Best Assisted Living in Iowa

Overview of Azria Health Winterset

Azria Health Winterset is a 70-bed skilled nursing and post-acute rehabilitation facility in Winterset, Iowa, providing long-term care, short-stay rehabilitation, memory care, and respite stays for residents in Madison County. The facility is privately owned and operated by Kristin Merron and accepts Medicare, Medicaid, and private pay.

CMS rates the facility at 2 stars overall, with all three sub-ratings below the Iowa average — Health Inspection 30% below, Staffing 15% below, and Quality Measures 39% below. Nurse staffing averages 3 hours and 42 minutes per resident per day, roughly 14% below Iowa’s average of 4 hours and 18 minutes, with weekend RN staffing at 17 minutes per day compared with the state’s average of 30. A payment denial was issued in May 2024 and lasted for two days; the facility carries no federal fines, ranking first among 246 Iowa skilled nursing facilities on that measure.

The facility’s on-site therapy — physical, occupational, and speech — supports the rehabilitation program. Lifestyle amenities include chef-prepared menus and a private dining room. The facility’s occupancy rate is 65.8%, below the Iowa average of 75.4%, suggesting current availability.

The facility is structured for residents seeking post-acute rehabilitation or long-term skilled nursing care in Winterset, with current availability and on-site therapy capacity.

Overview of Accura Healthcare of Spirit Lake

Accura Healthcare of Spirit Lake is an 85-bed privately owned skilled nursing facility at 1912 Zenith Avenue in Spirit Lake, Iowa, offering short-term rehabilitation, long-term care, memory care, and respite services to residents in Dickinson County.

The facility holds a 1-star overall CMS rating, driven largely by its health inspection sub-rating — also 1 star and 64.9% below the Iowa average. In August 2024, CMS imposed a $35,000 civil money penalty and a 31-day payment denial for new Medicare and Medicaid admissions, both stemming from the same enforcement action. These findings are significant, and families should weigh them alongside the full inspection record.

Nurse staffing averages 4 hours and 18 minutes per resident per day, matching the Iowa average — a neutral data point in an otherwise below-average profile. Physical therapist staffing is a standout, running double the state average, which matters for short-stay rehabilitation residents. The staff-to-resident ratio, at 1.48:1, is 28% below the Iowa norm of 2.05:1. Short-stay quality measures are above average; long-stay measures are below average. The facility’s current occupancy rate is 66.6%, below Iowa’s average of 75.4%, which suggests availability.

Amenities and services include private short-stay suites, outpatient therapy, a Life Enrichment Program, and outdoor patio and courtyard spaces.

While Accura Healthcare of Spirit Lake may suit short-term post-acute rehabilitation residents who prioritize access to therapy in a smaller Iowa community, families considering long-term placement should carefully review the facility’s inspection history, enforcement actions, and long-stay quality outcomes

Overview of Accura Healthcare of Lake City, LLC

Accura Healthcare of Lake City, LLC is an 80-bed skilled nursing and long-term care community in Lake City, Iowa, providing short-term rehabilitation, long-term care, memory care, and respite services to residents in Calhoun County. It is operated by Accura Healthcare of the Heartland LLC and accepts Medicare, Medicaid, and private pay.

CMS rates the facility at 1 star overall — the lowest tier nationally. The 1-star rating is driven primarily by the facility’s health inspection performance, while staffing levels are noticeably stronger. Adjusted nursing staffing averages 5 hours 10 minutes per resident per day, ranking 31st among 241 Iowa skilled nursing facilities and running roughly 20% above the state average of 4 hours 18 minutes. The facility has received two federal fines in the past three years — $35,000 in January 2025 and $3,000 in September 2023.

Services include 24-hour skilled nursing, a Life Enrichment Program, and an on-site outdoor patio and courtyard.

The combination of strong staffing levels and a 1-star inspection rating positions this facility well for residents and families who prioritize access to hands-on nursing care. However, families should review the inspection record independently before making a placement decision.

Overview of Spurgeon Manor

Spurgeon Manor is a 55-bed nonprofit skilled nursing and memory care community in Dallas Center, Dallas County, Iowa, offering skilled nursing, rehabilitation, memory care, and assisted living services to residents across the greater Des Moines area. It is administered by Crystal Scroggin.

Spurgeon Manor holds a 5-star CMS overall rating — the highest possible — with every sub-rating performing above Iowa averages. Staffing is the standout: nurse staffing averages 5 hours and 36 minutes per resident per day, roughly 27% above the Iowa average of 4 hours and 25 minutes, ranking the facility 18th among 241 Iowa skilled nursing facilities.

Across 21 inspections since 2020 — 40% more visits than the Iowa average of 15 — the facility averaged 1.4 deficiencies per inspection, 22% below the Iowa mean of 1.8. The most recent inspection on December 10, 2025, accepted the facility’s plan of correction. Two substantiated complaints appear in the record: one involving timely abuse reporting (February 2023) and one involving the posting of required information (August 2024). No fines, immediate jeopardy findings, or license actions have been issued.

The facility’s occupancy rate is 89%, well above the Iowa average of 75.4%, reflecting consistent local demand. The facility accepts both Medicare and Medicaid and maintains 24-hour staffing. On-site services include physician services, laboratory, pharmacy, podiatry, and optometry. Amenities include a chapel, private dining rooms, and an exercise room. The facility received a 2021 Silver Achievement in Quality Award.

Spurgeon Manor is best suited for residents seeking long-term skilled nursing or memory care in a small nonprofit community with strong staffing ratios and a consistent compliance record in Dallas Center, Iowa.

Westbrook Acres is a 46-bed skilled nursing facility in Gladbrook, Tama County, Iowa, serving residents with skilled nursing, long-term care, memory care, rehabilitation, hospice, and respite care. The facility has been operated by Crystal Even under family ownership since 1995 and accepts both Medicare and Medicaid.
CMS rates the facility 3 stars overall. Health inspection performance sits at the Iowa average, but staffing trails the benchmark — nurse staffing averages 3 hours and 53 minutes per resident per day, roughly 12% below Iowa’s average of 4 hours and 25 minutes.

Across inspections over the past five years, the facility averaged 6.2 deficiencies per year — 41% above the Iowa average of 4.4. The most recent annual survey in March 2025 cited six deficiencies: RN coverage gaps on multiple dates, failures to notify the Long-Term Care Ombudsman about resident hospitalizations, and inaccurate MDS assessments.

A September 2023 complaint investigation substantiated resident-to-resident physical abuse on the memory care unit, causing actual harm to both residents, and confirmed staff theft of a resident’s narcotic medication. A separate 2024 complaint added RN coverage lapses and a failure to follow a physician’s tube-feeding order. No fines or license actions appear in the available reports.

On-site services include physical, occupational, and respiratory therapy. The facility’s occupancy rate is 96% — well above the Iowa average of 75.4% — with an average length of stay of 345 days, indicating a predominantly long-term resident population.

Westbrook Acres’ memory care unit (CCDI), on-site rehabilitation, hospice access, and Medicaid acceptance position it to serve complex, long-term care needs in a small rural setting in Tama County. Families considering placement should weigh the facility’s deficiency history and prior abuse-related findings before making a placement decision.

West Point Care Center is a 46-bed skilled nursing facility in West Point, Iowa, offering skilled nursing, short-term rehabilitation, respite care, and Alzheimer’s and dementia care to residents in Lee County. The facility is owned privately by Miriam Johnson and administered by Hattie Boyer.

CMS rates the facility 4 stars overall, driven by a Health Inspection rating 35.6% above the Iowa average. Across 17 inspections since 2020, the facility recorded 25 total deficiencies — roughly 7% below the Iowa average of 27, at 1.5 citations per inspection against a state norm of 1.8. However, the record is mixed: a January 2024 survey substantiated verbal abuse and neglect by a staff member, failure to protect residents from abuse, and delayed reporting of allegations, resulting in a $14,000 federal fine and a 26-day payment denial — the only enforcement actions in the six-year window, and both well below the Iowa fine average of $48,000. The two most recent annual inspections, in August 2024 and June 2025, found no deficiencies.

Nurse staffing averages 4 hours and 31 minutes per resident per day, in line with Iowa averages, with weekend RN staffing 60% above the state norm — a meaningful figure for residents who need consistent clinical oversight through the week. The facility provides 24-hour staffing, wound care, respiratory care, and palliative and hospice services on site.

The facility’s occupancy rate is 59%, below the Iowa average of 75.4%, indicating current availability. The payer mix includes 42% private-pay admissions, 35% Medicare, and 23% Medicaid; the average length of stay is 125 days, reflecting a mix of post-acute rehabilitation and longer-term residents.

West Point Care Center fits residents seeking skilled nursing or post-acute rehabilitation in a small, rural Iowa setting — including those with dementia-related care needs — where current bed availability and on-site clinical services align with both short- and longer-term placements. However, families should review the facility’s prior abuse-related findings and inspection performance before making a placement decision.

Overview of Westhaven Community

Westhaven Community is a 40-bed nonprofit skilled nursing facility in Boone, Iowa, offering independent living, assisted living, and skilled care. The community is operated as a ministry of the Evangelical Free Church and accepts Medicare, Medicaid, and private pay.

Across inspections since 2017, the facility has averaged approximately 2 deficiencies per year — 55% below the Iowa average of 4.4 — a strong long-term compliance picture. That record includes two notable exceptions: a 2023 inspection that found an Immediate Jeopardy citation for failure to re-evaluate a resident’s advance directives and code status.

A separate complaint investigation that year in which a resident sustained a fatal fall and staff were cited for inadequate supervision. The April 2025 standard inspection recorded 8 deficiencies covering medication management, infection control, and respiratory care. The most recent visit, a September 2025 complaint investigation, found no regulatory issues.

CMS rates Westhaven 4 stars overall, with staffing hours 34.8% above the Iowa average — nurse staffing averaging 5 hours and 20 minutes per resident per day places the community 24th out of 241 Iowa skilled nursing facilities. Occupancy is significantly below the state average at 43%, indicating current availability.

The on-site salon is the one amenity listed on the profile; the facility’s broader lifestyle programming is not detailed on the page.

Westhaven Community is best studied for residents seeking independent, assisted, or skilled nursing care in a small, faith-affiliated residential setting in Boone County, with immediate availability across bed types. However, families should review the facility’s prior Immediate Jeopardy finding and fall-related complaint history.

Westview Acres Care Center is a 58-bed skilled nursing facility in Leon, Iowa, providing long-term care, short-term stays, and respite care. The center has been locally owned and operated by Stegotek Inc. since 1966 and accepts Medicare, Medicaid, and private pay.

CMS rates the facility well above the Iowa average overall, driven by strong health inspection and staffing sub-ratings. Total nursing hours average 5 hours and 3 minutes per resident per day — roughly 14% above the Iowa average of 4 hours and 25 minutes, ranking the facility 47th among 241 Iowa SNFs. One staffing note worth flagging: registered nurse staffing is 29 minutes per resident per day, below the state’s 44-minute average, while LPN staffing is 50% above the state figure.

Across 17 inspections since 2020, the facility logged 5.8 deficiencies per year — 32% above the Iowa average of 4.4. One complaint was substantiated in February 2024, involving a staff member’s early return to work following a positive COVID-19 test in violation of facility policy. No fines, Immediate Jeopardy findings, or license actions appear in the record. The trajectory is improving: the most recent annual survey in June 2025 produced a single documentation deficiency, down from seven in the prior year’s survey.

On-site therapy services include physical, occupational, and speech-language therapy. The facility offers 24-hour staffing.

Westview Acres is best suited for residents seeking long-term skilled nursing care or post-acute stays in a small, locally rooted facility in Decatur County — particularly those whose care needs are well-served by strong total nursing hours and established Medicare and Medicaid acceptance.

Overview of Kahl Home for Aged & Infirm

Kahl Home for Aged & Infirm is a 112-bed nonprofit nursing facility in Davenport, Iowa, offering long-term care, skilled nursing, short-term rehabilitation, memory care, and respite services to residents in Scott County. The community is operated by the Carmelite Sisters for the Aged and Infirm.

CMS rates the facility 2 stars overall, with Health Inspection performance as the primary driver. The record is more nuanced than the rating suggests. Since 2020, Kahl has undergone more than twice the Iowa average number of inspections, pushing total citations to 74% above the state mean. Deficiencies per inspection, however, are 17% below the Iowa average — individual surveys have been comparatively contained.

Substantiated findings in the record include a 2020 medication error that resulted in a resident’s hospitalization, a 2020 elopement, and 2025 citations related to pressure ulcer care and an unsafe mechanical lift transfer. No fines or license suspensions appear in the available reports.

Quality measures point in a different direction. Long-stay performance is rated significantly above Iowa averages; short-stay quality measures are also above average. Both reflect strong resident outcomes across the facility’s care tracks.

Kahl has received the Locals Love Us award for Best Nursing Home in the Quad Cities for the 13th consecutive year in 2026. Amenities include a bistro, pub, courtyards, and common living areas. The facility accepts both Medicare and Medicaid. Its current occupancy rate is 93% — well above the Iowa average of 75.4% and ranks among the top 50 SNFs statewide.

Kahl Home for Aged & Infirm is best suited for long-term and post-acute care under nonprofit, mission-driven operations in the Davenport area, with quality-measure performance that distinguishes it from its inspection footprint.

Keystone Nursing Care Center is a 55-bed skilled nursing facility in Keystone, Iowa, part of a Continuing Care Retirement Community and owned by Tracy Hanson. The community accepts Medicare, Medicaid, and private pay, serving a mix of short-term rehabilitation and long-term care residents in Benton County.

The overall 4-star CMS rating reflects a strong health inspection record — 35.6% above the Iowa average — as the leading driver. Across 14 inspections since 2020, the facility recorded 8 total deficiencies — 70% below the Iowa average of 27 — with the most recent standard survey in September 2025 finding the facility in full compliance with no citations. A substantiated complaint in February 2025 involved a CNA transferring a resident without a required mechanical lift, resulting in a fall and a fractured femur; the staff member was terminated, and the facility achieved verified compliance by February 20, 2025. No federal fines or enforcement actions have been recorded.

Total nurse staffing averages 5 hours and 16 minutes per resident per day, 20% above the Iowa average, ranking the facility 24th out of 241 Iowa skilled nursing facilities. The facility’s occupancy rate is 71%, modestly below the Iowa average, indicating current availability.

The facility operates an active resident council and an on-site Nurse Aide Training and Competency Evaluation Program. As part of a Continuing Care Retirement Community, it offers a pathway through multiple levels of care. The average length of stay of 339 days and a payer mix evenly distributed among Medicare, Medicaid, and private pay reflect a population spanning post-acute recovery and extended long-term care.

Keystone Nursing Care Center fits residents seeking skilled nursing care in a small, community-based setting — including those entering for post-acute rehabilitation and those planning for longer-term placement within a continuing care framework in rural Benton County.