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4/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
4/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Serving the community for many years, Elkader Care Center is a 40-bed nursing home in Iowa owned by Kristin Dunlap. Residents stay an average of 429 days, including those admitted for post-acute rehabilitation and receiving longer-term care.
The home has 70% occupancy and provides rehabilitation services alongside skilled nursing care. Daily nursing support averages 3 hours and 20 minutes per resident. Registered nurses and nurse aides are part of that. Medicare, Medicaid, and private pay are all accepted, so families have different options when arranging coverage.
Elkader Care Center is in a moderately walkable area with a Walk Score of 59. Some errands and nearby services are within walking distance, but most trips require driving. It’s a quieter small-town setting.
Inspection records from the past six years show periods of compliance challenges and at the same time, improvement. Training protocols and timely care delivery have been recurring areas noted during inspections, but the facility has worked to address those findings. Recent inspection data shows movement toward substantial compliance with all surveyed regulatory standards. That’s part of the facility’s ongoing effort to strengthen operations.
Families considering Elkader Care Center should keep that history in mind when evaluating the home. Taking a tour can provide a better understanding of current operations and the facility’s approach to care.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 228th out of 241 homes in Iowa for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 1h 9m per day | ▲ 57% State avg: 44m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 21m per day | ▼ 38% State avg: 34m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 2h 5m per day | ▼ 18% State avg: 2h 32m per day · National avg: 2h 20m per day |
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 3h 3m per day | ▼ 9% State avg: 3h 21m per day · National avg: 3h 26m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 1m per day | ▼ 52% State avg: 2m per day · National avg: 4m per day |
|
Weekend RN
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 36m per day | ▲ 18% State avg: 30m per day · National avg: 28m per day |
Lower than the Iowa average: 75.4%Elkader Care Center is administrated by Amy Murphy.
In Iowa, the Department of Inspections, Appeals, and Licensing conducts unannounced health and safety surveys to monitor compliance and protect residents in long-term care settings.
This scorecard compares key inspection, citation, and complaint metrics at this facility against the Iowa state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | IA Average | vs. IA Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 15 | 27 | This facility has 44% fewer total deficiencies than a typical Iowa nursing home (15 vs. IA avg 27).↓ 44% better |
|
Deficiencies per year
Average deficiencies per year since 2020.
| 2.5 | 4.5 | This facility has 44% fewer deficiencies per year than a typical Iowa nursing home (2.5 vs. IA avg 4.5).↓ 44% better |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 1.2 | 1.8 | This facility has 33% fewer deficiencies per inspection than a typical Iowa nursing home (1.2 vs. IA avg 1.8).↓ 33% better |
Inspections
| This Facility | IA Average | vs. IA Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 13 | 15 | This facility has 13% fewer total inspections than a typical Iowa nursing home (13 vs. IA avg 15).↓ 13% better |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
Iowa average 4.9
Last Health inspection on Oct 2024
Iowa average 21.7
Iowa average 4.11
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
4 of 7 citations resulted from standard inspections; and 3 of 7 resulted from complaint investigations.
100% better than Iowa averageIowa average: 0.6
11% worse than Iowa averageIowa average: 0.9
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
58% more staff per resident than Iowa average
12% worse than Iowa average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
6 total: 3 full-time employees and 3 contractors.
6
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.2 hoursAssists with medical care and medications.
All 4 LPN Staff are full-time employees. No contractors work on this role.
4
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.1 hoursHelps with daily care and mobility.
47 total: 21 full-time employees and 26 contractors.
47
Average shift length. Calculated as total hours divided by days worked and average staff per day.
6.9 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
1,982 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 21 | 26 | 47 | 4,427 | 92 | 100% | 6.9 |
| Registered Nurse | 3 | 3 | 6 | 1,734 | 92 | 100% | 10.2 |
| Licensed Practical Nurse | 4 | 0 | 4 | 740 | 76 | 83% | 8.1 |
| Nurse Practitioner | 1 | 0 | 1 | 479 | 61 | 66% | 7.9 |
| Other Dietary Services Staff | 1 | 0 | 1 | 432 | 62 | 67% | 7 |
| Administrator | 2 | 1 | 3 | 428 | 54 | 59% | 7.8 |
| Clinical Nurse Specialist | 1 | 6 | 7 | 221 | 33 | 36% | 6.1 |
| Speech Language Pathologist | 0 | 4 | 4 | 116 | 56 | 61% | 2 |
| Physical Therapy Aide | 0 | 1 | 1 | 79 | 49 | 53% | 1.6 |
| Occupational Therapy Aide | 0 | 2 | 2 | 70 | 20 | 22% | 3.5 |
| Physical Therapy Assistant | 0 | 2 | 2 | 56 | 41 | 45% | 1.3 |
| Mental Health Service Worker | 0 | 1 | 1 | 44 | 11 | 12% | 4 |
| Qualified Social Worker | 0 | 3 | 3 | 37 | 40 | 43% | 0.9 |
| Respiratory Therapy Technician | 0 | 3 | 3 | 34 | 19 | 21% | 1.8 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 9 | 5 | 5% | 1.8 |
| Medical Director | 0 | 1 | 1 | 4 | 3 | 3% | 1.3 |
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
9.3
9% better than Iowa averageIowa average: 10.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
18.1
16% better than Iowa averageIowa average: 21.6
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
15.1%
20% better than Iowa averageIowa average: 18.8%
Percent of long-stay residents whose ability to move independently worsened
16.5%
16% better than Iowa averageIowa average: 19.7%
Percent of low risk long-stay residents who lose control of their bowels or bladder
22.6%
14% better than Iowa averageIowa average: 26.2%
Percent of long-stay residents experiencing one or more falls with major injury
1.0%
74% better than Iowa averageIowa average: 3.6%
Percent of long-stay high risk residents with pressure ulcers
3.7%
15% better than Iowa averageIowa average: 4.4%
Percent of long-stay residents with a urinary tract infection
2.9%
16% worse than Iowa averageIowa average: 2.5%
Percent of long-stay residents who lose too much weight
10.3%
107% worse than Iowa averageIowa average: 5.0%
Percent of long-stay residents who have depressive symptoms
3.4%
12% better than Iowa averageIowa average: 3.9%
Percent of long-stay residents who received an antipsychotic medication
21.2%
12% worse than Iowa averageIowa average: 19.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
91.4%
In line with Iowa averageIowa average: 94.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
5% better than Iowa averageIowa average: 95.3%
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
90.9%
7% better than Iowa averageIowa average: 85.1%
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
100% better than Iowa averageIowa average: 1.8%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
10.8%
49% better than Iowa averageIowa average: 21.3%
Percentage of short-stay residents who had an outpatient emergency department visit.
33.0%
152% worse than Iowa averageIowa average: 13.1%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Iowa averageIowa average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
47.6%
11% worse than Iowa averageIowa average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
40.7%
20% worse than Iowa averageIowa average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
52% of new residents, usually for short-term rehab.
45% of new residents, often for short stays.
3% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
27Residents meet regularly to discuss policies, care quality, and activities
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for Elkader Care Center from 2011–2023, based on CMS SNF Cost Reports.
Based on the 2023 CMS SNF Cost Report.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #215 / 242Payroll — State benchmarkedThis home is ranked 215th out of 242 homes in Iowa. Shows total annual staff payroll benchmarked to the Iowa average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Most residents typically stay for a few weeks or months before returning home or moving on.
Most new residents arrive under Medicare (52% of admissions), and a typical Medicare stay runs around 1 - 2 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
0.0 miles from city center
Estimated distance in miles from Elkader's city center to Elkader Care Center's address, calculated via Google Maps.
Add your location
Elkader Care Center is located in Elkader, Iowa.
Here are the financial assistance programs available to residents in Iowa.
The information below is reported by the Iowa Department of Inspections, Appeals, and Licensing.
| Mill Pond |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Ankeny | 60
Facility
60
IA AVG
71
Rank
#214 / 407 |
98.3%
Facility
98.3%
IA AVG
75.4%
Rank
#14 / 401 | +30% | 4.91
Facility
4.91
IA AVG
4.30
Rank
#52 / 241 | -16% | +14% | $0
Facility
$0
IA AVG
$53.4k
Rank
#1 / 246 | 9
Facility
9
IA AVG
21.7
Rank
#62 / 241 | 3.0
Facility
3.0
IA AVG
4.1
Rank
#81 / 241 | - | 57 | - |
16
Facility
16
IA AVG
45
Rank
#439 / 528 | Phs Management, LLC | $13.9M
Facility
$13.9M
IA AVG
$7.0M
Rank
#32 / 242 | $6.9M
Facility
$6.9M
IA AVG
$3.1M
Rank
#34 / 242 | 49.4%
Facility
49.4%
IA AVG
46.3%
Rank
#177 / 242 | 165261 | ||||
| Elkader Care Center |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Elkader | 40
Facility
40
IA AVG
71
Rank
#325 / 407 |
70.0%
Facility
70.0%
IA AVG
75.4%
Rank
#189 / 401 | -7% | 3.34
Facility
3.34
IA AVG
4.30
Rank
#228 / 241 | -41% | -22% | $0
Facility
$0
IA AVG
$53.4k
Rank
#1 / 246 | 7
Facility
7
IA AVG
21.7
Rank
#38 / 241 | 2.3
Facility
2.3
IA AVG
4.1
Rank
#47 / 241 | 1 | 28 | - |
59
Facility
59
IA AVG
45
Rank
#160 / 528 | Kristin Dunlap | $3.8M
Facility
$3.8M
IA AVG
$7.0M
Rank
#216 / 242 | $2.2M
Facility
$2.2M
IA AVG
$3.1M
Rank
#215 / 242 | 56.6%
Facility
56.6%
IA AVG
46.3%
Rank
#107 / 242 | 165391 | ||||
| Valley View Village |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
HC Home Care Professional care delivered in the person's own home — from companionship and errands to skilled nursing and therapy. Allows seniors to age in place. Medicare covers skilled home health when medically necessary.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk.
RC Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision. | Des Moines (Fairmont Park) | 79
Facility
79
IA AVG
71
Rank
#117 / 407 |
100.0%
Facility
100.0%
IA AVG
75.4%
Rank
#1 / 401 | +33% | 5.52
Facility
5.52
IA AVG
4.30
Rank
#22 / 241 | +29% | +29% | $9.1k
Facility
$9.1k
IA AVG
$53.4k
Rank
#170 / 246 | 19
Facility
19
IA AVG
21.7
Rank
#139 / 241 | 3.2
Facility
3.2
IA AVG
4.1
Rank
#94 / 241 | 2 | 75 | - |
38
Facility
38
IA AVG
45
Rank
#305 / 528 | Elim Care Inc | $9.7M
Facility
$9.7M
IA AVG
$7.0M
Rank
#70 / 242 | $7.0M
Facility
$7.0M
IA AVG
$3.1M
Rank
#32 / 242 | 71.8%
Facility
71.8%
IA AVG
46.3%
Rank
#13 / 242 | 165507 | ||||
| Ramsey Village Continuing Care |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk.
RC Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision.
RC Respite Care Short-term temporary care — days to weeks — to give family caregivers a break. Full care provided during the stay. Often used after hospitalization or to trial a facility before a permanent placement decision. | Des Moines (Drake) | 78
Facility
78
IA AVG
71
Rank
#119 / 407 |
85.8%
Facility
85.8%
IA AVG
75.4%
Rank
#93 / 401 | +14% | 4.04
Facility
4.04
IA AVG
4.30
Rank
#148 / 241 | -46% | -6% | $0
Facility
$0
IA AVG
$53.4k
Rank
#1 / 246 | 31
Facility
31
IA AVG
21.7
Rank
#188 / 241 | 4.4
Facility
4.4
IA AVG
4.1
Rank
#156 / 241 | 1 | 70 | - |
38
Facility
38
IA AVG
45
Rank
#305 / 528 | Claremont House Inc. | $12.4M
Facility
$12.4M
IA AVG
$7.0M
Rank
#43 / 242 | $8.5M
Facility
$8.5M
IA AVG
$3.1M
Rank
#20 / 242 | 68.5%
Facility
68.5%
IA AVG
46.3%
Rank
#29 / 242 | 165514 | ||||
| Ridgecrest Village |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Davenport (Northwest Boulevard) | 82
Facility
82
IA AVG
71
Rank
#100 / 407 |
67.1%
Facility
67.1%
IA AVG
75.4%
Rank
#202 / 401 | -11% | 3.98
Facility
3.98
IA AVG
4.30
Rank
#148 / 241 | +31% | -7% | $118.9k
Facility
$118.9k
IA AVG
$53.4k
Rank
#223 / 246 | 43
Facility
43
IA AVG
21.7
Rank
#213 / 241 | 7.2
Facility
7.2
IA AVG
4.1
Rank
#220 / 241 | 3 | 55 | - |
41
Facility
41
IA AVG
45
Rank
#287 / 528 | Michael Beaderstadt | $15.8M
Facility
$15.8M
IA AVG
$7.0M
Rank
#20 / 242 | $8.1M
Facility
$8.1M
IA AVG
$3.1M
Rank
#23 / 242 | 51.1%
Facility
51.1%
IA AVG
46.3%
Rank
#156 / 242 | 165049 |
Elkader Care Center has a walk score of 59. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
According to IA state health department records, Elkader Care Center's license number is 220240.
According to IA state health department records, Elkader Care Center's license expires on November 1, 2026.
Elkader Care Center's occupancy is 70%.
The team at Elkader Care Center can be reached at [email protected].
Amy Murphy is the administrator of Elkader Care Center.
Elkader Care Center has 40 beds.
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