Federal inspection record · CMS data as of October 1, 2026
Avoca Specialty Care
610 East York Street, Avoca, IA · (712) 343-6398
- Certified beds
- 46
- Residents per day
- 34
- Ownership
- Non-Profit
- Chain
- Care Initiatives
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- August 1, 1996
1
How this home got 2 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Iowa.
-
Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★2 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Iowa homes
Avoca Specialty Care carries 77 inspection points. That is fewer than 22% of Iowa's 385 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Iowa: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–7 pts
- 4★ 7–21 pts
- 3★ 21–41 pts
- 2★ 41–86.5 pts
- 1★ over 86.5 pts
Bars show every rated home in Iowa by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
59 health citations on record since 2024. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Resident Assessment and Care Planning13E
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure each resident receives an accurate assessment.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure each resident receives an accurate assessment.
- E
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure each resident receives an accurate assessment.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
Quality of Life and Care13E
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide safe and appropriate respiratory care for a resident when needed.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
- E
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
- D
Provide enough food/fluids to maintain a resident's health.
- D
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
- D
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Nutrition and Dietary8F
- E
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Dispose of garbage and refuse properly.
- F
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
- E
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
- E
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Resident Rights6D
- D
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
- D
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Nursing and Physician Services5E
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- E
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Freedom from Abuse, Neglect, and Exploitation4E
- E
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
- D
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
- D
Respond appropriately to all alleged violations.
Pharmacy Service4E
- D
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
- E
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
- D
Ensure medication error rates are not 5 percent or greater.
- D
Ensure that residents are free from significant medication errors.
Infection Control3E
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
Environmental2E
- D
Have policies on smoking.
- E
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Administration1F
- F
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Inspection history
2026-03-05
13 health deficiencies · 5 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (6 deficiencies)
2025-01-30
13 health deficiencies · 4 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (3 deficiencies)
2024-02-01
33 health deficiencies · 10 fire-safety deficiencies
Top issue: Nutrition and Dietary (8 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 2 min of nursing staff time a day, 50 min of it from a registered nurse.
This home
3 h 2 min
Iowa average
3 h 52 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 60% of nursing staff and 20% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine1.2 pts worse | 93.0% | 94.2% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine9.1 pts worse | 86.7% | 95.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury0.4 pts worse | 4.3% | 3.9% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms2.2 pts better | 2.0% | 4.2% | 13.5% |
| Percentage of long-stay residents who lose too much weight3.2 pts better | 1.2% | 4.4% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication10.3 pts worse | 31.3% | 21.0% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication9.2 pts worse | 29.0% | 19.8% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.2 pts better | 0.0% | 0.2% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened8.4 pts worse | 23.6% | 15.2% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased3.7 pts worse | 20.3% | 16.6% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.9 pts worse | 2.3% | 1.4% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.5 pts better | 0.9% | 2.4% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence0.7 pts better | 24.3% | 25.0% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.6 pts better | 3.5% | 4.1% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine7.3 pts better | 91.3% | 84.0% | 82.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication2.1 pts better | 0.0% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine11.8 pts better | 86.2% | 74.4% | 80.1% |
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Who owns and runs it
24 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Care Initiatives | 5% Or Greater Direct Ownership Interest · Organization | 100% | 43 facilities |
| Beal, Michael | Corporate Director · Individual | 0% | 43 facilities |
| Beal, Michael | Corporate Officer · Individual | 0% | 43 facilities |
| Boeve, Destiny | Operational/Managerial Control · Individual | 0% | 17 facilities |
| Bowen, Lane | Corporate Director · Individual | 0% | 44 facilities |
| Carothers, Mary Jane | Corporate Director · Individual | 0% | 43 facilities |
| Childs, Kevin | Corporate Director · Individual | 0% | 43 facilities |
| Computershare Corporate Trust Company, Na | 5% Or Greater Mortgage Interest · Organization | 0% | 59 facilities |
| Computershare Corporate Trust Company, Na | Adp Of The SNF · Organization | 0% | 59 facilities |
| Corless, Peter | Corporate Director · Individual | 0% | 43 facilities |
| Corless, Peter | Adp Of The SNF · Individual | 0% | 43 facilities |
| Dixon, David | Corporate Officer · Individual | 0% | 44 facilities |
| Drake, Emily | Corporate Officer · Individual | 0% | 43 facilities |
| Gilyard, Tanya | Corporate Officer · Individual | 0% | 42 facilities |
| Krein, Keith | Corporate Director · Individual | 0% | 43 facilities |
| Kuhn, Jeramy | Corporate Officer · Individual | 0% | 43 facilities |
| Mcdyer, Jessica | Corporate Officer · Individual | 0% | 43 facilities |
| Monroe, Marquita | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Monroe, Marquita | Adp Of The SNF · Individual | 0% | 1 facilities |
| Rust, Elizabeth | Corporate Director · Individual | 0% | 43 facilities |
| Sturm, Denise | Corporate Director · Individual | 0% | 43 facilities |
| Upmeyer, Linda | Corporate Director · Individual | 0% | 43 facilities |
| Walters, Jeffery | Adp Of The SNF · Individual | 0% | 1 facilities |
| Wei, Shipeng | Adp Of The SNF · Individual | 0% | 17 facilities |
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Fire safety
19 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Miscellaneous6F
- F
Have simulated fire drills held at unexpected times.
- F
Have simulated fire drills held at unexpected times.
- E
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- E
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F
Have simulated fire drills held at unexpected times.
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Emergency Preparedness4F
- F
Conduct testing and exercise requirements.
- F
Develop and maintain an Emergency Preparedness Program (EP).
- F
Develop and maintain an Emergency Preparedness Program (EP).
- E
Establish roles under a Waiver declared by secretary.
Smoke4F
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Provide properly protected cooking facilities.
- F
Provide properly protected cooking facilities.
- F
Inspect, test, and maintain automatic sprinkler systems.
Gas, Vacuum, and Electrical Systems3F
- F
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F
Have generator or other power source capable of supplying service within 10 seconds.
Egress2F
- F
Install emergency lighting that can last at least 1 1/2 hours.
- E
Have corridors or aisles that are unobstructed and are at least 8 feet in width.
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Other homes nearby
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★★★★★- Worst citation, 3 yrs
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Oakland Manor
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