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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.
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 227th 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.
| 59m per day | ▲ 34% 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.
| 22m per day | ▼ 35% 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 10m per day | ▼ 14% 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 58m per day | ▼ 11% 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.
| 36m per day | ▲ 20% State avg: 30m per day · National avg: 28m per day |
Most residents typically stay for a few weeks or months before returning home or moving on.
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.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #228 / 241Payroll — state benchmarkedThis home is ranked 228th 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.
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.
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 18, 2025 found the facility to be in substantial compliance with no deficiencies cited. Earlier inspections showed a mixed record with some deficiencies related to staff training, background checks, medication administration, nutrition, and care planning. Prior issues included failure to complete required Dependent Adult Abuse training and background checks for some staff, as well as documentation and procedural gaps in psychotropic drug use and dietary services. Complaint investigations during this period were mostly unsubstantiated or found the facility in substantial compliance, with no enforcement actions or fines listed in the available reports. The facility’s inspection history suggests improvement over time, with recent surveys showing compliance following correction of earlier deficiencies.
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
1
11% worse than Iowa averageIowa average: 0.9
Issues related to how the facility is managed, including policies, procedures, and compliance with regulations.
Oct 24, 2024
Corrected
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Oct 24, 2024
Corrected
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Oct 24, 2024
Corrected
Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment.
Aug 30, 2023
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 | ||||
| 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 | 76.5% | +1% | 3.34 | +19% | -22% | 0 | 7 | 2.3 | 1 | 27 | - | - | Dunlap, Kristin | $3.8M | $1.5M | 39.2% | 165391 | ||||
| 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 | ||||
| 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 Elkader's city center to Elkader Care Center's address, calculated via Google Maps.
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This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
48% better than Iowa averageIowa average ratio: 2.00:1
9% worse 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.
8.5 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.
9.1 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.
6.9 hoursThis role is partially covered by contractors.
Total hours from contractors
1,183 contractor hours this quarter
| Certified Nursing Assistant | 24 | 15 | 39 | 5,194 | 91 | 100% | 6.9 |
| Registered Nurse | 5 | 6 | 11 | 1,811 | 91 | 100% | 8.5 |
| Licensed Practical Nurse | 2 | 1 | 3 | 933 | 78 | 86% | 9.1 |
| Administrator | 1 | 0 | 1 | 504 | 63 | 69% | 8 |
| Other Dietary Services Staff | 1 | 0 | 1 | 388 | 59 | 65% | 6.6 |
| Clinical Nurse Specialist | 0 | 5 | 5 | 236 | 33 | 36% | 6.9 |
| Nurse Practitioner | 1 | 0 | 1 | 195 | 25 | 27% | 7.8 |
| Speech Language Pathologist | 0 | 3 | 3 | 80 | 43 | 47% | 1.9 |
| Physical Therapy Assistant | 0 | 2 | 2 | 73 | 40 | 44% | 1.7 |
| Qualified Social Worker | 0 | 5 | 5 | 56 | 41 | 45% | 1.4 |
| Occupational Therapy Aide | 0 | 2 | 2 | 55 | 17 | 19% | 3.1 |
| Physical Therapy Aide | 0 | 1 | 1 | 50 | 37 | 41% | 1.3 |
| Respiratory Therapy Technician | 0 | 3 | 3 | 47 | 24 | 26% | 2 |
| Mental Health Service Worker | 0 | 1 | 1 | 38 | 12 | 13% | 3.2 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 21 | 7 | 8% | 3 |
| Medical Director | 0 | 1 | 1 | 14 | 6 | 7% | 2.3 |
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.
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.
Historical financial and operational data for Elkader Care Center based on CMS SNF Cost Reports.
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