Cycle 1
Health 2025-09-18 · Fire 2025-09-18
5 health deficiencies
Top issue: Nutrition and Dietary (2 deficiencies)
1 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (1 deficiency)
Keokuk, IA
River Hills Village in Keokuk
3-star overall rating with 3-star inspections with 5 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
20 Village Circle, Keokuk, IA
(319) 524-5772
Overall
3 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
4 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
84
Certified beds
Average residents
63
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Unlimited Development, Inc.
Operator or chain grouping
Approved since
1998-07-13
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
10 facilities
Chain averages 3 overall / 3 health / 3 staffing / 3 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
0.48
Registered nurse staffing · state 0.73 · national 0.68
LPN hours / resident day
0.76
Licensed practical nurse staffing · state 0.57 · national 0.87
Aide hours / resident day
2.90
Nurse aide staffing · state 2.53 · national 2.35
Total nurse hours
4.14
All reported nurse hours · state 3.83 · national 3.89
Licensed hours
1.24
RN + LPN hours · state 1.30 · national 1.54
Weekend hours
3.73
Weekend nurse staffing · state 3.35 · national 3.43
Weekend RN hours
0.30
Weekend registered nurse coverage · state 0.50 · national 0.47
Physical therapist
0.04
Reported PT staffing · state 0.04 · national 0.07
Adjusted RN hours
0.43
CMS adjusted RN staffing hours
Adjusted total hours
3.70
CMS adjusted total nurse staffing hours
Case-mix index
1.53
Higher values indicate more complex resident acuity
RN turnover
14%
Annual RN turnover · state 44% · national 45%
Total nurse turnover
44%
Annual nurse turnover · state 44% · national 46%
SNF VBP
Value-based purchasing
Program rank
4,451
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
39.92
Composite VBP score used to determine payment impact.
Payment multiplier
0.9929
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
4.43
Baseline 18.23% · Performance 19.38% · Measure score 4.43 · Achievement 4.43 · Improvement 0
Healthcare-associated infections
0
Baseline 5.69% · Performance 7.85% · Measure score 0 · Achievement 0 · Improvement 0
Total nurse turnover
6.82
Baseline 43.48% · Performance 35.80% · Measure score 6.82 · Achievement 6.82 · Improvement 3.62
Adjusted total nurse staffing
4.71
Baseline 4.11 hours · Performance 4.42 hours · Measure score 4.71 · Achievement 4.71 · Improvement 1.35
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 14.05% |
10.72%
3.3 pts worse
|
No Different than the National Rate · Eligible stays 203 · Observed rate 16.75% · Lower 95% interval 10.25% |
| Discharge to community | 58.51% |
50.57%
7.9 pts better
|
Better than the National Rate · Eligible stays 191 · Observed rate 54.45% · Lower 95% interval 51.29% |
| Medicare spending per beneficiary | 1.19 |
1.02
0.2 pts worse
|
|
| Drug regimen review with follow-up | 98.63% |
95.27%
3.4 pts better
|
Numerator 144 · Denominator 146 |
| Falls with major injury | 2.05% |
0.77%
1.3 pts worse
|
Numerator 3 · Denominator 146 |
| Discharge self-care score | 69.23% |
53.69%
15.5 pts better
|
Numerator 72 · Denominator 104 |
| Discharge mobility score | 66.35% |
50.94%
15.4 pts better
|
Numerator 69 · Denominator 104 |
| Pressure ulcers or injuries, new or worsened | 2.74% |
2.29%
0.5 pts worse
|
Numerator 4 · Denominator 146 · Adjusted rate 3.11% |
| Healthcare-associated infections requiring hospitalization | 7.85% |
7.12%
0.7 pts worse
|
No Different than the National Rate · Eligible stays 154 · Observed rate 7.79% · Lower 95% interval 5.25% |
| Staff COVID-19 vaccination coverage | 0.86% |
8.2%
7.3 pts worse
|
Numerator 1 · Denominator 116 |
| Staff flu vaccination coverage | 22.37% |
42%
19.6 pts worse
|
Numerator 34 · Denominator 152 |
| Discharge function score | 71.15% |
56.45%
14.7 pts better
|
Numerator 74 · Denominator 104 |
| Transfer of health information to provider | 97.67% |
95.95%
1.7 pts better
|
Numerator 42 · Denominator 43 |
| Transfer of health information to patient | 95.95% |
96.28%
0.3 pts worse
|
Numerator 71 · Denominator 74 |
| Resident COVID-19 vaccinations up to date | 24.36% |
25.2%
0.8 pts worse
|
Numerator 19 · Denominator 78 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 0.7 |
1.5
0.8 pts better
|
1.9
1.2 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.7 · Observed 0.6 · Expected 1.7 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 2.0 |
2.1
0.1 pts better
|
1.8
0.2 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.0 · Observed 1.7 · Expected 1.5 · 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 | 50.0% |
95.2%
45.2 pts worse
|
95.5%
45.5 pts worse
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 50.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 7.5% |
3.7%
3.8 pts worse
|
3.3%
4.2 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 4.3% · Q2 8.7% · Q3 10.6% · Q4 6.5% · 4Q avg 7.5% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.0% |
4.0%
4 pts better
|
11.4%
11.4 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 who lose too much weight | 7.5% |
4.9%
2.6 pts worse
|
5.4%
2.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 6.5% · Q3 16.2% · Q4 6.5% · 4Q avg 7.5% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 32.6% |
20.6%
12 pts worse
|
19.6%
13 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 25.7% · Q2 29.4% · Q3 37.8% · Q4 37.5% · 4Q avg 32.6% |
| Percentage of long-stay residents who received an antipsychotic medication | 12.1% |
19.8%
7.7 pts better
|
16.7%
4.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 14.3% · Q2 12.5% · Q3 8.3% · Q4 13.2% · 4Q avg 12.1% · 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 | 15.5% |
18.5%
3 pts better
|
16.3%
0.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 11.0% · Q2 8.6% · Q3 29.5% · Q4 12.8% · 4Q avg 15.5% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 16.0% |
18.3%
2.3 pts better
|
14.9%
1.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 9.1% · Q2 15.2% · Q3 22.9% · Q4 16.7% · 4Q avg 16.0% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 0.5% |
1.7%
1.2 pts better
|
1.0%
0.5 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 1.8% · Q4 0.0% · 4Q avg 0.5% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.0% |
2.5%
2.5 pts better
|
1.7%
1.7 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 new or worsened bowel or bladder incontinence | 14.0% |
26.0%
12 pts better
|
19.8%
5.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.2% · Q2 18.3% · Q3 12.0% · Q4 18.2% · 4Q avg 14.0% |
| Percentage of long-stay residents with pressure ulcers | 8.0% |
4.3%
3.7 pts worse
|
5.1%
2.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 14.8% · Q2 10.6% · Q3 6.6% · Q4 0.0% · 4Q avg 8.0% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 99.7% |
84.3%
15.4 pts better
|
81.7%
18 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 100.0% · Q3 100.0% · Q4 98.8% · 4Q avg 99.7% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 15.6% |
13.1%
2.5 pts worse
|
12.0%
3.6 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 15.6% · Observed 12.9% · Expected 9.3% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 0.4% |
1.9%
1.5 pts better
|
1.6%
1.2 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 1.8% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.4% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 51.9% |
73.3%
21.4 pts worse
|
79.7%
27.8 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 51.9% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 19.8% |
21.3%
1.5 pts better
|
23.9%
4.1 pts better
|
Short Stay · 20240701-20250630 · Adjusted 19.8% · Observed 16.9% · Expected 20.3% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-09-12 · Fire 2024-09-12
2 health deficiencies
Top issue: Quality of Life and Care (1 deficiency)
5 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Cycle 3
Health 2024-03-11 · Fire 2024-03-11
1 health deficiencies
Top issue: Resident Assessment and Care Planning (1 deficiency)
3 fire-safety deficiencies
Top issue: Gas and Vacuum and Electrical Systems (2 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-09-18
K921 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure that testing and maintenance of electrical equipment is performed.
Corrected 2025-09-26
F · Potential for more than minimal harm
2024-09-12
E39 · Emergency Preparedness Deficiencies
Fire Safety
Conduct testing and exercise requirements.
Corrected 2024-10-02
F · Potential for more than minimal harm
2024-09-12
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2024-09-27
F · Potential for more than minimal harm
2024-09-12
K354 · Smoke Deficiencies
Fire Safety
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Corrected 2024-09-27
F · Potential for more than minimal harm
2024-09-12
K761 · Miscellaneous Deficiencies
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2024-09-27
E · Potential for more than minimal harm
2024-09-12
K291 · Egress Deficiencies
Fire Safety
Install emergency lighting that can last at least 1 1/2 hours.
Corrected 2024-09-18
F · Potential for more than minimal harm
2024-03-11
K345 · Smoke Deficiencies
Fire Safety
Have approved installation, maintenance and testing program for fire alarm systems.
Corrected 2024-03-15
F · Potential for more than minimal harm
2024-03-11
K921 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure that testing and maintenance of electrical equipment is performed.
Corrected 2024-04-08
F · Potential for more than minimal harm
2024-03-11
K926 · Gas, Vacuum, and Electrical Systems Deficiencies
Fire Safety
Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk.
Corrected 2024-03-13
Inspection history
Recent health citations
E · Potential for more than minimal harm
2025-09-18
F803 · Nutrition and Dietary Deficiencies
Health
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.
Corrected 2025-11-24
E · Potential for more than minimal harm
2025-09-18
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 2025-11-24
D · Potential for more than minimal harm
2025-09-18
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 2025-11-24
D · Potential for more than minimal harm
2025-09-18
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2025-11-24
D · Potential for more than minimal harm
2025-09-18
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2025-11-24
D · Potential for more than minimal harm
2024-09-12
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2024-09-19
G · Actual harm
2024-07-16
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 2024-07-31
D · Potential for more than minimal harm
2024-03-11
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 2024-03-20
Penalties and ownership
What sits behind the stars
Ownership
Unlimited Development, Inc
5% Or Greater Direct Ownership Interest · Organization
Ballew, Heather
W-2 Managing Employee · Individual
Finke, Audrey
Corporate Director · Individual
Gilmore, Jerry
Corporate Director · Individual
Haney, David
Corporate Director · Individual
Wagner, Robert
Corporate Director · Individual
Wilson, Ronald
Corporate Officer · Individual
Nearby options
Other facilities in reach
#1
Southeast Iowa Healthcare Center
Keokuk, IA
5-star overall rating with 4-star inspections with 6 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
#2
Mississippi Valley
Keokuk, IA
5-star overall rating with 4-star inspections with $19,663 in total fines with 2 fire-safety deficiencies in the latest cycle
#3
Montrose Health Center
Montrose, IA
4-star overall rating with 3-star inspections with $49,309 in total fines with 1 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
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