Federal inspection record · CMS data as of October 1, 2026
Grand Meadows Senior Living & Health Care
5300 Grand Meadow Drive, Asbury, IA · (563) 588-1413
- Certified beds
- 32
- Residents per day
- 28
- Ownership
- For-Profit
- Chain
- Tutera Senior Living & Health Care
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- July 12, 2017
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
Grand Meadows Senior Living & Health Care carries 55.75 inspection points. That is fewer than 32% 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
18 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.
Harm and immediate-jeopardy citations (1)
-
J
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Everything else, by area of care
Resident Rights4E
- E
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Freedom from Abuse, Neglect, and Exploitation3D
- D
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- D
Respond appropriately to all alleged violations.
Quality of Life and Care3D
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
- D
Provide care or services that was trauma informed and/or culturally competent.
Nutrition and Dietary3F
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Dispose of garbage and refuse properly.
Infection Control2D
- D
Provide and implement an infection prevention and control program.
- D
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Pharmacy Service1D
- D
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Administration1D
- D
Have a plan that describes the process for conducting QAPI and QAA activities.
Inspection history
2026-03-26
7 health deficiencies · 1 fire-safety deficiencies
Top issue: Resident Rights (3 deficiencies)
2025-03-06
5 health deficiencies · 1 fire-safety deficiencies
Top issue: Quality of Life and Care (2 deficiencies)
2024-04-23
6 health deficiencies · 1 fire-safety deficiencies
Top issue: Freedom from Abuse and Neglect and Exploitation (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 5 h 8 min of nursing staff time a day, 1 h 36 min of it from a registered nurse.
This home
5 h 8 min
Iowa average
3 h 52 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
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
$16,448 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2024-04-23 | Fine | $16,448 |
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. |
|---|---|---|---|
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine12 pts worse | 82.2% | 94.2% | 93.7% |
| Percentage of long-stay residents experiencing one or more falls with major injury4.3 pts worse | 8.2% | 3.9% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms1.2 pts better | 3.0% | 4.2% | 13.5% |
| Percentage of long-stay residents who lose too much weight2.1 pts better | 2.3% | 4.4% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication3.2 pts better | 17.8% | 21.0% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication7 pts better | 12.8% | 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 worsened8.7 pts worse | 23.9% | 15.2% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased1.6 pts worse | 18.2% | 16.6% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.8 pts better | 0.6% | 1.4% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.8 pts worse | 4.2% | 2.4% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence4.4 pts worse | 29.4% | 25.0% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1 pts worse | 5.1% | 4.1% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine11.9 pts worse | 72.1% | 84.0% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit22.7 pts worse | 35.7% | 13.0% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medicationAbout the same | 2.1% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine5.7 pts worse | 68.7% | 74.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission14.9 pts worse | 35.6% | 20.7% | 23.4% |
·
Who owns and runs it
22 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 |
|---|---|---|---|
| Bloom, Randall | Operational/Managerial Control · Individual | 0% | 15 facilities |
| Bloom, Randall | Adp Of The SNF · Individual | 0% | 15 facilities |
| Brooks, Kiley | Operational/Managerial Control · Individual | 0% | 27 facilities |
| Brooks, Kiley | Adp Of The SNF · Individual | 0% | 27 facilities |
| Constace Marie Mendolia 2009 Irrv Tr | Indirect Ownership Interest · Organization | 0% | 2 facilities |
| Constace Marie Mendolia 2009 Irrv Tr | Adp Of The SNF · Organization | 0% | 2 facilities |
| Dominic Frank Tutera 2016 Irrv Tr | Indirect Ownership Interest · Organization | 0% | 4 facilities |
| Grand Meadows Senior Living & Health Care Property LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Hannah Marie Tutera 2016 Irrv Tr | Indirect Ownership Interest · Organization | 0% | 1 facilities |
| Jewell, Susan | Adp Of The SNF · Individual | 0% | 1 facilities |
| Joseph Charles Tutera Jr 2016 Irrv Tr | Indirect Ownership Interest · Organization | 0% | 1 facilities |
| Laura Cirese Tutera 2016 Irrv Tr | Indirect Ownership Interest · Organization | 0% | 1 facilities |
| Mary Margaret Cunningham 2009 Irrv Tr | Indirect Ownership Interest · Organization | 0% | 2 facilities |
| Mary Margaret Cunningham 2009 Irrv Tr | Adp Of The SNF · Organization | 0% | 2 facilities |
| Seitera LP LLC | Direct Ownership Interest · Organization | 0% | 1 facilities |
| Tutera Group, Inc | Adp Of The SNF · Organization | 0% | 5 facilities |
| Tutera, Joseph | Operational/Managerial Control · Individual | 0% | 21 facilities |
| Tutera, Joseph | Adp Of The SNF · Individual | 0% | 21 facilities |
| Walnut Creek Management Company LLC | Operational/Managerial Control · Organization | 0% | 21 facilities |
| Walnut Creek Management Company LLC | Adp Of The SNF · Organization | 0% | 21 facilities |
| Warren, Janet | Operational/Managerial Control · Individual | 0% | 1 facilities |
| Warren, Janet | Adp Of The SNF · Individual | 0% | 1 facilities |
·
Fire safety
3 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke2F
- E
Provide properly protected cooking facilities.
- F
Inspect, test, and maintain automatic sprinkler systems.
Miscellaneous1F
- F
Provide a written emergency evacuation plan.
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Other homes nearby
-
Hawkeye Care Center Dubuque
Asbury, IA
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 3 h 33 min
- Fines
- $0
-
Ennoble Nursing and Rehab
Dubuque, IA · Shlomo Hoffman
★★★★★- Worst citation, 3 yrs
- E
- Nursing / resident / day
- 3 h 52 min
- Fines
- $0
-
Luther Manor at Hillcrest
Dubuque, IA · Shlomo Hoffman
★★★★★- Worst citation, 3 yrs
- G
- Nursing / resident / day
- 4 h 7 min
- Fines
- $42,406