Federal inspection record · CMS data as of October 1, 2026
Friendship Home Association
714 Division, Audubon, IA · (712) 563-2651
- Certified beds
- 46
- Residents per day
- 40
- Ownership
- Non-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- October 3, 1994
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.
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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.
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Overall
★★★★★2 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Iowa homes
Friendship Home Association carries 44 inspection points. That is fewer than 40% 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
15 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 Rights4E
- E
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
- D
Ensure that residents are fully informed and understand their health status, care and treatments.
- 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 request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Nutrition and Dietary3F
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- 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
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Resident Assessment and Care Planning3E
- E
Ensure each resident receives an accurate assessment.
- D
Assess the resident when there is a significant change in condition
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Freedom from Abuse, Neglect, and Exploitation2E
- D
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
- E
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Quality of Life and Care2D
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Infection Control1D
- D
Provide and implement an infection prevention and control program.
Inspection history
2026-07-30
9 health deficiencies · 7 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
2025-06-19
2 health deficiencies · 5 fire-safety deficiencies
Top issue: Quality of Life and Care (1 deficiency)
2024-08-01
4 health deficiencies · 9 fire-safety deficiencies
Top issue: Nutrition and Dietary (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 55 min of nursing staff time a day, 33 min of it from a registered nurse.
This home
3 h 55 min
Iowa average
3 h 52 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 58% of nursing staff and 60% of registered nurses left in the past year.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$7,342 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2023-11-06 | Fine | $2,797 |
| 2023-10-30 | Fine | $2,447 |
| 2023-10-23 | Fine | $2,098 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.1 pts worse | 1.5 | 1.4 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.9 pts worse | 2.8 | 1.9 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine2.6 pts better | 96.8% | 94.2% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine1.7 pts better | 97.5% | 95.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury2 pts better | 1.9% | 3.9% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms0.8 pts better | 3.4% | 4.2% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.7 pts worse | 6.1% | 4.4% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication0.8 pts better | 20.2% | 21.0% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication18.3 pts worse | 38.1% | 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 worsened0.4 pts better | 14.8% | 15.2% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased2.3 pts worse | 18.9% | 16.6% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.9 pts better | 0.5% | 1.4% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.4 pts worse | 3.8% | 2.4% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence8 pts better | 17.0% | 25.0% | 18.3% |
| Percentage of long-stay residents with pressure ulcers2.8 pts better | 1.3% | 4.1% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine12.6 pts worse | 71.4% | 84.0% | 82.3% |
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Who owns and runs it
14 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 |
|---|---|---|---|
| Alt, Melinda | Corporate Director · Individual | 0% | 1 facilities |
| Andersen, Jessica | W-2 Managing Employee · Individual | 0% | 1 facilities |
| Andersen, Jessica | Corporate Director · Individual | 0% | 1 facilities |
| Andersen, Jessica | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Andersen, Timothy | Corporate Director · Individual | 0% | 1 facilities |
| Andersen, Timothy | Corporate Officer · Individual | 0% | 1 facilities |
| Deist, Genelle | Corporate Director · Individual | 0% | 1 facilities |
| Deist, Genelle | Corporate Officer · Individual | 0% | 1 facilities |
| Edwards, Jeffrey | Corporate Director · Individual | 0% | 1 facilities |
| Edwards, Jeffrey | Corporate Officer · Individual | 0% | 1 facilities |
| Frolich, Pattie | Corporate Director · Individual | 0% | 1 facilities |
| Jones, Mark | Corporate Director · Individual | 0% | 1 facilities |
| Nelsen, Karen | Corporate Director · Individual | 0% | 1 facilities |
| Wede, Susan | Corporate Director · Individual | 0% | 1 facilities |
·
Fire safety
21 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke10F
- F
Install a fire alarm system that can be heard throughout the facility.
- E
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- F
Properly install and monitor supervisory attachments on automatic sprinkler systems.
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
- F
Install a fire alarm system that can be heard throughout the facility.
- E
Inspect, test, and maintain automatic sprinkler systems.
- D
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Install an approved automatic sprinkler system.
- D
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Gas, Vacuum, and Electrical Systems4F
- F
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F
Ensure that testing and maintenance of electrical equipment is performed.
- 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.
Emergency Preparedness2F
- F
Establish roles under a Waiver declared by secretary.
- F
Develop and maintain an Emergency Preparedness Program (EP).
Egress2F
- F
Install emergency lighting that can last at least 1 1/2 hours.
- E
Have properly located and lighted "Exit" signs.
Miscellaneous2F
- E
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F
Have simulated fire drills held at unexpected times.
Services1D
- D
Have properly installed electrical wiring and gas equipment.
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Other homes nearby
-
Exira Care Center
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★★★★★- Worst citation, 3 yrs
- J
- Nursing / resident / day
- 4 h 13 min
- Fines
- $22,880
-
Salem Lutheran Home
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★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 55 min
- Fines
- $15,260
-
Thomas Rest Haven
Coon Rapids, IA
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 4 h 19 min
- Fines
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