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The Overall CMS Rating is scored from 1 to 5 stars and 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.
The Overall CMS Rating is scored from 1 to 5 stars and 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.
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.
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 170th out of 240 homes in Iowa.| Staff type | Hours / day | 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.
| 25m per day | ▼ 43% 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.
| 39m per day | ▲ 15% 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.
| 1h 54m per day | ▼ 25% State avg: 2h 32m per day · National avg: 2h 20m per day |
|
Total Nursing (Weekend)
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.
| 2h 31m per day | ▼ 25% 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 | ▼ 50% State avg: 2m per day · National avg: 4m per day |
|
RN (Weekend)
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.
| 12m per day | ▼ 60% State avg: 30m per day · National avg: 28m per day |
Most residents stay for extended periods and receive ongoing daily care.
16% of new residents, usually for short-term rehab.
23% of new residents, often for short stays.
61% of new residents, often for long-term daily care.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #17 / 241Payroll — state benchmarkedThis home is ranked 17th out of 241 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.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Higher than the Iowa average: 75.4%Pillar of Cedar Valley is administrated by Kersten Kelinlein.
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.
Inspections are mandatory, regular evaluations conducted by state health departments or regulatory agencies. They ensure the community provides safe, compliant care, covering areas like resident health, staff and management.
Iowa average: 17 visits/inspections
Iowa average: 0 inspections
Deficiencies indicate regulatory issues. A higher number implies the facility had several areas requiring improvement.
Iowa average: 27 deficiencies
The most recent inspection on December 23, 2025, identified deficiencies related to failure to protect residents from resident-to-resident abuse, untimely reporting of abuse incidents, and inadequate investigation and intervention following these events. Earlier inspections showed a pattern of various deficiencies including issues with resident care, medication management, infection control, and safety, with some substantiated complaints involving abuse and neglect. Prior reports noted problems such as failure to follow care plans, unsafe storage of hazardous tools, expired medication administration, and environmental sanitation concerns. Several complaint investigations were conducted over time, most of which were unsubstantiated, though some substantiated complaints involved abuse, neglect, and environmental safety. The inspection history indicates ongoing challenges with resident protection and care practices, with recent findings continuing concerns noted in prior surveys.
Iowa average 4.9
Last Health inspection on Nov 2025
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.
18 of 21 citations resulted from standard inspections; 1 of 21 resulted from complaint investigations; and 2 of 21 came from combined inspections (standard and complaint).
100% better than Iowa averageIowa average: 0.6
0
100% better than Iowa averageIowa average: 0.9
Issues related to building safety, cleanliness, maintenance, and overall living conditions.
Nov 17, 2025
Corrected
Issues related to medication management, including how drugs are stored, administered, and monitored.
Nov 17, 2025
Corrected
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Nov 17, 2025
Corrected
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Nov 17, 2025
Corrected
Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.
| Akron Care Center, INC |
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. | Akron | 45 | 98.1% | +30% | 4.71 | +15% | +10% | 0 | 4 | 2.0 | 0 | 42 | - | - | City Of Akron | $4.7M | $2.1M | 45.1% | 165595 | ||||
| Accura HealthCare of Carlisle |
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. | Carlisle | 80 | 80.5% | +7% | 5.85 | -40% | +36% | 0 | 17 | 5.7 | 2 | 39 | - | - | American Healthcare Associates Inc | $4.1M | $2.5M | 59.6% | 165311 | ||||
| Pillar of Cedar Valley |
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. | Waterloo | 114 | 89.8% | +19% | 3.85 | - | -36% | -10% | 0 | 21 | 5.3 | 0 | 136 | - | - | Tamid Waterloo Llc | $20.1M | $7.5M | 37.4% | 165307 | |||
| Accura Healthcare of Spirit Lake |
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. | Spirit Lake | 85 | 66.6% | -12% | 4.29 | -8% | 0% | 1 | 21 | 7.0 | 1 | 65 | - | - | - | $7.1M | $3.0M | 42.3% | 165528 | ||||
| Accura Healthcare of Lake City, LLC |
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. | Lake City | 46 | 70.4% | -7% | 5.17 | -33% | +20% | 4 | 39 | 3.9 | 4 | 40 | - | - | Accura Healthcare Of The Heartland Llc | $2.1M | $1.0M | 46.7% | 165082 |
0.0 miles from city center
Estimated distance in miles from Waterloo's city center to Pillar of Cedar Valley's address, calculated via Google Maps.
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This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
29% worse than Iowa averageIowa average ratio: 2.00:1
5% better than Iowa averageIowa average: 7.4 hours
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.2 hoursThis role is partially covered by contractors.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.9 hoursThis role is partially covered by contractors.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.6 hoursThis role is partially covered by contractors.
Total hours from contractors
3,955 contractor hours this quarter
| Certified Nursing Assistant | 60 | 7 | 67 | 18,698 | 91 | 100% | 7.6 |
| Diagnostic X-ray Services Staff | 36 | 0 | 36 | 14,755 | 91 | 100% | 8 |
| Licensed Practical Nurse | 10 | 6 | 16 | 7,270 | 91 | 100% | 8.9 |
| Registered Nurse | 11 | 3 | 14 | 4,625 | 91 | 100% | 8.2 |
| Medication Aide/Technician | 14 | 0 | 14 | 4,224 | 91 | 100% | 7.9 |
| Dietitian | 4 | 0 | 4 | 1,666 | 89 | 98% | 6.7 |
| Mental Health Service Worker | 5 | 0 | 5 | 1,629 | 68 | 75% | 7.7 |
| Administrator | 4 | 0 | 4 | 1,553 | 67 | 74% | 8.1 |
| Clinical Nurse Specialist | 2 | 0 | 2 | 865 | 64 | 70% | 7.6 |
| Nurse Practitioner | 1 | 0 | 1 | 480 | 60 | 66% | 8 |
| Occupational Therapy Aide | 0 | 1 | 1 | 330 | 67 | 74% | 4.9 |
| Respiratory Therapy Technician | 0 | 3 | 3 | 265 | 53 | 58% | 5 |
| Physical Therapy Assistant | 0 | 5 | 5 | 249 | 59 | 65% | 3.9 |
| Qualified Social Worker | 0 | 3 | 3 | 244 | 46 | 51% | 5.3 |
| Physical Therapy Aide | 0 | 7 | 7 | 195 | 40 | 44% | 3.1 |
| Speech Language Pathologist | 0 | 4 | 4 | 64 | 24 | 26% | 2.7 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 54 | 3 | 3% | 17.8 |
| Medical Director | 0 | 1 | 1 | 1 | 1 | 1% | 1 |
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
132Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
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.
6.8
33% better than Iowa averageIowa average: 10.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
15.7
27% better than Iowa averageIowa average: 21.6
Percent of long-stay residents whose need for help with daily activities has increased
14.7%
22% better than Iowa averageIowa average: 18.8%
Percent of long-stay residents whose ability to move independently worsened
12.8%
35% better than Iowa averageIowa average: 19.7%
Percent of low risk long-stay residents who lose control of their bowels or bladder
19.4%
26% better than Iowa averageIowa average: 26.2%
Percent of long-stay residents experiencing one or more falls with major injury
2.1%
42% better than Iowa averageIowa average: 3.6%
Percent of long-stay high risk residents with pressure ulcers
1.3%
70% better than Iowa averageIowa average: 4.4%
Percent of long-stay residents with a urinary tract infection
0.2%
92% better than Iowa averageIowa average: 2.5%
Percent of long-stay residents who lose too much weight
3.1%
39% better than Iowa averageIowa average: 5.0%
Percent of long-stay residents who have depressive symptoms
17.7%
357% worse than Iowa averageIowa average: 3.9%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
65.6%
31% worse than Iowa averageIowa average: 94.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
93.3%
In line with Iowa averageIowa average: 95.3%
Number of hospitalizations per 1,000 long-stay resident days.
1.50
In line with Iowa averageIowa average: 1.48
Number of outpatient emergency department visits per 1,000 long-stay resident days.
2.48
19% worse than Iowa averageIowa average: 2.09
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
68.2%
20% worse than Iowa averageIowa average: 85.1%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
Historical financial and operational data for Pillar of Cedar Valley based on CMS SNF Cost Reports.
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