CARE INITIATIVES
Ownership rollup across 43 nursing homes in 1 state: Iowa. The "follow the money" view of an operator’s whole portfolio — the pattern a single facility page can’t show.
The chain’s homes average 2.9 of 5 stars on the CMS overall rating — roughly in line with the ~3.1 average of its state. It is improving: across the same 43 homes rated throughout, the average rose 0.65 stars between 2025-02 and 2026-06. We benchmark against its own states because CMS ranks the health-inspection star within each state, so a national comparison (national average ~3.0) partly measures where a chain operates rather than how it operates.
Where the rating comes from
The CMS overall star blends three different things. Split apart across the whole portfolio, they say different things about an operator: thin staffing is a budget decision made above the building, while a weak inspection score is what surveyors actually found inside it.
| Component | Chain average | Basis | |
|---|---|---|---|
| Health inspection | 2.5 of 5 | 43 rated homes | state surveyors’ findings, ranked within each state |
| Staffing | 3.7 of 5 | 43 rated homes | from payroll (PBJ) hours |
| Quality measures | 3.7 of 5 | 43 rated homes | largely self-reported clinical data |
Averaged across this chain’s rated homes. Health-inspection stars are assigned within each state’s own distribution, so for a chain spanning several states this component mixes distributions and is best read alongside each home’s actual citations.
Portfolio red flags
How many of this chain’s homes carry the most serious CMS markers. One flagged home can be local; a pattern across the portfolio is an operator-level signal worth researching.
Follow the money — chain finances
Aggregated from each home’s CMS Medicare cost report (HCRIS). Related-party payments are dollars a home sends to landlords or management companies under common ownership — the main channel through which private-equity and REIT owners can pull money out of a home while its own books still show a thin margin.
Only homes with a cost report on file are included, so the related-party total is a floor. Cost reports are self-filed, unaudited, and a year or two behind.
Weighted by each home’s average daily census, across the all 43 homes that report both a usable payer mix and a census. Homes whose cost report fails the same validity check the facility pages apply are left out of this figure entirely rather than counted as zero.
Every home in this chain
Lowest-rated first, so the homes most worth a closer look sit at the top. Each links to its full inspection, staffing, fines, and ownership record.
| Home | CMS rating | Flags |
|---|---|---|
| Avoca Specialty CareAvoca, IA | 1 of 5 | — |
| Correctionville Specialty CareCorrectionville, IA | 1 of 5 | 5 immediate-jeopardy $60,316 fined |
| Crestview Specialty CareWest Branch, IA | 1 of 5 | 1 immediate-jeopardy $216,061 fined |
| Heritage Specialty CareCedar Rapids, IA | 1 of 5 | 1 immediate-jeopardy $14,365 fined |
| Kingsley Specialty CareKingsley, IA | 1 of 5 | 1 immediate-jeopardy $27,378 fined |
| Parkridge Specialty CarePleasant Hill, IA | 1 of 5 | $34,450 fined |
| Ravenwood Specialty CareWaterloo, IA | 1 of 5 | — |
| Westwood Specialty CareSioux City, IA | 1 of 5 | $181,086 fined |
| Chariton Specialty CareChariton, IA | 2 of 5 | 1 immediate-jeopardy $15,134 fined |
| Creston Specialty CareCreston, IA | 2 of 5 | $19,663 fined |
| Dubuque Specialty CareDubuque, IA | 2 of 5 | $53,372 fined |
| Lantern Park Specialty CareCoralville, IA | 2 of 5 | 1 immediate-jeopardy $62,595 fined |
| New London Specialty CareNew London, IA | 2 of 5 | — |
| Northcrest Specialty CareWaterloo, IA | 2 of 5 | — |
| Northern Mahaska Specialty CareOskaloosa, IA | 2 of 5 | 1 immediate-jeopardy $39,033 fined |
| Pinnacle Specialty CareCedar Falls, IA | 2 of 5 | $8,362 fined |
| Southridge Specialty CareMarshalltown, IA | 2 of 5 | 1 immediate-jeopardy $45,406 fined |
| Stratford Specialty CareStratford, IA | 2 of 5 | — |
| Atlantic Specialty CareAtlantic, IA | 3 of 5 | — |
| Centerville Specialty CareCenterville, IA | 3 of 5 | — |
| Cherokee Specialty CareCherokee, IA | 3 of 5 | — |
| Eldora Specialty CareEldora, IA | 3 of 5 | Abuse flag |
| Manly Specialty CareManly, IA | 3 of 5 | 1 immediate-jeopardy $13,627 fined |
| Montezuma Specialty CareMontezuma, IA | 3 of 5 | — |
| Odebolt Specialty CareOdebolt, IA | 3 of 5 | $14,433 fined |
| Panora Specialty CarePanora, IA | 3 of 5 | — |
| Ridgewood Specialty CareOttumwa, IA | 3 of 5 | 1 immediate-jeopardy $8,999 fined |
| Southern Hills Specialty CareOsceola, IA | 3 of 5 | $36,865 fined |
| West Ridge Specialty CareKnoxville, IA | 3 of 5 | — |
| Bedford Specialty CareBedford, IA | 4 of 5 | — |
| Belle Plaine Specialty CareBelle Plaine, IA | 4 of 5 | — |
| Corning Specialty CareCorning, IA | 4 of 5 | — |
| Corydon Specialty CareCorydon, IA | 4 of 5 | — |
| Dunlap Specialty CareDunlap, IA | 4 of 5 | 4 immediate-jeopardy $10,062 fined |
| Laporte City Specialty CareLa Porte City, IA | 4 of 5 | — |
| Lyon Specialty CareRock Rapids, IA | 4 of 5 | — |
| Oakwood Specialty CareAlbia, IA | 4 of 5 | — |
| Fonda Specialty CareFonda, IA | 5 of 5 | — |
| Lamoni Specialty CareLamoni, IA | 5 of 5 | — |
| Mechanicsville Specialty CareMechanicsville, IA | 5 of 5 | — |
| Sibley Specialty CareSibley, IA | 5 of 5 | — |
| State Center Specialty CareState Center, IA | 5 of 5 | — |
| Wapello Specialty CareWapello, IA | 5 of 5 | — |
Source: CMS Provider Data Catalog (nursing-home ratings, deficiencies, penalties, and ownership) and the CMS Medicare cost report (HCRIS) for finances. Chain membership is as reported to CMS. CMS extracts retrieved 30 August 2026; CMS refreshes them monthly, so counts here are as of that date. Verify with the facility and your state regulator.