Azria Health Winterset

Nursing Home in Iowa

CMS overall rating Info 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.
Azria Health Winterset

Nursing Home in Iowa

CMS overall rating Info 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.

Overview of Azria Health Winterset

Azria Health Winterset provides excellence at every level, delivering exceptional service to each individual. The facility offers post-acute rehabilitation, long-term care, and independent living with a focus on personalized services. Residents can enjoy a friendly, comfortable environment with various specialized care programs.

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info 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.
2/5 ▼ 1.1 Iowa average: 3.1/5
Health Inspection Info 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.
2/5 ▼ 0.9 Iowa average: 2.9/5
Staffing Info 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.
3/5 ▼ 0.5 Iowa average: 3.5/5
Quality Measures Info 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.
2/5 ▼ 1.3 Iowa average: 3.3/5

Staffing hours breakdown

Info 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.

Hours per resident per day — compared to Iowa state averages

Total nursing care / resident Info This home is ranked 193rd out of 240 homes in Iowa.

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.
3h 42m per day
Rank #193 / 240Nurse hours — state benchmarkedThis home is ranked 193rd out of 240 homes in Iowa.Shows adjusted nurse hours per resident per day benchmarked to the Iowa average, with a ranking across 240 Iowa SNFs. More hours mean more direct care. The national average is about 3.5 hrs; below 3.0 is a red flag.
This facility Iowa avg (4h 18m per day)
vs Iowa avg
-14%

4 of 6 metrics below state avg

Standout metric Physical Therapist is +250% above state avg
Staff typeHours / dayvs state avg
Registered Nurse (RN) Info 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. 28m per day ▼ 36% State avg: 44m per day · National avg: 41m per day
LPN / LVN Info 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. 41m per day ▲ 21% State avg: 34m per day · National avg: 52m per day
Nurse Aide Info 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 23m per day ▼ 6% State avg: 2h 32m per day · National avg: 2h 20m per day
Total Nursing (Weekend) Info 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 15m per day ▼ 3% State avg: 3h 21m per day · National avg: 3h 26m per day
Physical Therapist Info 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. 7m per day ▲ 250% State avg: 2m per day · National avg: 4m per day
RN (Weekend) Info 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. 17m per day ▼ 43% State avg: 30m per day · National avg: 28m per day

Capacity and availability

This home usually has availability

Occupancy lower than 85% suggests more openings may be available.

Lower occupancy than the Iowa average: 75.4%
Occupancy rate 65.8% Rank #195 / 246Occupancy rate — state benchmarkedThis home is ranked 195th out of 246 homes in Iowa.Shows this facility's occupancy rate versus the Iowa average, with its statewide rank out of 246. Higher occupancy signals strong local demand and financial stability.
Avg. Length of Stay 208 days
Occupancy rate
65.8% Rank #195 / 246Occupancy rate — state benchmarkedThis home is ranked 195th out of 246 homes in Iowa.Shows this facility's occupancy rate versus the Iowa average, with its statewide rank out of 246. Higher occupancy signals strong local demand and financial stability.
Avg. Length of Stay
208 days

Who this home usually serves

TYPE OF STAY

Primarily short stays

Residents typically stay for brief periods, with frequent admissions and discharges throughout the year.

Might be optimal for
Post-acute recovery Temporary care Transitional stays

Breakdown by payment type

Medicare

20% of new residents, usually for short-term rehab.

Typical stay 1 - 2 months

Private pay

79% of new residents, often for short stays.

Typical stay 3 - 4 months

Medicaid

1% of new residents, often for long-term daily care.

Typical stay 23 - 24 years

Finances and operations

Privately-owned community
Operated by a business corporation.
Home revenue
$5.0M
Operating loss
-$222.7K
Privately-owned community Operated by a business corporation.
Home revenue
$5.0M Rank #183 / 241Revenue — state benchmarkedThis home is ranked 183rd out of 241 homes in Iowa.Shows this facility's annual revenue compared to the Iowa SNF average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.
Operating loss
-$222.7K
Payroll costs Info The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations. Rank #177 / 241Payroll — state benchmarkedThis home is ranked 177th 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.
$2.2M
43.9% of revenue Rank #112 / 241Payroll % — state benchmarkedThis home is ranked 112th out of 241 homes in Iowa.Shows payroll as a percentage of revenue versus the Iowa average. Well-run SNFs often land around 55–65%. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.
Other operating costs Info All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$3.0M
Total costs $5.2M

About this community

License Details

AccreditationsMember of Iowa Health Care Association, Member of American Healthcare Association, Medicare and Medicaid approved facility.

Payment & Insurance

2 services
Accept Medicaid
Accept Medicare

Therapy & Rehabilitation

3 services
Rehabilitation Services
Respite Care
Short-Term Rehab

Staffing & Medical

2 services
Doctor on Staff
24-Hour Staffing

Additional Services

1 service
Post-Acute Rehabilitation

Additional Policies & Features

Pets Allowed
HousekeepingYes
Linen ServiceYes
Utilities IncludedYes

Amenities & Lifestyle

Physical Therapy
Occupational Therapy
Speech Therapy
Maintenance Free Living
Personalized Services
Customized Dining Program
Activities On Campus
Beauty Shop On Site
Complimentary Wi-Fi
Chef-Prepared Menus
Private Dining Room
Laundry Services
Specific ProgramsLong Term Care, Specialized Care Programs

Dining & Nutrition

Food DescriptionConvenient, home cooked meals on a schedule that works for you.
Meals IncludedYes
Meal ScheduleMeals provided two times a day when requested, or scheduled.

Contact Azria Health Winterset

Health Inspection History

Inspections
Total health inspections 4

Iowa average 4.9


Last Health inspection on Mar 2025

Total health citations
24 Rank #165 / 240Health citations — state benchmarkedThis home is ranked 165th out of 240 homes in Iowa.Shows this facility's total health deficiency citations benchmarked to the Iowa state average, with a ranking across all 240 IA SNFs. Lower citation counts earn a better rank.

Iowa average 21.7

Citations per inspection
6

Iowa average 4.11


Health citations are formal notices following inspections when they fail to comply with safety and care standards.

23 of 24 citations resulted from standard inspections; and 1 of 24 resulted from complaint investigations.

Breakdown of citation severity (last 3 years)
Critical Health citations More info
0 Rank #1 / 139Severe citations — state benchmarkedThis home is ranked 1st out of 139 homes in Iowa.Shows citations where actual resident harm occurred, compared to the Iowa average and ranked across 139 SNFs statewide. Even a single severe citation is significant — lower is always better.
100% better than Iowa average

Iowa average: 0.6


Serious Health citations More info 1
11% worse than Iowa average

Iowa average: 0.9

0 critical citations More info Iowa average: 0.6

1 serious citation More info Iowa average: 0.9

22 moderate citations More info Iowa average: 19.7

1 minor citation More info Iowa average: 0.5
Citations history (last 3 years)
Infection Control moderate citation Info Issues related to preventing and controlling infections, including hygiene practices and safety protocols. Mar 10, 2025
Corrected

Nutrition moderate citation Info Issues related to food quality, meal service, and resident's nutritional needs. Mar 10, 2025
Corrected

Pharmacy moderate citation Info Issues related to medication management, including how drugs are stored, administered, and monitored. Mar 10, 2025
Corrected

Pharmacy moderate citation Info Issues related to medication management, including how drugs are stored, administered, and monitored. Mar 10, 2025
Corrected

Compare Nursing Homes around Iowa The information below is reported by the Iowa Department of Inspections, Appeals, and Licensing.

5 facilities compared · CMS & IA Dept. of Health data · Updated Apr 2026

Filter by care type
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.

Akron45 98.1% +30%4.71 +15%+10%042.0042--City Of Akron$4.7M$2.1M45.1%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.

Carlisle80 80.5% +7%5.85 -40%+36%0175.7239--American Healthcare Associates Inc$4.1M$2.5M59.6%165311
Azria Health Winterset
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.

Winterset70 65.8% -13%3.70 -9%-14%0246.0151--Merron, Kristin$5.0M$2.2M43.9%165188
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 Lake85 66.6% -12%4.29 -8%0%1217.0165---$7.1M$3.0M42.3%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 City46 70.4% -7%5.17 -33%+20%4393.9440--Accura Healthcare Of The Heartland Llc$2.1M$1.0M46.7%165082

Financial Assistance for
Nursing Home in Iowa

Get Financial aid guidance

Elderly Waiver

Iowa Medicaid Elderly Waiver

Age 65+
General Iowa resident, Medicaid-eligible, nursing home-level care need.
Income Limits (2025) ~$2,829/month 300% FBR, individual
Asset Limits $2,000 (individual), $3,000 (couple).
IA

Rural focus; waitlists possible.

Benefits
In-home care (5-7 hours/day) Meals ($6/meal) Respite (240 hours/year) Adult day care ($60/day)

Iowa Family Caregiver Support

IA NFCSP

Age Caregiver of someone 60+
General Iowa resident.
Income Limits No strict limit; prioritizes low-income.
Asset Limits Not applicable.
IA

Limited slots; rural emphasis.

Benefits
In-home respite (4-6 hours/day) Adult day care (~$60/day) Short-term facility care (up to 5 days)

Medicare Savings Program (MSP)

Iowa Medicare Savings Program

Age 65+ or disabled
General Iowa resident, Medicare Part A/B.
Income Limits (2025) ~$2,510/month (QMB), ~$3,380/month (SLMB), ~$3,598/month (QI)—individual.
Asset Limits $9,430 (individual), $14,130 (couple).
IA

Three tiers; no waitlist.

Benefits
Covers Part B premiums ($174.70/month) Deductibles ($240/year) Copays (~20%)

Program of All-Inclusive Care for the Elderly (PACE)

Iowa PACE

Age 55+
General Iowa resident, nursing home-level care need, safe with PACE support.
Income Limits (2025) ~$2,829/month 300% FBR, Medicaid-eligible
Asset Limits $2,000 (individual), $3,000 (couple).
IA

Limited to western Iowa (e.g., Council Bluffs); expanding slowly.

Benefits
Personal care (5-7 hours/day) Medical care Meals Transportation Therapy Respite

Senior Community Service Employment Program (SCSEP)

Iowa SCSEP

Age 55+
General unemployed, low-income, Iowa resident.
Income Limits (2025) ~$1,983/month 125% FPL
Asset Limits Not specified; income-focused.
IA

Priority for veterans, rural residents.

Benefits
Paid training (~20 hours/week at ~$7.25/hour) Job placement

VA Aid and Attendance (A&A) and Housebound Benefits

Iowa VA Aid and Attendance/Housebound

Age 65+ or disabled veteran/spouse
General Iowa resident, wartime service, need for ADL help (A&A) or homebound.
Income Limits (2025) Net income < ~$1,984/month (veteran with dependent, A&A); pension offsets income.
Asset Limits ~$155,356 net worth limit
IA

High veteran demand in rural areas.

Benefits
Cash (~$1,433-$2,642/month veteran, ~$951-$1,318 spouse) for care costs (e.g., in-home, assisted living)

Able Up Iowa

Able Up Iowa

Age 65+ or disabled
General Iowa resident, ability to repay loan, need for assistive tech or mods.
Income Limits (2025) No strict limit; must demonstrate repayment capacity.
Asset Limits Not specified; credit-based.
IA

Loans up to $25,000; statewide via Easterseals partnership.

Benefits
Loans for wheelchairs Ramps Walk-in tubs (~$500-$10,000 avg.) Reducing reliance on paid care

Places of interest near Azria Health Winterset

Address 0.0 miles from city center Info Estimated distance in miles from Winterset's city center to Azria Health Winterset's address, calculated via Google Maps.

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Address

Staffing Data (Q2 2025)

This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.

Total staff 95
Employees 93
Contractors 2
Staff to resident ratio 1.90:1
5% worse than Iowa average

Iowa average ratio: 2.00:1

Avg staff/day 28
Average shift 7.5 hours
0% compared with Iowa average

Iowa average: 7.4 hours

Total staff hours (quarter) 19,029
Nursing staff breakdown
Registered Nurse

Manages medical care and health needs.

Total count 10
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 8.6 hours

No contractors work on this role.

Licensed Practical Nurse

Assists with medical care and medications.

Total count 10
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.4 hours

No contractors work on this role.

Certified Nursing Assistant

Helps with daily care and mobility.

Total count 44
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 7.4 hours

No contractors work on this role.

Contractor staffing

Total hours from contractors

0.4%

73 contractor hours this quarter

Medical Director: 1 Occupational Therapy Assistant: 1
Staff by category
Certified Nursing Assistant4404411,01991100%7.4
Licensed Practical Nurse100102,69191100%9.4
Registered Nurse100101,1518695%8.6
Medication Aide/Technician9096326571%6
Clinical Nurse Specialist3035005965%7.9
Mental Health Service Worker1014896774%7.3
Administrator1014886167%8
RN Director of Nursing1014806066%8
Nurse Practitioner1014645864%8
Physical Therapy Assistant3034256369%6.7
Speech Language Pathologist2022633235%7.3
Occupational Therapy Aide1011201415%8.6
Other Dietary Services Staff101891516%6
Respiratory Therapy Technician404863033%2.7
Qualified Social Worker202592932%2
Occupational Therapy Assistant011431011%4.3
Medical Director011313336%0.9
44 Certified Nursing Assistant
% of Days 100%
10 Licensed Practical Nurse
% of Days 100%
10 Registered Nurse
% of Days 95%
9 Medication Aide/Technician
% of Days 71%
3 Clinical Nurse Specialist
% of Days 65%
1 Mental Health Service Worker
% of Days 74%
1 Administrator
% of Days 67%
1 RN Director of Nursing
% of Days 66%
1 Nurse Practitioner
% of Days 64%
3 Physical Therapy Assistant
% of Days 69%
2 Speech Language Pathologist
% of Days 35%
1 Occupational Therapy Aide
% of Days 15%
1 Other Dietary Services Staff
% of Days 16%
4 Respiratory Therapy Technician
% of Days 33%
2 Qualified Social Worker
% of Days 32%
1 Occupational Therapy Assistant
% of Days 11%
1 Medical Director
% of Days 36%

Facility Characteristics

Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)

Total residents 50
Medicare
5
10% of residents
Medicaid
26
52% of residents
Private pay or other
19
38% of residents
Programs & Services
Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Quality of care over time

These measures show how residents usually do over time at this home, based on health outcomes and preventive care.

High-risk clinical events score Info A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline. 14.6
42% worse than Iowa average

Iowa average: 10.2

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 28.6
33% worse than Iowa average

Iowa average: 21.6

Long-stay resident measures
Below average Iowa avg: 3.3 Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 31.9%
69% worse than Iowa average

Iowa average: 18.8%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 31.4%
59% worse than Iowa average

Iowa average: 19.7%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 22.6%
14% better than Iowa average

Iowa average: 26.2%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 0.5%
85% better than Iowa average

Iowa average: 3.6%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 6.6%
51% worse than Iowa average

Iowa average: 4.4%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 1.1%
56% better than Iowa average

Iowa average: 2.5%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 2.5%
50% better than Iowa average

Iowa average: 5.0%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 0.6%
86% better than Iowa average

Iowa average: 3.9%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 18.9%
In line with Iowa average

Iowa average: 19.0%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 100.0%
6% better than Iowa average

Iowa average: 94.4%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 94.0%
In line with Iowa average

Iowa average: 95.3%

Hospitalizations per 1,000 days Info Number of hospitalizations per 1,000 long-stay resident days. 1.57
6% worse than Iowa average

Iowa average: 1.48

ED visits per 1,000 days Info Number of outpatient emergency department visits per 1,000 long-stay resident days. 3.66
75% worse than Iowa average

Iowa average: 2.09

Short-stay resident measures
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 97.3%
14% better than Iowa average

Iowa average: 85.1%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 2.4%
29% worse than Iowa average

Iowa average: 1.8%

Successful return to home or community Info Rate of successful return to home or community from a skilled nursing facility. 54.0%
7% better than Iowa average

Iowa average: 50.6%

Penalties and fines

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 (Data as of Jan 2026)

Total fines amount $0
100% lower than Iowa average

Iowa average: $48K

Number of fines 0
100% fewer fines than Iowa average

Iowa average: 1.7

Payment Denials Info Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed. 1
88% more payment denials than Iowa average

Iowa average: 0.5

Fines amount comparison
Fines amount comparison
This facility $0
Iowa average $48K
Penalty History

Penalties are imposed by CMS for violations of federal nursing home regulations.

Payment Denial Info Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed. May 9, 2024
2 days

Last updated: Jan 2026

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