Cycle 1
Health 2025-07-31 · Fire 2025-07-31
0 health deficiencies
No concentrated health issue counts in this cycle.
2 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)
Milford, IA
Accura Healthcare of Milford
5-star overall rating with 5-star inspections with 2 fire-safety deficiencies in the latest cycle
1600 13th Street, Milford, IA
(712) 338-4742
Overall
5 / 5
CMS overall stars
Health inspections
5 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
2 / 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
1999-02-01
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
0.48
Registered nurse staffing · state 0.73 · national 0.68
LPN hours / resident day
0.86
Licensed practical nurse staffing · state 0.57 · national 0.87
Aide hours / resident day
2.20
Nurse aide staffing · state 2.53 · national 2.35
Total nurse hours
3.54
All reported nurse hours · state 3.83 · national 3.89
Licensed hours
1.34
RN + LPN hours · state 1.30 · national 1.54
Weekend hours
3.17
Weekend nurse staffing · state 3.35 · national 3.43
Weekend RN hours
0.37
Weekend registered nurse coverage · state 0.50 · national 0.47
Physical therapist
0.09
Reported PT staffing · state 0.04 · national 0.07
Adjusted RN hours
0.51
CMS adjusted RN staffing hours
Adjusted total hours
3.78
CMS adjusted total nurse staffing hours
Case-mix index
1.28
Higher values indicate more complex resident acuity
RN turnover
0%
Annual RN turnover
Total nurse turnover
45%
Annual nurse turnover · state 44% · national 46%
SNF VBP
Value-based purchasing
Program rank
5,543
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
35.85
Composite VBP score used to determine payment impact.
Payment multiplier
0.9894
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
5.44
Baseline 19.48% · Performance 18.91% · Measure score 5.44 · Achievement 5.44 · Improvement 1.81
Healthcare-associated infections
3.51
Baseline 5.73% · Performance 6.78% · Measure score 3.51 · Achievement 3.51 · Improvement 0
Total nurse turnover
3.06
Performance 51.16% · Measure score 3.06 · Achievement 3.06 · This facility did not have sufficient data to calculate a baseline period measure result.
Adjusted total nurse staffing
2.33
Baseline 4.31 hours · Performance 3.74 hours · Measure score 2.33 · Achievement 2.33 · Improvement 0
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 9.1% |
10.72%
1.6 pts better
|
No Different than the National Rate · Eligible stays 87 · Observed rate 3.45% · Lower 95% interval 5.93% |
| Discharge to community | 50.17% |
50.57%
0.4 pts worse
|
No Different than the National Rate · Eligible stays 76 · Observed rate 50% · Lower 95% interval 40.11% |
| Medicare spending per beneficiary | 0.81 |
1.02
0.2 pts better
|
|
| Drug regimen review with follow-up | 98% |
95.27%
2.7 pts better
|
Numerator 49 · Denominator 50 |
| Falls with major injury | 2% |
0.77%
1.2 pts worse
|
Numerator 1 · Denominator 50 |
| Discharge self-care score | 27.27% |
53.69%
26.4 pts worse
|
Numerator 12 · Denominator 44 |
| Discharge mobility score | 25% |
50.94%
25.9 pts worse
|
Numerator 11 · Denominator 44 |
| Pressure ulcers or injuries, new or worsened | 4% |
2.29%
1.7 pts worse
|
Numerator 2 · Denominator 50 · Adjusted rate 3.89% |
| Healthcare-associated infections requiring hospitalization | 6.79% |
7.12%
0.3 pts better
|
No Different than the National Rate · Eligible stays 35 · Observed rate 2.86% · Lower 95% interval 3.93% |
| Staff COVID-19 vaccination coverage | 1.47% |
8.2%
6.7 pts worse
|
Numerator 1 · Denominator 68 |
| Staff flu vaccination coverage | 9.21% |
42%
32.8 pts worse
|
Numerator 7 · Denominator 76 |
| Discharge function score | 29.55% |
56.45%
26.9 pts worse
|
Numerator 13 · Denominator 44 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 4 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 22 · Denominator 22 |
| Resident COVID-19 vaccinations up to date | 66.67% |
25.2%
41.5 pts better
|
Numerator 16 · Denominator 24 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 2.8 |
1.5
1.3 pts worse
|
1.9
0.9 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.8 · Observed 2.0 · Expected 1.3 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 2.1 |
2.1
About the same
|
1.8
0.3 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.1 · Observed 1.6 · Expected 1.3 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 98.1% |
94.0%
4.1 pts better
|
93.4%
4.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 97.4% · Q3 97.4% · Q4 97.4% · 4Q avg 98.1% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
95.2%
4.8 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 3.2% |
3.7%
0.5 pts better
|
3.3%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 5.1% · Q2 0.0% · Q3 5.1% · Q4 2.6% · 4Q avg 3.2% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 6.0% |
4.0%
2 pts worse
|
11.4%
5.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 5.4% · Q2 8.1% · Q3 5.4% · Q4 5.1% · 4Q avg 6.0% |
| Percentage of long-stay residents who lose too much weight | 8.0% |
4.9%
3.1 pts worse
|
5.4%
2.6 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 16.7% · Q2 9.7% · Q3 6.5% · Q4 0.0% · 4Q avg 8.0% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 25.0% |
20.6%
4.4 pts worse
|
19.6%
5.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 20.6% · Q2 25.7% · Q3 26.5% · Q4 27.3% · 4Q avg 25.0% |
| Percentage of long-stay residents who received an antipsychotic medication | 13.6% |
19.8%
6.2 pts better
|
16.7%
3.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 15.4% · Q2 13.3% · Q3 10.0% · Q4 15.6% · 4Q avg 13.6% · 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 | 33.3% |
18.5%
14.8 pts worse
|
16.3%
17 pts worse
|
Long Stay · 2024Q4-2025Q3 · 4Q avg 33.3% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 31.7% |
18.3%
13.4 pts worse
|
14.9%
16.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 33.3% · Q2 29.0% · Q3 40.6% · Q4 23.3% · 4Q avg 31.7% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.9% |
1.7%
0.8 pts better
|
1.0%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 2.0% · Q4 1.6% · 4Q avg 0.9% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 2.1% |
2.5%
0.4 pts better
|
1.7%
0.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 5.7% · Q2 0.0% · Q3 2.8% · Q4 0.0% · 4Q avg 2.1% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 33.0% |
26.0%
7 pts worse
|
19.8%
13.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 42.5% · Q2 32.4% · Q3 19.6% · Q4 37.2% · 4Q avg 33.0% |
| Percentage of long-stay residents with pressure ulcers | 4.9% |
4.3%
0.6 pts worse
|
5.1%
0.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 4.4% · Q2 4.5% · Q3 9.1% · Q4 1.9% · 4Q avg 4.9% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
84.3%
15.7 pts better
|
81.7%
18.3 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 12.9% |
13.1%
0.2 pts better
|
12.0%
0.9 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 12.9% · Observed 11.4% · Expected 9.8% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.0% |
1.9%
1.9 pts better
|
1.6%
1.6 pts better
|
Short Stay · 2024Q4-2025Q3 · Q3 0.0% · 4Q avg 0.0% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 100.0% |
73.3%
26.7 pts better
|
79.7%
20.3 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 20.3% |
21.3%
1 pts better
|
23.9%
3.6 pts better
|
Short Stay · 20240701-20250630 · Adjusted 20.3% · Observed 18.2% · Expected 21.3% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-08-15 · Fire 2024-08-15
1 health deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (1 deficiency)
2 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Cycle 3
Health 2023-05-18 · Fire 2023-05-18
7 health deficiencies
Top issue: Resident Assessment and Care Planning (5 deficiencies)
7 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (3 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-07-31
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-09-30
F · Potential for more than minimal harm
2025-07-31
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2025-08-01
F · Potential for more than minimal harm
2024-08-15
K324 · Smoke Deficiencies
Fire Safety
Provide properly protected cooking facilities.
Corrected 2024-09-20
E · Potential for more than minimal harm
2024-08-15
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 2024-08-26
F · Potential for more than minimal harm
2023-05-18
K346 · Smoke Deficiencies
Fire Safety
Follow proper procedures when the fire alarm was out of service for more than 4 hours.
Corrected 2023-06-16
F · Potential for more than minimal harm
2023-05-18
K354 · Smoke Deficiencies
Fire Safety
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Corrected 2023-06-16
F · Potential for more than minimal harm
2023-05-18
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-06-16
F · Potential for more than minimal harm
2023-05-18
K914 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Corrected 2023-06-16
F · Potential for more than minimal harm
2023-05-18
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-06-16
D · Potential for more than minimal harm
2023-05-18
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-06-16
D · Potential for more than minimal harm
2023-05-18
K920 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure proper usage of power strips and extension cords.
Corrected 2023-06-16
Inspection history
Recent health citations
D · Potential for more than minimal harm
2024-08-15
F607 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Corrected 2024-09-15
E · Potential for more than minimal harm
2023-05-18
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2023-06-18
E · Potential for more than minimal harm
2023-05-18
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2023-06-18
D · Potential for more than minimal harm
2023-05-18
F641 · Resident Assessment and Care Planning Deficiencies
Health
Ensure each resident receives an accurate assessment.
Corrected 2023-06-18
D · Potential for more than minimal harm
2023-05-18
F644 · Resident Assessment and Care Planning Deficiencies
Health
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected 2023-06-18
D · Potential for more than minimal harm
2023-05-18
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2023-06-18
D · Potential for more than minimal harm
2023-05-18
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2023-06-18
D · Potential for more than minimal harm
2023-05-18
F805 · Nutrition and Dietary Deficiencies
Health
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Corrected 2023-06-18
Penalties and ownership
What sits behind the stars
Ownership
Accura Healthcare
5% Or Greater Indirect Ownership Interest · Organization
Accura Midwest Healthcare LLC
5% Or Greater Indirect Ownership Interest · Organization
American Healthcare Management Services LLC
Operational/Managerial Control · Organization
Butcher, Daren
W-2 Managing Employee · Individual
Leneave, Ted
5% Or Greater Indirect Ownership Interest · Individual
Leneave, Ted
Corporate Director · Individual
Leneave, Ted
Corporate Officer · Individual
Leneave, Thomas
5% Or Greater Indirect Ownership Interest · Individual
Leneave, Thomas
Corporate Director · Individual
Leneave, Thomas
Corporate Officer · Individual
Olson, Brett
W-2 Managing Employee · Individual
Toti, Lisa
Corporate Director · Individual
Toti, Lisa
W-2 Managing Employee · Individual
Nearby options
Other facilities in reach
#1
Accura Healthcare of Spirit Lake
Spirit Lake, IA
2-star overall rating with 2-star inspections with $34,567 in total fines with 5 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
#2
Spencer Post Acute Rehabilitation Center
Spencer, IA
1-star overall rating with 2-star inspections with $24,706 in total fines with 14 recent health deficiencies with 14 fire-safety deficiencies in the latest cycle
#3
St Luke Lutheran Nursing Home
Spencer, IA
2-star overall rating with 1-star inspections with $90,076 in total fines with 9 recent health deficiencies with 3 fire-safety deficiencies in the latest cycle
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