Grand Meadows Senior Living & Health Care
5300 Grand Meadow Drive, Asbury, IA 52002 · Dubuque County · 32 certified beds · avg 29 residents/day · certified since Jul 12, 2017
Part of chain: TUTERA SENIOR LIVING & HEALTH CARE (25 facilities, chain avg rating 2.0★)
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 1/5
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 · Apr 23, 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: Apr 24, 2024 (Deficient, Provider has date of correction)
All citations in the current public record (20)
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 |
|---|---|---|
| Mar 26, 2026 | E · Potential for harm, repeated | 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. |
| Mar 26, 2026 | D · Potential for harm, one-off | 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 |
| Mar 26, 2026 | 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. |
| Mar 26, 2026 | D · Potential for harm, one-off | 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. |
| Mar 26, 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 |
| Mar 26, 2026 | D · Potential for harm, one-off | 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. |
| Mar 26, 2026 | D · Potential for harm, one-off | The facility did not develop and follow policies and procedures for offering residents flu and pneumonia vaccinations. |
| Jun 13, 2025 | 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 |
| Mar 6, 2025 | E · Potential for harm, repeated | 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. |
| Mar 6, 2025 | D · Potential for harm, one-off | The facility did not provide the care needed to maintain or improve residents' movement and flexibility — such as range-of-motion exercises — leading to avoidable decline. |
| Mar 6, 2025 | D · Potential for harm, one-off | The facility did not provide care that took into account residents' past trauma or their cultural backgrounds. Care is supposed to be sensitive to what residents have lived through and where they come from. |
| Mar 6, 2025 | D · Potential for harm, one-off | The facility did not try to gradually reduce doses of mood- and mind-altering medications or use non-drug approaches first, as required, or used 'as needed' psychiatric drugs without proper limits. |
| Apr 23, 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 |
| Apr 23, 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. · from a complaint |
| Apr 23, 2024 | E · Potential for harm, repeated | The facility did not dispose of garbage and refuse properly. |
| Apr 23, 2024 | D · Potential for harm, one-off | The facility did not protect residents from abuse or neglect. This covers physical, mental, and sexual abuse, physical punishment, and neglect, by anyone — staff, other residents, or visitors. · from a complaint |
| Apr 23, 2024 | D · Potential for harm, one-off | The 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 |
| Apr 23, 2024 | D · Potential for harm, one-off | The facility did not have a written plan describing how it runs its quality improvement program — the ongoing process of finding problems in care and fixing them. · from a complaint |
| Sep 14, 2023 | 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 |
| Sep 14, 2023 | 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 |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (4 → 7).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 2 | 0 | D |
| 2024 | 6 | 1 | J ▲ |
| 2025 | 5 | 0 | E |
| 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 $16,448.
| Date | Type | Amount / length |
|---|---|---|
| Apr 23, 2024 | Fine | $16,448 |
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) | 0.00 | 4.37 | 3.95 | — |
| Registered Nurse hours | 0.00 | 0.85 | 0.69 | — |
| Weekend total nurse staffing | 0.00 | 3.86 | 3.50 | — |
| Weekend RN hours (not acuity-adjusted) | 0.00 | 0.51 | 0.48 | — |
| Total nursing staff turnover (%) | 0.0 | 44.0 | 45.8 | — |
| RN turnover (%) | 0.0 | 42.1 | 42.9 | — |
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 0.00, RN 0.00, weekend 0.00. Staffing rating: 1/5.
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: 2/5
Who owns this facility
For profit - Corporation
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Constace Marie Mendolia 2009 Irrv Tr | Organization | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2024 |
| Dominic Frank Tutera 2016 Irrv Tr | Organization | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2024 |
| Hannah Marie Tutera 2016 Irrv Tr | Organization | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2024 |
| Joseph Charles Tutera Jr 2016 Irrv Tr | Organization | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2024 |
| Laura Cirese Tutera 2016 Irrv Tr | Organization | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2024 |
| Mary Margaret Cunningham 2009 Irrv Tr | Organization | Indirect Ownership Interest | NOT APPLICABLE | 10/01/2024 |
| Seitera LP LLC | Organization | Direct Ownership Interest | NOT APPLICABLE | 10/01/2024 |
| Bloom, Randall | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2024 |
| Bloom, Randall | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Brooks, Kiley | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2024 |
| Brooks, Kiley | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Constace Marie Mendolia 2009 Irrv Tr | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Grand Meadows Senior Living & Health Care Property LLC | Organization | ADP of the SNF | NOT APPLICABLE | 09/30/2024 |
| Jewell, Susan | Individual | ADP of the SNF | NOT APPLICABLE | 05/01/2025 |
| Mary Margaret Cunningham 2009 Irrv Tr | Organization | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Tutera Group, INC | Organization | ADP of the SNF | NOT APPLICABLE | 09/30/2024 |
| Tutera, Joseph | Individual | Operational/Managerial Control | NOT APPLICABLE | 10/01/2024 |
| Tutera, Joseph | Individual | ADP of the SNF | NOT APPLICABLE | 10/01/2024 |
| Walnut Creek Management Company LLC | Organization | Operational/Managerial Control | NOT APPLICABLE | 10/01/2024 |
| Walnut Creek Management Company LLC | Organization | ADP of the SNF | NOT APPLICABLE | 05/07/2025 |
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?"
- "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
- "If my family member falls or their condition changes, exactly when and how will I be notified?"
- "Before any service that isn't covered by Medicare or Medicaid, how will you notify us and get our agreement?"
- "What percentage of your residents are on antipsychotic or sedating medications, and how do you work to reduce that?"
- "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
- "Who leads your infection prevention program, and how do you make sure staff follow practices like hand hygiene every day?"
- "What percentage of your residents and staff are vaccinated against flu and pneumonia, and how do you offer the vaccines?"
- "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 |
|---|---|---|---|---|---|
| Hawkeye Care Center Dubuque | 0.9 mi | Asbury, IA | ★★★☆☆ | 3/5 | |
| Ennoble Nursing and Rehab | 1.9 mi | Dubuque, IA | ★★★★★ | 5/5 | |
| Luther Manor at Hillcrest | 2.0 mi | Dubuque, IA | ★☆☆☆☆ | 1/5 | |
| Dubuque Specialty Care | 2.3 mi | Dubuque, IA | ★★☆☆☆ | 2/5 | |
| Harmony Dubuque | 4.3 mi | Dubuque, IA | ★★☆☆☆ | 2/5 | |
| Stonehill Care Center | 4.5 mi | Dubuque, IA | ★★★★☆ | 4/5 | |
| Bethany Home | 4.7 mi | Dubuque, IA | ★★★★★ | 4/5 | |
| Sunnycrest Manor | 5.1 mi | Dubuque, IA | ★★★★☆ | 4/5 | |
| Mount Carmel Bluffs | 5.6 mi | Dubuque, IA | ★★★★★ | 4/5 | |
| St Dominic Villa | 11.0 mi | Hazel Green, WI | ★★☆☆☆ | 1/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 165618.