Elkader Care Center

Nursing Home, Assisted Living & Skilled Nursing · Elkader, IA

CMS overall rating

116 Reimer Street Sw, Elkader, Ia 520439558 View map

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Elkader Care Center accepts Medicare, Medicaid, and private pay.

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Elkader Care Center accepts Medicare, Medicaid, and private pay.

Overview of Elkader Care Center

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.

Facility Direct Line (563) 245-1620

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Staffing hours breakdown

Hours per resident per day — compared to state averages

Total nursing care / resident

3h 20m per day

vs avg

4 of 6 metrics below state avg

Standout metric Registered Nurse (RN) is +57% above state avg

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

Capacity and availability

429 days

40-bed community

A moderately sized community that may balance personal attention with shared amenities and social activities.

39 years in operation

A longer operating history, which may indicate experience navigating regulations and delivering ongoing care.

Walk Score: 59 / 100

Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.

About this community

Occupancy

Occupancy rate

70%

Lower than the Iowa average: 75.4%

Occupied beds

28 / 40

Average occupied beds in Iowa homes 51 beds

Facility TypeFree Standing Nursing Facility / Skilled Nursing Facility

StatusActive

IssuanceFebruary 1, 1987

ExpirationNovember 1, 2026

CountyClayton

License Number220240

CMS Certification Number165391

Certification TypeFALSE

Elkader Care Center is administered by Amy Murphy.

Rehabilitation Services

Skilled Rehabilitation

Email epierce@elkadercarecenter.com

Fax5632452198

Pets not allowed

Since 2020 · 6 years of data 15 deficiencies 13 inspections

Inspection Scorecard This scorecard compares key inspection, deficiency, 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.

Since 2020 vs. Iowa state average

Overall vs. IA average

Latest Inspection December 18, 2025

Deficiencies Deficiencies are formal regulatory issues recorded during state inspections.	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 assisted living residence (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 assisted living residence (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 assisted living residence (1.2 vs. IA avg 1.8).↓ 33% better

Inspections State inspections evaluate whether the facility meets health and safety standards.	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 had 13% fewer total inspections than the Iowa average (13 vs. IA avg 15). More inspections can mean more regulatory scrutiny rather than worse care.↓ 13% fewer

Inspection Reports Summary An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

The December 18, 2025 annual inspection found no health deficiencies and the facility was in substantial compliance with all regulations surveyed.
The August 30, 2023 inspection cited two deficiencies for failure to complete required Dependent Adult Abuse training and background checks prior to hire.
The October 24, 2024 complaint investigation found three deficiencies related to failure in timely assessments and pressure ulcer care, resulting in resident harm and death from sepsis.

Show Inspection Reports

Inspections since 2022

Total health inspections 3

State average N/A

Last Health inspection on Oct 2024

Total health citations

State average N/A

Citations per inspection

2.33

State average N/A

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.

Breakdown of citation severity (last 4 years)

Critical health citations

In line with State average

State average: N/A

Serious health citations

In line with State average

State average: N/A

0 critical citations State average: N/A

1 serious citation State average: N/A

6 moderate citations State average: N/A

0 minor citations State average: N/A

Citations history (last 4 years)

Administration moderate citation Oct 24, 2024

Corrected

Quality of Care moderate citation Oct 24, 2024

Corrected

Quality of Care serious citation Oct 24, 2024

Corrected

Abuse/Neglect moderate citation Aug 30, 2023

Corrected

Total staff 87

Employees 33

Contractors 54

Staff to resident ratio 3.22 : 1

0% compared with State average

State average ratio: 0 : 0

Avg staff/day 15

Average shift 6.5 hours

0% compared with State average

State average: 0 hours

Total staff hours (quarter) 8,908

Nursing staff breakdown

10.2 hours

8.1 hours

6.9 hours

Contractor staffing

1,982 contractor hours this quarter

Certified Nursing Assistant: 26 Clinical Nurse Specialist: 6 Speech Language Pathologist: 4 Registered Nurse: 3 Qualified Social Worker: 3 Respiratory Therapy Technician: 3 Physical Therapy Assistant: 2 Occupational Therapy Aide: 2 Administrator: 1 Physical Therapy Aide: 1 Mental Health Service Worker: 1 Occupational Therapy Assistant: 1 Medical Director: 1

Staff by category


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

47 Certified Nursing Assistant

% of Days 100%

6 Registered Nurse

% of Days 100%

4 Licensed Practical Nurse

% of Days 83%

1 Nurse Practitioner

% of Days 66%

1 Other Dietary Services Staff

% of Days 67%

3 Administrator

% of Days 59%

7 Clinical Nurse Specialist

% of Days 36%

4 Speech Language Pathologist

% of Days 61%

1 Physical Therapy Aide

% of Days 53%

2 Occupational Therapy Aide

% of Days 22%

2 Physical Therapy Assistant

% of Days 45%

1 Mental Health Service Worker

% of Days 12%

3 Qualified Social Worker

% of Days 43%

3 Respiratory Therapy Technician

% of Days 21%

1 Occupational Therapy Assistant

% of Days 5%

1 Medical Director

% of Days 3%

View All Staffing Data

No penalties in the past 3 years

No civil money penalties or payment denials were reported in the last 3 years.

High-risk clinical events score 9.3

9% better than State average

State average: 10.2

Functional decline score 18.1

16% better than State average

State average: 21.6

Long-stay resident measures

Average State avg: 3.3

Need for Help with Daily Activities Increased 15.1%

20% better than State average

State average: 18.8%

Walking Ability Worsened 16.5%

16% better than State average

State average: 19.7%

Low Risk Residents with Bowel/Bladder Incontinence 22.6%

14% better than State average

State average: 26.2%

Falls with Major Injury 1.0%

74% better than State average

State average: 3.6%

High Risk Residents with Pressure Ulcers 3.7%

15% better than State average

State average: 4.4%

Urinary Tract Infection 2.9%

16% worse than State average

State average: 2.5%

Lost Too Much Weight 10.3%

107% worse than State average

State average: 5.0%

Depressive Symptoms 3.4%

12% better than State average

State average: 3.9%

Antipsychotic Use 21.2%

12% worse than State average

State average: 19.0%

Pneumococcal Vaccine 91.4%

In line with State average

State average: 94.4%

Influenza Vaccine 100.0%

5% better than State average

State average: 95.3%

Short-stay resident measures

Below average State avg: 2.6

Pneumococcal Vaccine 90.9%

7% better than State average

State average: 85.1%

Antipsychotic medication increase 0.0%

100% better than State average

State average: 1.8%

Re-hospitalized after SNF stay 10.8%

49% better than State average

State average: 21.3%

Emergency department visits 33.0%

152% worse than State average

State average: 13.1%

Falls with major injury 0.0%

100% better than State average

State average: 0.8%

Ability to care for self at discharge 47.6%

11% worse than State average

State average: 53.7%

Successful return to home or community 40.7%

20% worse than State average

State average: 50.6%

Breakdown by payment type

Medicare

52% of new residents, usually for short-term rehab.

Typical stay 1 - 2 months

Private pay

45% of new residents, often for short stays.

Typical stay 10 - 11 months

Medicaid

3% of new residents, often for long-term daily care.

Typical stay 20 years

Total residents 27

Medicare

7.4% of residents

Medicaid

66.7% of residents

Private pay or other

25.9% 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.

Financial Trends

Historical financial and operational data for Elkader Care Center from 2011–2023, based on CMS SNF Cost Reports.

Key figures below are for fiscal year ending in 12/2023.

Occupancy Rate 76.5% ↓ 8.8pp vs 2022

Net Patient Income $139.2K ↓ ~$185.4K vs 2022

Payroll Costs $1.7M ↑ ~$35.6K vs 2022

Operating Margin 4.0% ↓ 6.0pp vs 2022

Metric	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	2022	2023
Occupancy %	83.6%	78.8%	71.1%	77.4%	84.1%	80.9%	75.3%	57.3%	66.5%	82.5%	85.2%	76.5%
Beds	44	44	44	44	44	44	44	44	44	40	40	40
Net Income	$191,341	$93,995	$79,618	$258,624	$431,283	$311,837	$140,240	$176,846	$309,043	$583,425	$342,093	$169,198
Gross Revenue	$2,498,004	$2,540,061	$2,546,707	$2,893,751	$3,100,677	$3,123,751	$3,039,079	$2,599,977	$2,783,717	$3,111,747	$3,416,995	$3,779,456
Operating Expenses	$2,139,204	$2,231,922	$2,169,938	$2,461,270	$2,485,908	$2,591,192	$2,655,763	$2,211,200	$2,264,133	$2,647,665	$2,926,280	$3,381,363
Net Patient Income	$162,991	$66,567	$73,556	$217,830	$390,107	$276,058	$107,164	$142,234	$276,655	$237,640	$324,546	$139,189
Net Patient Revenue	$2,302,195	$2,298,489	$2,243,494	$2,679,100	$2,876,015	$2,867,250	$2,762,927	$2,353,434	$2,540,788	$2,885,305	$3,250,826	$3,520,552
Payroll Costs	$1,179,619	$1,191,484	$1,139,628	$1,291,055	$1,388,265	$1,461,878	$1,465,559	$1,199,560	$1,265,226	$1,446,011	$1,625,390	$1,660,990
Operating Margin %	7.1%	2.9%	3.3%	8.1%	13.6%	9.6%	3.9%	6.0%	10.9%	8.2%	10.0%	4.0%
Medicare %	4.8%	6.3%	6.8%	4.5%	4.9%	5.6%	5.3%	5.1%	5.0%	5.0%	3.9%	5.1%
Medicaid %	47.1%	53.6%	50.3%	56.5%	42.1%	40.5%	41.8%	46.1%	53.4%	63.1%	53.4%	56.3%
Private %	48.1%	40.1%	42.9%	38.9%	53.1%	53.9%	52.9%	48.8%	41.6%	31.9%	42.6%	38.5%
Net Patient Revenue/Day	$171	$181	$197	$216	$213	$220	$229	$256	$238	$239	$261	$315
Cost/Day	$159	$176	$190	$198	$184	$199	$220	$241	$212	$219	$235	$303
Avg Length of Stay	406.8 days	528.4 days	317.0 days	289.0 days	314.2 days	449.1 days	251.8 days	242.0 days	296.8 days	287.4 days	289.3 days	429.3 days

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2023.

Net patient revenue

$3.5M

Net patient income

$139.2K

For-profit Operated by a single business entity.

Net patient revenue

$3.5M

Net patient income

$139.2K

Other income

$30.0K

Payroll costs

$1.7M 47.2% of net patient revenue

Other operating costs

$1.7M

Total costs

$3.4M

TYPE OF STAY

Mostly short-term rehab stays

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.

Medicare 52%

Private pay 45%

Medicaid 3%

Coverage residents most often leave under.

Medicare 38%

Private pay 42%

Medicaid 19%

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


Bethany Home Retirement Center	NH IL MC SNF	Dubuque (Eagle Point District)	-	66	-	69	1 Bed / 2 Bed
Friendship Village	NH AL IL MC SNF	Waterloo	-	72	-	52	2 Bed / 3 Bed
Prairie Vista Village	NH AL IL SNF	South Altoona	-	68	A	29	-
St Francis Manor	NH AL HOS SNF	Grinnell	-	78	-	82	-
Elkader Care Center	NH AL SNF	Elkader	-	40	-	59	-

Nursing Home Explorer

Is Elkader Care Center in a walkable area?

Elkader Care Center has a walk score of 59. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.

What is the license number of Elkader Care Center?

According to IA state health department records, Elkader Care Center's license number is 220240.

When does Elkader Care Center's license expire?

According to IA state health department records, Elkader Care Center's license expires on November 1, 2026.

What is the occupancy rate at Elkader Care Center?

Elkader Care Center's occupancy is 70%.

Are pets allowed at Elkader Care Center?

No, Elkader Care Center has a no-pet policy.

What is the best email address for Elkader Care Center?

The team at Elkader Care Center can be reached at epierce@elkadercarecenter.com.

Does Elkader Care Center operate as a for-profit or non-profit?

Elkader Care Center is registered as a for-profit in IA.

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Elkader Care Center

Overview of Elkader Care Center

Quality ratings

Staffing hours breakdown

Capacity and availability

About this community

Occupancy

License Details

Ownership & Operating Entity

Therapy & Rehabilitation

Additional Services

Contact Information

Additional Policies & Features

Amenities & Lifestyle

Contact Elkader Care Center

Inspection History

Inspection Scorecard This scorecard compares key inspection, deficiency, 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 Deficiencies are formal regulatory issues recorded during state inspections.

Inspections State inspections evaluate whether the facility meets health and safety standards.

Inspection Reports Summary An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

Health Inspection History

Inspections since 2022

Breakdown of citation severity (last 4 years)

Citations history (last 4 years)

Staffing Data

Nursing staff breakdown

Registered Nurse

Licensed Practical Nurse

Certified Nursing Assistant

Contractor staffing

Staff by category

47 Certified Nursing Assistant

6 Registered Nurse

4 Licensed Practical Nurse

1 Nurse Practitioner

1 Other Dietary Services Staff

3 Administrator

7 Clinical Nurse Specialist

4 Speech Language Pathologist

1 Physical Therapy Aide

2 Occupational Therapy Aide

2 Physical Therapy Assistant

1 Mental Health Service Worker

3 Qualified Social Worker

3 Respiratory Therapy Technician

1 Occupational Therapy Assistant

1 Medical Director

Penalties and fines

Quality of care over time

Long-stay resident measures

Short-stay resident measures

Breakdown by payment type

Medicare

Private pay

Medicaid

Facility Characteristics

Programs & Services

Residents Group

Active Resident Council

Financial Trends

Financial Performance

Payroll & Labor Costs

Payer Mix (percentage)

Finances and operations

Who this home usually serves

Mostly short-term rehab stays

Admissions

Discharges

Places of interest near Elkader Care Center

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