ElderGrade
A

94.5/100

Excellent

Titonka Care Center

312 First Avenue Nw, Titonka, IA 50480

CMS 5/5 stars #1 of 4 in Kossuth County (515) 928-2600
Certified beds
26
Occupancy
77%
Ownership
Non-profit
Accepts
Medicare + Medicaid

How this grade was calculated

Every point is shown. Nothing is weighted behind the scenes — the full formula is on How we grade.

Inspection 30/30 Staffing 27.5/30 Stability 15/15 Outcomes 12/15 Enforcement 10/10

A full pentagon is full marks. The shape shows what kind of good or bad a home is — two homes can share a score and look nothing alike.

Inspection safety

30/30

Citations from state health inspections over the last three surveys, weighted by how much harm CMS says they caused.

Staffing

27.5/30

Nursing hours per resident per day, adjusted for how sick the residents are, plus RN cover and weekend consistency.

  • 5.43 total nurse hours per resident per day (national median 3.77)
  • 1.04 RN hours per resident per day
  • Weekend staffing drops 22% against weekdays

Staff stability

15/15

How much of the nursing team leaves in a year. High turnover means a resident rarely sees the same face twice.

  • 25% of nursing staff left in the last year

Resident outcomes

12/15

The CMS quality-measure rating, built from resident outcomes like falls, pressure ulcers, infections and antipsychotic use.

  • 4 of 5 stars on the CMS quality-measure rating

Enforcement history

10/10

Fines and payment denials CMS has imposed. A denial of payment means CMS stopped paying for new admissions.

  • No federal fines on record

Staffing, against the national average

Full detail

Hours of nursing care each resident receives per day. The marker on each bar is the national average.

Total nurse hours per resident per day 4.15 hrs
National average 3.86 hrs Better than average
Registered nurse (RN) hours 1.04 hrs
National average 0.69 hrs Better than average

RNs are the licence level most likely to catch a resident deteriorating.

Weekend nurse hours 3.23 hrs
National average 3.42 hrs Below average

The shift most families visit, and the one thinned first.

Nursing staff turnover 25.00%
National average 45.80% Better than average

The share of nursing staff who left over the last year.

Recent inspection findings

All 9 citations

Last standard health inspection: April 30, 2026 (3 months ago). That inspection produced no citations — the findings below are older.

F Apr 17, 2025 F0836

Administration Deficiencies

Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.

No actual harm, potential for more than minimal harm

F Apr 17, 2025 F0880

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

No actual harm, potential for more than minimal harm

D Apr 17, 2025 F0625

Resident Rights Deficiencies

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

No actual harm, potential for more than minimal harm

D Apr 17, 2025 F0658

Resident Assessment and Care Planning Deficiencies

Ensure services provided by the nursing facility meet professional standards of quality.

No actual harm, potential for more than minimal harm

D Apr 17, 2025 F0684

Quality of Life and Care Deficiencies

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

No actual harm, potential for more than minimal harm

D Apr 17, 2025 F0695

Quality of Life and Care Deficiencies

Provide safe and appropriate respiratory care for a resident when needed.

No actual harm, potential for more than minimal harm

D Apr 17, 2025 F0758

Pharmacy Service Deficiencies

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the m...

No actual harm, potential for more than minimal harm

F May 2, 2024 F0851

Administration Deficiencies

Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.

No actual harm, potential for more than minimal harm

Who owns this home

Full record
Owner Type Role Since
RASCH, COREY Individual CONTRACTED MANAGING EMPLOYEE
ANDERSON POST, SHERRI Individual CORPORATE DIRECTOR
GERZEMA, DEAN Individual CORPORATE DIRECTOR
RASCH, COREY Individual CORPORATE DIRECTOR
ANDERSON POST, SHERRI Individual CORPORATE OFFICER
BUFFINGTON-MISSMAN, TAMMY Individual CORPORATE OFFICER
CHRISTENSEN, WENDELL Individual CORPORATE OFFICER
HEYER, STEVEN Individual CORPORATE OFFICER
LARSEN, PAUL Individual CORPORATE OFFICER
PHELPS, LAURA Individual CORPORATE OFFICER
CONTINUUM HEALTH CARE SERVICES LLC Organization OPERATIONAL/MANAGERIAL CONTROL

What families say

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Common questions about Titonka Care Center

What is the ElderGrade for Titonka Care Center? +

Titonka Care Center holds an ElderGrade of A (94.5 out of 100), which we describe as "excellent". The grade combines its inspection citations, nurse staffing levels, staff turnover, resident outcomes and enforcement history from the federal CMS record.

How many nursing hours does each resident get at Titonka Care Center? +

Residents receive an average of 4.15 nursing hours per day across all nursing staff, against a national average of 3.86 hours.

Has Titonka Care Center been cited for harming residents? +

No. None of the 9 citations on record were scored at the levels CMS uses to indicate actual harm or immediate jeopardy.

Does Titonka Care Center accept Medicaid? +

Yes, Titonka Care Center is certified to accept Medicaid, which is the programme that pays for long-term custodial care once a resident meets their state's income and asset limits.