Heartland Care Center

Nursing Home, Assisted Living, Hospice Care & Skilled Nursing · Marcus, IA

CMS overall rating

604 East Fenton, Marcus, Ia 510350608 View map

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

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

Overview of Heartland Care Center

Heartland Care Center has operated a 38-bed clinical senior community on East Fenton Street in Marcus, Iowa, since 1994. Under the leadership of administrator Tim Nielsen, the facility maintains an average occupancy level near 76 percent. Accounts are processed through public networks like Medicare and state Medicaid alongside regular private billing, establishing an operational framework where temporary rehab stays are blended with long-term nursing placements.

Residents here receive an average of 4 hours and 44 minutes of direct, hands-on attention from the floor nursing roster each day. Registered nurses dedicate 1 hour and 50 minutes of this daily schedule to handle more complex clinical treatments, collaborating with licensed practical nurses and certified aides to oversee medication distribution and respiratory support.

The property features indoor dining spaces, a beauty salon, and routine spiritual programming, while the surrounding neighborhood registers a walkability score of 31 out of 100, showing that personal cars are necessary for typical regional errands.

Past health audits from state oversight agencies focused on routine documentation checks across care planning records, medication management lines, and standard infection control practices. The management uses these official state surveys to adjust internal clinical policies and maintain ongoing training requirements for the floor staff.

Prospective families can contact the main desk to check on open room availability, ask about dietary accommodations, or coordinate a morning to visit the campus.

Facility Direct Line (712) 376-2500

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

4h 44m per day

vs avg

2 of 6 metrics below state avg

Standout metric Registered Nurse (RN) is +150% 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 50m per day	▲ 150% 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.	32m per day	▼ 5% 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 35m per day	▲ 7% 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.	5m per day	▲ 147% 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.	1h 11m per day	▲ 137% State avg: 30m per day · National avg: 28m per day

Capacity and availability

162 days

38-bed community

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

31 years in operation

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

Walk Score: 31 / 100

Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.

About this community

Occupancy

Occupancy rate

76%

Similar to the Iowa average: 75.4%

Occupied beds

29 / 38

Average occupied beds in Iowa homes 51 beds

Facility TypeFree Standing Nursing Facility / Skilled Nursing Facility

StatusActive

IssuanceAugust 1, 1994

ExpirationAugust 1, 2026 Expires in 18 days

CountyCherokee

License Number180689

CMS Certification Number165397

Certification TypeFALSE

Heartland Care Center is administered by Tim Nielsen.

Accept Medicaid

Accept Medicare

Rehabilitation Services

24-Hour Staffing

Email heartland@midlands.net

Fax7123762512

Pets not allowed

Religious Services

Since 2020 · 6 years of data 39 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 November 29, 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.	39	27	This facility has 44% more total deficiencies than a typical Iowa assisted living residence (39 vs. IA avg 27).↑ 44% worse
Deficiencies per year Average deficiencies per year since 2020.	6.5	4.5	This facility has 44% more deficiencies per year than a typical Iowa assisted living residence (6.5 vs. IA avg 4.5).↑ 44% worse
Deficiencies per inspection Average deficiencies per inspection.	3	1.8	This facility has 67% more deficiencies per inspection than a typical Iowa assisted living residence (3 vs. IA avg 1.8).↑ 67% worse

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 November 29, 2025 plan of correction was accepted, certifying the facility in compliance effective November 25, 2025 with no deficiencies noted.
The September 25, 2025 complaint investigation substantiated failure to provide adequate respiratory care for Resident #3, causing low oxygen levels, increased lethargy, and hospitalization.
The April 10, 2025 annual inspection found seven deficiencies including incomplete care plans, improper psychotropic medication use, and failure to implement infection prevention and control measures.

Show Inspection Reports

Inspections since 2023

Total health inspections 4

State average N/A

Last Health inspection on Sep 2025

Total health citations

State average N/A

Citations per inspection

3.75

State average N/A

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

14 of 15 citations resulted from standard inspections; and 1 of 15 resulted from complaint investigations.

Breakdown of citation severity (last 3 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

0 serious citations State average: N/A

15 moderate citations State average: N/A

0 minor citations State average: N/A

Citations history (last 3 years)

Quality of Care moderate citation Sep 25, 2025

Corrected

Infection Control moderate citation Apr 10, 2025

Corrected

Pharmacy moderate citation Apr 10, 2025

Corrected

Care Planning moderate citation Apr 10, 2025

Corrected

Total staff 47

Employees 38

Contractors 9

Staff to resident ratio 1.42 : 1

0% compared with State average

State average ratio: 0 : 0

Avg staff/day 16

Average shift 7.5 hours

0% compared with State average

State average: 0 hours

Total staff hours (quarter) 10,967

Nursing staff breakdown

10.5 hours

7.5 hours

7.3 hours

Contractor staffing

222 contractor hours this quarter

Respiratory Therapy Technician: 4 Qualified Social Worker: 2 Occupational Therapy Assistant: 2 Medical Director: 1

Staff by category


Certified Nursing Assistant	14	0	14	4,487	92	100%	7.3
Registered Nurse	12	0	12	3,450	92	100%	10.5
Licensed Practical Nurse	5	0	5	1,159	90	98%	7.5
Other Dietary Services Staff	3	0	3	597	77	84%	5.7
Administrator	2	0	2	540	60	65%	6.6
Nurse Practitioner	2	0	2	512	63	68%	8
Respiratory Therapy Technician	0	4	4	178	62	67%	2.7
Occupational Therapy Assistant	0	2	2	29	4	4%	4.9
Qualified Social Worker	0	2	2	8	5	5%	1.6
Medical Director	0	1	1	7	2	2%	3.5

14 Certified Nursing Assistant

% of Days 100%

12 Registered Nurse

% of Days 100%

5 Licensed Practical Nurse

% of Days 98%

3 Other Dietary Services Staff

% of Days 84%

2 Administrator

% of Days 65%

2 Nurse Practitioner

% of Days 68%

4 Respiratory Therapy Technician

% of Days 67%

2 Occupational Therapy Assistant

% of Days 4%

2 Qualified Social Worker

% of Days 5%

1 Medical Director

% of Days 2%

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 8.9

13% better than State average

State average: 10.2

Functional decline score 20.3

6% better than State average

State average: 21.6

Long-stay resident measures

Average State avg: 3.3

Need for Help with Daily Activities Increased 15.7%

17% better than State average

State average: 18.8%

Walking Ability Worsened 23.3%

19% worse than State average

State average: 19.7%

Low Risk Residents with Bowel/Bladder Incontinence 22.0%

16% better than State average

State average: 26.2%

Falls with Major Injury 3.2%

12% better than State average

State average: 3.6%

High Risk Residents with Pressure Ulcers 0.0%

100% better than State average

State average: 4.4%

Urinary Tract Infection 0.0%

100% better than State average

State average: 2.5%

Lost Too Much Weight 2.4%

53% better than State average

State average: 5.0%

Depressive Symptoms 4.5%

16% worse than State average

State average: 3.9%

Antipsychotic Use 18.1%

5% better than State average

State average: 19.0%

Pneumococcal Vaccine 100.0%

6% better than State average

State average: 94.4%

Influenza Vaccine 84.0%

12% worse than State average

State average: 95.3%

Hospitalizations per 1,000 days 1.50

In line with State average

State average: 1.48

ED visits per 1,000 days 3.90

87% worse than State average

State average: 2.09

Short-stay resident measures

Significantly above average State avg: 2.6

Pneumococcal Vaccine 100.0%

18% better than State average

State average: 85.1%

Antipsychotic medication increase 1.5%

16% better than State average

State average: 1.8%

Influenza Vaccine 19.4%

73% worse than State average

State average: 73.3%

Re-hospitalized after SNF stay 17.9%

16% better than State average

State average: 21.3%

Emergency department visits 4.7%

64% better 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 69.7%

30% better than State average

State average: 53.7%

Successful return to home or community 47.3%

6% worse than State average

State average: 50.6%

Breakdown by payment type

Medicare

47% of new residents, usually for short-term rehab.

Typical stay 20 days

Private pay

30% of new residents, often for short stays.

Typical stay 9 months

Medicaid

23% of new residents, often for long-term daily care.

Typical stay 10 - 11 months

Total residents 33

Medicare

18.2% of residents

Medicaid

39.4% of residents

Private pay or other

42.4% 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 Heartland Care Center from 2012–2024, based on CMS SNF Cost Reports.

Key figures below are for fiscal year ending in 06/2024.

Occupancy Rate 71.1% ↑ 17.8pp vs 2023

Net Patient Income -$292.4K ↑ ~$240.7K vs 2023

Payroll Costs $2.8M ↑ ~$619.7K vs 2023

Operating Margin -8.1% ↑ 9.3pp vs 2023

Metric	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023	2024
Occupancy %	81.5%	78.4%	80.2%	75.4%	79.2%	72.1%	72.3%	70.1%	65.8%	58.9%	53.5%	53.2%	71.1%
Beds	51	51	51	51	51	51	51	51	51	59	59	59	38
Net Income	$8,872	$183,208	$279,317	$45,151	$84,918	-$92,615	-$46,535	-$95,219	$72,188	$147,308	-$399,271	-$473,049	-$218,902
Gross Revenue	$2,524,281	$2,535,777	$2,728,058	$2,499,675	$2,667,491	$2,568,407	$2,511,373	$2,581,988	$2,661,142	$2,772,639	$2,974,255	$3,345,826	$3,853,867
Operating Expenses	$2,394,256	$2,346,033	$2,379,740	$2,380,400	$2,530,471	$2,585,585	$2,493,061	$2,532,728	$2,664,747	$2,939,693	$3,228,836	$3,608,875	$3,925,923
Net Patient Income	-$13,455	$137,082	$258,380	$22,698	$62,280	-$115,639	-$65,845	-$112,025	-$125,079	-$292,393	-$473,303	-$533,180	-$292,436
Net Patient Revenue	$2,380,801	$2,483,115	$2,638,120	$2,403,098	$2,592,751	$2,469,946	$2,427,216	$2,420,703	$2,539,668	$2,647,300	$2,755,533	$3,075,695	$3,633,487
Payroll Costs	$1,587,423	$1,578,076	$1,587,146	$1,592,905	$1,668,097	$1,713,571	$1,655,441	$1,704,828	$1,772,798	$1,926,725	$1,969,806	$2,176,539	$2,796,252
Operating Margin %	-0.6%	5.5%	9.8%	0.9%	2.4%	-4.7%	-2.7%	-4.6%	-4.9%	-11.0%	-17.2%	-17.3%	-8.1%
Medicare %	3.6%	1.0%	2.0%	2.6%	1.6%	2.6%	1.4%	3.5%	2.4%	4.5%	4.3%	6.6%	5.6%
Medicaid %	27.9%	28.8%	26.8%	25.1%	23.7%	25.0%	28.9%	23.0%	31.3%	40.5%	39.3%	30.9%	45.1%
Private %	68.5%	70.2%	71.1%	72.3%	74.7%	72.4%	69.6%	73.5%	66.3%	55.0%	56.4%	62.5%	49.2%
Net Patient Revenue/Day	$157	$170	$177	$171	$175	$184	$180	$186	$207	$221	$239	$268	$368
Cost/Day	$157	$161	$159	$170	$171	$193	$185	$194	$217	$246	$280	$315	$397
Avg Length of Stay	155.1 days	349.4 days	349.5 days	283.9 days	225.9 days	761.1 days	296.9 days	244.3 days	255.0 days	208.6 days	218.2 days	190.8 days	162.0 days

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 06/2024.

Net patient revenue

$3.6M

Net patient income

-$292.4K

Nonprofit Other Nonprofit

Net patient revenue

$3.6M

Net patient income

-$292.4K

Other income

$73.5K

Payroll costs

$2.8M 77% of net patient revenue

Other operating costs

$1.1M

Total costs

$3.9M

TYPE OF STAY

Mostly short-term rehab stays

Most residents typically stay for a few weeks or months before returning home or moving on.

New residents most often arrive under Medicare (47% of admissions), and a typical Medicare stay runs around 20 days.

Coverage residents most often arrive under.

Medicare 47%

Private pay 30%

Medicaid 23%

Coverage residents most often leave under.

Medicare 23%

Private pay 62%

Medicaid 15%

0.0 miles from city center Estimated distance in miles from Marcus's city center to Heartland 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	-
Heartland Care Center	NH AL HOS SNF	Marcus	-	38	-	31	-

Nursing Home Explorer

Is Heartland Care Center in a walkable area?

Heartland Care Center has a walk score of 31. Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.

What is the license number of Heartland Care Center?

According to IA state health department records, Heartland Care Center's license number is 180689.

When does Heartland Care Center's license expire?

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

What is the occupancy rate at Heartland Care Center?

Heartland Care Center's occupancy is 76%.

Are pets allowed at Heartland Care Center?

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

What is the best email address for Heartland Care Center?

The team at Heartland Care Center can be reached at heartland@midlands.net.

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

Heartland Care Center is registered as a non-profit in IA.

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Heartland Care Center

Overview of Heartland Care Center

Quality ratings

Staffing hours breakdown

Capacity and availability

About this community

Occupancy

License Details

Ownership & Operating Entity

Payment & Insurance

Therapy & Rehabilitation

Staffing & Medical

Contact Information

Additional Policies & Features

Amenities & Lifestyle

Contact Heartland 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 2023

Breakdown of citation severity (last 3 years)

Citations history (last 3 years)

Staffing Data

Nursing staff breakdown

Registered Nurse

Licensed Practical Nurse

Certified Nursing Assistant

Contractor staffing

Staff by category

14 Certified Nursing Assistant

12 Registered Nurse

5 Licensed Practical Nurse

3 Other Dietary Services Staff

2 Administrator

2 Nurse Practitioner

4 Respiratory Therapy Technician

2 Occupational Therapy Assistant

2 Qualified Social Worker

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 Heartland Care Center

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