Iowa ›Avoca

Avoca Specialty Care

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610 East York Street, Avoca, IA 51521 (opens Google Maps) · Pottawattamie County · (712) 343-6398· 46 certified beds · avg 33 residents/day · certified since Aug 1, 1996 · Medicare and Medicaid certified

Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →

Part of chain: CARE INITIATIVES (43 facilities, chain avg rating 2.9★)

1/5
Health inspection rating (on-site)
inspected Mar 5, 2026
1
Serious findings on record
most recent Aug 8, 2023
$0
Fines, last 3 years
3.78
Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

New to these records? How to read an inspection report →

Health inspection rating: ★☆☆☆☆1/5 · CMS overall rating: 1/5 · how star ratings work →

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 quality measures from resident assessments and claims.

Most serious findings (actual harm or immediate jeopardy)

▲ Actual harm, isolated · Aug 8, 2023 · 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): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Aug 28, 2023 (Deficient, Provider has date of correction)

Inspection findings in the public record

Showing the latest 3 of 68 inspection findings. Open the full record below to read every finding.

  1. E · Potential for more than minimal harm, pattern

    The facility gave residents unnecessary mind-altering (psychotropic) medications, or used drugs in a way that restrained residents by dulling their ability to think, move, or function. F-0605

  2. E · Potential for more than minimal harm, pattern

    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. F-0656

  3. E · Potential for more than minimal harm, pattern

    The facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. F-0725

View all 68 inspection findingsShow only the latest 3 findings

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.

DateSeverityWhat the facility was cited for
Mar 5, 2026E · Potential for more than minimal harm, patternThe facility gave residents unnecessary mind-altering (psychotropic) medications, or used drugs in a way that restrained residents by dulling their ability to think, move, or function. · F-0605
Mar 5, 2026E · Potential for more than minimal harm, patternThe 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. · F-0656
Mar 5, 2026E · Potential for more than minimal harm, patternThe facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. · F-0725
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. · F-0578
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · F-0584
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe 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. · F-0644
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe 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. · F-0657
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · F-0658
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · F-0677
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe 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. · F-0695
Mar 5, 2026D · Potential for more than minimal harm, isolatedThe 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. · F-0880
Oct 7, 2025D · Potential for more than minimal harm, isolatedThe 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 · F-0658
Jun 16, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · from a complaint · F-0677
May 16, 2025E · Potential for more than minimal harm, patternThe facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · from a complaint · F-0677
May 16, 2025E · Potential for more than minimal harm, patternThe facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. · from a complaint · F-0725
May 16, 2025E · Potential for more than minimal harm, patternThe facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · from a complaint · F-0842
May 16, 2025D · Potential for more than minimal harm, isolatedThe 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 · F-0607
May 16, 2025D · Potential for more than minimal harm, isolatedThe facility did not report suspected abuse, neglect, or theft to the proper authorities quickly enough, or did not report the results of its investigation. · from a complaint · F-0609
May 16, 2025D · Potential for more than minimal harm, isolatedThe facility did not respond appropriately to alleged violations, such as reports of abuse, neglect, or mistreatment. Facilities must investigate every allegation and protect residents while they do. · from a complaint · F-0610
May 16, 2025D · Potential for more than minimal harm, isolatedThe 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 · F-0657
May 16, 2025D · Potential for more than minimal harm, isolatedThe facility did not provide the right treatment and services for residents with dementia or signs of dementia. Dementia care requires specific approaches, training, and patience. · from a complaint · F-0744
May 16, 2025D · Potential for more than minimal harm, isolatedThe facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · from a complaint · F-0761
Jan 30, 2025E · Potential for more than minimal harm, patternThe facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. · F-0725
Jan 30, 2025D · Potential for more than minimal harm, isolatedThe facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641
Jan 30, 2025D · Potential for more than minimal harm, isolatedThe 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. · F-0880
Jul 1, 2024E · Potential for more than minimal harm, patternThe facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · from a complaint · F-0677
Jul 1, 2024E · Potential for more than minimal harm, patternThe facility did not have enough nursing staff each day to meet every resident's needs, or did not have a licensed nurse in charge on each shift. Adequate staffing is one of the strongest predictors of good care. · from a complaint · F-0725
Jul 1, 2024E · Potential for more than minimal harm, patternThe facility did not employ enough qualified food and nutrition staff, including a qualified dietician, to properly run its food service. · from a complaint · F-0801
Jul 1, 2024E · Potential for more than minimal harm, patternThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · from a complaint · F-0812
Jul 1, 2024D · Potential for more than minimal harm, isolatedThe 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 · F-0550
Jul 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Jul 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not dispose of garbage and refuse properly. · from a complaint · F-0814
Jul 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not have policies on smoking. · from a complaint · F-0926
Feb 1, 2024F · Potential for more than minimal harm, widespreadThe facility did not employ enough qualified food and nutrition staff, including a qualified dietician, to properly run its food service. · F-0801
Feb 1, 2024F · Potential for more than minimal harm, widespreadThe facility's quality committee — the internal group responsible for finding and fixing care problems — did not have the required members or did not meet at least every three months. · F-0868
Feb 1, 2024E · Potential for more than minimal harm, patternThe 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. · F-0657
Feb 1, 2024E · Potential for more than minimal harm, patternThe facility did not make sure its nurses and nurse aides had the skills and training needed to properly care for every resident. · F-0726
Feb 1, 2024E · Potential for more than minimal harm, patternThe facility did not label drugs according to professional standards or did not store them in locked compartments, with controlled drugs (medications with a high risk of misuse) kept under a separate lock. · F-0761
Feb 1, 2024E · Potential for more than minimal harm, patternThe facility's menus did not meet residents' nutritional needs, or were not prepared in advance, followed as written, kept up to date, or reviewed by a dietician. · F-0803
Feb 1, 2024E · Potential for more than minimal harm, patternThe 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. · F-0805
Feb 1, 2024E · Potential for more than minimal harm, patternThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
Feb 1, 2024E · Potential for more than minimal harm, patternThe 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. · F-0880
Feb 1, 2024E · Potential for more than minimal harm, patternThe facility did not keep its building and grounds safe, functional, clean, and comfortable for residents, staff, and visitors. · F-0921
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not honor residents' right to share a room with their spouse or a roommate of their choosing, or moved residents to a different room without written notice beforehand. · F-0559
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0580
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · F-0584
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0656
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · F-0658
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0676
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · F-0677
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0686
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. · F-0692
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe facility used feeding tubes without a valid medical reason or the resident's agreement, or did not provide proper care to residents who have feeding tubes. · F-0693
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide safe, appropriate care for residents who need dialysis — the treatment that filters the blood when kidneys fail. · F-0698
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe 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. · F-0759
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not keep residents free from significant medication errors — such as giving the wrong drug, the wrong dose, or missing a critical medication. · F-0760
Feb 1, 2024D · Potential for more than minimal harm, isolatedThe facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · F-0804
Aug 8, 2023▲ G · Actual harm, isolatedThe 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 · F-0686
Aug 8, 2023E · Potential for more than minimal harm, patternThe facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · from a complaint · F-0584
Aug 8, 2023D · Potential for more than minimal harm, isolatedThe 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 · F-0550
Aug 8, 2023D · Potential for more than minimal harm, isolatedThe 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 · F-0580
Aug 8, 2023D · Potential for more than minimal harm, isolatedThe 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 · F-0657
Aug 8, 2023D · Potential for more than minimal harm, isolatedThe 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 · F-0658
Aug 8, 2023D · Potential for more than minimal harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Aug 8, 2023D · Potential for more than minimal harm, isolatedThe 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 · F-0690
Aug 8, 2023D · Potential for more than minimal harm, isolatedThe 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. · from a complaint · F-0880

Inspection trend by year

Citations from standard inspections increased between the last two inspection cycles (3 → 12).

Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01
All citationsSerious citations (G–L)
2023
All citations: 9
Serious citations (G–L): 1
2024
All citations: 33
Serious citations (G–L): 0
2025
All citations: 14
Serious citations (G–L): 0
2026
All citations: 12
Serious citations (G–L): 0

All bars start at zero. Exact values and supporting details remain below.

YearCitationsSerious (G–L)Worst severity that year
202391G ▲
2024330F
2025140E
2026120E

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)

How to file a complaint about care →

No fines or payment denials in the published 3-year window.

Nurse staffing (from payroll records, adjusted for how much care residents need)

What these staffing numbers mean →

Nurse time, in contextAdjusted hours per resident per day · Source: CMS, 2026-08-01
This facilityIowa averageU.S. average
Total nurse staffing (hours per resident per day)
This facility: 3.78
Iowa average: 4.37
U.S. average: 3.95
Registered Nurse hours
This facility: 1.25
Iowa average: 0.85
U.S. average: 0.69
Weekend total nurse staffing
This facility: 3.42
Iowa average: 3.86
U.S. average: 3.50

All bars start at zero. Exact values and supporting details remain below.

MeasureThis facilityIowa avgU.S. avgWhere it stands
Total nurse staffing (hours per resident per day)3.784.373.95bottom 22% in Iowa; top 49% in the U.S.
Registered Nurse hours1.250.850.69top 10% in Iowa; top 8% in the U.S.
Weekend total nurse staffing3.423.863.50bottom 31% in Iowa; top 46% in the U.S.
Weekend RN hours (not acuity-adjusted)0.780.510.48top 11% in Iowa; top 12% in the U.S.
Total nursing staff turnover (%)63.944.045.8bottom 8% in Iowa; bottom 11% in the U.S.
RN turnover (%)57.142.142.9bottom 30% in Iowa; bottom 26% in the U.S.

Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — 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 3.01, RN 0.99, weekend 2.72.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.01 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 3/5.

Quality measures: assessments & claims

Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.

Quality measures rating: 3/5 · long-stay residents: 4/5 · short-stay residents: 3/5

Costs & payment

Price evidence · separate from quality

No verified facility-specific private-pay price is available in our data for Avoca Specialty Care. CMS inspection and staffing records do not tell us what this home will charge you.

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Who owns this facility

How to read ownership records →

Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →

Non profit - Corporation

Owner / managerTypeRoleStakeSince
Care InitiativesOrganization5% or Greater Direct Ownership Interest100%08/01/2012
Beal, MichaelIndividualCorporate DirectorNOT APPLICABLE06/01/2020
Beal, MichaelIndividualCorporate OfficerNOT APPLICABLE06/01/2020
Boeve, DestinyIndividualOperational/Managerial ControlNOT APPLICABLE01/01/2024
Bowen, LaneIndividualCorporate DirectorNOT APPLICABLE01/01/2021
Carothers, Mary JaneIndividualCorporate DirectorNOT APPLICABLE01/01/2023
Childs, KevinIndividualCorporate DirectorNOT APPLICABLE04/01/2023
Computershare Corporate Trust Company, NaOrganization5% or Greater Mortgage InterestNOT APPLICABLE01/01/2025
Computershare Corporate Trust Company, NaOrganizationADP of the SNFNOT APPLICABLE04/07/2025
Corless, PeterIndividualCorporate DirectorNOT APPLICABLE01/01/2025
Corless, PeterIndividualADP of the SNFNOT APPLICABLE01/01/2025
Dixon, DavidIndividualCorporate OfficerNOT APPLICABLE06/01/2016
Drake, EmilyIndividualCorporate OfficerNOT APPLICABLE01/04/2023
Gilyard, TanyaIndividualCorporate OfficerNOT APPLICABLE05/23/2025
Krein, KeithIndividualCorporate DirectorNOT APPLICABLE01/01/2023
Kuhn, JeramyIndividualCorporate OfficerNOT APPLICABLE01/01/2008
McDyer, JessicaIndividualCorporate OfficerNOT APPLICABLE03/01/2023
Monroe, MarquitaIndividualOperational/Managerial ControlNOT APPLICABLE06/09/2025
Monroe, MarquitaIndividualADP of the SNFNOT APPLICABLE06/18/2025
Rust, ElizabethIndividualCorporate DirectorNOT APPLICABLE01/01/2023

Showing 20 of 24 parties CMS has on file for this facility; 4 are not displayed. The full list is in the CMS Ownership dataset.

Other facilities in the same chain

CMS lists this facility under the chain Care Initiatives — 43 facilities in the current records. Chain membership says who operates these homes. It says nothing about how any individual one of them was inspected; each has its own record.

Listed by state, then facility name — not a ranking. Showing 8 of the 42 others, continuing from this facility's own place in that list.

Questions to ask on your visit

Full visit checklist →

Print visit checklist

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

  • "How do you prevent bedsores for residents who can't move themselves, and how often are at-risk residents repositioned?"
  • "What percentage of your residents are on antipsychotic or sedating medications, and how do you work to reduce that?"
  • "Can you show me an example care plan, and how are families included when it's created and updated?"
  • "What is your nurse and aide staffing ratio on each shift, including nights and weekends?"
  • "How do you record and honor each resident's treatment wishes and advance directives, and how do staff know about them?"
  • "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 identify and arrange specialized services for residents with mental health conditions or disabilities?"

Also worth asking anywhere

  • "Your weekend nurse staffing is reported below the Iowa midpoint — how does the weekend schedule differ from a weekday?"
  • "Can I see the plan of correction for the findings in your most recent state inspection?"
  • "CMS reports 64% total nursing staff turnover here — who on the care team has been with you longest?"
  • "The ownership record on file lists 24 owning or managing parties — who makes the decisions about staffing levels?"
  • "Can I visit again unannounced, at a mealtime or on a weekend?"

Nearby facilities (within 20 miles)

FacilityDistanceCityOverallInspectionFlags
Elm Crest Retirement Community10.3 miHarlan, IA★★☆☆☆2/5
Oakland Manor13.1 miOakland, IA★☆☆☆☆1/5abuse
Salem Lutheran Home18.0 miElk Horn, IA★☆☆☆☆1/5

Compare this facility with the 3 closest →

Other facilities in the same county

CMS records place this facility in Pottawattamie, IA — 7 certified facilities there. These are outside the 20-mile list above, or far enough down it not to appear.

Listed by facility name — not a ranking. Homes already in the table above are not repeated here.

All facilities in Avoca →

Facility data as of CMS processing date 2026-08-01. CCN 165294.

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