide incontinence care to 2 of 17 residents (R47, R43) reviewed for activities of daily living in the sample of 17.
Inspectors wroteBased on observation, interview, and record review the facility failed to assess a resident and notify the physician after a change in condition for 1 of 17 residents (R168) reviewed for care and services in the sample of 17.
Inspectors wroteBased on observation, interview and record review the facility failed to ensure pressure ulcer injuries were identified prior to an unstageable wound. This applies to 1 of 4 residents (R20) reviewed for pressure ulcer injuries in the sample of 17.
Inspectors wroteBased on observation, interview, and record review the facility failed to safely secure an oxygen cylinder in a resident's room for 1 of 17 residents (R47) reviewed for safety in the sample of 17.
Inspectors wroteBased on observation, interview, and record review the facility failed to ensure residents were provided perineal care to prevent the spread of infection. This applies to 2 of 5 residents (R58 & R43) reviewed for incontinence care in the sample of 17.
Inspectors wroteBased on observation, interview, and record the facility failed to ensure staff wore the required PPE (personal protection equipment) in COVID-19 positive rooms. This applies to 1 of 17 residents (R58) reviewed for infection control in the sample of 17.
1 fire safety citation on file: 1 on October 25, 2023.
| Date | Penalty | Amount or length |
|---|---|---|
| May 26, 2026 | Fine | $195,340 |
| September 16, 2025 | Fine | $36,517 |
| September 16, 2025 | Payment Denial | 36 days from October 10, 2025 |
| November 4, 2024 | Fine | $39,683 |
| November 4, 2024 | Payment Denial | 12 days from November 29, 2024 |
| October 2, 2024 | Fine | $127,785 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Illinois | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 2.85 | 3.45 | 3.86 |
| Registered nurses | 0.40 | 0.72 | 0.69 |
| All nursing staff on weekends | 2.57 | 3.07 | 3.42 |
| Nurse aides | 1.61 | ||
| Licensed practical nurses | 0.84 | ||
| Nursing staff turnover (share who left in a year) | 53.4% | 44.5% | 45.8% |
| Registered nurse turnover | 55.6% | 41.8% | 42.9% |
| Administrators who left | 0 |
CMS expects 4.17 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 2.96 on weekdays and 2.57 on weekends, 13% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.04 in April to June 2025 to 2.85 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 2.85 | 0.40 | 2.96 | 2.57 | 0.0% | 0 of 90 | 69 |
| Oct to Dec 2025 | 3.19 | 0.46 | 3.35 | 2.78 | 0.0% | 0 of 92 | 64 |
| Jul to Sep 2025 | 3.12 | 0.43 | 3.24 | 2.82 | 0.0% | 0 of 92 | 66 |
| Apr to Jun 2025 | 3.04 | 0.52 | 3.20 | 2.64 | 0.4% | 0 of 91 | 66 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Illinois, Jan to Mar 2026 | 3.26 | 0.65 | 3.40 | 2.92 | 5.4% | 0.6% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review. If you work here, your report helps start one.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Illinois, all employers | |||
| CNAs (nursing assistants) | $22.10 | $18.95 to $23.26 | 68,640 |
| LPNs and LVNs | $36.06 | $30.57 to $38.25 | 17,440 |
| Registered nurses | $46.15 | $38.47 to $50.94 | 138,910 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Illinois | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 3.8 | 13.4 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 0.9 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 1.8 | 1.5 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 0.9 | 3.1 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 2.5 | 2.2 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 9.9 | 14.3 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.3 | 4.8 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 15.6 | 21.7 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 35.1 | 26.1 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 28.7 | 13.8 | 12.0 |
For a stay to recover after a hospital visit, these are the results CMS publishes for The Sapphire at Maple Crest's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (49.3% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
49.3% this home
No different from the national rate
US median of homes 51.5% · Illinois: 106 better, 85 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 80 eligible stays.
10.9% this home
No different from the national rate
US median of homes 10.7% · Illinois: 2 better, 14 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 74 eligible stays.
6.8% this home
No different from the national rate
US median of homes 7.1% · Illinois: 3 better, 10 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 42 eligible stays.
58.6% this home
Median of homes: Illinois50.0% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 29 residents counted.
0.0% this home
Median of homes: Illinois0.3% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 51 residents counted.
1.6% this home
Median of homes: Illinois1.5% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 51 residents counted.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Median of homes: Illinois100.0% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 12 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: SYMPHONY MAPLE CREST LLC. CMS links this home to Symphony Care Network, a group of 7 nursing homes averaging 1.7 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Symphony Healthcare LLC | 5% or greater direct ownership interest | Organization | 99% | 11/22/2011 |
| Symag Holdings LLC | 5% or greater indirect ownership interest | Organization | 11/22/2011 | |
| Symphony Ml LLC | 5% or greater indirect ownership interest | Organization | 11/22/2011 | |
| Symphony Monarch Holdings, LLC | 5% or greater indirect ownership interest | Organization | 11/22/2011 | |
| Willow Delta Trust | 5% or greater indirect ownership interest | Organization | 01/01/2019 | |
| Hartman, Debra | 5% or greater indirect ownership interest | Individual | 11/22/2011 | |
| Midcap Funding IV Trust | 5% or greater security interest | Organization | 08/21/2018 | |
| McAfee, John | W-2 managing employee | Individual | 01/01/2017 | |
| Woods, Renee | W-2 managing employee | Individual | 01/01/2017 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Chosen from this home's own inspection record.
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