Iowa › Pottawattamie County › Avoca
Avoca Specialty Care
610 East York Street, Avoca, IA 51521
Ratings are based on the most recent data available; a facility's ratings may have changed since the last update. The health inspection rating is based on the three most recent standard surveys and complaint investigations. CMS processed this record on 1 Aug 2026. View the Care Compare record.
Avoca Specialty Care, in Avoca, Iowa, is certified for 46 beds under non-profit, corporation ownership and belongs to the Care Initiatives chain.
CMS gives it 1 of 5 stars overall, below the Iowa median of 3; the health inspection rating is 1, staffing 3 and quality measures 3.
Inspectors recorded 68 health deficiencies across the three most recent survey cycles (13, 13, 42 by cycle, most recent first), 1 of them at the actual-harm or immediate-jeopardy level. That is 147.8 per 100 beds, more than the state median of 27.5.
CMS lists no fines or payment denials against the facility in the period covered.
Reported nurse staffing is 3.0 hours per resident per day (1.0 RN), close to the Iowa median of 3.7; nursing staff turnover is 63.9%.
Compared with county, state and nation
| Measure | This facility | Pottawattamie Co. median | Iowa median | US average |
|---|---|---|---|---|
| Overall star rating | 1 | 1 | 3 | 3.0 |
| Health citations, 3 cycles | 68 | 43 | 16 | 28.7 |
| Citations per 100 beds | 147.8 | 54.8 | 27.5 | 26.8 |
| Total nurse hours per resident day | 3.0 | 3.9 | 3.7 | 3.9 |
| RN hours per resident day | 1.0 | 1.0 | 0.7 | 0.7 |
| Nursing staff turnover | 63.9% | 47.5% | 41.9% | 45.8% |
| Fines listed | $0 | $15,593 | $0 | — |
County and state figures are medians across facilities (7 in the county, 387 in the state); the US column is the CMS national average where CMS publishes one.
Citations by survey cycle
Dark bar: this facility. Grey bar: Iowa average per facility for the same cycle, as published by CMS. Standard health survey dates: 5 Mar 2026, 30 Jan 2025.
Severity mix: G ×1 D ×45 E ×20 F ×2
Health deficiencies
Every health citation in the current CMS record (three survey cycles), most recent first. Tag text is the CMS requirement summary, not the inspection narrative.
Scope and severity letters (A–L)
| Survey date | Tag | What the tag requires | Severity | Type | Corrected |
|---|---|---|---|---|---|
| 5 Mar 2026 | F0605 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | E | Standard survey | 23 Mar 2026 |
| 5 Mar 2026 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | E | Standard survey | 23 Mar 2026 |
| 5 Mar 2026 | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | E | Standard survey | 23 Mar 2026 |
| 5 Mar 2026 | F0578 | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. | D | Standard survey | 23 Mar 2026 |
| 5 Mar 2026 | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | Standard survey | 23 Mar 2026 |
| 5 Mar 2026 | F0641 | Ensure each resident receives an accurate assessment. | D | Standard survey | 23 Mar 2026 |
| 5 Mar 2026 | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | Standard survey | 23 Mar 2026 |
| 5 Mar 2026 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Standard survey | 23 Mar 2026 |
| 5 Mar 2026 | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Standard survey | 23 Mar 2026 |
| 5 Mar 2026 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Standard survey | 23 Mar 2026 |
| 5 Mar 2026 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Standard survey | 23 Mar 2026 |
| 5 Mar 2026 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 23 Mar 2026 |
| 7 Oct 2025 | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Complaint investigation | 29 Nov 2025 |
| 16 Jun 2025 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Complaint investigation | 29 Jun 2025 |
| 16 May 2025 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | Complaint investigation | 1 Jun 2025 |
| 16 May 2025 | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | E | Complaint investigation | 2 Jun 2025 |
| 16 May 2025 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | E | Complaint investigation | 2 Jun 2025 |
| 16 May 2025 | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | D | Complaint investigation | 28 May 2025 |
| 16 May 2025 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint investigation | 28 May 2025 |
| 16 May 2025 | F0610 | Respond appropriately to all alleged violations. | D | Complaint investigation | 28 May 2025 |
| 16 May 2025 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Complaint investigation | 2 Jun 2025 |
| 16 May 2025 | F0744 | Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. | D | Complaint investigation | 2 Jun 2025 |
| 16 May 2025 | F0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | D | Complaint investigation | 2 Jun 2025 |
| 30 Jan 2025 | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | E | Standard survey | 7 Feb 2025 |
| 30 Jan 2025 | F0641 | Ensure each resident receives an accurate assessment. | D | Standard survey | 5 Feb 2025 |
| 30 Jan 2025 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 4 Feb 2025 |
| 1 Jul 2024 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | Complaint investigation | 25 Jul 2024 |
| 1 Jul 2024 | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | E | Complaint investigation | 25 Jul 2024 |
| 1 Jul 2024 | F0801 | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | E | Complaint investigation | 25 Jul 2024 |
| 1 Jul 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Complaint investigation | 25 Jul 2024 |
| 1 Jul 2024 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Complaint investigation | 25 Jul 2024 |
| 1 Jul 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Complaint investigation | 27 May 2024 |
| 1 Jul 2024 | F0814 | Dispose of garbage and refuse properly. | D | Complaint investigation | 25 Jul 2024 |
| 1 Jul 2024 | F0926 | Have policies on smoking. | D | Complaint investigation | 25 Jul 2024 |
| 1 Feb 2024 | F0801 | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. | F | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | F | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | E | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | E | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0761 | Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs. | E | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | E | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0805 | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | E | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0880 | Provide and implement an infection prevention and control program. | E | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0921 | Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public. | E | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0559 | Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0641 | Ensure each resident receives an accurate assessment. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0676 | Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0692 | Provide enough food/fluids to maintain a resident's health. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0693 | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0698 | Provide safe, appropriate dialysis care/services for a resident who requires such services. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0759 | Ensure medication error rates are not 5 percent or greater. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0760 | Ensure that residents are free from significant medication errors. | D | Standard survey | 22 Feb 2024 |
| 1 Feb 2024 | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | D | Standard survey | 22 Feb 2024 |
| 8 Aug 2023 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | G | Complaint investigation | 28 Aug 2023 |
| 8 Aug 2023 | F0584 | Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. | E | Complaint investigation | 28 Aug 2023 |
| 8 Aug 2023 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Complaint investigation | 28 Aug 2023 |
| 8 Aug 2023 | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Complaint investigation | 28 Aug 2023 |
| 8 Aug 2023 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Complaint investigation | 28 Aug 2023 |
| 8 Aug 2023 | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Complaint investigation | 28 Aug 2023 |
| 8 Aug 2023 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Complaint investigation | 28 Aug 2023 |
| 8 Aug 2023 | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Complaint investigation | 28 Aug 2023 |
| 8 Aug 2023 | F0880 | Provide and implement an infection prevention and control program. | D | Complaint investigation | 28 Aug 2023 |
Penalties
CMS lists no fines or payment denials for this facility in the period covered.
Staffing
Hours per resident per day as reported through the Payroll-Based Journal; grey bars are the Iowa average. Turnover: nursing staff 63.9%, RNs 57.1%; 3 administrators left in the reporting year.
Quality measures
| Measure | Residents | This facility | Iowa median | US median |
|---|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 12.0% | 16.8% | 12.6% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 2.2% | 0.8% | 0.3% |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 2.6% | 1.8% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 0.9% | 3.4% | 2.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 0.0% | 1.0% | 1.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 21.8% | 15.9% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 2.4% | 3.6% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 30.6% | 18.2% | 13.4% |
Four-quarter averages for the measures CMS uses in the quality-measure star rating (2025Q2-2026Q1). Lower is better for every measure listed. Medians are computed across facilities on this site.
Ownership
Ownership type: non-profit, corporation. Legal business name: Care Initiatives. Chain: Care Initiatives (43 facilities).
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Care Initiatives | 5% or greater direct ownership interest | 100% | 08/01/2012 |
| Computershare Corporate Trust Company, Na | 5% or greater mortgage interest | NOT APPLICABLE | 01/01/2025 |
| Computershare Corporate Trust Company, Na | Adp of the snf | NOT APPLICABLE | 04/07/2025 |
Only organisations are shown. CMS also records individual owners, officers and managing employees; this site does not publish people's names.
Other nursing homes in Pottawattamie County
| Facility | City | Beds | Overall | Health | Staffing | Citations | Per 100 beds | Fines | Last survey |
|---|---|---|---|---|---|---|---|---|---|
| Midlands Living Center L L C | Council Bluffs | 94 | 4 | 3 | 4 | 16 | 17.0 | — | 8 Jan 2026 |
| Prairie Gate | Council Bluffs | 72 | 2 | 2 | 4 | 23 | 31.9 | $28K | 9 Oct 2025 |
| Bethany Lutheran Home | Council Bluffs | 112 | 1 | 1 | 4 | 43 | 38.4 | $47K | 21 May 2026 |
| Chapters Living of Council BluffsSFF Candidate | Council Bluffs | 102 | 1 | 1 | 4 | 68 | 66.7 | $164K | 30 Jan 2026 |
| North Crest Living Center | Council Bluffs | 62 | 1 | 1 | 4 | 34 | 54.8 | — | 26 Aug 2025 |
| Oakland Manorabuse icon | Oakland | 61 | 1 | 1 | 2 | 67 | 109.8 | $16K | 22 Apr 2026 |
All 7 facilities in Pottawattamie County
Questions and answers
How many deficiencies has Avoca Specialty Care been cited for?
68 health deficiencies across the three most recent survey cycles, 1 at the actual-harm or immediate-jeopardy level. The Iowa median is 16 per facility.
Has Avoca Specialty Care been fined?
CMS lists no fines against the facility in the period covered.
How does staffing at Avoca Specialty Care compare?
Reported total nurse staffing is 3.0 hours per resident per day against a Iowa median of 3.7 and a national average of 3.9.
Who operates Avoca Specialty Care?
It is part of the Care Initiatives chain. Ownership type is non-profit, corporation. Organisations in the CMS ownership record include Care Initiatives. Individual owners and managers are not listed on this site.
When was Avoca Specialty Care last inspected?
The most recent survey or investigation in the CMS record is dated 5 Mar 2026; the most recent standard health survey was 5 Mar 2026.
Where does this data come from?
All figures are from the Centers for Medicare & Medicaid Services Care Compare datasets (provider information, health deficiencies, penalties, ownership and quality measures), processed 1 Aug 2026. Ratings and citations may change; the Care Compare record is authoritative.
Provenance
Source: Centers for Medicare & Medicaid Services, Care Compare nursing home datasets (provider information, health deficiencies, penalties, ownership, MDS quality measures, state and national averages), public domain, processed by CMS on 1 Aug 2026. Facility record: Care Compare. Errors in processing are corrected at the next daily build; see corrections.