Pillar of Cedar Valley

Location & what’s nearby

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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

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.

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.

Therapy staffing: this home’s payroll records show 0.06 therapist hours per resident per day in 2026Q1 — more than 2% of the 13,892 homes that report any therapy hours at all.

Weekend therapy: weekend therapy hours are 4% of this home’s weekday level — it runs therapy on weekdays, with essentially none at the weekend. 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.

Staffing

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 2.92 hrs/resident/day is below the 3.48-hour benchmark and RN staffing of 0.33 is below the 0.55-hour RN benchmark and nurse-aide staffing of 1.90 is below 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 2.49 hrs/resident/day on weekends vs 3.09 on weekdays — 20% thinner on weekends — a notable drop. RN hours go from 0.41 to 0.13 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)

This home’s total nursing-staff turnover of 33% 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

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.

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.

24 citations, most serious first. The 10 most serious are shown; the remaining 14 are one tap away and print in full.

• Potential for harm · Dcited before2026-06-11 · 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, document review, policy review and staff interview, the facility failed to provide one to one supervision for resident safety for 1 of 10 residents sampled (Resident #4). The facility reported a census of 136 residents. Findings include:1. Resident #4's Minimum Data Set (MDS) assessment dated [DATE] showed a Brief Interview for Mental Status (BIMS) Score of 3 out of 15 indicating a severe cognitive loss. Resident #4 exhibited physical behaviors (hitting, kicking, pushing, scratching, grabbing) 1-3 days and rejection of care 1-3 days of the lookback period. Resident #4 was independent with chair/bed to chair transfers and could walk distances of 10-150 feet independently. The MDS listed diagnoses of bipolar disorder, unspecified, Non-Alzheimer's Dementia, and anxiety disorder. Resident #4's Care Plan revised 4/17/26 specified the resident demonstrated physical aggressive behaviors toward staff and resident peers related to dementia and mental illness. Resident #4 would frequently…

  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 · D2025-12-23 · tag F0600 — failed to protect residents from abuse and neglect — isolated
  Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
  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, staff interviews, and policy review, the facility failed to protect and prevent resident to resident abuse for 2 of 2 residents reviewed (Residents #1 and #5). The facility reported a census of 136 residents.Findings include:1. Resident #2's Minimum Data Set (MDS) assessment dated [DATE] identified a Brief Interview for Mental Status (BIMS) score of 99, signifying the interview could not be completed. The MDS documented during the lookback period Resident #2 had physical behavior symptoms directed toward others that occurred daily. In addition, the MDS documented Resident #2 had verbal behavior symptoms directed toward others that occurred 4 to 6 days during the lookback period. Resident #2 had behaviors of rejection of care that occurred daily. The MDS included diagnoses of depression, anxiety, post-traumatic stress disorder (PTSD) and bipolar disorder (mental health condition causing extreme mood swings that include emotional highs, called mania, and lows, known as…

  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 · D2025-12-23 · 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 records, policy review, resident and staff interviews, the facility failed to report alleged violations of physical abuse within the required time frame to the Iowa Department of Inspections, Appeals and Licensing (DIAL) for 3 of 4 incidents (11/14/25, 12/10/25 and 12/15/25) reviewed. The facility reported a census of 136.Findings include:Resident #2's Minimum Data Set (MDS) assessment dated [DATE] identified a Brief Interview for Mental Status (BIMS) score of 99, signifying the interview could not be completed. The MDS documented during the lookback period Resident #2 had physical behavior symptoms directed toward others that occurred daily. In addition, the MDS documented Resident #2 had verbal behavior symptoms directed toward others that occurred 4 to 6 days during the lookback period. Resident #2 had behaviors of rejection of care that occurred daily. The MDS included diagnoses of depression, anxiety, post-traumatic stress disorder (PTSD) and bipolar disorder…

  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 · D2025-12-23 · tag F0610 — failed to investigate and act on abuse reports — isolated
  Respond appropriately to all alleged violations.
  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 policy review, and staff interviews the facility failed to thoroughly investigate and put interventions in place following a resident-to-resident abuse for 1 of 3 residents reviewed (Resident #2). The investigation determined Resident #2 hit Resident #1 and Resident #5 on different occasions. The facility failed to conduct resident and staff interviews for the date of the incidents to determine the extent of the allegation or determine if other residents had been affected. The facility reported a census of 136 residents.Findings include:1. Resident #2's Minimum Data Set (MDS) assessment dated [DATE] identified a Brief Interview for Mental Status (BIMS) score of 99, signifying the interview could not be completed. The MDS documented during the lookback period Resident #2 had physical behavior symptoms directed toward others that occurred daily. In addition, the MDS documented Resident #2 had verbal behavior symptoms directed toward others that occurred 4 to 6 days during…

  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 · D2025-11-17 · tag F0640 — isolated
  Encode each resident’s assessment data and transmit these data to the State within 7 days of 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 Based on record review, staff interview, and Resident Assessment Instrument (RAI) Manual the facility failed to transmit Minimum Data Set (MDS) assessments timely for 2 of 3 residents reviewed (Residents #29 and #139). The facility reported a census of 136 residents. Findings include:1. Resident #29's MDS Quarterly assessment listed a completed date of [DATE]. The record lacked a transmitted status.On [DATE] at 11:12 AM Staff M, MDS Coordinator, reported their electronic health record (EHR) program directed to not submit the MDS, so she didn't submit the assessment. She reported she didn't know why the MDS got coded like that.On [DATE] at 11:20 AM the Administrator reported the facility didn't have a policy, they used the RAI manual.The RAI manual dated [DATE] on page 2-18 directed to transmit the Quarterly MDS no later than 14 days after the completion of the assessment.2. Resident #139's MDS Death assessment with assessment reference date [DATE] was completed on [DATE]. The record identified the facility…

  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 · D2025-11-17 · 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

  Based on observations, clinical record review, policy review, and staff interviews, the facility failed to follow a resident's Care Plan for 1 of 2 residents reviewed (Resident 5). The facility reports a census of 136.Findings include: On 9/9/25 at 1:49 PM observed Resident #5's wheelchair without anti-tippers on front of the wheelchair, no pressure relieving cushion, or non-slip material (Dycem) in the wheelchair.The Care Plan Focus dated 9/25/19 reflected Resident #5 had a risk of falls. The Care Plan directed the following Interventions:a. 9/25/19: Front anti-tippersb. 9/15/22: Dycem for the wheelchair.The Care Plan Focus dated indicated Resident #5 had a potential for pressure ulcers. The Intervention dated 9/3/20 directed to place a pressure reduction cushion in the wheelchair. On 9/10/25 at 7:33 AM observed Resident #5 sitting in a wheelchair in the hallway. Her wheelchair lacked the cushion, anti-tippers, and Dycem.On 9/10/25 at 9:24 AM Staff A, Registered Nurse (RN), verbalized she said she didn't know anything what Resident #5 needed for her wheelchair. On 9/10/25 at 9:26…

  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 · D2025-11-17 · 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 observation, clinical record review, policy review and staff interview the facility failed to provide a palm splint to the left hand to reduce/prevent contracture for 1 of 1 resident's sampled (Resident #15). The facility identified a census of 136 residents.Findings include:Resident #15's Minimum Data Set (MDS) assessment dated [DATE] showed a Brief Interview for Mental Status (BIMS) score of 13/15 indicating intact cognition. The MDS documented Resident #15 had a functional limitation in range of motion to one upper extremity (shoulder, elbow, wrist, hand) and depended on staff for eating, oral hygiene, toileting, upper/lower body dressing and personal hygiene. The MDS listed diagnoses of non-traumatic brain dysfunction, stroke and hemiplegia/hemiparesis (paralysis or loss of muscle function on one side of the body).An Occupational Therapy (OT) Home Therapy Program dated 1/17/25 signed by Staff I, Assistant Director of Nursing (ADON), directed the staff to apply a soft carrot splint with larger end…

  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 before2025-11-17 · 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 observations, staff interviews and policy review, the facility failed to lock up hazardous tools when they didn't have staff present in resident areas. The facility reported a census of 136 residents.Findings include: During a continuous observation on 9/8/25 at 1:38 PM of the 3rd floor west side hallway noted the housekeeping closet open and unattended with a wheeled cart in front of the doorway. The unattended wheeled cart had a box cutter, pipe wrench, fire fighter eliminator 1330 (non-toxic antifreeze solution for fire sprinklers), and an impact drill. Observed 3 residents go by the area with no staff present. At 1:42 PM the contracted sprinkler company staff came to the housekeeping closet and worked with the cart items, shut the housekeeping closest, and left shortly after arriving with the cart of tools and antifreeze.During a continuous observation on 9/9/25 at 8:54 AM of the 3rd floor west side hallway noted the housekeeping closet open and unattended with a wheeled cart in front of the doorway. The wheeled cart noted a box cutter, pipe wrench, fire fighter…

  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 · D2025-11-17 · 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 observation, clinical record review, policy review and staff interview, the facility failed to implement current physician orders for oxygen therapy for 1 of 1 resident's sample (Resident #15). The facility identified a census of 136 residents.Findings include:Resident #15's Minimum Data Set (MDS) assessment dated [DATE] showed a Brief Interview for Mental Status (BIMS) score of 13/15 indicating intact cognition. The MDS documented Resident #15 exhibited shortness of breath (SOB) trouble breathing with exertion, at rest and while lying flat. The MDS documented diagnoses of chronic obstructive pulmonary disease (COPD, a group of lung diseases that cause ongoing breathing problems characterized by narrow airways which make it difficult to breath, irritation and mucus of the airways that worsen breathing over time) and respiratory failure with use of oxygen therapy. Resident #15 Care Plan revised 3/13/25 documented a diagnosis of COPD and the resident utilized oxygen as needed. The Care Plan directed 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.

  Quality of Life and Care Deficiencies · Deficient, Provider has date of correction
• Potential for harm · D2025-11-17 · tag F0760 — failed to prevent significant medication errors — isolated
  Ensure that residents are free from significant medication errors.
  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, clinical record review, policy review, manufactures instructions for use, and staff interviews, the facility failed to ensure residents didn't receive expired insulin to diabetic residents for 2 of2 residents sampled (Residents #401 and #9). The facility reported a census of 136 residents.Finding include:1. Resident #401 Minimum Data Set (MDS) assessment dated [DATE] showed a Brief Interview for Mental Status (BIMS) score of 15/15 indicating intact cognition. The MDS listed a diagnosis of diabetes mellitus. In addition, the MDS identified Resident #401 utilized insulin seven days a week.The Order Review History Report acknowledged by the provider on [DATE] at 13:38 PM listed the following physician orders:a. Humalog Injection solution 100 units (U) per milliliter (ML) injection 2 U subcutaneously twice a day for diabetes.b. Humalog Injection solution 100 U/ML inject 2 units per sliding scale for a blood sugar of 151-200.Observation on [DATE] at 8:23 AM Staff A, Registered Nurse (RN),…

  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

“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.

Fines & penalties

No federal fines in the current CMS record.

Who owns this facility

3 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.

About 96% of this home’s resident-days are paid by Medicaid, which reimburses well below the cost of care in most states. Heavily Medicaid-dependent homes run on thinner budgets — a context worth holding next to the staffing and inspection record, not a fault in itself. This home reported $5.4M paid to related parties — landlords or management companies under common ownership — equal to about 29% 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.

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

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