River Hills Village in Keokuk
20 Village Circle, Keokuk, IA 52632 · Lee County · 84 certified beds · avg 65 residents/day · certified since Jul 13, 1998
Part of chain: UNLIMITED DEVELOPMENT, INC. (10 facilities, chain avg rating 2.5★)
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 · Jul 16, 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: Jul 31, 2024 (Deficient, Provider has date of correction)
All citations in the current public record (8)
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 |
|---|---|---|
| Sep 18, 2025 | 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. |
| Sep 18, 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. |
| Sep 18, 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. |
| Sep 18, 2025 | 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. |
| Sep 18, 2025 | 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. |
| Sep 12, 2024 | 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. |
| Jul 16, 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 |
| Mar 11, 2024 | D · Potential for harm, one-off | The facility did not protect residents' personal information or did not keep complete, accurate medical records that meet professional standards. |
Inspection trend by year
Citations from standard inspections increased between the last two inspection cycles (1 → 5).
| Year | Citations | Serious (G–L) | Worst severity that year |
|---|---|---|---|
| 2024 | 3 | 1 | G ▲ |
| 2025 | 5 | 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)
No fines or payment denials in the published 3-year window.
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) | 3.88 | 4.37 | 3.95 | bottom 31% in Iowa; top 45% in the U.S. |
| Registered Nurse hours | 0.36 | 0.85 | 0.69 | bottom 2% in Iowa; bottom 17% in the U.S. |
| Weekend total nurse staffing | 3.62 | 3.86 | 3.50 | bottom 43% in Iowa; top 37% in the U.S. |
| Weekend RN hours (not acuity-adjusted) | 0.24 | 0.51 | 0.48 | bottom 5% in Iowa; bottom 20% in the U.S. |
| Total nursing staff turnover (%) | 40.0 | 44.0 | 45.8 | top 43% in Iowa; top 36% in the U.S. |
| RN turnover (%) | 28.6 | 42.1 | 42.9 | top 32% in Iowa; top 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 4.28, RN 0.40, weekend 3.99. 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: 4/5 · long-stay residents: 4/5 · short-stay residents: 4/5
Who owns this facility
For profit - Limited Liability company
| Owner / manager | Type | Role | Stake | Since |
|---|---|---|---|---|
| Unlimited Development, INC | Organization | 5% or Greater Direct Ownership Interest | 100% | 06/01/2010 |
| Ballew, Heather | Individual | W-2 Managing Employee | NOT APPLICABLE | 04/27/2022 |
| Finke, Audrey | Individual | Corporate Director | NOT APPLICABLE | 06/01/2010 |
| Gilmore, Jerry | Individual | Corporate Director | NOT APPLICABLE | 06/01/2010 |
| Haney, David | Individual | Corporate Director | NOT APPLICABLE | 06/01/2010 |
| Wagner, Robert | Individual | Corporate Director | NOT APPLICABLE | 06/01/2010 |
| Wilson, Ronald | Individual | Corporate Officer | NOT APPLICABLE | 06/01/2010 |
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?"
- "Who reviews your menus, and can I see this week's menu and join my family member for a meal?"
- "What did your most recent kitchen inspection find, and can I see how food is stored and prepared?"
- "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
- "Who is on the team that builds each resident's care plan, and how quickly is it in place after admission?"
- "Can you tell me what this citation involved and what steps you took to bring care back up to standard?"
- "How do you keep residents' medical records accurate, complete, and secure?"
- "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 | 0.8 mi | Keokuk, IA | ★★★★☆ | 2/5 | |
| Mississippi Valley | 1.2 mi | Keokuk, IA | ★★★☆☆ | 3/5 | |
| Montrose Health Center | 6.4 mi | Montrose, IA | ★★★☆☆ | 2/5 | |
| Birkwood Village of Fort Madison | 13.4 mi | Fort Madison, IA | ★★★☆☆ | 3/5 | |
| Clark County Nursing Home | 16.1 mi | Kahoka, MO | ★★☆☆☆ | 3/5 |
Compare this facility with the 3 closest →
Facility data as of CMS processing date 2026-08-01. CCN 165396.