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Accura Healthcare of Stanton

213 Halland Avenue, Stanton, IA 51573 · For profit - Limited Liability company · 46 certified beds · (712) 829-2727 Medicare & Medicaid certified

Call the home — (712) 829-2727 Need help choosing, fast? Free, unbiased: Eldercare Locator 1-800-677-1116
Abuse-prevention, restraint, or reporting citations — no harm found (F0607, F0609) — most recent Jul 2024
Insights

This home’s record is mixed — some reassuring signs, some worth asking about.

In its favor
  • a middle-of-the-pack inspection score (3/5)
  • no federal fines or payment denials on record
  • a high payroll-based staffing rating (5/5)
  • lower-than-typical staff turnover (25% vs 45% nationally) — better care continuity
  • fewer deficiencies at its most recent standard inspection than at the one before — a sign of improvement
Worth asking about
  • it has citations for its abuse-prevention policies, restraint use, or reporting and investigating of allegations (F0607, F0609) — cited below the harm level, meaning inspectors found the process wanting but did not find a resident harmed
  • a high number of inspection citations overall (27) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
  • its payroll-based staffing score sits well above its independent inspection score
  • its facility-reported quality-measure rating is low (1/5)

One thing this read cannot see: what residents and families actually experience day to day. Public data misses the feel of a place — visit unannounced, ideally at a mealtime or on a weekend, talk to staff and families, and ask your tour questions.

A plain-English summary of the public record below — not a rating, ranking, or recommendation. We take no money from any facility.

3/5
CMS overall
3 of 5
Health inspectionSurveyor-assigned, ranked within your stateInspector-verified 3 of 5
StaffingFrom payroll records (PBJ) 5 of 5
Quality measuresSelf-reported by the facility 1 of 5

Worth a closer look. This home's staffing rating runs 2 stars above its independent health-inspection score. The inspection is done by state surveyors; the staffing score rests on the facility's own payroll (PBJ) submissions — so a gap this large is worth reading the inspection record for.

Location & what’s nearby

Hospital
Emergency dept. usually open 24/7 · ER 24/7
Urgent care / clinic
205 N U Ave · (712) 826-4422 · Call to confirm hours
Pharmacy
408 S 3rd Ave · (712) 826-4112 · Call to confirm hours
Grocery
811 N Broadway St · (712) 623-2651 · Call to confirm hours
Park
210 Halland Ave · (712) 829-2981 · Typically dawn to dusk
Place of worship

Nearest of each type, straight-line distance. Hospitals come from the CMS Hospital General Information registry; everything else from Overture Maps (public data). Hospital and park hours are typical — call ahead to confirm.

Quality measures — how residents actually fare

Overall quality measures 1 of 5
Long-stay residentspeople who live here 1 of 5
Short-stay residentsrehab / post-hospital 1 of 5

Quality-measure stars summarize outcomes CMS tracks from the assessments each home submits — avoidable hospitalizations and ER visits, falls with injury, pressure ulcers, unplanned weight loss, and long-term antipsychotic use. Because the underlying data is self-reported, weigh a high score against the independent inspection record. Long-stay = permanent residents; short-stay = rehab and post-hospital stays.

Trend — is this home getting better or worse?

Over 2025-02 to 2026-06, this home’s CMS overall rating held steady at 2 stars. From monthly CMS archive snapshots.

Horizontal axis runs 2025-02 to 2026-06. That is where CMS’s monthly archive ends, so the right-hand edge of each line is that month — not today.

Overall rating2★
Inspection scorelower = better
See all quality measures vs. state & national benchmarks
MeasureThis homeState avgTypical statevs typical state
Long-stay residents whose need for help with daily activities increased22.7%17.1%15.4%worse
Long-stay residents who lose too much weight5.1%4.6%5.4%typical
Long-stay residents with a catheter left in their bladder0.0%1.5%0.9%better
Long-stay residents with a urinary tract infection1.4%2.4%2.0%better
Long-stay residents with depressive symptoms4.2%4.2%6.5%better
Long-stay residents who were physically restrained0.0%0.2%0.1%better than state — see note marked double-dagger below the table
Long-stay residents with falls causing major injury6.1%3.8%3.3%worse
Long-stay residents whose ability to walk worsened17.0%16.6%16.1%typical
Long-stay residents on antianxiety or hypnotic medication35.0%20.8%18.9%worse
Long-stay residents given the seasonal flu vaccine95.2%95.3%95.3%typical
Long-stay residents with pressure ulcers6.2%4.2%4.7%worse
Long-stay residents with worsening bladder/bowel control31.3%25.6%21.2%worse
Long-stay residents who got an antipsychotic medication — see the note below the table21.6%19.5%17.1%worse
Short-stay residents who newly got an antipsychotic medication0.0%2.1%1.4%better
Short-stay residents rehospitalized after admission29.3%20.9%22.6%worse
Short-stay residents with an outpatient ER visit13.4%13.2%12.0%worse
Long-stay hospitalizations per 1,000 resident days3.211.491.67worse
Long-stay outpatient ER visits per 1,000 resident days4.062.081.80worse

On this measure the state average is at least twice (or half) the typical state — a gap that size is usually how the state codes and reports the measure, not how its homes actually perform. Against a benchmark this state does not sit on, a “vs typical state” verdict would mostly be measuring the state, so we compare this home with its own state instead and show both averages.

§ Antipsychotics carry an FDA boxed warning — they raise the risk of death in older people with dementia-related psychosis, and are not approved for that use. So this measure is partly a read on whether a home sedates residents instead of staffing for them. But read a low rate carefully in both directions: CMS excludes residents coded with schizophrenia (and Tourette's or Huntington's) from this measure, and federal auditors have found implausible increases in schizophrenia coding since the measure was published — so a very low rate can reflect recoding rather than less prescribing. Ask the home what share of its residents carry a schizophrenia diagnosis, and how it handles behavioral symptoms without medication.

CMS quality measures, as Care Compare shows them. For most rows lower is better (fewer falls, ulcers, hospitalizations); vaccination rates are the exception. Not every row is risk-adjusted. CMS adjusts some measures for resident mix, but falls with major injury, antipsychotic use, physical restraints and the vaccination rates are unadjusted rates — so a home caring for heavier or more behaviorally complex residents can look worse on them without providing worse care. The “typical state” column is the median of the 50 state averages — not a national average of all homes. We use it because a plain average across homes is pulled badly off course by a few states’ reporting habits (long-stay depressive symptoms is the clearest case: Illinois codes it several times higher than most states, which alone lifted the all-homes figure to about twice what a typical state records). The median of state averages resists that — but it does weigh every state equally, so a large state counts no more than a small one, and it is a benchmark of our construction rather than a CMS-published figure. better/worse means the home differs from that benchmark by more than 10% of it; closer than that reads typical. CMS does not publish how many residents each measure covers, and the counts are often small — a single resident can move a rate by several points — so treat small gaps as noise. These come from data the facility reports, so weigh them against the independent inspection record above.

Short-stay rehab — if you are coming here from a hospital

Arriving from a hospital right now? Read the discharge guide → — your appeal rights, how to slow a rushed discharge, and what to ask about the numbers below.

34.4% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — CMS rates that worse than the national rate. This is CMS’s risk-adjusted rate over 29 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.

34.4%U.S. median 51.5%
Got home and stayed home
12.2%U.S. median 10.7%
Went back to hospital
0.13U.S. median 0.31
Therapy hours / resident / day
0.06hours / resident / day
Physical therapy
0.06hours / resident / day
Occupational therapy
0.01hours / resident / day
Speech therapy

Therapy staffing: this home’s payroll records show 0.13 therapist hours per resident per day in 2026Q1 — more than 9% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 14% of this home’s weekday level — it runs some therapy at the weekend, at a lower level than on weekdays. The median home that reports therapy runs 13% — weekday-focused therapy is the industry norm, not a shortfall. But recovery does not pause on a Saturday: ask what the weekend actually looks like here.

This section is about rehab stays, not living here. Most of this page — the stars, the quality measures, the inspection record — describes the home the way a permanent resident experiences it. These figures describe the short Medicare stay after a hospital discharge: a hip, a stroke, a bad infection, six weeks and home. They are different residents, different staff, often a different wing. Therapy hours are per resident in the building, not per rehab patient — the count includes every long-stay resident, and they mostly get no therapy at all. So a home with a small rehab wing inside a large nursing population reads low here even if its rehab patients get plenty of therapy, and a mostly-rehab home reads high. Use it to compare homes doing similar work, ask what a rehab resident actually gets in a day, and remember that CMS does not publish therapy minutes per patient — nobody does.

See every short-stay measure CMS publishes for this home
MeasureThis homeU.S. medianPeriod coveredCMS’s call
Got home and stayed homeRate of successful return to home or community from a SNF34.4%CMS range 21.7–49.551.5%Oct 2022–Sep 2024worse than U.S.
Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF12.2%CMS range 7.9–17.610.7%Oct 2022–Sep 2024no different from U.S.
Met the expected recoveryPercentage of residents who are at or above an expected ability to care for themselves and move around at dischargenot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Self-care at dischargePercentage of residents who are at or above an expected ability to care for themselves at dischargenot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Moving around at dischargePercentage of residents who are at or above an expected ability to move around at dischargenot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Medication problems followed upPercentage of residents whose medications were reviewed and who received follow-up care when medication issues were identifiednot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Medication list to the next providerPercentage of residents where the SNF provided a current medication list to the next health care settingnot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Medication list to the familyPercentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final dischargenot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Falls with major injuryPercentage of SNF residents who experience one or more falls with major injury during their SNF staynot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
New or worsened pressure ulcersPercentage of residents with pressure ulcers/pressure injuries that are new or worsenednot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Infections that led to hospitalPercentage of infections residents got during their SNF stay that resulted in hospitalizationnot reported — The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs1.141.02Oct 2022–Sep 2024CMS makes no comparison for this measure

From the CMS Skilled Nursing Facility Quality Reporting Program — Medicare short-stay outcomes, which is a different dataset from the long-stay quality measures above and describes a different set of residents. Where CMS risk-adjusts a measure we show its adjusted rate, and the CMS range beside it is the confidence interval CMS publishes: a home whose range is wide is a home with few stays, where one patient moves the number several points. Read the period column. These measures do not share a window — the claims-based ones (getting home, readmission, spending) lag by a year or more, because a stay has to finish and its claims settle before it can be counted. CMS’s call is CMS’s, not ours: it is the only place anyone tests whether this home differs from the national rate at all, and most homes on most measures do not. Two caveats on it. CMS tests only three of these measures — getting home, readmission, and infections that led to hospital; on the other nine it publishes a rate and no comparison, and rather than compute a verdict CMS declined to make, we say so in the column. And on readmission almost every home in the country lands on “no different”, so that row separates homes far less than getting-home does — which is why met the expected recovery, a measure CMS does not test but which spreads across the whole range, is called out above the table rather than left in this list. The U.S. median column is our own, taken across every home CMS publishes that measure for in this same file; it is not a CMS-published benchmark. Homes CMS gives no rate for are left out of it rather than counted as zero. Medicare spending per stay is a ratio, not a percentage — 1.00 means this home’s Medicare spending for a stay matched the national figure CMS compares it against, and it measures cost to Medicare, not quality of care.

Staffing

0.84
RN hours/ resident / day
0.40
LPN hours/ resident / day
2.55
Aide hours/ resident / day
3.79
Total nurse hours/ resident / day
0.53
RN hoursweekends
25.0%
Total nursing turnover
25.0%
RN turnover

How full it usually is: this home is certified for 46 beds and averages 39.0 residents a day — about 85% occupied, or roughly 7 beds typically open. It usually has some room. This is a CMS average, not live availability — no public source publishes real-time vacancies, and a home can be full the day you call. Confirm with the home, and if you need a Medicaid bed specifically, ask about that separately: a home with open beds may still not have an open Medicaid bed.

Against a benchmark — not a legal minimum. In May 2024 CMS finalized the first federal staffing floor for nursing homes: 3.48 total nurse hours per resident per day, including 0.55 RN hours and 2.45 nurse-aide hours. Its hour requirements never took effect and are no longer on the books. Homes had until 2026 (2027 if rural) to comply, and that deadline never arrived: a federal court vacated the hour requirements in April 2025 (CMS has appealed), Congress then barred enforcement until 2034, and CMS formally repealed them by rule effective February 2026. This home is not required to meet these numbers, and is not violating anything by missing them. We still show the comparison because the figures are CMS’s own published estimate of adequate staffing, which makes them a useful yardstick — but they are our benchmark, not federal law: this home’s total nurse staffing of 3.79 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 0.84 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.55 is at or above the 2.45-hour aide benchmark. What federal law does require today is unchanged: “sufficient” nursing staff for residents’ needs and an RN on duty at least 8 consecutive hours a day, 7 days a week (42 CFR 483.35). Those are judged by inspectors on site, not by these averages, so read this comparison alongside the inspection record rather than as a pass/fail.

Weekend coverage: total nurse staffing is 3.14 hrs/resident/day on weekends vs 4.05 on weekdays — 22% thinner on weekends — a notable drop. RN hours go from 0.96 to 0.53 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 25% is below the national median of 45%.

Payroll-based (PBJ) staffing hours, as reported for Jan–Mar 2026 (CMS PBJ CY2026Q1) — the most recent quarter CMS has published, so they can lag a change of operator or staffing agency. Higher is generally better. Registered-nurse coverage and weekend staffing are the numbers families most often overlook — an RN on site matters most when something goes wrong, and coverage usually thins on weekends. High turnover means residents rarely see the same caregiver twice. One caveat: these are hours as reported, not adjusted for how sick or heavy-care this home’s residents are. CMS separately publishes a case-mix-adjusted view; we show the reported hours. A home caring for higher-acuity residents needs more hours to deliver the same care, so compare these figures against homes doing similar work, and read them next to the inspection record rather than alone.

Inspection trend

3
deficiencies at the latest standard inspection (2025-06-19)
15
at the previous standard inspection (2024-07-22)

Deficiencies are fewer than at the previous inspection — improving. Fewer citations over time suggests a home is fixing problems; a rising count is a warning sign — though two surveys are a short record, and survey teams differ. These counts are from the standard annual health survey only; the full citation list below may also include findings from complaint investigations, so the two won’t always add up.

Inspection deficiencies

State health-inspection citations, most serious first. Each carries an F-code (the federal rule it cites, e.g. F-684 = quality of care) and a letter A–L marking how serious and how widespread the problem was — we translate that grid into the plain tiers shown here. Wording is the official federal description.

ABCDEFGHIJKL

Each letter is a CMS scope-severity level; highlighted ones are where this home has citations. A–C = no harm found; D–F = potential for harm; G–I = actual harm; J–L = immediate jeopardy. Within each band the later letter is the more widespread finding (an isolated G is one resident; a widespread I is a pattern), so rightward and downward is worse.

27 citations, most serious first. The 10 most serious are shown; the remaining 17 are one tap away and print in full.

  • Potential for harm · Dcited before2025-10-07 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on clinical record review, policy review, family interview and staff interviews the facility failed to provide adequate nursing supervision for 1 of 3 residents reviewed with a high risk for elopement (Resident #2). The facility reported a census of 40.Findings include:1. The Minimum Data Set (MDS) for Resident #2, dated 8/10/25 did not document a Brief Interview for Mental Status (BIMS). Review of Progress Notes dated 8/10/25 revealed a BIMS evaluation with a BIMS of 7 indicating moderate cognitive impairment documented. The MDS also documented diagnosis of unspecified dementia. Review of Risk Assessment: Elopement dated 6/10/25 documented Resident #2 was at high risk for elopement. Risk Assessment further documented Resident #2 was considered an elopement risk at that time, wore a wander guard and had a history of exiting the building. Review of document titled, Self Report for Resident #2 had documented on 7/3/25 at approximately 2:00 pm the Director of Nursing (DON) became aware that Resident #2 was not present at an outdoor supervised activity. At approximately 2:40 pm on…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Past Non-Compliance
  • Potential for harm · D2025-06-19 · tag F0644 — isolated
    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, PASRR document review and staff interview, the facility failed to refer 1 resident with a negative Level I result for the Preadmission Screening and Resident Review (PASRR), who was later identified with newly evident or possible serious mental disorder or other related condition, to the appropriate state-designated authority for Level II PASRR evaluation and determination for 1 out of 1 residents (Resident #35) reviewed for PASRR requirements. The facility reported a census of 38 residents. Finding include: The Minimum Data Set (MDS) dated [DATE] for Resident #35 documented a Brief Interview for Mental Status (BIMS) score of 13 indicating no cognitive impairment. Review of Resident #35's Electronic Health Record (EHR) titled, Diagnosis revealed diagnoses of anorexia on 5/2/25 and unspecified psychosis on 10/2/25. Review of Resident #35's EHR titled, Notice of PASRR level 1 Screen Outcome dated October 1, 2024 documented under mental health diagnoses major depression and anxiety…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-06-19 · tag F0684 — failed to provide proper treatment and quality of care — isolated
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, hospital record review, and staff interviews, the facility failed to provide adequate and timely assessment and intervention for 1 of 13 residents (Resident #38) reviewed. Resident #38 experienced nausea with vomiting for 4 days and the chart lacked vital signs or bowel assessments throughout that time period. The resident was sent to the hospital and was found to have a bowel obstruction with perforation. The facility reported a census of 38 residents. Findings include: According to the Minimum Data Set (MDS) dated [DATE], Resident #38 had a Brief Interview for Mental Status (BIMS) score of 15 (intact cognitive ability). The resident required partial assistance with hygiene, dressing and toileting. He was occasionally incontinent of urine and bowel and had occasional constipation. Diagnoses for Resident #38 included anemia, atrial fibrillation, heart failure, Benign Prostatic Hyperplasia (BPH) and urgency incontinence. The Care Plan initiated on 4/16/25, showed that Resident #38…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2025-06-19 · tag F0695 — failed to provide proper breathing / tracheostomy care — isolated
    Provide safe and appropriate respiratory care for a resident when needed.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, staff interviews and clinical record review the facility failed to ensure that a resident was provided supplemental oxygen for 1 of 1 resident reviewed. In two separate observations in the dining room, it was discovered that the oxygen tank for Resident #89 was empty. The facility reported a census of 38 residents. Findings include: According to the Minimum Data Set (MDS) dated [DATE], Resident #89 had a Brief Interview for Mental Status (BIMS) of 15 (intact cognitive ability). She required minimal assistance with hygiene, dressing, personal hygiene and was on continuous oxygen therapy. Her diagnoses included atrial fibrillation, heart failure, renal insufficiency, diabetes mellitus, presence of cardiac pacemaker. The Care Plan dated 6/12/25, showed that the resident had the potential for actual respiratory abnormalities related to Congestive Heart Failure (CHF), shortness of breath and the use of supplemental oxygen. Staff were to assist with the tank/concentrator as needed. The Orders…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2024-07-22 · tag F0656 — failed to write and follow a full care plan — pattern
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on clinical record review and staff interviews, the facility failed to fully develop and personalize comprehensive care plans for 6 of 14 residents reviewed. (Residents #3, #6, #25, #29, #32 & #40). The facility reported a census of 42 residents. Findings include: 1. The Medication Administration Record (MAR) of Resident #6 for July 2024 documented the resident to have an order for Eliquis, an anticoagulant medication (a medication, also called a blood thinner, used to prevent and treat blood clots), twice day due to chronic atrial fibrillation (a type of an irregular heartbeat). The Care Plan revealed a Focus Area of anticoagulant therapy, dated 5/6/24. The only intervention on the focus area stated Administer anticoagulant medications as ordered by physician. Monitor for side effects and effectiveness every shift. The Care Plan failed to reveal a reason why the resident takes the medication. The Care Plan failed to reveal what side effects to monitor for or how to monitor for effectiveness. 2. The MAR of Resident #25 for July, 2024 documented the resident to have an order…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2024-07-22 · tag F0801 — pattern
    Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
    What the surveyor found here — the official record, unedited, may be distressing

    Based on document review and staff interview, the facility failed to employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service by not having a certified dietary manager. The facility reported a census of 42 residents. Findings include: On 7/17/24 at 11:30 AM, the Dietary Manager (DM) stated she passed the certification test but hadn't purchased the license. On 7/18/24 at 1:15 PM, a course completion certificate revealed she was not certified as an approved nutrition and food service manager. On 7/18/24 at 1:19 PM, the DM stated she did not have a national certification. A policy titled Personnel - General dated 2021 indicated the food and nutrition services department will be staffed to assure that sufficient, competent, supportive personnel carry out the functions of the department. On 7/22/24 at 8:35 AM, the Administrator stated the Dietary Manager was expected to have the correct dietary management certification.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · E2024-07-22 · tag F0803 — failed to meet residents' dietary needs — pattern
    Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, menu review, and staff interview, the facility failed to properly prepare pureed diets for 2 of 2 residents (Resident #27 & #20) reviewed. The facility also failed to serve the appropriate portions for 11 residents who received regular diets and 3 residents who received carbohydrate-controlled (4 CHO) diets (Resident #17, #22, and #29). The facility reported a census of 42. Findings include: The facility's Menu for lunch for 7/18/24 identified the following items to be served as part of the planned pureed textured diet: #12 scoop (2 2/3 oz) of pureed ribs #8 scoop (4 oz) of pureed macaroni & cheese #12 scoop (2 2/3 oz) of pureed green beans, no bacon #20 scoop (1 5/8 oz) of pureed bread & margarine #12 scoop (4 oz) of pureed gooey butter cake 8 fluid oz milk The facility's Menu also identified a 2-oz serving for 4 CHO diets. Record review of the Diet Orders for Residents #20 and #27 revealed both had an order for regular diet, puree texture and Residents #17, #22, and #29 had an order for 4…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2024-07-22 · tag F0812 — failed to store, cook, and serve food safely — pattern
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, staff interviews, and facility policy review, the facility failed to maintain sanitary practices by improperly storing and serving food. The facility reported a census of 42 residents. Findings include: On 7/16/24 at 8:25 AM, an initial kitchen observation identified the following findings: An Arctic Air refrigerator contained: 1) An unlabeled, undated clear container with sliced orange items. 2) An undated, previously opened bottle of tomato juice. 3) An unlabeled pouch of round, yellow items. An American Panel refrigerator contained: 1) An unlabeled, clear package of chopped meat. 2) An undated, partially closed, clear storage bag of sliced Swiss and American cheese. 3) An undated, previously opened jar of minced garlic. 4) An undated, previously opened bottle of Sweet and Smokey BBQ sauce. An American Panel freezer contained: 1) A box of packaged breaded chicken chunks stored on the floor. 2) An open box of exposed beef patties. The dry goods storage contained: 1) An opened box of…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2024-07-22 · tag F0880 — failed to prevent and control infections — pattern
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, staff interviews, record reviews, and policy review, the facility failed to implement the Infection Prevention and Control Program (IPCP) by staff not discarding Personal Protective Equipment (PPE) immediately after use nor appropriately performing hand hygiene. The facility also failed to identify areas or devices in the building to reduce the risk and prevent the growth of Legionella or other waterborne pathogens. The facility reported a census of 42 residents. Findings include: On 7/16/24 at 12:45 PM, a covered, yellow isolation container in the northeast hall had PPE (isolation gowns) hanging out of it. On 7/17/24 at 8:20 AM, Staff G, Certified Nurse Aide (CNA) picked up a resident's meal ticket off of the floor in front of the service window, put it on the counter, then grabbed 2 packs of plastic utensils wrapped in paper towel and took it to the residents in room [ROOM NUMBER]. No hand hygiene was observed. On 7/17/24 at 8:23 AM, an observation revealed a covered isolation bin near…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-07-22 · tag F0582 — isolated
    Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on clinical record review and staff interview, and instructions of CMS form 10123-NOMNC, the facility failed to provide notice within the required 2 calendar days of Medicare Non Coverage for 2 of 3 (Resident #43 and #44) residents reviewed. The facility reported a census of 42. Findings include: The census portion of the Electronic Health Record (EHR) of Resident #43 revealed the Resident began receiving skilled care under Medicare A payer source on 5/2/24 and Medicare continued to pay for her stay through 5/20/24. The facility provided a Skilled Nursing Facility Advance Beneficiary Notice of Non-Coverage (SNFABN) which was signed by the resident representative on 5/17/24. The facility was unable to produce a signed Notice of Medicare Non Coverage (NOMNC) form. The NOMNC form given was the typed name of the resident representative noted as t/o (telephone order) and the date of 5/17/24. The census portion of the Electronic Health Record (EHR) of Resident #44 revealed the Resident began receiving skilled care under Medicare A payer source on 11/1/23 and Medicare continued to…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
Show the remaining 17 citations
  • Potential for harm · D2024-07-22 · tag F0607 — failed to have anti-abuse policies — isolated
    Develop and implement policies and procedures to prevent abuse, neglect, and theft.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on employee file review, staff interview, and facility policy review the facility failed to ensure 2 of 5 staff members reviewed (Staff L & Staff M) completed the two hour Dependent Adult Abuse training within 6 months of their hire date. The facility reported a census of 42 residents. Findings include: 1. Review of the employee file of Staff L, conducted on 7/19/24, revealed a hire date of 12/8/23. The employee file lacked documentation of Iowa Department of Public Health (IDPH) approved Dependent Adult Abuse Mandatory Reporter training having been completed. 2. Review of the employee file of Staff M, conducted on 7/19/24, revealed a hire date of 1/4/24. The employee file lacked documentation of Iowa Department of Public Health (IDPH) approved Dependent Adult Abuse Mandatory Reporter training having been completed. On 7/19/24 at 2:38 pm the Business Office Manager stated she would search to see if the certificates could be located. On 7/19/24 at 5:00 pm, no certificates had been located. The facility policy titled Nursing Facility Abuse Prevention, Identification,…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-07-22 · tag F0609 — failed to report abuse allegations — isolated
    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, facility document review, and staff interview, the facility failed to report timely an allegation of possible abuse or injury of unknown origin for 1 of 1 resident (#21). The facility reported a census of 42 residents. Findings include: A facility self-report dated 7/05/24 revealed a resident sustained an injury of unknown origin and accused a staff member of making her fall on 6/26/24. The admission Minimum Data Set (MDS) dated [DATE] revealed a Brief Interview for Mental Status (BIMS) score of 12 out of 15 which indicated moderately impaired cognition. It included diagnoses of cancer, Alzheimer's disease, chronic obstructive pulmonary disease (COPD), and thoracogenic scoliosis (spinal curvature caused by disease or surgery). It revealed the resident was dependent with toileting hygiene and putting on and removing footwear, required supervision with eating and maximum assistance with all other activities of daily living (ADLs). The Electronic Health Record (EHR) included a…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Freedom from Abuse, Neglect, and Exploitation Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-07-22 · tag F0641 — isolated
    Ensure each resident receives an accurate assessment.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY #3 The MDS assessment of Resident #37 dated 7/2/24 identified a BIMS score of 7 which indicated severe cognitive impairment. The MDS revealed the resident independent with bed mobility, personal care, transfers, toileting, eating, and dressing. The MDS revealed the resident occasionally incontinent of urine and always continent of bowel. The MDS documented diagnoses that included: unspecified dementia without behavioral, cancer, atrial fibrillation (irregular and often very rapid heart rhythm), hypertension, renal insufficiency, arthritis, anxiety disorder, spinal stenosis lumbar region without neurogenic [NAME] (chronic condition-spinal canal narrows, compressing the spinal cord and nerve roots), and cervicalgia (neck pain). The MDS revealed the resident was not at risk for developing pressure ulcers/injuries and the resident does not have one or more unhealed pressure ulcers/injuries. The Care Plan updated 7/11/24 revealed no documentation of the resident's unstageable pressure ulcer on right lateral foot. The…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-07-22 · tag F0657 — failed to keep the care plan current — isolated
    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, observation, staff interview, the facility failed to revise and update the care plan for 2 of 14 residents reviewed for care plan revision (Resident # 37, #16). The facility reported a census of 42 residents. Findings include: 1. The Minimum Data Sheet (MDS) assessment of Resident #37, dated 7/2/24, identified a Brief Interview of Mental Status (BIMS) score of 7 which indicated severe cognitive impairment. The MDS revealed the resident independent with bed mobility, personal care, transfers, toileting, eating, and dressing. The MDS revealed the resident occasionally incontinent of urine and always continent of bowel. The MDS documented diagnoses that included: unspecified dementia without behavioral, cancer, atrial fibrillation (irregular and often very rapid heart rhythm), hypertension, renal insufficiency, arthritis, anxiety disorder, spinal stenosis lumbar region without neurogenic [NAME] (chronic condition-spinal canal narrows, compressing the spinal cord and nerve roots),…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-07-22 · tag F0688 — failed to keep residents mobile / prevent decline — isolated
    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.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, observation, staff interviews, and policy review, the facility failed to provide restorative activities for 1 of 2 sampled residents in order to maintain a functional range of motion and prevent a decline in activities of daily living (Resident #22). The facility reported a census of 42 residents. Findings include: The Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #22 to be dependent on staff for bathing, dressing, bed mobility, transferring and toileting. The MDS revealed the resident to have a functional limitation in range of motion on 1 upper extremity and 1 lower extremity. The MDS documented the resident to have diagnoses of hypertension (high blood pressure), diabetes, hemiplegia (paralysis of one side of the body) and a prior stroke. The MDS failed to reveal the resident had received any Speech, Occupational or Physical Therapies or any Restorative Nursing Programs during the lookback period. The Care Plan revealed a Focus Area of CVA/Stroke, revision…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2024-07-22 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, facility document review, staff interviews, family interview, and facility policy review, the facility failed to supervise and provide a secure environment for 1 of 1 residents reviewed for elopement (Resident #29). The facility reported a census of 42 residents. Finding include: The Minimum Data Sheet (MDS) assessment of Resident #29, dated 10/5/23, identified a Brief Interview of Mental Status (BIMS) score of 11 which indicated moderate cognitive impairment. The MDS recorded the resident experienced mood symptoms of feeling down, depressed, or hopeless on 12 to 14 days of the previous 2-week look back period. The MDS did not reveal any wandering or exit seeking behavior. The MDS revealed the resident independent with bed mobility, personal care, transfers, toileting, eating, and dressing. The MDS documented diagnoses that included: type 2 diabetes mellitus, coronary artery disease, hypertension, renal insufficiency, and pancytopenia (low levels of red blood cells, white blood…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-07-22 · tag F0697 — failed to manage pain — isolated
    Provide safe, appropriate pain management for a resident who requires such services.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, resident interview, family interview and staff interviews, the facility failed to provide appropriate pain management for 2 of 2 residents reviewed (Res #16 and Res #21). The facility reported a census of 42 residents. Findings include: The Minimum Data Set (MDS) assessment of Resident #16 dated 5/21/24 identified a Brief Interview of Mental Status (BIMS) score of 13 which indicated cognition intact. The Care Plan of Resident #16 documented a Focus Area of Pain initiated 12/11/23. The Care Plan directed staff to administer as needed pain medication as directed by physician and notify the nurse of any signs of pain. On 7/16/24 at 10:52 am, Resident #16 stated she had taken a fall which resulted in a broken tailbone prior to moving to the facility. She stated she still had a lot of pain and although the facility administered pain medication, it was not effective enough. She stated that at that moment, she could hardly stand to sit in the chair due to pain. The Treatment…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-07-22 · tag F0732 — isolated
    Post nurse staffing information every day.
    What the surveyor found here — the official record, unedited, may be distressing

    Based on document review and staff interview, the facility failed to complete and post nurse staffing information at the beginning of each shift. The facility reported a census of 42 residents. Findings include: On 7/19/24 at 12:45 PM, the posted staffing sheet revealed incomplete day and evening shift staffing data. On 7/19/24 at 2:30 PM, a nurse staffing information binder review revealed 17 out of 17 staffing sheets for July 2024 were incomplete. There was no staffing sheet for July 17, 2024. On 7/19/24 at 3:15 PM, the Director of Nursing (DON) stated the staffing information sheet is initiated during night shift and the nurse for each shift was expected to complete and post the staffing information. On 7/22/24 at 8:35 AM, the DON stated the facility did not have a policy regarding posting of staffing data.

    Nursing and Physician Services Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2024-07-22 · tag F0804 — failed to serve food at safe, palatable temperature — isolated
    Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, staff interview, and policy review, the facility failed to provide food served by a method to maintain a safe and appetizing temperature. The facility reported a census of 42. Findings include: On 7/19/24 at 11:50 AM, Staff A, Cook, prepared pork ribs, carrots, and macaroni & cheese for two (2) pureed lunch menus. He divided each menu item into separate bowls, heated the pureed carrots, and placed all six (6) bowls in a pan on the steam table. The temperatures were not checked for any of the pureed items before being placed in the steam table pan. At 12:22 PM, Staff A put one (1) of each item on a plate for Staff B, Dietary Aide (DA) to deliver to the resident. Both Staff A and Staff B indicated the lunch plate was being delivered to the resident. A temperature check of each item was performed with the following results. a) Pureed pork ribs were 129.4° Fahrenheit (F). b) Pureed macaroni & cheese was 80.1° F. Staff A gave Staff B the plate and she took it to the resident. A policy titled Food Temperatures dated 2021indicated all hot food items must be cooked to…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Ecited before2023-05-18 · tag F0880 — failed to prevent and control infections — pattern
    Provide and implement an infection prevention and control program.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observations, clinical record review, facility record review and staff interviews the facility failed to provide appropriate hand hygiene while assisting with dining, during perineal care and during grooming for 6 of 12 residents reviewed (Resident #8, Resident #12, Resident #20, Resident #22, Resident #25 and Resident #30). The facility reported a census of 37 residents. Findings include: 1. On 5/15/23 from 12:00 PM - 1:00 PM the dining observation revealed the following: A. Staff M, Certified Nursing Assistant (CNA), assisted Resident #8 with eating then moved to the table on the right and assisted Resident #30 with eating. Staff M then moved to the table on the right and assisted Resident #22 with eating and walked back to Resident #8 and assisted him with eating. This pattern was completed throughout lunch without any hand hygiene between residents. B. Staff N, CNA, entered the dining room at 12:05 PM and applied gloves. Staff N assisted Resident #8 with eating then moved to the table on the left and assisted Resident #12 with eating. This pattern was completed…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Infection Control Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-05-18 · tag F0578 — failed to honor advance directives / code status — isolated
    Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, and staff interviews the facility failed to have correct documentation of resident's choice related to advance directives for 1 of 5 residents reviewed (Resident #7). The facility reported a census of 37 residents. Findings include: The Minimum Data Set (MDS) dated [DATE] documented Resident #7 entered the facility on [DATE]. The MDS also documented a Brief Interview of Mental Status (BIMS) of 11 out of 15 possible points indicating moderate cognitive impairment. The Care Plan dated [DATE] documented Resident #7 requested advance directives for Do Not Resuscitate (DNR) and documented the resident has a Power of Attorney (POA). The Clinical Physician Orders for Resident #7 documented an order for Cardiopulmonary Resuscitation (CPR) dated [DATE]. The document titled Iowa Physician Orders for Scope of Treatment (IPOST) revealed the POA for Resident #7 requested a DNR order and signed it on [DATE]. The Medication Administration Record dated [DATE] documented an order for CPR. The…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-05-18 · tag F0582 — isolated
    Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on facility record review, clinical record review and staff interview, the facility failed to provide 48 hour notification to the resident/resident representative of discontinued Medicare Part A services and the right to an appeal for 1 of 3 residents reviewed (Resident#13). The facility reported a census of 37 residents. Findings include: The Skilled Nursing Facility Beneficiary Protection Notification (BPN) Review completed for Resident #13, documented resident's Medicare Part A skilled services episode start date of 9/15/22 and last covered day of Part A service of 11/23/22. The facility/provider initiated the discharge from Medicare Part A services when benefit days were not exhausted. The Notice of Medicare Non-Coverage Form 10123 for Resident #13, documented the resident was provided notice of Medicare covered skilled nursing services to be discontinued on 11/23/22 and signed by the resident on 11/23/22. During an interview on 5/16/23 at 11:55 AM, the Administrator stated the facility did not have a policy but expectation was per standards to give a 48 hour notice to the…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Rights Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-05-18 · tag F0656 — failed to write and follow a full care plan — isolated
    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review and staff interviews the facility failed to provide a comprehensive care plan that included anticoagulant therapy for 1 of 5 residents reviewed (Resident #27). The facility reported a census of 37 residents. Finding include: The Minimum Data Set (MDS) dated [DATE] documented Resident #27 entered the facility on 2/17/21. The MDS documented a Brief Interview of Mental Status (BIMS) score of 00 out of 15 possible points indicating severe cognitive impairment. The MDS documented diagnoses that included chronic embolism and thrombosis of an unspecified vein. The Care Plan dated 3/1/21 for Resident #27 documented the resident had the potential for actual injury related to a history of falls. The Care Plan lacked any documentation the resident was on anticoagulant therapy and adverse effects to watch for. The Medication Administration Record (MAR) dated 5/1/23 - 5/31/23 documented an order for Xarelto tablet 20 milligrams (mg) by mouth once a day for chronic embolism and thrombosis of an…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Resident Assessment and Care Planning Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-05-18 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolated
    Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on clinical record review, observations, facility record review and staff interviews, the facility failed to use safe transfer techniques, lifting on a resident without a gait belt, for 1 of 1 resident reviewed (Resident # 20). The facility reported a census of 37 residents. Findings include: The Minimum Data Set (MDS) assessment for Resident #20, dated 5/3/23, included diagnoses of non-Alzheimer's dementia, anxiety disorder, muscle wasting, and difficulty in walking. The MDS identified the resident needed extensive assistance of two staff for toileting and extensive assist of one staff for bed mobility, transfer and dressing. The MDS documented the resident was frequently incontinent of urine and bowel. The MDS indicated the resident had a Brief Interview for Mental Status (BIMS) score of 00 out of 15 possible points, indicating severe cognitive impairment. The Care Plan dated 1/11/19 for Resident #20 documented a risk for falls anf related injury. During an observation on 5/17/23 at 7:57 AM, Staff C, Certified Nurse Aide entered Resident #20's room and washed her hands.…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-05-18 · tag F0755 — failed to provide safe pharmacy services — isolated
    Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
    What the surveyor found here — an excerpt from the official record, may be distressing

    NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, facility investigation, facility policy review and staff interviews the facility failed to keep narcotic records in an order that accounts for all narcotics and is maintained to enable an accurate reconciliation for 1 of 1 residents reviewed (Resident #40). The facility reported a census of 37 residents. Findings include: The Minimum Data Set (MDS) dated [DATE] documented Resident #40 scored 00 out of 15 possible points on the Brief Interview of Mental Status indicating severe cognitive impairment. The MDS documented diagnoses to inlcude anxiety disorder and depression. The Medication Administration Record (MAR) for May 2022 revealed an order for Lorazepam Intensol Concentrate 2 milligrams(mg)/milliliter(ml). Give 0.25 ml by mouth every one hour as needed for anxiety/restlessness by mouth or under tongue. The undated facility investigation, provided by the Administrator, revealed a 30 ml bottle of Ativan was reported to be missing on 5/24/22 from the south medication room…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Pharmacy Service Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · D2023-05-18 · tag F0800 — isolated
    Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, clinical record review, and staff interviews, the facility failed to provide the resident with the correct diet of a mechanical soft, ground meat diet as ordered by the physician for 2 of 2 residents reviewed (Resident # 8 and #23). The facility reported a census of 37 residents. Findings include: 1. The Minimum Data Set (MDS) assessment for Resident #23 dated 2/28/23, included diagnoses of non-Alzheimer's dementia and Parkinson's disease. The MDS identified the resident needed extensive assistance of 1 staff for eating and extensive assistance of two staff for bed mobility, transfers, dressing, and toilet use. The MDS documented the resident on a mechanically altered diet (require change in texture of food or liquids). The MDS indicated the resident had a Brief Interview for Mental Status (BIMS) score of 00 out of 15 possible points, indicating severe cognitive impairment. During an observation on 5/16/23 at 1:00 PM, in the south lounge area, Resident #23's sister was assisting the resident to dine with a meal of a bacon, lettuce and tomato sandwich, (sandwich…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction
  • Potential for harm · Dcited before2023-05-18 · tag F0812 — failed to store, cook, and serve food safely — isolated
    Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
    What the surveyor found here — an excerpt from the official record, may be distressing

    Based on observation, facility policy review and staff interview the facility failed to store food in accordance with professional standards for 37 of 37 residents. The facility reported a census of 37 residents. Findings include: 1. On 5/15/23 from 11:30 AM through 12:00 PM a continuous observation during the initial kitchen tour revealed: a. a bottle of peach wine in the walk-in refrigerator without an open date, b. a bottle of concord grape wine in the walk-in refrigerator without an open date, c. a bottle of blush wine in the walk-in refrigerator without an open date, d. sausage patties and sausage links on a cookie sheet in the walk-in freezer uncovered and undated, e. a clear bag of dinner rolls in the walk-in freezer without an open date, and f. a loaf of bread on a shelf without an open date. The facility policy Food Storage dated 2021 provided by Staff L revealed the following: a. Plastic containers with tight-fitting covers or sealable plastic bags must be used for storing grain products, sugar, dried vegetables, and broken lots of bulk foods or opened packages. All…

    This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

    Nutrition and Dietary Deficiencies · Deficient, Provider has date of correction

“Cited before” means this same F-tag appears on at least one other survey date in the record we hold — counting complaint investigations as well as standard surveys, with no time limit. It is our own read of the data, not CMS’s: CMS uses repeat deficiency as a formal term tied to consecutive standard surveys, and that is a narrower test than this one. A tag marked here may or may not meet it.

Worried about a resident here? There are three different people you can turn to, and they do different jobs:
  • Long-Term Care Ombudsman — a free, confidential advocate for the resident. They act only with the resident’s consent and work to resolve the problem. Find yours at theconsumervoice.org/get_help.
  • Adult Protective Services — the state agency that investigates suspected abuse, neglect, or exploitation of a vulnerable adult. Not sure of your state’s APS number? The federal Eldercare Locator will route you: 1-800-677-1116 or eldercare.acl.gov.
  • State survey agency — the regulator that licenses and inspects the home. Every state has an official nursing-home complaint line and most take complaints online; the Ombudsman or Eldercare Locator can connect you.
Not sure where to start, or need other help? Dial 2-1-1 for local resources — and if a call is hard or impossible for you, many local 211s also take a text (send your ZIP code to 898-211) or a web chat at 211.org; both vary by area, and 211.org will show what yours offers. Deaf or hard of hearing: dial 711 for the telecommunications relay service, then any number above. In an emergency, call 911.
It is illegal for a facility to retaliate against a resident or family for reporting a concern: federal law gives a resident the right to voice grievances — to the home or to any outside agency — without discrimination or reprisal (42 CFR §483.10(j)(1)). You may report anonymously.

Fines & penalties

No federal fines in the current CMS record.

Part of a chain

This home belongs to ACCURA HEALTHCARE — 41 facilities. Here is how its ratings compare with the chain’s average across all its homes: See the whole chain — ratings, flags, fines and finances →

RatingThis homeChain avg
Overall 3 of 52.5+0.5 vs chain
Health inspection 3 of 52.6+0.4 vs chain
Staffing 5 of 53.1+1.9 vs chain
Quality measures 1 of 52.8-1.8 vs chain
The other 40 homes this chain runs (chain average 2.5★, per CMS)
1 of 5Aberdeen Health And RehabAberdeen, SD 1 of 5Accura HealthCare of TekamahTekamah, NE 1 of 5Accura Healthcare of CarrollCarroll, IA 1 of 5Accura Healthcare of MarshalltownMarshalltown, IA 1 of 5Accura Healthcare of Newton East, LLCNewton, IA 1 of 5Accura Healthcare of O'NeillO' Neill, NE 1 of 5Accura Healthcare of Pleasantville, LLCPleasantville, IA 1 of 5Accura Healthcare of ShenandoahShenandoah, IA 1 of 5Green Lea Senior LivingMabel, MN 1 of 5Lake Andes Senior LivingLake Andes, SD 1 of 5Shell Rock Senior LivingShell Rock, IA 2 of 5Accura Healthcare of Cascade LLCCascade, IA 2 of 5Accura Healthcare of CrestonCreston, IA 2 of 5Accura Healthcare of FranklinFranklin, NE 2 of 5Accura Healthcare of Knoxville, LLCKnoxville, IA 2 of 5Accura Healthcare of Lake City, LLCLake City, IA 2 of 5Accura Healthcare of MuscatineMuscatine, IA 2 of 5Accura Healthcare of OnawaOnawa, IA 2 of 5Accura Healthcare of Spirit LakeSpirit Lake, IA 2 of 5Sterling Park Health Care CenterWaite Park, MN 2 of 5Woodlyn Heights Healthcare CenterInver Grove Heights, MN 3 of 5Accura Healthcare of Ames, LLCAmes, IA 3 of 5Accura Healthcare of Aurelia, LLCAurelia, IA 3 of 5Accura Healthcare of Cherokee, LLCCherokee, IA 3 of 5Accura Healthcare of FullertonFullerton, NE 3 of 5Accura Healthcare of Pomeroy, LLCPomeroy, IA 3 of 5Accura Healthcare of ToledoToledo, IA 3 of 5Meadow ManorGrand Meadow, MN 3 of 5Prairie View Senior LivingTracy, MN 3 of 5Traditions Memory Care of NewtonNewton, IA 4 of 5Accura HealthCare of North PlatteNorth Platte, NE 4 of 5Accura Healthcare of Le MarsLe Mars, IA 4 of 5Accura Healthcare of MilfordMilford, IA 4 of 5Accura Healthcare of New HamptonNew Hampton, IA 4 of 5Accura Healthcare of Ogden, LLCOgden, IA 4 of 5Accura Healthcare of Sioux City, LLCSioux City, IA 4 of 5Faulkton Senior LivingFaulkton, SD 5 of 5Accura HealthCare of HartingtonHartington, NE 5 of 5Accura Healthcare of BancroftBancroft, IA 5 of 5Karlstad Healthcare Center INCKarlstad, MN

A home rated well below its chain’s average can signal local problems; a chain with a low average across the board is a bigger pattern worth researching. CMS chain data under-reports private-equity and REIT ownership, so treat this as a floor, not the full picture.

Who owns this facility

Owner / managerTypeRoleSince
COUSE, BRIANIndividualW-2 MANAGING EMPLOYEEsince 01/01/2024
MORRIS, SPENCERIndividualW-2 MANAGING EMPLOYEEsince 03/01/2024
TOTI, LISAIndividualW-2 MANAGING EMPLOYEE; CORPORATE DIRECTORsince 01/01/2020
LENEAVE, TEDIndividualCORPORATE DIRECTOR; CORPORATE OFFICERsince 01/01/2022
LENEAVE, THOMASIndividualCORPORATE OFFICERsince 01/01/2022
AMERICAN HEALTHCARE ASSOCIATES INCOrganizationOPERATIONAL/MANAGERIAL CONTROLsince 07/01/2021
AMERICAN HEALTHCARE MANAGEMENT SERVICES LLCOrganizationOPERATIONAL/MANAGERIAL CONTROLsince 03/01/2017

CMS files one row per role, so the 9 rows in the source record cover these 7 parties — each is shown once here with every role it holds. Nothing is omitted. The source lists no ownership percentage for any of them — PECOS records a share only for equity interests, not for board or management roles.

2 organizational owners listed — a facility can be part of a larger chain. CMS ownership data is known to under-report private-equity and REIT ties; treat as a starting point.

Follow the money — this home’s finances

Where a nursing home’s revenue comes from and where it goes — including money paid to companies under the same ownership. Most consumer sites never show this; we reproduce it straight from the Medicare cost report.

$3.6M
Net patient revenuemost recent cost report
-5.5%
Operating marginrevenue minus expenses
$434K
Related-party expense11% of expenses
Who pays — share of resident-days
Medicaid 55%Medicare 4%Other / private 42%

This home reported $434K paid to related parties — landlords or management companies under common ownership — equal to about 11% of its total expenses. Money routed to affiliated companies can leave a home’s own books looking lean while owners still profit; it is the mechanism regulators watch most closely in private-equity and REIT deals. A reported operating loss is common in this industry and is not by itself a sign of trouble — but paired with large related-party payments it can mean profit is being taken elsewhere in the ownership structure.

Source: CMS Healthcare Provider Cost Reporting Information System (HCRIS), Medicare cost report Form CMS-2540 · fiscal year 2023. Facilities self-file these reports; figures are unaudited and a year or two behind. A home with no Medicare cost report on file shows no figures here.

Cost & finances

$266per resident / day
operating cost
$8,075per month
≈ monthly operating cost
$252per day
avg. revenue, all payers

Straight from this home’s Medicare cost report (CMS, FY2023). These are its operating economics — what it costs to run per resident-day and what it collects on average across Medicare, Medicaid, and private pay — not a private-pay quote. Your out-of-pocket cost depends on payer and room type, so ask the facility directly; a higher operating cost can reflect richer staffing or a sicker population. The cost-of-care planner shows regional benchmarks by care type.

What families pay in IA

Paying with Medicaid

This is a Medicare- and Medicaid-certified nursing home, so it can accept Medicaid for long-term care — like nearly all U.S. nursing homes. The private-pay figures below are what families without Medicaid pay; once a resident qualifies for Medicaid, out-of-pocket cost for covered nursing-home care is typically close to $0 (almost all of their income goes to the home as their share of the cost; they keep a small personal needs allowance — for clothing, haircuts, a phone — and Medicaid pays the rest). The amount of that allowance is set by each state. Confirm Medicaid-bed availability with the home, and see the Iowa Medicaid page.

Typical monthly cost in Iowa
$9,277/mo
Nursing home (semi-private)
$10,038/mo
Nursing home (private)
$5,381/mo
Assisted living

Median private-pay cost, CareScout (Genworth) 2025 Cost of Care Survey — a regional midpoint, not any single community’s rate. Private rooms and higher care levels cost more; ask for a current quote. Project your own in the cost-of-care planner.

Every figure above is reproduced from the CMS Provider Data Catalog (a public record), from the CMS extract processed 2026-08-01 — CMS provider number 165332. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2025-06-19, which can lag current conditions. Staffing hours are CMS PBJ CY2026Q1 (Jan–Mar 2026). Check this record against the government’s own page for it: this home on Medicare Care Compare ↗ — the authoritative source, and the place to confirm anything here before you act on it. How we present it →

Not a government site. Eldercare Lens is not affiliated with, endorsed by, or authorized by the Centers for Medicare & Medicaid Services (CMS), Medicare, or any government agency. The star ratings, citations, and inspection wording on this page are reproduced from the public CMS record; the plain-English summaries, tiers, and comparisons around them are ours. We do not speak for CMS, and CMS has not reviewed this page. For the official record, go to Medicare Care Compare. How we’re funded →

Are you this operator? If the record here is out of date, or misses what you have since fixed, tell us and we will look: hello@eldercarelens.com. We reproduce the public CMS record and cannot change what it says — corrections to the underlying data go through CMS and your state survey agency — but we will correct anything we have got wrong about it, and we will say so on the page.

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