Exira Care Center
411 South Carthage, Exira, IA 50076 · Audubon County · 60 certified beds · avg 38 residents/day · certified since Apr 1, 1999
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 · Nov 8, 2024 · F-0689 · triggered by a complaint
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 (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: Nov 4, 2024 (Past Non-Compliance)
All citations in the current public record (21)
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 |
|---|---|---|
| May 6, 2026 | E · Potential for harm, repeated | 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 |
| May 6, 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 |
| May 6, 2026 | D · Potential for harm, one-off | The 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 |
| May 6, 2026 | 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 |
| May 6, 2026 | 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 |
| May 6, 2026 | 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 |
| May 6, 2026 | D · Potential for harm, one-off | 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. · from a complaint |
| Aug 7, 2025 | 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. |
| Aug 7, 2025 | 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. |
| Aug 7, 2025 | D · Potential for harm, one-off | The facility did not provide enough food and fluids to keep residents healthy, such as preventing unplanned weight loss or dehydration. |
| Aug 7, 2025 | D · Potential for harm, one-off | The facility did not provide pharmacy services that meet each resident's needs, or did not employ or contract with a licensed pharmacist. |
| Nov 8, 2024 | ▲ J · Immediate jeopardy, 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 |
| Nov 8, 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. · from a complaint |
| Nov 8, 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. · from a complaint |
| Dec 21, 2023 | 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 |
| Jul 13, 2023 | F · Potential for harm, facility-wide | The facility did not have enough backup water supply for essential areas of the building. |
| Jul 13, 2023 | E · Potential for harm, repeated | 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. |
| Jul 13, 2023 | 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 13, 2023 | 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 13, 2023 | 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. |
| Jul 13, 2023 | C · Minimal risk, facility-wide | The facility did not make its inspection results easy for residents to see, or made it hard for residents to contact advocacy agencies like the ombudsman. |
Inspection trend by year
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 7 | 0 | F |
| 2024 | 3 | 1 | J ▲ |
| 2025 | 4 | 0 | D |
| 2026 | 7 | 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 $22,880.
| Date | Type | Amount / length |
|---|---|---|
| Oct 10, 2024 | Fine | $22,880 |
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) | 4.60 | 4.37 | 3.95 | top 35% in Iowa; top 21% in the U.S. |
| Registered Nurse hours | 0.80 | 0.85 | 0.69 | top 49% in Iowa; top 28% in the U.S. |
| Weekend total nurse staffing | 4.21 | 3.86 | 3.50 | top 30% in Iowa; top 17% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.53 | 0.51 | 0.48 | top 34% in Iowa; top 29% in the U.S. |
| Total nursing staff turnover (%) | 50.0 | 44.0 | 45.8 | bottom 32% in Iowa; bottom 38% in the U.S. |
| RN turnover (%) | 57.1 | 42.1 | 42.9 | bottom 30% in Iowa; bottom 26% 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 3.74, RN 0.65, weekend 3.42. Staffing rating: 4/5.
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: 3/5
Who owns this facility
Non profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| BCG Holdings INC | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Brighton Consulting Group LLC | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Burns, Marty | Individual | Operational/Managerial Control | NOT APPLICABLE | 09/15/2020 |
| Cattail BCG LLC | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Cattail INC | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Creative Planning Hold Co LLC | Organization | ADP of the SNF | NOT APPLICABLE | 08/01/2024 |
| Dentlinger, Lori | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/25/2018 |
| Ecsi INC | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Godwin, Thomas | Individual | Corporate Officer | NOT APPLICABLE | 10/01/2017 |
| Iowa Health Care Association | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Joni Anderson Consulting LLC | Organization | ADP of the SNF | NOT APPLICABLE | 06/30/2018 |
| Key Rehabilitation INC | Organization | ADP of the SNF | NOT APPLICABLE | 06/30/2018 |
| Marshall, Tanya | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/29/2024 |
| Nelson, Dale | Individual | Corporate Director | NOT APPLICABLE | 10/01/2017 |
| Olsen, Tina | Individual | Operational/Managerial Control | NOT APPLICABLE | 01/31/1994 |
| Paulsen, Julie | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/1994 |
| Thompson, Becky | Individual | Corporate Director | NOT APPLICABLE | 05/01/2025 |
| Vampola-Runyan, Stephanie | Individual | Operational/Managerial Control | NOT APPLICABLE | 05/05/1988 |
| Vampola-Runyan, Stephanie | Individual | ADP of the SNF | NOT APPLICABLE | 09/15/2025 |
Questions to ask on your visit
Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.
- "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
- "What is your nurse and aide staffing ratio on each shift, including nights and weekends?"
- "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
- "How many aides are on each shift, and how do you make sure every resident gets timely help with bathing, dressing, and meals?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "How do you verify that your nurses and aides have the skills to care for residents with needs like my family member's?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "How do you care for residents with incontinence or catheters, and what do you do to prevent urinary tract infections?"
- "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 |
|---|---|---|---|---|---|
| Friendship Home Association | 9.3 mi | Audubon, IA | ★★★★☆ | 4/5 | |
| Salem Lutheran Home | 9.4 mi | Elk Horn, IA | ★☆☆☆☆ | 1/5 | |
| Caring Acres Nursing and Rehab Center | 11.9 mi | Anita, IA | ★☆☆☆☆ | 1/5 | SFF |
| Heritage House | 14.4 mi | Atlantic, IA | ★★★★★ | 4/5 | |
| Atlantic Specialty Care | 14.8 mi | Atlantic, IA | ★★★☆☆ | 2/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 165412.