Accura Healthcare of Creston
1000 East Howard, Creston, IA 50801 · Union County · 31 certified beds · avg 25 residents/day · certified since Jun 21, 1996
Part of chain: ACCURA HEALTHCARE (41 facilities, chain avg rating 2.5★)
2/5
Health inspection rating (on-site)
2
Serious findings on record
$16,801
Fines, last 3 years
4.16
Nurse hours/resident/day (adjusted)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 2/5
The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and self-reported quality measures.
Most serious findings (actual harm or immediate jeopardy)
▲ Immediate jeopardy, one-off · Jul 11, 2024 · F-0805
The facility did not prepare and serve food in a form that meets each resident's individual needs — for example, chopped, pureed, or softened food for residents with chewing or swallowing problems.
Why it matters: Food served in the wrong texture can cause choking or lead residents to stop eating and lose weight.
Severity (J): Inspectors found a situation that put a resident's life or safety in immediate danger, affecting one or a few residents. The facility must fix it immediately — these citations often come with large fines.
Corrected: Jul 25, 2024 (Deficient, Provider has date of correction)
▲ Actual harm, one-off · Feb 1, 2024 · F-0686 · triggered by a complaint
The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving.
Why it matters: Bedsores are painful, can become deeply infected, and in serious cases can be life-threatening.
Severity (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Feb 8, 2024 (Deficient, Provider has date of correction)
All citations in the current public record (38)
CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed.
| Date | Severity | What the facility was cited for |
|---|---|---|
| Jun 25, 2026 | E · Potential for harm, repeated | The facility allowed residents to lose the ability to do daily activities — like bathing, dressing, and eating — when there was no medical reason for the decline. Good care helps residents keep the abilities they have. |
| Jun 25, 2026 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint |
| Jun 25, 2026 | D · Potential for harm, one-off | The facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. |
| Jun 25, 2026 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Jun 25, 2026 | D · Potential for harm, one-off | The facility did not properly complete the required screening (called PASARR) that identifies whether a person entering a nursing home has a mental illness or intellectual disability and needs specialized services. |
| Oct 30, 2025 | D · Potential for harm, one-off | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint |
| Oct 30, 2025 | D · Potential for harm, one-off | The facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident. · from a complaint |
| Jul 11, 2024 | ▲ J · Immediate jeopardy, one-off | The facility did not prepare and serve food in a form that meets each resident's individual needs — for example, chopped, pureed, or softened food for residents with chewing or swallowing problems. |
| Jul 11, 2024 | F · Potential for harm, facility-wide | The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. |
| Jul 11, 2024 | F · Potential for harm, facility-wide | The facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. |
| Jul 11, 2024 | E · Potential for harm, repeated | The facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint |
| Jul 11, 2024 | E · Potential for harm, repeated | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · from a complaint |
| Jul 11, 2024 | E · Potential for harm, repeated | The facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. |
| Jul 11, 2024 | E · Potential for harm, repeated | The facility did not develop, carry out, or maintain an effective training program for all new and existing staff members. |
| Jul 11, 2024 | E · Potential for harm, repeated | The facility did not develop or maintain an effective training program for its direct care staff, including training on how to communicate effectively with residents. |
| Jul 11, 2024 | E · Potential for harm, repeated | The facility did not educate its staff on residents' rights and the facility's responsibilities toward residents. Staff can only respect rights they've been taught about. |
| Jul 11, 2024 | E · Potential for harm, repeated | The facility did not give all staff the required training on its quality improvement program — the internal system for finding problems and making care better. |
| Jul 11, 2024 | E · Potential for harm, repeated | The facility did not include required infection control training — with written standards, policies, and procedures — as part of its infection prevention program. |
| Jul 11, 2024 | E · Potential for harm, repeated | The facility did not provide its staff with training in compliance and ethics — teaching employees the laws and ethical standards that govern how residents must be treated. |
| Jul 11, 2024 | E · Potential for harm, repeated | The facility did not provide its staff with required training on behavioral health — caring for residents with conditions like dementia, depression, or other mental health needs. |
| Jul 11, 2024 | D · Potential for harm, one-off | The facility did not give residents proper notice about what Medicare or Medicaid covers, or about charges the resident might owe for services that aren't covered. |
| Jul 11, 2024 | D · Potential for harm, one-off | The facility did not reassess a resident after a significant change in their condition, such as a sudden decline in health. A full new assessment is required when a resident's condition changes in a major way. |
| Jul 11, 2024 | D · Potential for harm, one-off | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| Jul 11, 2024 | D · Potential for harm, one-off | The facility did not coordinate resident assessments with the state's pre-admission screening program for mental illness and intellectual disabilities, or failed to refer residents for the special services they need. |
| Jul 11, 2024 | D · Potential for harm, one-off | The facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. |
| Jul 11, 2024 | D · Potential for harm, one-off | The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint |
| Jul 11, 2024 | D · Potential for harm, one-off | The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint |
| Jul 11, 2024 | D · Potential for harm, one-off | The facility did not provide appropriate care related to bladder and bowel needs — including care for residents who use catheters and steps to prevent urinary tract infections. · from a complaint |
| Jul 11, 2024 | D · Potential for harm, one-off | The facility did not provide safe and appropriate respiratory care — such as oxygen, breathing treatments, or care for residents on breathing equipment — for residents who needed it. |
| Jul 11, 2024 | D · Potential for harm, one-off | The facility's medication error rate was 5 percent or higher — meaning too many doses were given incorrectly, such as the wrong drug, dose, or time. |
| Jul 11, 2024 | C · Minimal risk, facility-wide | The facility did not conduct and document a facility-wide assessment of what staff, supplies, and resources it needs to care for its residents properly — during everyday operations, nights, weekends, and emergencies. |
| Jul 11, 2024 | C · Minimal risk, facility-wide | The facility did not have an agreement with at least one Medicare- or Medicaid-certified hospital to ensure residents can be transferred quickly when they need hospital care. |
| May 16, 2024 | D · Potential for harm, one-off | The facility did not develop a resident's complete plan of care within 7 days of the full assessment, or the plan wasn't prepared, reviewed, and updated by a team of health professionals as required. · from a complaint |
| Mar 21, 2024 | F · Potential for harm, facility-wide | The facility did not develop and follow policies and procedures to prevent abuse, neglect, and theft. These written safeguards are the foundation of resident protection. · from a complaint |
| Feb 1, 2024 | ▲ G · Actual harm, one-off | The facility did not provide proper care for pressure ulcers (bedsores) or did not do enough to prevent new ones from forming. Bedsores develop when residents stay in one position too long without help moving. · from a complaint |
| Feb 1, 2024 | D · Potential for harm, one-off | The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint |
| Feb 1, 2024 | D · Potential for harm, one-off | The facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint |
| Feb 1, 2024 | D · Potential for harm, one-off | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint |
Inspection trend by year
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2024 | 31 | 2 | J ▲ |
| 2025 | 2 | 0 | D |
| 2026 | 5 | 0 | E |
Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.
Fines and enforcement (last 3 years)
1 fine totaling $16,801, plus 1 Medicare payment denial period.
| Date | Type | Amount / length |
|---|---|---|
| Jul 11, 2024 | Fine | $16,801 |
| Jan 31, 2024 | Payment Denial | 28 days from Feb 23, 2024 |
Nurse staffing (from payroll records, adjusted for how much care residents need)
| Measure | This facility | Iowa avg | U.S. avg | Where it stands |
|---|---|---|---|---|
| Total nurse staffing (hours per resident per day) | 4.16 | 4.37 | 3.95 | bottom 46% in Iowa; top 34% in the U.S. |
| Registered Nurse hours | 0.98 | 0.85 | 0.69 | top 29% in Iowa; top 16% in the U.S. |
| Weekend total nurse staffing | 3.42 | 3.86 | 3.50 | bottom 30% in Iowa; top 46% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.51 | 0.51 | 0.48 | top 38% in Iowa; top 31% in the U.S. |
| Total nursing staff turnover (%) | 68.4 | 44.0 | 45.8 | bottom 6% in Iowa; bottom 7% in the U.S. |
| RN turnover (%) | 77.8 | 42.1 | 42.9 | bottom 10% in Iowa; bottom 7% in the U.S. |
Hours are per resident per day, case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.80, RN 0.90, weekend 3.13. Staffing rating: 3/5.
Self-reported quality measures
Note: these ratings are based on data the facility reports about itself to CMS. They are not independently verified by inspectors, and can look better than inspection findings. Give more weight to the inspection results above.
Quality measures rating: 2/5 · long-stay residents: 2/5 · short-stay residents: —/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Allen, Brady | Individual | Indirect Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| Avenue94 LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| Aviv Healthcare Holdings LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| Aviv Healthcare of the Midwest LLC | Organization | Direct Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| Glaser, Kristopher | Individual | Indirect Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| Kimmons Healthcare Investments LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| Kleinsasser, Megan | Individual | Indirect Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| KTL Enterprises LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| Leneave, Ted | Individual | Indirect Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| Little River Investments LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| Toti, Lisa | Individual | Indirect Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| ZRR Opco LLC | Organization | Indirect Ownership Interest | NOT APPLICABLE | 02/01/2025 |
| Accura Management Consulting Services LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 02/01/2025 |
| Accura Management Consulting Services LLC | Organization | ADP of the SNF | NOT APPLICABLE | 02/01/2025 |
| Allen, Brady | Individual | Operational/Managerial Control | NOT APPLICABLE | 02/01/2025 |
| Allen, Brady | Individual | ADP of the SNF | NOT APPLICABLE | 02/01/2025 |
| Aviv Financing II LLC | Organization | ADP of the SNF | NOT APPLICABLE | 02/01/2025 |
| Aviv Healthcare Holdings LLC | Organization | ADP of the SNF | NOT APPLICABLE | 06/03/2025 |
| Aviv Healthcare of the Midwest LLC | Organization | ADP of the SNF | NOT APPLICABLE | 06/03/2025 |
| Aviv Healthcare Properties Operating Partnership I LP | Organization | ADP of the SNF | NOT APPLICABLE | 02/01/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "How do you handle residents who need modified food textures, and how do you make those meals appetizing?"
- "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
- "How do you help residents maintain their daily living skills, and how do you measure whether it's working?"
- "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
- "Can we tour the resident rooms, bathrooms, and common areas today, including areas not on the usual tour route?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "How do you screen new residents for mental health and disability-related needs, and how do you provide the specialized services they require?"
- "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
- "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
- "Can I see the results and plan of correction from your most recent state inspection?"
Nearby facilities (within 20 miles)
| Facility | Distance | City | Overall | Inspection | Flags |
|---|---|---|---|---|---|
| Creston Specialty Care | 1.9 mi | Creston, IA | ★★☆☆☆ | 2/5 | |
| Lenox Care Center | 16.2 mi | Lenox, IA | ★★★☆☆ | 2/5 | |
| Greenfield Rehabilitation & Health Care Center | 17.5 mi | Greenfield, IA | ★★★☆☆ | 2/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 165275.