Cycle 1
Health 2025-05-08 · Fire 2025-05-08
5 health deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
5 fire-safety deficiencies
Top issue: Egress (2 deficiencies)
Creston, IA
Creston Specialty Care
3-star overall rating with 3-star inspections with $19,663 in total fines with 5 recent health deficiencies with 5 fire-safety deficiencies in the latest cycle
1001 Cottonwood Drive, Creston, IA
(641) 782-8511
Overall
3 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
74
Certified beds
Average residents
50
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Care Initiatives
Operator or chain grouping
Approved since
1994-03-01
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
43 facilities
Chain averages 3 overall / 3 health / 4 staffing / 4 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
0.55
Registered nurse staffing · state 0.73 · national 0.68
LPN hours / resident day
0.87
Licensed practical nurse staffing · state 0.57 · national 0.87
Aide hours / resident day
1.68
Nurse aide staffing · state 2.53 · national 2.35
Total nurse hours
3.10
All reported nurse hours · state 3.83 · national 3.89
Licensed hours
1.42
RN + LPN hours · state 1.30 · national 1.54
Weekend hours
2.85
Weekend nurse staffing · state 3.35 · national 3.43
Weekend RN hours
0.28
Weekend registered nurse coverage · state 0.50 · national 0.47
Physical therapist
0.01
Reported PT staffing · state 0.04 · national 0.07
Adjusted RN hours
0.61
CMS adjusted RN staffing hours
Adjusted total hours
3.46
CMS adjusted total nurse staffing hours
Case-mix index
1.23
Higher values indicate more complex resident acuity
RN turnover
50%
Annual RN turnover · state 44% · national 45%
Total nurse turnover
43%
Annual nurse turnover · state 44% · national 46%
SNF VBP
Value-based purchasing
Program rank
2,156
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
51.40
Composite VBP score used to determine payment impact.
Payment multiplier
1.0057
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
6.44
Baseline 20.05% · Performance 18.45% · Measure score 6.44 · Achievement 6.44 · Improvement 4.82
Healthcare-associated infections
6.12
Baseline 7.11% · Performance 6.01% · Measure score 6.12 · Achievement 6.12 · Improvement 4.72
Total nurse turnover
5.11
Baseline 70.79% · Performance 45.00% · Measure score 5.11 · Achievement 4.57 · Improvement 5.11
Adjusted total nurse staffing
2.88
Baseline 3.12 hours · Performance 3.90 hours · Measure score 2.88 · Achievement 2.88 · Improvement 2.42
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 8.91% |
10.72%
1.8 pts better
|
No Different than the National Rate · Eligible stays 151 · Observed rate 4.64% · Lower 95% interval 5.84% |
| Discharge to community | 55.15% |
50.57%
4.6 pts better
|
No Different than the National Rate · Eligible stays 131 · Observed rate 57.25% · Lower 95% interval 47.23% |
| Medicare spending per beneficiary | 0.93 |
1.02
0.1 pts better
|
|
| Drug regimen review with follow-up | 82.42% |
95.27%
12.8 pts worse
|
Numerator 75 · Denominator 91 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 91 |
| Discharge self-care score | 72.97% |
53.69%
19.3 pts better
|
Numerator 54 · Denominator 74 |
| Discharge mobility score | 58.11% |
50.94%
7.2 pts better
|
Numerator 43 · Denominator 74 |
| Pressure ulcers or injuries, new or worsened | 4.4% |
2.29%
2.1 pts worse
|
Numerator 4 · Denominator 91 · Adjusted rate 5.34% |
| Healthcare-associated infections requiring hospitalization | 6.01% |
7.12%
1.1 pts better
|
No Different than the National Rate · Eligible stays 92 · Observed rate 2.17% · Lower 95% interval 3.21% |
| Staff COVID-19 vaccination coverage | 0% |
8.2%
8.2 pts worse
|
Numerator 0 · Denominator 78 |
| Staff flu vaccination coverage | 12.5% |
42%
29.5 pts worse
|
Numerator 18 · Denominator 144 |
| Discharge function score | 72.97% |
56.45%
16.5 pts better
|
Numerator 54 · Denominator 74 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 52 · Denominator 52 |
| Resident COVID-19 vaccinations up to date | 34.78% |
25.2%
9.6 pts better
|
Numerator 16 · Denominator 46 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.6 |
1.5
0.1 pts worse
|
1.9
0.3 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.6 · Observed 1.3 · Expected 1.6 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 3.0 |
2.1
0.9 pts worse
|
1.8
1.2 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 3.0 · Observed 2.5 · Expected 1.4 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 100.0% |
94.0%
6 pts better
|
93.4%
6.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 100.0% · 4Q avg 100.0% |
| 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 | 3.4% |
3.7%
0.3 pts better
|
3.3%
0.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 2.3% · Q2 2.2% · Q3 4.8% · Q4 4.4% · 4Q avg 3.4% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.6% |
4.0%
3.4 pts better
|
11.4%
10.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 2.5% · Q4 0.0% · 4Q avg 0.6% |
| Percentage of long-stay residents who lose too much weight | 3.8% |
4.9%
1.1 pts better
|
5.4%
1.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.1% · Q2 2.9% · Q3 3.1% · Q4 3.2% · 4Q avg 3.8% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 12.9% |
20.6%
7.7 pts better
|
19.6%
6.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 15.2% · Q2 11.4% · Q3 12.5% · Q4 12.5% · 4Q avg 12.9% |
| Percentage of long-stay residents who received an antipsychotic medication | 10.6% |
19.8%
9.2 pts better
|
16.7%
6.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 10.3% · Q2 13.3% · Q3 11.5% · Q4 7.1% · 4Q avg 10.6% · 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 | 23.2% |
18.5%
4.7 pts worse
|
16.3%
6.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q2 21.1% · Q3 26.9% · Q4 33.9% · 4Q avg 23.2% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 18.3% |
18.3%
About the same
|
14.9%
3.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 12.1% · Q2 17.1% · Q3 19.4% · Q4 25.0% · 4Q avg 18.3% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.0% |
1.7%
1.7 pts better
|
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% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 1.1% |
2.5%
1.4 pts better
|
1.7%
0.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 2.4% · Q4 2.3% · 4Q avg 1.1% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 37.6% |
26.0%
11.6 pts worse
|
19.8%
17.8 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 32.1% · Q2 45.5% · Q3 28.7% · Q4 43.2% · 4Q avg 37.6% |
| Percentage of long-stay residents with pressure ulcers | 4.5% |
4.3%
0.2 pts worse
|
5.1%
0.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.1% · Q2 4.4% · Q3 3.6% · Q4 1.9% · 4Q avg 4.5% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 99.2% |
84.3%
14.9 pts better
|
81.7%
17.5 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 98.5% · Q2 100.0% · Q3 98.5% · Q4 100.0% · 4Q avg 99.2% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 16.9% |
13.1%
3.8 pts worse
|
12.0%
4.9 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 16.9% · Observed 15.0% · Expected 9.9% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 3.3% |
1.9%
1.4 pts worse
|
1.6%
1.7 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 4.5% · Q2 2.6% · Q3 2.6% · Q4 3.2% · 4Q avg 3.3% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 98.5% |
73.3%
25.2 pts better
|
79.7%
18.8 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 98.5% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 22.9% |
21.3%
1.6 pts worse
|
23.9%
1 pts better
|
Short Stay · 20240701-20250630 · Adjusted 22.9% · Observed 18.3% · Expected 19.1% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-06-20 · Fire 2024-06-20
7 health deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
6 fire-safety deficiencies
Top issue: Egress (2 deficiencies)
Cycle 3
Health 2023-07-20 · Fire 2023-07-20
5 health deficiencies
Top issue: Nutrition and Dietary (2 deficiencies)
5 fire-safety deficiencies
Top issue: Egress (2 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-05-08
K222 · Egress Deficiencies
Fire Safety
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Corrected 2025-05-12
F · Potential for more than minimal harm
2025-05-08
K281 · Egress Deficiencies
Fire Safety
Install proper backup exit lighting.
Corrected 2025-05-12
F · Potential for more than minimal harm
2025-05-08
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2025-05-09
F · Potential for more than minimal harm
2025-05-08
K923 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have proper medical gas storage and administration areas.
Corrected 2025-05-09
D · Potential for more than minimal harm
2025-05-08
K754 · Miscellaneous Deficiencies
Fire Safety
Provide properly sized and located linen or trash receptacles.
Corrected 2025-05-08
F · Potential for more than minimal harm
2024-06-20
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 2024-06-26
F · Potential for more than minimal harm
2024-06-20
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2024-06-26
E · Potential for more than minimal harm
2024-06-20
K761 · Miscellaneous Deficiencies
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2024-07-08
D · Potential for more than minimal harm
2024-06-20
K222 · Egress Deficiencies
Fire Safety
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Corrected 2024-06-25
D · Potential for more than minimal harm
2024-06-20
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2024-07-01
D · Potential for more than minimal harm
2024-06-20
K341 · Smoke Deficiencies
Fire Safety
Install a fire alarm system that can be heard throughout the facility.
Corrected 2024-07-01
F · Potential for more than minimal harm
2023-07-20
K761 · Miscellaneous Deficiencies
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2023-08-01
F · Potential for more than minimal harm
2023-07-20
K918 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Have generator or other power source capable of supplying service within 10 seconds.
Corrected 2023-08-01
E · Potential for more than minimal harm
2023-07-20
K222 · Egress Deficiencies
Fire Safety
Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
Corrected 2023-07-27
E · Potential for more than minimal harm
2023-07-20
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2023-08-01
D · Potential for more than minimal harm
2023-07-20
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-07-27
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-10-09
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2025-10-10
D · Potential for more than minimal harm
2025-10-09
F725 · Nursing and Physician Services Deficiencies
Health
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected 2025-10-10
E · Potential for more than minimal harm
2025-05-08
F637 · Resident Assessment and Care Planning Deficiencies
Health
Assess the resident when there is a significant change in condition
Corrected 2025-05-09
D · Potential for more than minimal harm
2025-05-08
F561 · Resident Rights Deficiencies
Health
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Corrected 2025-05-09
D · Potential for more than minimal harm
2025-05-08
F887 · Infection Control Deficiencies
Health
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Corrected 2025-05-09
D · Potential for more than minimal harm
2024-12-31
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2025-01-01
G · Actual harm
2024-06-20
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2024-07-01
E · Potential for more than minimal harm
2024-06-20
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 2024-07-11
E · Potential for more than minimal harm
2024-06-20
F842 · Resident Assessment and Care Planning Deficiencies
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2024-07-11
E · Potential for more than minimal harm
2024-06-20
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-07-11
D · Potential for more than minimal harm
2024-06-20
F550 · Resident Rights Deficiencies
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2024-07-11
D · Potential for more than minimal harm
2024-06-20
F759 · Pharmacy Service Deficiencies
Health
Ensure medication error rates are not 5 percent or greater.
Corrected 2024-07-11
G · Actual harm
2024-01-04
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2024-01-11
E · Potential for more than minimal harm
2023-07-20
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2023-08-20
E · Potential for more than minimal harm
2023-07-20
F804 · Nutrition and Dietary Deficiencies
Health
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected 2023-08-20
E · Potential for more than minimal harm
2023-07-20
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 2023-08-20
D · Potential for more than minimal harm
2023-07-20
F602 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from the wrongful use of the resident's belongings or money.
Corrected 2023-08-20
Penalties and ownership
What sits behind the stars
$12,048
2024-06-20
Fine
Fine · fine $12,048
Fine
$7,615
2024-01-04
Fine
Fine · fine $7,615
Fine
Ownership
Care Initiatives
5% Or Greater Direct Ownership Interest · Organization
Beal, Michael
Corporate Director · Individual
Beal, Michael
Corporate Officer · Individual
Boeve, Destiny
Operational/Managerial Control · Individual
Bowen, Lane
Corporate Director · Individual
Carothers, Mary Jane
Corporate Director · Individual
Childs, Kevin
Corporate Director · Individual
Computershare Corporate Trust
5% Or Greater Mortgage Interest · Organization
Corless, Peter
Corporate Director · Individual
Dixon, David
Corporate Officer · Individual
Drake, Emily
Corporate Officer · Individual
Gijima, Desire
Operational/Managerial Control · Individual
Gilyard, Tanya
Corporate Officer · Individual
Harvey, Lori
Operational/Managerial Control · Individual
Krein, Keith
Corporate Director · Individual
Kuhn, Jeramy
Corporate Officer · Individual
Mcdyer, Jessica
Corporate Officer · Individual
Rust, Elizabeth
Corporate Director · Individual
Sturm, Denise
Corporate Director · Individual
Upmeyer, Linda
Corporate Director · Individual
Volm, Johanna
Corporate Officer · Individual
Nearby options
Other facilities in reach
#1
Accura Healthcare of Creston
Creston, IA
2-star overall rating with 2-star inspections with $16,801 in total fines with 2 recent health deficiencies
#2
Lenox Care Center
Lenox, IA
2-star overall rating with 2-star inspections with $40,054 in total fines with 13 recent health deficiencies
#3
Greenfield Rehabilitation & Health Care Center
Greenfield, IA
3-star overall rating with 2-star inspections with $4,516 in total fines with 9 recent health deficiencies with 6 fire-safety deficiencies in the latest cycle
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