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3/5
Health inspection rating (on-site)
inspected May 21, 2026
3
Serious findings on record
most recent Mar 12, 2026
$19,663
Fines, last 3 years
2.93
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)
▲ Actual harm, isolated · 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): 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: Mar 23, 2026 (Deficient, Provider has date of correction)
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: Jun 20, 2024 (Deficient, Provider has date of correction)
▲ Actual harm, isolated · 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): 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: Feb 16, 2024 (Deficient, Provider has date of correction)
Inspection findings in the public record
Showing the latest 3 of 12 inspection findings. Open the full record below to read every finding.
E · Potential for more than minimal harm, pattern
The facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand. F-0552
E · Potential for more than minimal harm, pattern
The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. F-0641
D · Potential for more than minimal harm, isolated
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). F-0628
View all 12 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
May 21, 2026
E · Potential for more than minimal harm, pattern
The facility did not make sure residents were fully informed about their own health, care, and treatments in a way they could understand. · F-0552
May 21, 2026
E · Potential for more than minimal harm, pattern
The facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641
May 21, 2026
D · Potential for more than minimal harm, isolated
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). · F-0628
May 21, 2026
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
Mar 12, 2026
▲ 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. · from a complaint · F-0689
Jun 19, 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 19, 2024
D · Potential for more than minimal harm, isolated
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. · F-0657
Jun 19, 2024
D · Potential for more than minimal harm, isolated
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. · F-0677
Jun 19, 2024
D · Potential for more than minimal harm, isolated
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. · F-0690
Jun 19, 2024
D · Potential for more than minimal harm, isolated
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. · F-0757
Jan 24, 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. · from a complaint · F-0689
Dec 6, 2023
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. · from a complaint · F-0725
Inspection trend by year
Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01
All citationsSerious citations (G–L)
2023
All citations:
1
Serious citations (G–L):
0
2024
All citations:
6
Serious citations (G–L):
2
2026
All citations:
5
Serious citations (G–L):
1
All bars start at zero. Exact values and supporting details remain below.
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.
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 19, 2024
Fine
$10,839
Jan 24, 2024
Fine
$8,824
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:
2.93
Iowa average:
4.37
U.S. average:
3.95
Registered Nurse hours
This facility:
0.81
Iowa average:
0.85
U.S. average:
0.69
Weekend total nurse staffing
This facility:
2.31
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)
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 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 5.67, RN 1.57, weekend 4.49.Comparing with Medicare Care Compare? Care Compare shows the raw figure (5.67 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 Mississippi Valley. 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.
CMS records place this facility in Lee, IA — 6 certified facilities there. These are outside the 20-mile list above, or far enough down it not to appear.
Facility data as of CMS processing date 2026-08-01. CCN 165151.
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The Care File
Visit checklist — Mississippi Valley
500 Messenger Road, Keokuk, IA 52632 · (319) 524-5321
Health inspection rating 3/5 · CMS overall 3/5· Fines (3y): $19,663
Most serious findings on record:
▲ Mar 12, 2026 (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.
▲ Jun 19, 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 24, 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.
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 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?"
☐ "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 37% total nursing staff turnover here — who on the care team has been with you longest?"
☐ "The ownership record on file lists 19 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 165151 · Verify at medicare.gov/care-compare · Printed from The Care File (thecarefile.com)