Cycle 1
Health 2025-05-15 · Fire 2025-05-15
2 health deficiencies
Top issue: Administration (1 deficiency)
3 fire-safety deficiencies
Top issue: Smoke (3 deficiencies)
Cascade, IA
Accura Healthcare of Cascade LLC
5-star overall rating with 4-star inspections with 2 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
701 North Johnson Street NW, Cascade, IA
(563) 852-3277
Overall
5 / 5
CMS overall stars
Health inspections
4 / 5
Survey and complaint cycles
Staffing
5 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
46
Certified beds
Average residents
43
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Accura Healthcare
Operator or chain grouping
Approved since
2006-01-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
37 facilities
Chain averages 2 overall / 2 health / 3 staffing / 3 quality stars
Changed ownership
No
Within the last 12 months
Family council
Yes
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.88
Registered nurse staffing · state 0.73 · national 0.68
LPN hours / resident day
0.63
Licensed practical nurse staffing · state 0.57 · national 0.87
Aide hours / resident day
2.98
Nurse aide staffing · state 2.53 · national 2.35
Total nurse hours
4.49
All reported nurse hours · state 3.83 · national 3.89
Licensed hours
1.51
RN + LPN hours · state 1.30 · national 1.54
Weekend hours
4.08
Weekend nurse staffing · state 3.35 · national 3.43
Weekend RN hours
0.32
Weekend registered nurse coverage · state 0.50 · national 0.47
Physical therapist
0.02
Reported PT staffing · state 0.04 · national 0.07
Adjusted RN hours
1.02
CMS adjusted RN staffing hours
Adjusted total hours
5.25
CMS adjusted total nurse staffing hours
Case-mix index
1.17
Higher values indicate more complex resident acuity
RN turnover
14%
Annual RN turnover · state 44% · national 45%
Total nurse turnover
33%
Annual nurse turnover · state 44% · national 46%
SNF VBP
Value-based purchasing
Program rank
1,981
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
52.47
Composite VBP score used to determine payment impact.
Payment multiplier
1.0070
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Healthcare-associated infections
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Total nurse turnover
5.25
Performance 42.22% · Measure score 5.25 · Achievement 5.25 · This facility did not have sufficient data to calculate a baseline period measure result.
Adjusted total nurse staffing
5.24
Baseline 4.65 hours · Performance 4.57 hours · Measure score 5.24 · Achievement 5.24 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 9.97% |
10.72%
0.8 pts better
|
No Different than the National Rate · Eligible stays 37 · Observed rate 5.41% · Lower 95% interval 6.42% |
| Discharge to community | 62.01% |
50.57%
11.4 pts better
|
No Different than the National Rate · Eligible stays 28 · Observed rate 64.29% · Lower 95% interval 47.6% |
| Medicare spending per beneficiary | 0.84 |
1.02
0.2 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 51 · Denominator 51 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 51 |
| Discharge self-care score | 61.9% |
53.69%
8.2 pts better
|
Numerator 26 · Denominator 42 |
| Discharge mobility score | 59.52% |
50.94%
8.6 pts better
|
Numerator 25 · Denominator 42 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 51 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | Not Available |
7.12%
|
Not Available · Eligible stays 22 · Observed rate Not Available · Lower 95% interval Not Available · Too few residents or stays to report publicly. |
| Staff COVID-19 vaccination coverage | 10.87% |
8.2%
2.7 pts better
|
Numerator 5 · Denominator 46 |
| Staff flu vaccination coverage | 20.9% |
42%
21.1 pts worse
|
Numerator 14 · Denominator 67 |
| Discharge function score | 66.67% |
56.45%
10.2 pts better
|
Numerator 28 · Denominator 42 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 8 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 23 · Denominator 23 |
| Resident COVID-19 vaccinations up to date | 42.86% |
25.2%
17.7 pts better
|
Numerator 12 · Denominator 28 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.5 |
1.5
About the same
|
1.9
0.4 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.5 · Observed 1.4 · Expected 1.7 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 1.6 |
2.1
0.5 pts better
|
1.8
0.2 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.6 · Observed 1.6 · Expected 1.6 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 83.1% |
94.0%
10.9 pts worse
|
93.4%
10.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 74.4% · Q2 78.9% · Q3 90.0% · Q4 88.4% · 4Q avg 83.1% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 97.5% |
95.2%
2.3 pts better
|
95.5%
2 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 97.5% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 3.8% |
3.7%
0.1 pts worse
|
3.3%
0.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.1% · Q2 0.0% · Q3 2.5% · Q4 7.0% · 4Q avg 3.8% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 1.5% |
4.0%
2.5 pts better
|
11.4%
9.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 2.8% · Q3 3.0% · Q4 0.0% · 4Q avg 1.5% |
| Percentage of long-stay residents who lose too much weight | 2.5% |
4.9%
2.4 pts better
|
5.4%
2.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.2% · Q2 0.0% · Q3 3.3% · Q4 0.0% · 4Q avg 2.5% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 41.1% |
20.6%
20.5 pts worse
|
19.6%
21.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 39.4% · Q2 37.5% · Q3 41.9% · Q4 45.5% · 4Q avg 41.1% |
| Percentage of long-stay residents who received an antipsychotic medication | 22.4% |
19.8%
2.6 pts worse
|
16.7%
5.7 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 19.2% · Q2 22.2% · Q3 22.2% · Q4 25.9% · 4Q avg 22.4% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.2%
0.2 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 17.8% |
18.5%
0.7 pts better
|
16.3%
1.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q2 29.8% · Q3 14.5% · Q4 12.7% · 4Q avg 17.8% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 20.8% |
18.3%
2.5 pts worse
|
14.9%
5.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 16.7% · Q2 26.7% · Q3 14.3% · Q4 25.0% · 4Q avg 20.8% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.6% |
1.7%
0.1 pts better
|
1.0%
0.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 4.2% · Q2 0.0% · Q3 2.1% · Q4 0.0% · 4Q avg 1.6% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 1.3% |
2.5%
1.2 pts better
|
1.7%
0.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 2.6% · Q4 2.5% · 4Q avg 1.3% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 28.8% |
26.0%
2.8 pts worse
|
19.8%
9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 16.8% · Q2 34.8% · Q3 26.1% · Q4 36.3% · 4Q avg 28.8% |
| Percentage of long-stay residents with pressure ulcers | 2.6% |
4.3%
1.7 pts better
|
5.1%
2.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 2.6% · Q2 6.4% · Q3 0.0% · Q4 1.7% · 4Q avg 2.6% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 81.1% |
84.3%
3.2 pts worse
|
81.7%
0.6 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 90.5% · Q2 90.9% · Q3 72.0% · Q4 72.7% · 4Q avg 81.1% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 19.0% |
13.1%
5.9 pts worse
|
12.0%
7 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 19.0% · Observed 19.4% · Expected 11.4% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 3.9% |
1.9%
2 pts worse
|
1.6%
2.3 pts worse
|
Short Stay · 2024Q4-2025Q3 · 4Q avg 3.9% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 52.2% |
73.3%
21.1 pts worse
|
79.7%
27.5 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 52.2% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 19.8% |
21.3%
1.5 pts better
|
23.9%
4.1 pts better
|
Short Stay · 20240701-20250630 · Adjusted 19.8% · Observed 19.4% · Expected 23.3% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-07-03 · Fire 2024-07-03
0 health deficiencies
No concentrated health issue counts in this cycle.
8 fire-safety deficiencies
Top issue: Smoke (3 deficiencies)
Cycle 3
Health 2023-06-01 · Fire 2023-06-01
1 health deficiencies
Top issue: Environmental (1 deficiency)
7 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-05-15
K372 · Smoke Deficiencies
Fire Safety
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2025-06-06
E · Potential for more than minimal harm
2025-05-15
K321 · Smoke Deficiencies
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2025-06-06
E · Potential for more than minimal harm
2025-05-15
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2025-06-06
F · Potential for more than minimal harm
2024-07-03
E39 · Emergency Preparedness Deficiencies
Fire Safety
Conduct testing and exercise requirements.
Corrected 2024-08-02
F · Potential for more than minimal harm
2024-07-03
E41 · Emergency Preparedness Deficiencies
Fire Safety
Implement emergency and standby power systems.
Corrected 2024-08-02
F · Potential for more than minimal harm
2024-07-03
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2024-08-02
E · Potential for more than minimal harm
2024-07-03
K211 · Egress Deficiencies
Fire Safety
Keep aisles, corridors, and exits free of obstruction in case of emergency.
Corrected 2024-08-02
E · Potential for more than minimal harm
2024-07-03
K321 · Smoke Deficiencies
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2024-08-02
E · Potential for more than minimal harm
2024-07-03
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2024-08-02
D · Potential for more than minimal harm
2024-07-03
K511 · Services Deficiencies
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2024-08-02
D · Potential for more than minimal harm
2024-07-03
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2024-08-02
F · Potential for more than minimal harm
2023-06-01
E39 · Emergency Preparedness Deficiencies
Fire Safety
Conduct testing and exercise requirements.
Corrected 2023-07-03
F · Potential for more than minimal harm
2023-06-01
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2023-07-03
F · Potential for more than minimal harm
2023-06-01
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-07-03
E · Potential for more than minimal harm
2023-06-01
K223 · Egress Deficiencies
Fire Safety
Provide exit doors that are held open by devices that will automatically close on the activation of a fire alarm or smoke detector.
Corrected 2023-07-03
E · Potential for more than minimal harm
2023-06-01
K321 · Smoke Deficiencies
Fire Safety
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Corrected 2023-07-03
D · Potential for more than minimal harm
2023-06-01
K511 · Services Deficiencies
Fire Safety
Have properly installed electrical wiring and gas equipment.
Corrected 2023-07-03
D · Potential for more than minimal harm
2023-06-01
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2023-07-03
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-07-03
F940 · Administration Deficiencies
Health
Develop, implement, and/or maintain an effective training program for all new and existing staff members.
Corrected 2025-07-11
E · Potential for more than minimal harm
2025-05-15
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-05-31
E · Potential for more than minimal harm
2023-06-01
F921 · Environmental Deficiencies
Health
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Corrected 2023-06-02
Penalties and ownership
What sits behind the stars
Ownership
Accura Healthcare Of The Heartland LLC
5% Or Greater Direct Ownership Interest · Organization
American Healthcare Associates Inc
5% Or Greater Direct Ownership Interest · Organization
American Healthcare Management Services LLC
5% Or Greater Direct Ownership Interest · Organization
Black, Taylor
W-2 Managing Employee · Individual
Dixon, Kevin
Corporate Director · Individual
Leneave, Ted
5% Or Greater Indirect Ownership Interest · Individual
Leneave, Ted
Corporate Officer · Individual
Toti, Lisa
5% Or Greater Indirect Ownership Interest · Individual
Toti, Lisa
Corporate Officer · Individual
Toti, Lisa
W-2 Managing Employee · Individual
Nearby options
Other facilities in reach
#1
Monticello Nursing & Rehab Center
Monticello, IA
3-star overall rating with 3-star inspections with $4,194 in total fines with 7 recent health deficiencies with 7 fire-safety deficiencies in the latest cycle
#2
MercyOne Dyersville Senior Care
Dyersville, IA
5-star overall rating with 5-star inspections with 3 fire-safety deficiencies in the latest cycle
#3
Anamosa Care Center
Anamosa, IA
5-star overall rating with 4-star inspections with 2 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
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