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Part of chain: CARE INITIATIVES (43 facilities, chain avg rating 2.9★)
2/5
Health inspection rating (on-site)
inspected Jul 1, 2026
2
Serious findings on record
most recent Jun 20, 2024
$19,663
Fines, last 3 years
3.73
Nurse hours/resident/day (adjusted)
Every record stays on this page.
What health inspectors found (on-site government inspections — the most independent evidence available)
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)
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.
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: Jul 1, 2024 (Deficient, Provider has date of correction)
▲ Actual harm, isolated · Jan 4, 2024 · F-0684 · triggered by a complaint
The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Why it matters: Care that strays from doctor's orders or ignores the resident's wishes can lead to declining health and avoidable harm.
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: Jan 11, 2024 (Deficient, Provider has date of correction)
Inspection findings in the public record
Showing the latest 3 of 19 inspection findings. Open the full record below to read every finding.
E · Potential for more than minimal harm, pattern
The 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
E · Potential for more than minimal harm, pattern
The 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. · from a complaintF-0803
E · Potential for more than minimal harm, pattern
The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. F-0804
View all 19 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.
Date
Severity
What the facility was cited for
Jul 1, 2026
E · Potential for more than minimal harm, pattern
The 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
Jul 1, 2026
E · Potential for more than minimal harm, pattern
The 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. · from a complaint · F-0803
Jul 1, 2026
E · Potential for more than minimal harm, pattern
The facility did not serve food and drinks that were appetizing, attractive, and at a safe and pleasant temperature. · F-0804
Jul 1, 2026
E · Potential for more than minimal harm, pattern
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. · F-0812
Jul 1, 2026
D · Potential for more than minimal harm, isolated
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 · F-0658
Jul 1, 2026
D · Potential for more than minimal harm, isolated
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689
Oct 9, 2025
D · Potential for more than minimal harm, isolated
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 · F-0658
Oct 9, 2025
D · Potential for more than minimal harm, isolated
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. · from a complaint · F-0725
May 8, 2025
E · Potential for more than minimal harm, pattern
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. · F-0637
May 8, 2025
D · Potential for more than minimal harm, isolated
The facility did not honor residents' right to make their own choices about their daily lives, such as when to wake up, what to eat, or how to spend their time. · from a complaint · F-0561
May 8, 2025
D · Potential for more than minimal harm, isolated
The facility did not educate residents and staff about COVID-19 vaccination, offer the vaccine to those eligible after that education, or properly document everyone's vaccination status. · F-0887
Dec 31, 2024
D · Potential for more than minimal harm, isolated
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 · F-0658
Jun 20, 2024
▲ G · Actual harm, isolated
The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689
Jun 20, 2024
E · Potential for more than minimal harm, pattern
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. · F-0812
Jun 20, 2024
E · Potential for more than minimal harm, pattern
The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. · F-0842
Jun 20, 2024
E · Potential for more than minimal harm, pattern
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. · F-0880
Jun 20, 2024
D · Potential for more than minimal harm, isolated
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. · F-0550
Jun 20, 2024
D · Potential for more than minimal harm, isolated
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. · F-0759
Jan 4, 2024
▲ G · Actual harm, isolated
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 · F-0684
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (3 → 6).
Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01
All citationsSerious citations (G–L)
2024
All citations:
8
Serious citations (G–L):
2
2025
All citations:
5
Serious citations (G–L):
0
2026
All citations:
6
Serious citations (G–L):
0
All bars start at zero. Exact values and supporting details remain below.
Year
Citations
Serious (G–L)
Worst severity that year
2024
8
2
G ▲
2025
5
0
E
2026
6
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.
Every penalty CMS publishes for this facility in the 3-year window is listed —none excluded. The count and the dollar total come from two different CMS datasets and agree for this facility. Penalties older than the window are dropped by CMS before publication, not by us.
Date
Type
Amount / length
Jun 20, 2024
Fine
$12,048
Jan 4, 2024
Fine
$7,615
Nurse staffing (from payroll records, adjusted for how much care residents need)
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:
3.73
Iowa average:
4.37
U.S. average:
3.95
Registered Nurse hours
This facility:
0.68
Iowa average:
0.85
U.S. average:
0.69
Weekend total nurse staffing
This facility:
3.22
Iowa average:
3.86
U.S. average:
3.50
All bars start at zero. Exact values and supporting details remain below.
Measure
This facility
Iowa avg
U.S. avg
Where it stands
Total nurse staffing (hours per resident per day)
3.73
4.37
3.95
bottom 20% in Iowa; bottom 48% in the U.S.
Registered Nurse hours
0.68
0.85
0.69
bottom 34% in Iowa; top 38% in the U.S.
Weekend total nurse staffing
3.22
3.86
3.50
bottom 18% in Iowa; bottom 43% in the U.S.
Weekend RN hours (not acuity-adjusted)
0.31
0.51
0.48
bottom 19% in Iowa; bottom 34% in the U.S.
Total nursing staff turnover (%)
48.1
44.0
45.8
bottom 35% in Iowa; bottom 42% in the U.S.
RN turnover (%)
62.5
42.1
42.9
bottom 22% in Iowa; bottom 19% 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 3.26, RN 0.60, weekend 2.81.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.26 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.
No verified facility-specific private-pay price is available in our data for Creston Specialty Care. CMS inspection and staffing records do not tell us what this home will charge you.
Calculate a stay from a quote you receive
Use a written private-pay quote. This worksheet adds only the amounts you enter; it does not calculate Medicare, Medicaid or insurance benefits.
Formula: (room rate + daily extras) × days + one-time charges. A 30-day scenario is not a calendar-month quote. Refundable deposits, rate changes and charges you omit are not automatically included. Entries are not saved or sent to our server.
Before you compare prices
Request the room type, effective date and itemized daily rate in writing.
Ask about therapy, medicines, supplies, care-level charges, deposits, refunds and annual increases.
Confirm insurance or Medicaid eligibility and bed availability directly; certification alone does not guarantee either.
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.
Facility data as of CMS processing date 2026-08-01. CCN 165199.
This page is the printable visit checklist. If your browser did not open the print dialog automatically, use File → Print (Ctrl/⌘-P).
The Care File
Visit checklist — Creston Specialty Care
1001 Cottonwood Drive, Creston, IA 50801 · (641) 782-8511
Health inspection rating 2/5 · CMS overall 2/5· Fines (3y): $19,663
Most serious findings on record:
▲ Jun 20, 2024 (F-0689, Actual harm, isolated): The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.
▲ Jan 4, 2024 (F-0684, Actual harm, isolated): The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.
Questions for the administrator:
☐ "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
☐ "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
☐ "Can you show me how medications are stored and secured on the units, including controlled drugs?"
☐ "Who reviews your menus, and can I see this week's menu and join my family member for a meal?"
☐ "Could I join residents for a meal to see the food quality and temperature for myself?"
☐ "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
☐ "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
☐ "What is your nurse and aide staffing ratio on each shift, including nights and weekends?"
☐ "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 48% 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?"
While you're there, notice:
☐ Smell and cleanliness in hallways, not just the lobby
☐ How staff speak to residents; call lights answered promptly
☐ Residents up, dressed, and engaged (visit mealtimes and a weekend if you can)
Data: CMS Provider Data Catalog, version 2026-08-01 · CCN 165199 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)