Southeast Iowa Regional Medical - Klein Center
1307 South Gear Avenue, West Burlington, IA 52655 · Non profit - Corporation · 160 certified beds · (319) 768-1000 Medicare & Medicaid certified
This home has serious findings on its record. Read them closely before you consider it.
- a high payroll-based staffing rating (5/5)
- lower-than-typical staff turnover (24% vs 45% nationally) — better care continuity
- it has an abuse, neglect, or exploitation citation (F0600), cited May 2025
- it has citations for its abuse-prevention policies, restraint use, or reporting and investigating of allegations (F0605, F0609, F0610) — cited below the harm level, meaning inspectors found the process wanting but did not find a resident harmed
- inspectors cited 2 immediate-jeopardy problems — the most serious level
- a high number of inspection citations overall (19) — worth reading through, though larger and more-often-surveyed homes tend to accrue more lower-severity tags
- the CMS record shows $65,094 in federal fines (most recent 2025-12-17)
- its payroll- and facility-reported staffing and quality-measure scores sit well above its independent inspection score
- its independent health-inspection 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.
| Health inspectionSurveyor-assigned, ranked within your stateInspector-verified | 1 of 5 |
| StaffingFrom payroll records (PBJ) | 5 of 5 |
| Quality measuresSelf-reported by the facility | 4 of 5 |
Worth a closer look. This home's staffing and quality-measure ratings run 4 stars above its independent health-inspection score. The inspection is done by state surveyors; the quality-measure score leans on data the facility reports about itself, and staffing on its payroll (PBJ) submissions — so a gap this large is worth reading the inspection record for.
Location & what’s nearby
Open in Google Maps ↗ · Directions ↗ · Larger map ↗
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 | 4 of 5 |
| Long-stay residentspeople who live here | 4 of 5 |
| Short-stay residentsrehab / post-hospital | 4 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 fell from 5 to 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.
See all quality measures vs. state & national benchmarks
| Measure | This home | State avg | Typical state | vs typical state |
|---|---|---|---|---|
| Long-stay residents whose need for help with daily activities increased | 18.2% | 17.1% | 15.4% | worse |
| Long-stay residents who lose too much weight | 2.7% | 4.6% | 5.4% | better |
| Long-stay residents with a catheter left in their bladder | 1.4% | 1.5% | 0.9% | worse |
| Long-stay residents with a urinary tract infection | 2.2% | 2.4% | 2.0% | worse |
| Long-stay residents with depressive symptoms | 1.7% | 4.2% | 6.5% | better |
| Long-stay residents who were physically restrained | 0.0% | 0.2% | 0.1% | better than state‡ — see note marked double-dagger below the table |
| Long-stay residents with falls causing major injury | 4.1% | 3.8% | 3.3% | worse |
| Long-stay residents whose ability to walk worsened | 8.9% | 16.6% | 16.1% | better |
| Long-stay residents on antianxiety or hypnotic medication | 22.2% | 20.8% | 18.9% | worse |
| Long-stay residents given the seasonal flu vaccine | 93.3% | 95.3% | 95.3% | typical |
| Long-stay residents with pressure ulcers | 9.1% | 4.2% | 4.7% | worse |
| Long-stay residents with worsening bladder/bowel control | 23.8% | 25.6% | 21.2% | worse |
| Long-stay residents who got an antipsychotic medication§ — see the note below the table | 14.1% | 19.5% | 17.1% | better |
| Short-stay residents who newly got an antipsychotic medication | 0.3% | 2.1% | 1.4% | better |
| Short-stay residents given the seasonal flu vaccine | 89.2% | 73.3% | 79.4% | better |
| Short-stay residents rehospitalized after admission | 21.6% | 20.9% | 22.6% | typical |
| Short-stay residents with an outpatient ER visit | 15.5% | 13.2% | 12.0% | worse |
| Long-stay hospitalizations per 1,000 resident days | 0.82 | 1.49 | 1.67 | better |
| Long-stay outpatient ER visits per 1,000 resident days | 1.12 | 2.08 | 1.80 | better |
‡ 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.
65.6% of the Medicare patients who left this home got back to the community and stayed there for at least 31 days — CMS rates that better than the national rate. This is CMS’s risk-adjusted rate over 67 Medicare stays in Oct 2022–Sep 2024, and CMS’s own comparison — not ours.
Therapy staffing: this home’s payroll records show 0.16 therapist hours per resident per day in 2026Q1 — more than 14% of the 13,892 homes that report any therapy hours at all.
Weekend therapy: weekend therapy hours are 2% 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.
See every short-stay measure CMS publishes for this home
| Measure | This home | U.S. median | Period covered | CMS’s call |
|---|---|---|---|---|
| Got home and stayed homeRate of successful return to home or community from a SNF | 65.6%CMS range 56.4–74.3 | 51.5% | Oct 2022–Sep 2024 | better than U.S. |
| Went back to hospitalRate of potentially preventable hospital readmissions 30 days after discharge from a SNF | 9.5%CMS range 5.9–14.6 | 10.7% | Oct 2022–Sep 2024 | no 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 discharge | not 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 discharge | not 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 discharge | not 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 identified | not 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 setting | not 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 discharge | not 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 stay | not 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 worsened | not 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 hospitalization | 6.5%CMS range 3.2–12.6 | 7.1% | Oct 2023–Sep 2024 | no different from U.S. |
| Medicare spending per stayMedicare Spending Per Beneficiary (MSPB) for residents in SNFs | 0.59 | 1.02 | Oct 2022–Sep 2024 | CMS 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
How full it usually is: this home is certified for 160 beds and averages 143.4 residents a day — about 90% occupied, or roughly 17 beds typically open. It runs fairly full. 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 4.78 hrs/resident/day is at or above the 3.48-hour benchmark and RN staffing of 1.43 is at or above the 0.55-hour RN benchmark and nurse-aide staffing of 2.93 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 4.29 hrs/resident/day on weekends vs 4.98 on weekdays — 14% thinner on weekends. RN hours go from 1.60 to 0.99 per resident-day. (Payroll-based daily records; the national median home is 15% thinner on weekends.)
This home’s total nursing-staff turnover of 24% 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 more than at the previous inspection — worsening. 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.
19 citations, most serious first. The 12 most serious are shown; the remaining 7 are one tap away and print in full.
- Immediate jeopardy · J2025-12-17 · tag F0684 — failed to provide proper treatment and quality of care — isolatedProvide 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, review of facility menu, and staff interviews, the facility failed to assess and intervene after a resident coughed, and then vomited during evening meal. On 12/5/25 at 5:25 PM, Resident #1 coughed and then reportedly vomited during a meal, which consisted of barbeque pork on a bun, pasta salad, buttered corn, and white cake. Another resident sitting at the table with Resident #1 reported to nursing staff Resident #1 vomited. The nursing staff checked Resident #1 and noted labored respirations, and described her as choking. Staff assisted Resident #1 outside of the dining room area while continuing to instruct her to spit out sputum. Nursing staff then assist Resident #1 to her room to use the bathroom, prepared her for bed, applied CPAP (Continuous Positive Airway Pressure, a medical device used to treat sleep apnea by continuous pressurized air through a mask to keep airways open during sleep) connected to an oxygen concentrator. Nursing staff elevated the head of Resident #1's…
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.
- Immediate jeopardy · Jcited before2024-11-13 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure 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 observation, clinical record review, facility incident and investigation reports, and staff interviews, the facility failed to ensure a resident with a severe cognitive impairment did not exit the facility without staff knowledge. On 7/26/24, Resident #1 left a group while walking from an activity area to the memory care unit unbeknownst to the staff supervising. Resident #1 walked through the front lobby and exited out an unlocked, unalarmed door to an unsecured courtyard area. The resident walked on the sidewalk to the area between the B and C wings of the building, a location approximately 100 yards from a large pond. A staff member saw the resident from a window, and went outside to assist her back to the building. Resident #1 estimated to be outside, unsupervised for approximately ten minutes for 1 of 1 resident reviewed for elopement (Resident #1). This deficient practice resulted in an Immediate Jeopardy (IJ) to the health and safety of residents who resided at the facility. The State Agency…
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.
- Potential for harm · E2026-06-18 · tag F0552 — patternEnsure that residents are fully informed and understand their health status, care and treatments.
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, policy review, and staff interviews, the facility failed to obtain a consent and provide information about the risks and benefits of psychotropic medications (medications that affected the mind, altering a person's emotions, thoughts, perceptions, or behavior) for 5 of 6 residents reviewed for medications (Residents #5, #6, #13, #17, #109). The facility reported a census of 141 residents.Findings included: 1. The Minimum Data Set (MDS) assessment tool dated 4/29/26, list of diagnoses for Resident #5 included anxiety, depression, and delirium due to a known condition. The MDS listed the resident's Brief Interview for Mental Status (BIMS) score as 6 out of 15, indicating severely impaired cognition. The MDS documented Resident #5 prescribed medications in the following high risk drug classes: antipsychotic, antianxiety, and antidepressants. A 7/15/23 Care Plan entry stated the resident would not exhibit side effects resulting from psychotropic medication use. A 6/11/25 Family Practice…
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.
- Potential for harm · E2026-06-18 · tag F0725 — failed to have enough nursing staff — patternProvide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
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, review facility Call Logs resident and staff interview, the facility failed to ensure sufficient staff available to answer resident calls lights in a timely manner for 6 of 7 residents (Residents #160, #7, #142, #23, #122, and #8) in the sample. The facility reported a census of 141 residents.Findings included: 1. Review of the electronic health record (EHR) Face Sheet revealed Resident #160 admitted to the facility on [DATE], with a primary diagnosis of aftercare for healing traumatic fracture of the left hip. Review of Nursing Assessment and Intervention dated 6/9/26, revealed, in part, an Intervention for Resident #160 for Activity Bed Rest with exceptions; up in chair; ambulate with assistance. Review of a Nursing Note dated 6/15/26, revealed, in part, Transferring and ambulating short distances with assist of one staff, gb (gait belt) and walker. During an interview on 6/15/26 at 10:34 AM, Resident #160 reported concerns with staff answering her call light. Resident #160…
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.
- Potential for harm · E2026-06-18 · tag F0880 — failed to prevent and control infections — patternProvide and implement an infection prevention and control program.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, staff interview, and facility policy review the facility failed to follow infection control procedures to prevent potential cross contamination during a blood draw procedure performed on 1 of 6 residents (Resident #17) reviewed for infection control, when the specimen drawn was placed on a clean dining room table. The facility also failed to prevent potential cross contamination during the laundry process in 1 of 10 units observed, when clean personal linens were placed on potentially contaminated public seating surfaces. The facility reported a census of 141 residents. Findings include:1. During an observation on 6/16/26 at 8:41 AM, Resident #17 sat at a dining room table with 2 other residents, the 3 residents continued to have a plate of breakfast set on the table in front of them. Staff S, Registered Nurse (RN), approached Resident #17 at the dining room table and collected blood specimen from Resident #17's left forearm. Staff S completed the blood draw from Resident #17, then set the vial containing the blood specimen on top of the dining room table…
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.
- Potential for harm · D2026-06-18 · tag F0578 — failed to honor advance directives / code status — isolatedHonor 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 record review, staff interviews, and the facility policy, the facility failed to have a resident's Iowa Physician Orders for Scope of Treatment (IPOST) and provider's orders on the electronic health record match for 1 of 2 residents reviewed for advanced directives (Resident #13). The facility reported a census of 141 residents. Findings include: The Minimum Data Set (MDS) dated [DATE] revealed Resident #13 scored a 5 out of 15 on the Brief Interview for Mental Status (BIMS), which indicated cognition severely impaired. The MDS indicated medical diagnosis for vascular dementia, unspecified severity, with anxiety. The Review of the signed IPOST dated [DATE] indicated Cardiopulmonary Resuscitation (CPR). The Review of the electronic health record (EHR) for Physician Orders indicated Do Not Resuscitate dated [DATE]. During an interview on [DATE] at 8:20 AM, Staff F, Registered Nurse (RN) queried where advanced directives or IPOST were located and Staff F pulled down a binder in the nurse's station and…
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.
- Potential for harm · D2026-06-18 · tag F0583 — failed to protect personal privacy — isolatedKeep residents' personal and medical records private and confidential.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on observation, staff interview, and clinical record review, the facility failed to provide Resident #17 with privacy during a blood draw when procedure was performed at dining room table during a meal with other residents present for 1 of 3 residents (Resident #17) reviewed for dignity. The facility reported a census of 141 residents.Findings include:Review of the Minimum Data Set (MDS) Assessment, dated 5/26/26, revealed Resident #17 had a Brief Interview for Mental Status (BIMS) score of 13 out of 15 which indicated intact cognition. The list of diagnoses included cerebrovascular accident ( stroke), seizure disorder, and anxiety disorder. Review of Resident #17's Active Order list, dated 6/18/26, revealed a laboratory order for routine levetiracetam (brand name Keppra) level (measures the concentration of the anti-epileptic medication within the blood to ensure at a therapeutic level), started on 6/05/26, with instructions for the nurse to collect blood specimen. During an observation on 6/16/26 at 8:41 AM, Resident #17 sat at a dining room table with 2 other residents, 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.
- Potential for harm · D2026-06-18 · tag F0605 — failed to not use drugs as a restraint — isolatedPrevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
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, policy review, and staff interview, the facility failed to complete reviews for gradual dose reduction for residents prescribed psychotropic medications, failed to attempt non-pharmacological interventions prior to the administration of as needed anti-anxiety medication, and failed to ensure as needed psychotropic medication orders did not exceed 14 days without a physician review for 3 of 6 residents (Resident#5, Resident #13 and Resident #109) reviewed for unnecessary medications. The facility reported a census of 141 residents. Findings included: Based on clinical record review, policy review, and staff interview, the facility failed to complete reviews for gradual dose reduction for residents prescribed psychotropic medications, failed to attempt non-pharmacological interventions prior to the administration of as needed anti-anxiety medication, and failed to ensure as needed anti-anxiety medication orders did not exceed 14 days for 3 of 6 residents (Resident#5, Resident #13…
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.
- Potential for harm · Dcited before2026-06-18 · tag F0658 — failed to meet professional standards of care — isolatedEnsure services provided by the nursing facility meet professional standards of quality.
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, resident and staff interviews, the facility to ensure only licensed nursing staff applied a prescribed topical medication for 1 of 1 resident (Resident #23) reviewed for professional standards. The facility reported a census of 141 residents. Findings include: The Minimum Data Set (MDS) assessment dated [DATE], revealed Resident #23 with intact cognition based on a Brief Interview for Mental Status (BIMS) score of 15 out of 15. m, which indicated cognition intact. Review of the electronic health record (EHR) revealed an order for clotrimazole (lotrimin) 1% cream topical, 2 times daily- administration instructions: topically to groin and breast folds for redness ordered on 6/6/26 and discontinued on 6/17/26During an interview on 6/17/26 at 11:57 AM, Resident #23 stated the Certified Nurse Assistants (CNA) put a prescribed cream on her and then takes the cream back to the nurses to put back in the medication cart. During an interview on 6/18/26 at 9:55 AM,…
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.
- Potential for harm · Dcited before2026-06-18 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure 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 observation, clinical record review and staff interview, the facility failed to maintain an environment free from accident and hazards by ensuring staff safely pushed wheelchairs with footrests in place during the transport of 2 of 5 residents (Resident #10 and Resident #138) reviewed for safety. The facility reported a census of 141 residents. Findings include:1. Review of Resident #138's Minimum Data Set (MDS) assessment dated [DATE], revealed a Brief Interview for Mental Status (BIMS) score of 12 out of 15, indicating a moderate cognitive impairment. The list of diagnoses included Parkinson's disease, anxiety disorder, depression, and chronic pain syndrome. The MDS indicated Resident #138 had one side lower extremity impairment, utilized a walker and wheelchair for mobility and independently propelled the wheelchair. The MDS identified the resident had 2 or more falls without injury since the previous assessment.Review of Resident #138's Plan of Care initiated on 3/13/26, revealed a Plan for Falls…
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.
- Potential for harm · Dcited before2025-10-30 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure 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, resident family interview, staff interviews, and the facility policy, the facility failed to ensure the fall intervention of a bed alarm worked properly for 1 of 3 residents reviewed for falls (Resident #1). The facility reported a census of 146 residents. Findings include:The Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #1 scored a 9 out of 15 on the Brief Interview for Mental Status (BIMS) exam, which indicated cognition moderately impaired. The MDS indicated resident required substantial/maximal assistance with walking 10 feet, lying to sitting on the side of the bed, and sitting to standing. The MDS revealed resident used an indwelling catheter and always continent of bowel. The MDS indicated medical diagnoses for other neurological conditions; encounter for surgical aftercare following surgery on the nervous system; and hemiplegia. The MDS indicated resident fell once since admission with no injury. The MDS indicated resident took opioids and used bed and…
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.
- Potential for harm · Dcited before2025-06-26 · tag F0689 — failed to keep residents free of avoidable accidents; supervise adequately — isolatedEnsure 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 observation,staff interview, and clinical record review, the facility failed to ensure adequate supervision to ensure a resident remained free from elopement for one of three residents reviewed for supervision/elopement (Resident #1). The resident exited the facility without the knowledge of facility staff on 5/25/25 when the resident left the area where they resided, walked through an unoccupied area of the facility, and exited to outside of the facility. The resident walked around the facility, was seen outside by staff through a window, and was brought back into the facility by staff. The facility reported a census of 115 residents. Findings include: Review of the Minimum Data Set (MDS) assessment for Resident #1 dated 4/23/25 revealed the resident scored 3 out of 15 on a Brief Interview for Mental Status (BIMS) exam, which indicated severely impaired cognition. Per this assessment, wandering occurred 1-3 days. Review of Resident #1's Care Plan revealed the following dated 11/8/24: LTC elopement risk IPOC. Review of the Investigation Report for Resident #1 dated 5/25/25…
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.
Show the remaining 7 citations
- Potential for harm · E2025-05-01 · tag F0803 — failed to meet residents' dietary needs — patternEnsure 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
Based on observation, policy review and staff interview, the facility failed to follow the menu, and provide pureed portions per dietician recommendations. The facility reported a census of 116 residents. Findings include: Review of the menu, signed on 3/7/25, by the facility Registered Dietician directed staff prepare and serve the following menu items for the noon meal on 4/29/25: a. Taco casserole prepared for residents on a puree diet. The RD directed a serving two (2) #8 scoops or 7.5 ounces of casserole; and 4 ounces of Spanish, rice apple sauce, and churro stick. b. Fresh grapes served to residents on a regular diet. During an observation of the pureed food preparation for four residents on 4/29/25 at 10:00 AM revealed the following put into a Robo-coup machine by Staff B, Kitchen Chef: a. 6 cups of lettuce, 1-1/2 cups per resident b. 6 cups of meat and beans mixture, 1-1/2 cups per resident c. 4 ounces of salsa, 1 ounce per resident d. 4 ounces of cheese, 1 ounce per resident During the observation, Staff B, Kitchen Chef pureed the food in the machine, added splash of tomato…
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.
- Potential for harm · D2025-05-01 · tag F0600 — failed to protect residents from abuse and neglect — isolatedProtect 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
Based on clinical record review, policy review, and staff interview, the facility failed to ensure residents were free from verbal abuse for 3 of 4 residents reviewed for abuse (Resident ##63, Resident #87, and Resident #126). The facility reported a census of 114 residents. Findings include: 1. The Minimum Data Set (MDS) assessment tool, dated 3/5/25, listed diagnoses for Resident #87 which included non-Alzheimer's dementia, anxiety disorder, and chronic kidney disease. The MDS listed her cognition as severely impaired. Review of the Care Plan, dated 9/9/24, revealed the resident had cognitive loss and directed staff to allow the resident time to process information and to adjust the tone of voice for her to hear. The facility policy [Facility name redacted] Abuse and Elder Rights Policy and Procedure, revised 7/2021, stated the facility would ensure residents were free from verbal abuse. The facility defined verbal abuse to include oral language that included disparaging and derogatory terms to elders. 2. The MDS assessment tool, dated 3/27/25, listed diagnoses for Resident #126…
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.
- Potential for harm · D2025-05-01 · tag F0609 — failed to report abuse allegations — isolatedTimely 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
Based on clinical record review, policy review, and staff interview, the facility failed to ensure staff reported 3 of 4 incidents of potential verbal abuse to administrative staff in a timely manner (Resident #63, Resident #87 and Resident #126). The facility reported a census of 114 residents. Findings include: 1. The Minimum Data Set (MDS) assessment tool, dated 3/5/25, listed diagnoses for Resident #87 which included non-Alzheimer's dementia, anxiety disorder, and chronic kidney disease. The MDS listed her cognition as severely impaired. Review of the Care Plan, dated 9/9/24, revealed the resident had cognitive loss and directed staff to allow the resident time to process information and to adjust the tone of voice for her to hear. 2. The MDS assessment tool, dated 3/27/25, listed diagnoses for Resident #126 which included non-traumatic brain dysfunction, irritability and anger, and hypertension (high blood pressure). The MDS listed his Brief Interview for Mental Status (BIMS) score as 3 out of 15, indicating severely impaired cognition. Review of the Care Plan, dated 3/21/25,…
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.
- Potential for harm · D2025-05-01 · tag F0610 — failed to investigate and act on abuse reports — isolatedRespond appropriately to all alleged violations.
What the surveyor found here — an excerpt from the official record, may be distressing
Based on clinical record review, policy review, and staff interview, the facility failed to separate residents from an alleged perpetrator of abuse in a timely manner. The facility reported a census of 114 residents. Findings include: Review of a Facility Reported Incident, dated 4/4/25 revealed on 4/3/25 the facility Director of Nursing submitted an allegation of potential abuse. Per the report A complaint was made to the DON [name redacted] on 4/1/25 by [name redacted, Staff E, Housekeeping] that CNA [name redacted, Staff F, Certified Nursing Assistant (CNA)] was speaking loudly and disrespectfully to resident [name redacted, Resident #126] while out in the memory care common area. On 4/3/25, [name redacted, RN manager (Registered Nurse) was notified of this complaint to further investigate with other CNAs and nurses that may have been present that day. Upon investigation, a second CNA working with [name redacted, Staff F, CNA] was interviewed, [name redacted, Staff D, CNA]. [Name redacted, Staff D, CNA] stated that [name redacted, Staff F} was very loudly telling resident [name…
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.
- Potential for harm · Dcited before2025-05-01 · tag F0804 — failed to serve food at safe, palatable temperature — isolatedEnsure 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
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observation, resident interview and staff interview the facility failed to ensure adequate food temperature for prevention of bacterial pathogen growth. The facility reported a census of 116 residents. Findings included: 1. The Minimum Data Set, dated [DATE] identified Resident #52 with Brief Interview for Mental Status score of 15 out of 15 indicated intact cognition. During an interview on 04/28/25 at 03:16 PM Staff #52 relayed food is often cold, at least every other day , fries are always cold. Staff #52 relayed the food has to travel a distance before served. 2. The Minimum Data Set, dated [DATE] identified Resident #113 with Brief Interview for Mental Status score of 15 out of 15 indicated intact cognition. During an interview on 04/28/25 at 04:18 PM, Resident #113 relayed food has not always been hot, portions can be small, not enough left for seconds and had spaghetti and meatballs recently that was not even warm. During a continuous observation of meal service on 4/29/25 starting at 12:04 PM 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.
- Potential for harm · Ecited before2024-06-13 · tag F0804 — failed to serve food at safe, palatable temperature — patternEnsure 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
NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, facility policy review, food temperatures, staff and resident interviews the facility failed to provide food at a safe temperature in 2 of the 7 households (Heritage House, and Cobblestone House) reviewed, and palatable food at a preferred temperature for 1 of 2 residents (Resident #90) in the sample. The facility reported a census of 101 residents. Findings Include: On 6/10/2024 at 11:35 AM, Food Service/Dietary Manager stated all food items are temped when they come out of the ovens and all individual household kitchens check and log all of the meal items at the point of service. On 6/11/2024 at 12:20 PM, upon arrival on the unit the Food Service/Dietary Manager learned Staff A, dietary staff had started to plate the noon meal. When asked, Staff A stated he had not checked the food temperatures prior to serving the noon meal. Food service was temporarily halted by the Food Service Manager and all food temperatures were checked by the staff for the steam table and the cold service food.…
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.
- Potential for harm · Dcited before2024-06-13 · tag F0658 — failed to meet professional standards of care — isolatedEnsure services provided by the nursing facility meet professional standards of quality.
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, interview, record review, and the facility policy, the facility failed to ensure nursing staff watched and supervised residents take their medications after issuing in a medication cup for 2 of 7 residents (Resident #7, and Resident #61) reviewed. The failure resulted in a medication being left unattended in common areas within the facility, and a resident not taking her medicaiton for more then 20 minutes after adminstered. The facility reported a census of 101 residents. Findings include: 1. The Minimum Data Set (MDS) assessment, dated 4/17/24, revealed Resident #7 scored a 12 out of 15 on the Brief Interview for Mental Status (BIMS) exam, which indicated moderately impaired cognition. The MDS revealed diagnoses for non-traumatic brain dysfunction, unspecified dementia without behavioral disturbance, and depression. The MDS revealed resident took antianxiety, antidepressant, and opioid medications. The EMR (Electronic Medical Record) Medication Administration Record (MAR) revealed 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.
“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.
- 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.
Fines & penalties
$65,094 in federal fines across 2 penalties.
- $57,073 — penalty dated 2025-12-17
- $8,021 — penalty dated 2024-11-12
Dates are the dates CMS records the penalty, not the date of the conduct behind it. CMS publishes penalties on a rolling window, so this is what is currently on the public file — not the home’s lifetime history, and an older fine may attach to a problem that has since been corrected. The amounts are as imposed: the CMS file does not record whether a penalty was appealed, reduced, or paid, so we don’t say. Ask the home what each one was for and what changed since.
Who owns this facility
| Owner / manager | Type | Role | Share | Since |
|---|---|---|---|---|
| GREAT RIVER HEALTH SYSTEM INC | Organization | 5% OR GREATER DIRECT OWNERSHIP INTEREST; OPERATIONAL/MANAGERIAL CONTROL | 100% | since 08/01/2018 |
| ANDERSON, JOY | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 03/01/2021 |
| BARR, DEANNA | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 03/01/2021 |
| DEETS, RYAN | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 01/27/2026 |
| DODD, NEAL | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 01/01/2022 |
| ENGBERG, ROBERT | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 01/01/2019 |
| HICKEY, MICHAEL | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 07/01/2024 |
| HUFFMAN, ROBERT | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 01/01/2022 |
| MARTIN, DOUGLAS | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 01/01/2019 |
| MCCOY, MICHAEL | Individual | CORPORATE DIRECTOR; CORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL | — | since 10/12/2022 |
| MCKILLIP, JOHN | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 01/01/2019 |
| MCNAMEE, CARLA | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 03/01/2021 |
| RIHERD, GINA | Individual | CORPORATE DIRECTOR | — | since 07/01/2025 |
| STEPHENSON, VICTORIA | Individual | CORPORATE DIRECTOR; OPERATIONAL/MANAGERIAL CONTROL | — | since 01/01/2022 |
| COLGAN, TERESA | Individual | CORPORATE OFFICER; OPERATIONAL/MANAGERIAL CONTROL | — | since 07/01/2021 |
| ARAMARK HEALTHCARE SUPPORT SERVICES LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 02/19/2025 |
| SOUTHEAST IOWA REGIONAL MEDICAL CENTER INC | Organization | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 04/01/2013 |
| ALEXANDER, JEREMY | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 09/16/2019 |
| CHELF, TODD | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 01/18/2021 |
| FLEMING, BETH | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 03/20/2023 |
| HAGAN, TOMI | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 12/03/2018 |
| KLOPFENSTEIN, MARY | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 12/01/2023 |
| RASHID, JOHN | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 01/01/2025 |
| RODRIGUEZ, RUSSELL | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | since 08/01/2022 |
| RYON, JOEL | Individual | OPERATIONAL/MANAGERIAL CONTROL | — | since 01/23/2023 |
| WEST, AMY | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 08/26/2024 |
| YOST, MICHAEL | Individual | OPERATIONAL/MANAGERIAL CONTROL; ADP OF THE SNF | — | since 02/13/2023 |
| CLIFTONLARSONALLEN LLP | Organization | ADP OF THE SNF | — | since 06/14/2021 |
| DUNN, HOPE | Individual | ADP OF THE SNF | — | since 06/27/2022 |
| LINHART, DANIEL | Individual | ADP OF THE SNF | — | since 01/01/2021 |
CMS files one row per role, so the 55 rows in the source record cover these 30 parties — each is shown once here with every role it holds. Nothing is omitted.
4 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.
What families pay in IA
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.
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 165110. CMS refreshes its data monthly, and the star rating rests on the last standard inspection — dated 2026-06-18, 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.