On November 30. 1899, the Galesburg Evening Mail published an article by one of its reporters. He had interviewed John Cook, the manager of the Knox County Poor Farm at Knoxville. At that time there were 140 patients including sixty insane persons and five or six children in the residence.
 
Efforts were made to provide the residents with some holiday experiences. The Thanksgiving dinner was served at 1:00 pm. It included chicken, cranberry sauce, pie, cake and gingerbread. Coffee, tea and milk were also available. After the meal was concluded and the clean dishes put away, the inmates were given time for recreation. Those who worked had the opportunity to rest. Visitors were also received.
 
Mr. Cook explained that most of the inmates were unable to work because they were elderly, in poor health or insane.  There were plenty of jobs in the community so there weren’t many lazy people asking for a place to stay.
 
The county almshouses in Illinois began in 1839. They provided the social services of the day for the elderly, insane, poor, sick, women with young children and no husband or income as well as men injured in industrial accidents. After the Civil War there were a few veterans who came to the almshouse. Some individuals might stay several days, a week or come and go as it suited them.
 
In 1856 Cephas Arms (1811-1883), John S. Winter (1822-1893) and Rufus S. Miles (1822-1894) served on a committee of the County Board of Supervisors (now named the County Board). The men stated that conditions at the poor farm were inadequate. The building wasn’t large enough for the number of residents.
 
One patient, Crazy Hannah, had to be locked in a small room to keep her away from the heating stove. She had been confined in that room for three years.
 
In that same year land was purchased in Section 21, Knox County. A two-story building was erected with ample ventilation, many windows to allow light into the rooms and supplied with a number of bathrooms. In 1876 a second wing was added to the facility.
 
The State Legislature oversaw the performance of all the county homes and farms so annual reports were prepared by inspectors. The 1881 Knox County report was quite favorable. The yearly cost of operating the facility was $8250. At that time there were 105 residents (28 were insane, but none were secluded or restrained). The inspector stated that the establishment was first class in every respect.
 
In 1983 a marble monument was placed on a plot where more than one hundred inmates had been buried. From 1870 until 1922 almshouse residents had been buried without markers identifying the graves. Death certificates filed in the County Clerk’s Office were used to identify the burials. Sometime following that period the land had been tilled and planted with crops. A record is available at the Galesburg Public Library. 

By 1967 all county poorhouses in Illinois were decommissioned. The Knox County Board chose to continue with a nursing home to serve constituents.