Federal inspection record · CMS data as of October 1, 2026
Harvest Acres Nursing and Rehab
204 North Keokuk Washington Road, Keota, IA · (641) 636-3400
- Certified beds
- 35
- Residents per day
- 29
- Ownership
- For-Profit
- Chain
- Cedar View Holdings
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- August 1, 1997
1
How this home got 1 star
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
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Iowa homes
Harvest Acres Nursing and Rehab carries 198.5 inspection points. That is fewer than 3% 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
51 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 (7)
-
G
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
K
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
-
K
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
-
K
Respond appropriately to all alleged violations.
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J
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
-
H
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
-
G
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Everything else, by area of care
Resident Rights9D
- D
Allow resident to participate in the development and implementation of his or her person-centered plan of care.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Ensure the transfer/discharge meets the resident's needs/preferences and that the resident is prepared for a safe transfer/discharge.
- 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.
- 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
Keep residents' personal and medical records private and confidential.
- D
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
- 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.
Resident Assessment and Care Planning9E
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- E
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Assess the resident when there is a significant change in condition
- 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
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Quality of Life and Care9D
- D
Ensure that the facility has sufficient staff members who possess the competencies and skills to meet the behavioral health needs of residents.
- D
Provide the appropriate treatment and services to a resident who displays or is diagnosed with mental disorder or psychosocial adjustment difficulty, or who has a history of trauma and/or post-traumatic stress disorder.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide activities to meet all resident's needs.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Try different approaches before using a bed rail. If a bed rail is needed, the facility must (1) assess a resident for safety risk; (2) review these risks and benefits with the resident/representative; (3) get informed consent; and (4) Correctly install and maintain the bed rail.
- D
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
Infection Control7E
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- E
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
- D
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
- E
Implement a program that monitors antibiotic use.
- E
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Pharmacy Service5E
- D
Ensure medication error rates are not 5 percent or greater.
- 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.
- 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.
Administration3E
- E
Have a plan that describes the process for conducting QAPI and QAA activities.
- E
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
- D
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Nursing and Physician Services1E
- E
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nutrition and Dietary1D
- D
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.
Inspection history
2025-12-11
14 health deficiencies · 4 fire-safety deficiencies
Top issue: Quality of Life and Care (4 deficiencies)
2024-11-19
27 health deficiencies · 4 fire-safety deficiencies
Top issue: Quality of Life and Care (7 deficiencies)
2024-01-23
10 health deficiencies · 11 fire-safety deficiencies
Top issue: Infection Control (3 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 23 min of nursing staff time a day, 43 min of it from a registered nurse.
This home
3 h 23 min
Iowa average
3 h 52 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 61% of nursing staff and 80% of registered nurses left in the past year, along with 2 administrators.
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
$136,500 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2024-11-07 | Fine | $136,500 |
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 better | 1.3 | 1.4 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days1.2 pts worse | 3.1 | 1.9 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine53.4 pts worse | 40.8% | 94.2% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine34.5 pts worse | 61.3% | 95.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury11.6 pts worse | 15.5% | 3.9% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms19.9 pts worse | 24.1% | 4.2% | 13.5% |
| Percentage of long-stay residents who lose too much weight3.4 pts worse | 7.8% | 4.4% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication21.4 pts worse | 42.4% | 21.0% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication26.5 pts worse | 46.3% | 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 worsened6.7 pts worse | 21.9% | 15.2% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased18.6 pts worse | 35.2% | 16.6% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder1.4 pts better | 0.0% | 1.4% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection2.4 pts better | 0.0% | 2.4% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence17.1 pts worse | 42.1% | 25.0% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.4 pts better | 3.7% | 4.1% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine60.8 pts worse | 23.2% | 84.0% | 82.3% |
| Percentage of short-stay residents who newly received an antipsychotic medication21.7 pts worse | 23.8% | 2.1% | 1.5% |
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Who owns and runs it
23 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 |
|---|---|---|---|
| 204 N Keokuk Washington Road Propco LLC | Adp Of The SNF · Organization | 0% | 1 facilities |
| Amaranthine Holdings LLC | 5% Or Greater Direct Ownership Interest · Organization | 0% | 5 facilities |
| Caresage Administrative Consulting, LLC | Adp Of The SNF · Organization | 0% | 5 facilities |
| Case, Janelle | Operational/Managerial Control · Individual | 0% | 3 facilities |
| Case, Janelle | Adp Of The SNF · Individual | 0% | 3 facilities |
| Cedar View Holdings LLC | 5% Or Greater Direct Ownership Interest · Organization | 0% | 9 facilities |
| Cedar View Tr | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 6 facilities |
| Clinical Consulting Services LLC | Adp Of The SNF · Organization | 0% | 45 facilities |
| Gamzeh, David | Individual Is An Owner, Partner Or Trustee Of Any Adp Of The SNF · Individual | 0% | 15 facilities |
| Greatorex, Tina | Individual Is An Owner, Partner Or Trustee Of Any Adp Of The SNF · Individual | 0% | 22 facilities |
| Iowa 5784 LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 5 facilities |
| Iowa 5784 LLC | Adp Of The SNF · Organization | 0% | 5 facilities |
| Jsj 2020 Fam Tr | Adp Of The SNF · Organization | 0% | 6 facilities |
| Jsj Property LLC | Adp Of The SNF · Organization | 0% | 8 facilities |
| Miller, Daniel | Operational/Managerial Control · Individual | 0% | 18 facilities |
| Miller, Daniel | Adp Of The SNF · Individual | 0% | 18 facilities |
| Samara Fam Tr | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 7 facilities |
| Samara Fam Tr | Adp Of The SNF · Organization | 0% | 7 facilities |
| Samara Family Holdings LLC | 5% Or Greater Indirect Ownership Interest · Organization | 0% | 22 facilities |
| Samara Family Holdings LLC | Adp Of The SNF · Organization | 0% | 22 facilities |
| Schiowitz, Marc | Individual Is An Owner, Partner Or Trustee Of Any Adp Of The SNF · Individual | 0% | 24 facilities |
| Sebbag, Gabriel | 5% Or Greater Indirect Ownership Interest · Individual | 0% | 33 facilities |
| Summation Financial Services LLC | Adp Of The SNF · Organization | 0% | 51 facilities |
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Fire safety
19 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke6F
- F
Inspect, test, and maintain automatic sprinkler systems.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- F
Have a fire alarm with audible and visual signals that transmits the alarm automatically to notify emergency forces in event of fire.
- F
Have approved installation, maintenance and testing program for fire alarm systems.
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Gas, Vacuum, and Electrical Systems5F
- F
Have generator or other power source capable of supplying service within 10 seconds.
- 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.
- F
Ensure that testing and maintenance of electrical equipment is performed.
- E
Have proper medical gas storage and administration areas.
Emergency Preparedness3F
- F
Develop and maintain an Emergency Preparedness Program (EP).
- F
Conduct testing and exercise requirements.
- F
Develop and maintain an Emergency Preparedness Program (EP).
Miscellaneous3F
- F
Have simulated fire drills held at unexpected times.
- F
Have simulated fire drills held at unexpected times.
- F
Have simulated fire drills held at unexpected times.
Egress2F
- E
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.
- F
Install emergency lighting that can last at least 1 1/2 hours.
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-
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