Mississippi Valley
500 Messenger Road, Keokuk, IA 52632 · Lee County · 83 certified beds · avg 57 residents/day · certified since Mar 25, 1989
What health inspectors found (on-site government inspections — the most independent evidence available)
Health inspection rating: ★★★☆☆3/5 · CMS overall rating: 3/5
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)
▲ Actual harm, one-off · Mar 12, 2026 · 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 (G): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Mar 23, 2026 (Deficient, Provider has date of correction)
▲ Actual harm, one-off · Jun 19, 2024 · F-0689
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): One or a few residents were actually harmed — physically or emotionally — though not put in immediate danger of serious injury or death.
Corrected: Jun 20, 2024 (Deficient, Provider has date of correction)
▲ Actual harm, one-off · Jan 24, 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 (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 16, 2024 (Deficient, Provider has date of correction)
All citations in the current public record (12)
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 21, 2026 | E · Potential for harm, repeated | The facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand. |
| May 21, 2026 | E · Potential for harm, repeated | The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. |
| May 21, 2026 | D · Potential for harm, one-off | The facility did not provide required paperwork or notices about a resident's needs, their right to appeal a transfer or discharge, or the facility's bed-hold policy (how long a bed is saved during a hospital stay). |
| May 21, 2026 | 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. |
| Mar 12, 2026 | ▲ G · Actual 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 |
| Jun 19, 2024 | ▲ G · Actual 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. |
| Jun 19, 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. |
| Jun 19, 2024 | 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. |
| Jun 19, 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. |
| Jun 19, 2024 | D · Potential for harm, one-off | The facility did not keep residents' medications free from unnecessary drugs. Residents should only take medicines they truly need, at the right dose, for a clear reason. |
| Jan 24, 2024 | ▲ G · Actual 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 |
| Dec 6, 2023 | 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 |
Inspection trend by year
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2023 | 1 | 0 | E |
| 2024 | 6 | 2 | G ▲ |
| 2026 | 5 | 1 | G ▲ |
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)
2 fines totaling $19,663.
| Date | Type | Amount / length |
|---|---|---|
| Jun 19, 2024 | Fine | $10,839 |
| Jan 24, 2024 | Fine | $8,824 |
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) | 2.93 | 4.37 | 3.95 | bottom 1% in Iowa; bottom 11% in the U.S. |
| Registered Nurse hours | 0.81 | 0.85 | 0.69 | top 48% in Iowa; top 27% in the U.S. |
| Weekend total nurse staffing | 2.31 | 3.86 | 3.50 | bottom 1% in Iowa; bottom 5% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 1.15 | 0.51 | 0.48 | top 2% in Iowa; top 4% in the U.S. |
| Total nursing staff turnover (%) | 36.8 | 44.0 | 45.8 | top 34% in Iowa; top 28% in the U.S. |
| RN turnover (%) | 11.8 | 42.1 | 42.9 | top 8% in Iowa; top 5% 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 5.67, RN 1.57, weekend 4.49. 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 |
|---|---|---|---|---|
| Lexington Square Irrevocable Trust | Organization | Direct Ownership Interest | NOT APPLICABLE | 04/07/2017 |
| Abell, Terri | Individual | Managing Control - Governing Body | NOT APPLICABLE | 01/20/2016 |
| Abell, Terri | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/03/2022 |
| Anderson, Halley | Individual | Managing Control - Governing Body | NOT APPLICABLE | 10/18/2023 |
| Anderson, Halley | Individual | ADP of the SNF | NOT APPLICABLE | 04/17/2025 |
| Bell Bank Arrowhead Office | Organization | 5% or Greater Mortgage Interest | NOT APPLICABLE | 06/15/2022 |
| Blume, Michael | Individual | Managing Control - Governing Body | NOT APPLICABLE | 01/20/2016 |
| Blume, Michael | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/01/2023 |
| Blume, Michael | Individual | ADP of the SNF | NOT APPLICABLE | 08/20/2024 |
| Hoskins, Heather | Individual | Managing Control - Governing Body | NOT APPLICABLE | 03/15/2011 |
| Hoskins, Heather | Individual | Operational/Managerial Control | NOT APPLICABLE | 03/20/2024 |
| Israel, David | Individual | Managing Control - Governing Body | NOT APPLICABLE | 08/12/2025 |
| Lexington Square Irrevocable Trust | Organization | Operational/Managerial Control | NOT APPLICABLE | 04/07/2017 |
| Peterson, Paige | Individual | Managing Control - Governing Body | NOT APPLICABLE | 04/07/2022 |
| Peterson, Paige | Individual | Trustee of the SNF | NOT APPLICABLE | 04/06/2022 |
| Stanley, Murray | Individual | Managing Control - Governing Body | NOT APPLICABLE | 04/07/2022 |
| Stanley, Murray | Individual | Operational/Managerial Control | NOT APPLICABLE | 04/01/2017 |
| Stanley, Murray | Individual | Trustee of the SNF | NOT APPLICABLE | 04/01/2017 |
| Stanley, Murray | Individual | ADP of the SNF | NOT APPLICABLE | 04/01/2017 |
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?"
- "How do you explain health changes and treatment options to residents and their families?"
- "Who completes resident assessments here, and how do you check them for accuracy?"
- "What written notices do we get before any transfer or discharge, and what is your bed-hold policy?"
- "What is your current medication error rate, and what have you changed to bring errors down?"
- "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
- "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 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 |
|---|---|---|---|---|---|
| Southeast Iowa Healthcare Center | 0.6 mi | Keokuk, IA | ★★★★☆ | 2/5 | |
| River Hills Village in Keokuk | 1.2 mi | Keokuk, IA | ★★★☆☆ | 3/5 | |
| Montrose Health Center | 7.3 mi | Montrose, IA | ★★★☆☆ | 2/5 | |
| Birkwood Village of Fort Madison | 14.1 mi | Fort Madison, IA | ★★★☆☆ | 3/5 | |
| Clark County Nursing Home | 17.1 mi | Kahoka, MO | ★★☆☆☆ | 3/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 165151.