222 of the 388 Medicare-certified nursing homes in Iowa (57%) are chain-owned, and all are listed below. 43 of the 222 graded homes earn an A and 11 earn a D or F. They average 3.62 nursing hours per resident per day, 0.2 hours below the 3.82 for every home in Iowa. Deerfield Health Care Center in Urbandale grades highest at A (100 out of 100).
How chain-owned homes in Iowa compare
This group set against every nursing home in Iowa, from the current CMS release.
Harmony Waterloo runs 88 certified beds under for-profit LLC ownership, and the numbers behind its record deserve a close look. Nurse staffing sits at 3.24 hours per resident day, roughly 16 percent under the national average, and weekends dip about 10 percent below what the home staffs on weekdays, so coverage thins out exactly when families tend to visit. The inspection history is the bigger concern: 21 deficiencies on the current record, including one at the harm or jeopardy level and two tied to abuse. One fine totaling $95,440 has been issued, and turnover runs 48.8 percent. The most recent inspection was January 14, 2026.
Harmony Dubuque runs on thinner nurse coverage than most homes, 3.39 hours per resident day against a national average of 3.86, and weekends dip about 8% below what the home itself staffs on weekdays. That gap matters most when a resident needs help on a Saturday, and it's harder to absorb when more than seven in ten workers leave over a year, well above the 45.8% national rate. On inspections the home has drawn a two-star rating, with 33 deficiencies on record, three serious enough to cause harm and one tied to abuse, plus two fines totaling $19,371. Its last inspection was January 14, 2026.
Embassy Rehab and Care Center runs 60 certified beds in Sergeant Bluff under for-profit LLC ownership, and the staffing picture is mixed. Nurses provide 3.51 hours per resident day, about 9% under the national average of 3.86, and weekends drop roughly 18% below the home's own weekday coverage. Annual turnover sits at 54.2%, well above the 45.8% national figure. Inspections tell the heavier story: 27 deficiencies on the current record, four of them abuse-related, though none rose to harm or jeopardy level, and the health inspection rating lands at 2 out of 5. A recent inspection date of May 2026 means the record is current, not stale.
Casa De Paz runs about 2.79 nurse hours per resident day, roughly 28% under the national average of 3.86, and weekends drop another 25% below its own weekday staffing. That thin coverage shows up in the numbers: a 2/5 CMS staffing rating, 60.3% annual turnover against a national 45.8%, and 36 deficiencies on record, including two tied to abuse. No deficiencies were flagged at the harm or jeopardy level, and the 4/5 quality measure rating suggests some clinical measures are being met. But with a for-profit LLC structure, a recent April 2026 inspection, and a 2/5 health inspection rating, the staffing pattern is the thing to ask about directly before deciding.
Oakland Manor runs on 3.05 nurse hours per resident day, roughly a fifth below the national average of 3.86, and weekend coverage drops about 15% below what it manages during the week. That thin staffing sits alongside a one-star health inspection rating and 68 deficiencies on the current record, including three at the harm or jeopardy level and 11 tied to abuse. Federal regulators have placed it in the Special Focus Facility program, the toughest track CMS uses, and the home carries a $15,593 fine. Ownership is for-profit through a limited liability company. The last inspection was January 8, 2026.
Eldora Specialty Care runs about 3.56 nursing hours per resident each day, roughly 8 percent under the national average of 3.86, and weekends dip another 6 percent below its own weekday coverage. Turnover sits at 38.5 percent, which is actually better than the 45.8 percent national figure, so staff tend to stick around longer than at the typical home. The record is clean where it counts: four deficiencies total, none at the harm or jeopardy level, no abuse citations, and the last inspection was recent, in December 2025. This is a small nonprofit home with solid inspection and quality marks; the main thing to weigh is whether the lighter daily staffing, especially on weekends, fits the care your family member needs.
Heritage Care and Rehabilitation Center runs 71 certified beds in Mason City under corporate for-profit ownership. The staffing numbers are where the concern sits: 3.33 total nurse hours per resident day, roughly 14 percent below the national average of 3.86, and weekends drop about 17 percent below the home's own weekday staffing. That thin coverage lines up with a 1-out-of-5 CMS staffing rating.
The current inspection record shows 7 deficiencies, including 1 at the harm or jeopardy level and none tied to abuse. The last inspection was August 14, 2025, so the findings are recent. Quality measures score 2 out of 5. If you're weighing this home against others nearby, the staffing pattern and that harm-level deficiency are the two things worth asking about directly.
Accura Healthcare Of Marshalltown is a for-profit, 84-bed home in Marshall County, and its record is thin in the places that matter most. Nurse staffing runs 3.60 hours per resident day, about 7% under the national average, and drops roughly another 10% on weekends, which is when families often visit and notice. The current inspection record carries 42 deficiencies, including three at the harm or jeopardy level and four tied to abuse, and the latest inspection was March 2026. Staff turnover, at 42.3%, is actually slightly better than the national 45.8%, so the problem isn't retention alone; it's what's happening on the floor and in the survey record.
Accura Healthcare of Cascade sits in a small Dubuque County town with 46 certified beds, run by a for-profit limited liability company. The staffing numbers are the strong point: 4.26 nurse hours per resident day, roughly 10% above the national average, and turnover at 30.6% beats the 45.8% national figure. Weekends run about 11% leaner than weekdays, which is common but worth knowing. The trouble is on the inspection side, where the health inspection rating lands at 2 out of 5. Five deficiencies are on the current record, including one at the harm or jeopardy level and one abuse-related. The last inspection was in May 2025. Good staffing can't fully offset a harm-level finding. Ask what happened and what changed.
Maquoketa Care Center runs 46 beds under for-profit LLC ownership, and its last full inspection was in May 2025, recent enough that the findings are worth reading closely. That record carries six deficiencies, including one at the harm or jeopardy level and one tied to abuse. It's not a long list, but those two categories matter more than the count suggests.
Staffing sits at 3.42 nurse hours per resident day, roughly 11% under the national average of 3.86, and weekends run about 10% thinner than weekdays. Annual turnover is 50%, a few points above the national 45.8%. Inspections scored well; the day-to-day staffing numbers are where this home looks more ordinary.
Azria Health Winterset runs 65 beds under for-profit LLC ownership, and its nurse staffing sits at 3.45 hours per resident day, roughly 11% under the national average of 3.86. Weekends dip about 9% below the home's own weekday coverage, so the thinnest shifts land when families tend to visit. Turnover at 42.9% is slightly better than the 45.8% national figure, but the inspection record is the bigger concern: 30 deficiencies, one of them serious enough to reach harm or jeopardy level. That March 2026 inspection is recent, and the two-out-of-five ratings on health inspections, quality measures, and staffing all point the same direction.
Country Lane Manor runs on thin staffing: 3.22 nurse hours per resident day, roughly 17 percent under the national average, and weekends dip about 10 percent below its own weekday levels. That's the kind of gap that shows up as unanswered call lights. Turnover sits at 62.1 percent against a 45.8 percent national figure, so the aides who know your mother's routines keep leaving. The inspection record is the harder read: 57 deficiencies, five serious enough to put residents in harm's way, two tied to abuse, and a $59,150 fine, with the last state visit in August 2025. Ownership is for-profit, through a limited liability company. The quality star rating of 4 out of 5 is real, but it measures a narrow slice of care.
Colonial Manor Of Elma runs 40 beds under for-profit LLC ownership, and its nurse staffing sits at 3.56 hours per resident day, roughly 8% under the national average of 3.86. Weekends drop about 12% below its own weekday coverage, so the thinnest shifts land when families tend to visit. Staff turnover is 62.2% against a national 45.8%, meaning most of the people caring for residents this year likely won't be there next year. The inspection record shows 16 deficiencies, including 2 at harm or jeopardy level and 3 abuse-related, with $44,768 in fines across two penalties and a February 2026 inspection.
Bettendorf Health Care Center runs 3.22 nurse hours per resident per day, roughly 17 percent under the national average, and weekend staffing drops another 13 percent below its own weekday level. That thin coverage shows up in its inspection history: 62 deficiencies on the current record, including three at the harm level and five tied to abuse, with two fines totaling $35,622. The quality measure score looks strong, but that comes from resident assessments rather than day-to-day care on the floor. Corporate-owned and certified for 86 beds, this home was last inspected in September 2025. The staffing and inspection numbers are the ones worth weighing.
Harmony Cedar Rapids runs 74% annual staff turnover against a national average of 45.8%, that means roughly three in four caregivers who work here won't be here a year from now. Nurse staffing sits at 3.70 hours per resident day, about 4% under the national figure, and weekends drop another 9% below the home's own weekday coverage. Its current inspection record carries 27 deficiencies, four of them serious enough to put residents at risk of harm, and the health inspection rating sits at 1 out of 5 stars. Ownership is for-profit, through a limited liability company. The most recent inspection was March 3, 2026, and CMS has fined the home once, for $10,358.
Crestview Specialty Care runs 65 certified beds in West Branch under nonprofit corporate ownership, and the numbers tell a mixed story. Nurse staffing sits at 3.67 hours per resident day, about 5% under the national average, and weekends drop roughly 11% below its own weekday level, so coverage thins out exactly when families tend to visit. Annual turnover of 62.7% is well above the 45.8% national figure, meaning the people caring for residents are cycling through fast.
What stands out most is the inspection record: 28 deficiencies, six of them serious enough to cause harm or jeopardy, and three fines totaling $216,061. The most recent inspection was December 2025. No abuse citations appear on file. Staffing and quality measures both land mid-range, but that deficiency history is the real weight here.
Accura Healthcare of Creston runs 31 certified beds under for-profit limited liability ownership, and the numbers worth your attention are the staffing ones. Nurse coverage sits at 3.80 hours per resident day, a bit under the national average, and it thins out on weekends, roughly 18% below the home's own weekday level. Annual turnover of 68.4% is well above the 45.8% national figure, meaning most of the people caring for residents are relatively new to the building. The inspection record shows 33 deficiencies, including two at the harm level and one tied to abuse, with a $16,801 fine and a May 2025 inspection. State surveyors rated health inspections and quality measures 2 out of 5.
Spencer Post Acute Rehabilitation Center runs 82 certified beds as a for-profit corporation, and its nurse staffing sits at 3.38 hours per resident day, roughly 12% under the national average of 3.86. Weekends dip about 10% below the home's own weekday levels, so coverage thins out exactly when families tend to visit. The inspection record shows 45 deficiencies, including two at the harm or jeopardy level and two tied to abuse, with $24,706 in fines across two penalties. Its last inspection was August 14, 2025, and all three CMS star ratings, health inspection, quality measures, and staffing, sit at 2 out of 5.
Lantern Park Specialty Care runs 90 certified beds in Coralville under nonprofit ownership, and its staffing sits at 3.52 nurse hours per resident day, roughly 9% under the national average of 3.86, with weekends dipping about 6% below its own weekday levels. Turnover tells a sharper story: 59.4% annually against a national 45.8%, meaning well over half the nursing staff leaves each year. The inspection record shows 47 deficiencies, including 5 at harm or jeopardy level and 3 tied to abuse, plus one fine totaling $62,595. CMS rated its last inspection two stars on health and two on quality measures, with staffing at three. The most recent survey was July 2025.
Stone Cottage Care Center runs 41 beds in Sigourney under for-profit LLC ownership, and its nurse staffing sits at 3.80 hours per resident day, just under the national average, with weekends running about 6% thinner than weekdays. The bigger issue is consistency: turnover hits 53.8% against a 45.8% national rate, meaning nearly six in ten caregivers left over the year. Its inspection record shows 69 deficiencies, including three at harm or jeopardy level and seven tied to abuse, with one fine totaling $18,682 and a survey as recent as September 2025. State inspectors and quality measures both land at the bottom of CMS's five-star scale; staffing is the relative bright spot at three stars.
Frequently asked questions
How many chain-owned nursing homes are there in Iowa?
There are 222 chain-owned Medicare-certified nursing homes in Iowa, 57% of the 388 nursing homes there.
Are chain-owned nursing homes better staffed?
In Iowa they average 3.62 total nursing hours per resident per day, against 3.82 for all nursing homes in Iowa, a difference of -0.2 hours. Staff turnover averages 46.1% against 44.1%.
Which chain-owned nursing home grades best in Iowa?