Homes where the federal record contains at least one of the following: a CMS abuse icon, Special Focus
Facility status or candidacy, or a citation scored at actual harm or immediate jeopardy. Ordered with
Special Focus homes first.
Read this as a prompt, not a verdict. A citation can be years old and the management
responsible may have gone. It means you ask what happened and what changed, and you get a specific answer
before you sign anything.
Greater Southside runs on 3.44 nurse hours per resident per day, about 11% under the national average, and weekends drop roughly 22% below its own weekday staffing. That thinner coverage adds up over time: 62.3% of staff left last year against a 45.8% national rate, and CMS flags the home as a Special Focus Facility. The inspection record backs that up, 66 deficiencies, including 8 at harm or jeopardy level and 8 tied to abuse, with four fines totaling $166,443. The most recent inspection was June 2025. For a family weighing this one, the staffing and inspection numbers are the ones that matter most.
Pine Acres holds 140 certified beds in West Des Moines under for-profit LLC ownership, and the nurse staffing figure, 3.84 hours per resident day, sits roughly even with the national average, though weekends run about 7% thinner than weekdays. The record is where the trouble shows: 85 deficiencies, nine of them at harm or jeopardy level and three abuse-related, plus $353,109 in fines across three CMS actions. Staff turnover is 56.9% against a national 45.8%, and CMS has placed the home in its Special Focus Facility program, a designation reserved for the most persistently poor performers. The last inspection was January 8, 2026.
Garden View Care Center is a 50-bed for-profit home in Shenandoah, and the numbers here deserve a hard look. Staff turnover runs at 55.3% a year against a national average of 45.8%, and the home carries 93 deficiencies on its current record, including 10 serious enough to involve harm or jeopardy to residents and 10 tied to abuse. Three CMS fines add up to $168,858, and the agency has placed Garden View in its Special Focus Facility program, a designation reserved for homes with a persistent record of poor care. The most recent inspection was December 8, 2025. If you're considering this home for someone you love, ask the administrator directly what's changed since that inspection and how they're keeping residents safe.
Harmony House is a for-profit home in Waterloo with 65 certified beds. The staffing numbers sit just under the national average, but the real problem is turnover: about 61.5% of nursing staff leave each year, against a national average near 46%, and weekend coverage drops roughly 7% below its own weekday level. On inspections, this home has drawn 33 deficiencies, including four at the harm or jeopardy level and four tied to abuse, plus one fine totaling $48,825. CMS has placed it in the Special Focus Facility program, which is reserved for homes with a persistent record of serious problems. Its last inspection was August 6, 2025.
Azria Health Park Place carries 70 certified beds under for-profit LLC ownership, and the numbers tell a hard story. Three-and-a-half nurse staffing hours per resident day sits about 9% under the national average, and weekends dip roughly 12% below the home's own weekday levels, so the thinnest coverage lands when families are most likely to visit. Staff turnover near 70% runs well above the national 46%, which means the people providing care keep changing. On inspections, the record shows 70 deficiencies, including three at harm or jeopardy level and five tied to abuse, plus $36,875 in fines. CMS has placed this home in its Special Focus Facility program, a designation reserved for the most persistently troubled nursing homes.
Northgate Care Center in Waukon carries 20 deficiencies on its current record, and two of those are serious enough to involve actual harm or jeopardy to residents. One is abuse-related, and CMS has placed the home in its Special Focus Facility program, which is reserved for the homes with the most persistent problems. A single fine of $71,110 is on record, and the last inspection was March 4, 2026.
Nurse staffing sits at 2.97 hours per resident day, roughly 23% below the national average, and weekends run about 12% thinner than weekdays. Turnover of 34.3% is better than the national 45.8%, so that's not the issue here.
Ivy At Davenport is a for-profit LLC home with 75 beds, and the numbers behind its record deserve a close look. Nurse staffing sits at 3.23 hours per resident per day, about 16% under the national average, and weekends drop roughly another 10% below its own weekday level, so coverage is thinnest exactly when families tend to visit. Staff turnover runs 58.8% against a national 45.8%, meaning more than half the caregivers leave within a year. The current inspection record shows 58 deficiencies, including 5 at harm or jeopardy level and 6 abuse-related, with four fines totaling $141,036. CMS has placed it in the Special Focus Facility program, which is reserved for homes with a persistent pattern of poor care.
Bishop Drumm is run by a church-affiliated nonprofit, and its staffing numbers tell two stories. Nurse hours sit at 3.64 per resident day, about 6% under the national average, and weekends drop roughly 13% below its own weekday coverage. Turnover is the bright spot: 34.9% against a national 45.8%, which suggests people stay. But the inspection record is where this home falls apart, 77 deficiencies, 9 of them at harm or jeopardy level, four fines totaling $258,177, and a place in CMS's Special Focus Facility program, reserved for the country's most troubled homes. A July 2025 inspection is recent, so the picture isn't stale.
Chapters Living Of Council Bluffs has real staffing strength, 4.88 nurse hours per resident day, well above the national average, though weekends run thinner than weekdays. The inspection record tells a different story: 68 deficiencies, including nine tied to abuse and one serious enough to put residents in harm's way, plus a $163,800 fine. That combination landed it in CMS's Special Focus Facility program, which is reserved for the country's most troubled homes. A recent inspection in January 2026 means the state is watching closely. For families weighing this one, the question isn't whether aides are present, it's what those inspections keep finding.
Adel Acres is a 50-bed for-profit home in Dallas County, and the numbers there split in two directions. The care itself measures well, a 4 out of 5 on quality measures, but the staffing behind that care runs thin: 3.02 nurse hours per resident day, roughly 22 percent under the national average, and weekends drop about 19 percent below the home's own weekday level. Inspections tell the harder story. The current record carries 44 deficiencies, five serious enough to involve harm or jeopardy, three tied to abuse, plus one fine of $16,544. The last inspection was in April 2025. If you're weighing this one, ask how they cover weekends and what's changed since that inspection.
Royal Oaks is a 115-bed for-profit home in Urbandale that CMS has placed in its Special Focus Facility program, a designation reserved for the homes with the most persistent problems. The inspection record backs that up: 71 deficiencies, seven serious enough to put residents in harm's way, two tied to abuse, and three fines totaling $122,945. Staffing runs about 6% under the national average, and the gap widens on weekends, when coverage drops roughly 9% below its own weekday level. Turnover sits at 66.7%, well above the 45.8% national figure, so the people caring for residents are constantly changing. If you're considering this one, ask hard questions about what's changed since the May 2025 inspection.
Northbrook Healthcare and Rehabilitation Center runs 130 certified beds under for-profit LLC ownership, and the numbers worth your attention start with staffing. At 3.14 nurse hours per resident day, it sits roughly 19% under the national average, and weekends drop about 11% below its own weekday levels, with annual turnover at 56.8% against a national 45.8%. Inspections tell a harder story: a 1-out-of-5 health inspection rating, 53 deficiencies on the current record, three at harm or jeopardy level, two tied to abuse, and one fine totaling $38,787. The most recent inspection was August 2025. Quality measures rate mid-range, but staffing and inspection history are where the concerns concentrate.
Parkview Manor runs on 2.80 nurse staffing hours per resident day, roughly 27% under the national average of 3.86, and weekends run about 8% thinner than weekdays. The inspection record shows 46 deficiencies, including six at the harm or jeopardy level and seven tied to abuse, with one fine totaling $93,473 and a last inspection dated August 2025. This is a for-profit corporation operating 62 certified beds, and the numbers behind each CMS rating, one star for health inspections, one for staffing, two for quality measures, point the same direction.
Regency Care Center runs about 3.15 nurse hours per resident per day, roughly 18% under the national average of 3.86, and weekends are thinner still, about 14% below its own weekday staffing. The inspection record is heavy: 49 deficiencies, three of them at the level where residents were actually harmed or put in jeopardy, plus one tied to abuse, and a $78,497 fine. The most recent inspection was in April 2025. Ownership is a for-profit limited liability company, with 101 certified beds. Federal staffing and health inspection ratings both sit at one star out of five.
Hillcrest runs on 3.11 nursing hours per resident day, roughly a fifth below the national average, and weekends drop another 18 percent below its own weekday coverage. Staff turnover sits at 75 percent against a national rate near 46 percent, so the people providing care change often. The inspection record carries 73 deficiencies, including three at the level where residents were actually harmed or put in jeopardy, plus four tied to abuse; two fines total $25,450, and the most recent inspection was March 2026. Ownership is a for-profit limited liability company. The quality measure score looks acceptable, but that reflects charted care, not the staffing and oversight problems the state has repeatedly cited.
Ridgecrest Village runs 137 certified beds in Davenport as a nonprofit, and the numbers worth knowing sit in its staffing and inspection record. Nurse staffing comes in at 3.69 hours per resident day, roughly 5% under the national average, and weekends drop about 7% below what the home staffs on weekdays. Annual turnover is 97.4%, more than double the national figure of 45.8%, meaning the aides and nurses around your family member likely change often. The current record carries 41 deficiencies, three at harm or jeopardy level and two tied to abuse, along with three fines totaling $118,886. The most recent inspection was October 2025, and the health inspection rating sits at 1 out of 5.
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.
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.
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.
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.
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.
Perry Lutheran Homes Eden Acres sits in Dallas County with 57 certified beds and a for-profit LLC owner. The staffing picture is mixed: 3.43 nurse hours per resident day lands about 11% under the national average, and weekends run roughly 15% lighter than weekdays, but turnover at 36.2% beats the national 45.8%, a sign this home can hold onto aides better than most. What stands out is the inspection record: six deficiencies, two at harm or jeopardy level and two tied to abuse, plus a $9,110 fine, with the most recent inspection in June 2025. Those harm-level and abuse findings are the kind regulators treat seriously, and they're the real weight on this home's record.
St. Anthony Senior Services runs 79 certified beds as a church-affiliated nonprofit in Carroll, and its nurse staffing sits at 3.87 hours per resident day, essentially level with the national average of 3.86, though weekends run about 8% leaner than weekdays. The real concern is the inspection record: 19 deficiencies, three of them serious enough to put residents at harm or jeopardy, including one abuse-related finding, and a $12,038 fine. A recent inspection in February 2026 means the record is current, not stale. Quality measures score well, but strong clinical numbers don't offset a pattern of serious health and safety findings.