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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 94th out of 224 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.
| 42m per day | ▼ 5% 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.
| 36m per day | ▲ 6% 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 23m per day | ▼ 6% 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.
| 3h 21m per day | ■ Avg State avg: 3h 21m per day · National avg: 3h 26m 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.
| 26m per day | ▼ 13% State avg: 30m per day · National avg: 28m per day |
This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.
31% of new residents, usually for short-term rehab.
58% of new residents, often for short stays.
12% 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 #172 / 226Payroll — state benchmarkedThis home is ranked 172nd out of 226 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%Friendship Home Association is administrated by Rae Ann Tucker.
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 September 22, 2025, identified one deficiency related to acceptance of a credible allegation of substantial compliance and plan of correction. Earlier inspections showed a mixed record with deficiencies primarily involving resident supervision and notification, food safety and preparation, documentation accuracy, and infection control. Complaint investigations substantiated issues with supervision leading to a resident elopement and medication management errors, while most other complaints were unsubstantiated. There were no fines, immediate jeopardy findings, or license actions listed in the available reports. The facility’s inspection history shows some recurring themes but also periods of substantial compliance, indicating a variable pattern without a clear trend toward consistent improvement or decline.
Iowa average 4.9
Last Health inspection on Sep 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.
9 of 15 citations resulted from standard inspections; and 6 of 15 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 well residents receive appropriate treatment and support for their medical and daily care needs.
Sep 04, 2025
Corrected
Issues related to resident's rights, including dignity, privacy, and the ability to make decisions about their care.
Sep 04, 2025
Corrected
Issues related to protecting resident's from harm, including abuse, neglect, or mistreatment.
Aug 01, 2024
Corrected
Issues related to food quality, meal service, and resident's nutritional needs.
Aug 01, 2024
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.
Friendship Home Association is located in Audubon, Iowa.
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0.0 miles from city center
Estimated distance in miles from Audubon's city center to Friendship Home Association's address, calculated via Google Maps.
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This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
0% compared with 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.
9.6 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.
8.4 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.
8.3 hoursThis role is partially covered by contractors.
Total hours from contractors
3,803 contractor hours this quarter
| Certified Nursing Assistant | 22 | 29 | 51 | 9,252 | 91 | 100% | 8.3 |
| Licensed Practical Nurse | 3 | 8 | 11 | 2,377 | 91 | 100% | 8.4 |
| Registered Nurse | 7 | 4 | 11 | 1,716 | 87 | 96% | 9.6 |
| Medication Aide/Technician | 2 | 1 | 3 | 1,005 | 90 | 99% | 8.4 |
| Dental Services Staff | 1 | 0 | 1 | 439 | 56 | 62% | 7.8 |
| Dietitian | 1 | 0 | 1 | 414 | 58 | 64% | 7.1 |
| Administrator | 1 | 0 | 1 | 389 | 54 | 59% | 7.2 |
| Other Dietary Services Staff | 1 | 0 | 1 | 368 | 50 | 55% | 7.4 |
| Nurse Practitioner | 1 | 0 | 1 | 328 | 47 | 52% | 7 |
| Clinical Nurse Specialist | 2 | 0 | 2 | 309 | 40 | 44% | 7.4 |
| RN Director of Nursing | 1 | 0 | 1 | 240 | 32 | 35% | 7.5 |
| Speech Language Pathologist | 0 | 2 | 2 | 101 | 47 | 52% | 2.1 |
| Occupational Therapy Aide | 0 | 1 | 1 | 64 | 13 | 14% | 4.9 |
| Physical Therapy Aide | 0 | 1 | 1 | 55 | 45 | 49% | 1.2 |
| Respiratory Therapy Technician | 0 | 1 | 1 | 26 | 18 | 20% | 1.5 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 19 | 3 | 3% | 6.4 |
| Physical Therapy Assistant | 0 | 1 | 1 | 14 | 13 | 14% | 1.1 |
| Qualified Social Worker | 0 | 1 | 1 | 2 | 2 | 2% | 1 |
| Medical Director | 0 | 1 | 1 | 1 | 1 | 1% | 1 |
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
46Residents 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.
6.2
40% better than Iowa averageIowa average: 10.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
15.2
30% 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
14.7%
22% better than Iowa averageIowa average: 18.8%
Percent of long-stay residents whose ability to move independently worsened
12.1%
39% better than Iowa averageIowa average: 19.7%
Percent of low risk long-stay residents who lose control of their bowels or bladder
18.7%
29% better than Iowa averageIowa average: 26.2%
Percent of long-stay residents experiencing one or more falls with major injury
1.2%
66% better than Iowa averageIowa average: 3.6%
Percent of long-stay high risk residents with pressure ulcers
0.0%
100% better than Iowa averageIowa average: 4.4%
Percent of long-stay residents with a urinary tract infection
2.6%
In line with Iowa averageIowa average: 2.5%
Percent of long-stay residents who lose too much weight
2.7%
45% better than Iowa averageIowa average: 5.0%
Percent of long-stay residents who have depressive symptoms
1.3%
67% better than Iowa averageIowa average: 3.9%
Percent of long-stay residents who received an antipsychotic medication
32.3%
70% worse than Iowa averageIowa average: 19.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
99.4%
5% better than Iowa averageIowa average: 94.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
97.7%
In line with Iowa averageIowa average: 95.3%
Number of hospitalizations per 1,000 long-stay resident days.
0.80
46% better than Iowa averageIowa average: 1.48
Number of outpatient emergency department visits per 1,000 long-stay resident days.
2.36
13% worse than Iowa averageIowa average: 2.09
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
75.0%
12% 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.
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)
37% lower than Iowa averageIowa average: $48K
194% more fines than Iowa averageIowa average: 1.7
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
100% fewer payment denials than Iowa averageIowa average: 0.5
Penalties are imposed by CMS for violations of federal nursing home regulations.
5 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Nov 6, 2023
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 30, 2023
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 23, 2023
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Oct 2, 2023Last updated: Jan 2026
| Friendship Home Association |
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. | Audubon | 46 | 85.9% | +14% | 4.44 | +2% | +3% | 5 | 15 | 3.8 | 1 | 45 | - | Andersen, Jessica | $5.1M | $2.1M | 40.8% | 165232 | ||||
| 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 | ||||
| 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 |
Historical financial and operational data for Friendship Home Association based on CMS SNF Cost Reports.
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