Madrid Home for the Aging

Nursing Home, Assisted Living, Independent Living, Memory Care & Skilled Nursing · Madrid, IA

CMS overall rating

613 West North Street, Madrid, Ia 501561059 View map

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Madrid Home for the Aging accepts Medicare, Medicaid, and private pay.

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Madrid Home for the Aging accepts Medicare, Medicaid, and private pay.

Overview of Madrid Home for the Aging

Madrid Home for the Aging is a 64-bed non-profit skilled nursing community in Madrid, Boone County, Iowa. Occupancy at 81 percent exceeds Iowa’s 75.4 percent average. Operated by Western Home Services Inc, the facility offers skilled nursing, memory care, and rehabilitation along with independent living and assisted living services. Medicare, Medicaid, and private pay accepted.

Over six years on file, the facility averaged 4.2 deficiencies annually, essentially at the Iowa average of 4.4, with no immediate jeopardy findings, fines, or enforcement actions. Medication management is the clearest recurring theme in the record: errors were cited in the 2021 and 2023 annual surveys, an August 2025 complaint was substantiated for missing fentanyl patches and inaccurate narcotic counts affecting both residents reviewed, and narcotic destruction procedures were also cited in 2021. The March 2023 annual survey cited medication errors in all four residents reviewed for that area. Care planning gaps and food safety deficiencies have each appeared in multiple surveys as well. The CMS staffing sub-rating reflects case-mix adjusted hours 19.1 percent below Iowa’s average, meaning the resident acuity outpaces what the staffing hours deliver relative to peers, the one metric consistently below average in an otherwise mid-range profile. Quality Measures run 15.6 percent above Iowa average which is a positive clinical outcome signal.

Madrid Home for the Aging fits Boone County residents wanting skilled nursing, memory support, or post-acute rehabilitation within a non-profit continuum that extends from independent and assisted living through skilled care.

Facility Direct Line (515) 795-3007

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 21m per day

vs avg

4 of 6 metrics below state avg

Standout metric Physical Therapist is +296% 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.	30m per day	▼ 32% 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.	28m per day	▼ 17% 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 32m per day	■ Avg 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 0m per day	▼ 10% 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.	8m per day	▲ 296% 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.	24m per day	▼ 21% State avg: 30m per day · National avg: 28m per day

Capacity and availability

194 days

64-bed community

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

Walk Score: 52 / 100

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

About this community

Occupancy

Occupancy rate

81%

Higher than the Iowa average: 75.4%

Occupied beds

52 / 64

Average occupied beds in Iowa homes 51 beds

Facility TypeFree Standing Nursing Facility / Skilled Nursing Facility

StatusActive

CountyBoone

License Number80797

CMS Certification Number165118

Certification TypeFALSE

Madrid Home for the Aging is administered by Rick Colby.

Rehabilitation Services

Memory Support

Email rick.colby@westernhome.org

Fax5157952138

Touring HoursMonday-Friday: 8am-5pm, Saturday-Sunday: 9am-5pm

Since 2020 · 6 years of data 47 deficiencies 18 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 September 25, 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.	47	27	This facility has 74% more total deficiencies than a typical Iowa assisted living residence (47 vs. IA avg 27).↑ 74% worse
Deficiencies per year Average deficiencies per year since 2020.	7.8	4.5	This facility has 73% more deficiencies per year than a typical Iowa assisted living residence (7.8 vs. IA avg 4.5).↑ 73% worse
Deficiencies per inspection Average deficiencies per inspection.	2.6	1.8	This facility has 44% more deficiencies per inspection than a typical Iowa assisted living residence (2.6 vs. IA avg 1.8).↑ 44% 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.	18	15	This facility has had 20% more total inspections than the Iowa average (18 vs. IA avg 15). More inspections can mean more regulatory scrutiny rather than worse care.↑ 20% more

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

The most recent complaint investigation on September 22, 2025 found the facility in substantial compliance with no deficiencies.
The August 5, 2025 complaint investigation substantiated medication errors and narcotic management failures affecting 2 of 2 residents reviewed.
The March 20, 2025 annual inspection cited five deficiencies including medication administration errors, inadequate psychotropic medication management, and food safety violations.

Show Inspection Reports

Inspections since 2022

Total health inspections 4

State average N/A

Last Health inspection on Mar 2025

Total health citations

State average N/A

Citations per inspection

State average N/A

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

8 of 16 citations resulted from standard inspections; 1 of 16 resulted from complaint investigations; and 7 of 16 came from combined inspections (standard and complaint).

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

0 serious citations State average: N/A

16 moderate citations State average: N/A

0 minor citations State average: N/A

Citations history (last 4 years)

Nutrition moderate citation Mar 20, 2025

Corrected

Pharmacy moderate citation Mar 20, 2025

Corrected

Quality of Care moderate citation Mar 20, 2025

Corrected

Care Planning moderate citation Mar 20, 2025

Corrected

Total staff 114

Employees 85

Contractors 29

Staff to resident ratio 2.19 : 1

0% compared with State average

State average ratio: 0 : 0

Avg staff/day 32

Average shift 7.8 hours

0% compared with State average

State average: 0 hours

Total staff hours (quarter) 22,944

Nursing staff breakdown

8.8 hours

9.6 hours

7.8 hours

Contractor staffing

1,724 contractor hours this quarter

Certified Nursing Assistant: 10 Registered Nurse: 10 Licensed Practical Nurse: 4 Dental Services Staff: 1 Administrator: 1 Occupational Therapy Assistant: 1 Occupational Therapy Aide: 1 Medical Director: 1

Staff by category


Certified Nursing Assistant	24	10	34	7,953	92	100%	7.8
Medication Aide/Technician	17	0	17	6,142	92	100%	8.6
Licensed Practical Nurse	7	4	11	2,077	92	100%	9.6
Registered Nurse	6	10	16	1,936	91	99%	8.8
Respiratory Therapy Technician	6	0	6	734	69	75%	6.2
Dental Services Staff	1	1	2	637	74	80%	5.6
Nurse Practitioner	2	0	2	528	66	72%	8
RN Director of Nursing	1	0	1	528	66	72%	8
Administrator	0	1	1	512	64	70%	8
Dietitian	1	0	1	488	61	66%	8
Speech Language Pathologist	7	0	7	467	72	78%	5.4
Clinical Nurse Specialist	1	0	1	296	37	40%	8
Physical Therapy Aide	6	0	6	245	36	39%	6.1
Qualified Social Worker	1	0	1	219	49	53%	4.5
Physical Therapy Assistant	3	0	3	69	22	24%	3
Occupational Therapy Aide	0	1	1	52	13	14%	4
Medical Director	0	1	1	30	3	3%	10
Occupational Therapy Assistant	0	1	1	24	3	3%	8
Other Dietary Services Staff	2	0	2	8	1	1%	4.2

34 Certified Nursing Assistant

% of Days 100%

17 Medication Aide/Technician

% of Days 100%

11 Licensed Practical Nurse

% of Days 100%

16 Registered Nurse

% of Days 99%

6 Respiratory Therapy Technician

% of Days 75%

2 Dental Services Staff

% of Days 80%

2 Nurse Practitioner

% of Days 72%

1 RN Director of Nursing

% of Days 72%

1 Administrator

% of Days 70%

1 Dietitian

% of Days 66%

7 Speech Language Pathologist

% of Days 78%

1 Clinical Nurse Specialist

% of Days 40%

6 Physical Therapy Aide

% of Days 39%

1 Qualified Social Worker

% of Days 53%

3 Physical Therapy Assistant

% of Days 24%

1 Occupational Therapy Aide

% of Days 14%

1 Medical Director

% of Days 3%

1 Occupational Therapy Assistant

% of Days 3%

2 Other Dietary Services Staff

% of Days 1%

View All Staffing Data

Total fines amount $0

100% lower than State average

State average: $48K

Number of fines 0

100% fewer fines than State average

State average: 1.7

Payment Denials 1

88% more payment denials than State average

State average: 0.5

Fines amount comparison

This facility $0

State average $48K

Penalty History

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

1 penalty in the past 3 years

Jun 6, 2024 · 12 days

Payment Denial Jun 6, 2024

12 days

Last updated: Jan 2026

High-risk clinical events score 14.1

38% worse than State average

State average: 10.2

Functional decline score 29.0

34% worse than State average

State average: 21.6

Long-stay resident measures

Average State avg: 3.3

Need for Help with Daily Activities Increased 32.3%

72% worse than State average

State average: 18.8%

Walking Ability Worsened 25.2%

28% worse than State average

State average: 19.7%

Low Risk Residents with Bowel/Bladder Incontinence 29.5%

12% worse than State average

State average: 26.2%

Falls with Major Injury 2.5%

30% better than State average

State average: 3.6%

High Risk Residents with Pressure Ulcers 2.9%

34% 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 7.8%

56% worse than State average

State average: 5.0%

Depressive Symptoms 1.7%

56% better than State average

State average: 3.9%

Antipsychotic Use 16.7%

12% better than State average

State average: 19.0%

Pneumococcal Vaccine 89.9%

5% worse than State average

State average: 94.4%

Influenza Vaccine 96.1%

In line with State average

State average: 95.3%

Hospitalizations per 1,000 days 2.10

42% worse than State average

State average: 1.48

ED visits per 1,000 days 0.97

54% better than State average

State average: 2.09

Short-stay resident measures

Significantly above average State avg: 2.6

Pneumococcal Vaccine 46.2%

46% worse than State average

State average: 85.1%

Antipsychotic medication increase 0.0%

100% better than State average

State average: 1.8%

Influenza Vaccine 40.0%

45% worse than State average

State average: 73.3%

Re-hospitalized after SNF stay 23.4%

10% worse than State average

State average: 21.3%

Emergency department visits 7.2%

45% 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 77.8%

45% better than State average

State average: 53.7%

Successful return to home or community 53.5%

6% better than State average

State average: 50.6%

Breakdown by payment type

Medicare

40% of new residents, usually for short-term rehab.

Typical stay 17 days

Private pay

13% of new residents, often for short stays.

Typical stay 1 - 2 years

Medicaid

48% of new residents, often for long-term daily care.

Typical stay 7 - 8 months

Total residents 52

Medicare

9.6% of residents

Medicaid

65.4% of residents

Private pay or other

25% of residents

Programs & Services

Residents Group

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

CCRC

Part of a Continuing Care Retirement Community offering multiple care levels

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 Madrid Home for the Aging from 2011–2023, based on CMS SNF Cost Reports.

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

Occupancy Rate 48.2% ↓ 6.3pp vs 2022

Net Patient Income -$1.6M ↑ ~$1.9M vs 2022

Payroll Costs $2.8M ↓ ~$1.7M vs 2022

Operating Margin -31.1% ↑ 12.6pp vs 2022

Metric	2011	2012	2013	2014	2015	2016	2017	2018	2019	2020	2021	2022	2023
Occupancy %	72.1%	69.7%	65.6%	71.0%	65.5%	71.4%	97.7%	114.0%	82.8%	73.9%	65.2%	54.5%	48.2%
Beds	155	155	155	155	155	304	304	249	88	88	88	88	88
Net Income	-$613,337	-$848,227	-$573,468	$45,709	-$546,832	-$947,251	-$705,104	-$682,467	$11,830,021	$1,282,218	-$1,009,447	-$2,444,133	-$1,529,842
Gross Revenue	$7,717,405	$7,888,754	$8,217,208	$8,965,191	$8,661,466	$11,310,045	$11,126,009	$11,102,200	$11,375,289	$10,074,232	$9,316,048	$8,484,131	$5,562,846
Operating Expenses	$8,106,826	$8,015,929	$8,014,124	$8,381,806	$8,671,723	$11,916,179	$11,554,650	$11,204,398	$11,030,025	$11,232,495	$11,417,134	$11,218,204	$6,579,808
Net Patient Income	-$649,226	-$600,919	-$429,934	$86,496	-$546,874	-$1,257,900	-$1,100,327	-$918,628	-$627,743	-$1,825,533	-$2,910,108	-$3,415,945	-$1,562,272
Net Patient Revenue	$7,457,600	$7,415,010	$7,584,190	$8,468,302	$8,124,849	$10,658,279	$10,454,323	$10,285,770	$10,402,282	$9,406,962	$8,507,026	$7,802,259	$5,017,536
Payroll Costs	$5,925,629	$5,893,614	$5,935,189	$6,146,515	$6,444,132	$7,446,367	$6,809,591	$6,152,449	$5,763,065	$5,722,297	$4,922,220	$4,467,712	$2,805,632
Operating Margin %	-8.7%	-8.1%	-5.7%	1.0%	-6.7%	-11.8%	-10.5%	-8.9%	-6.0%	-19.4%	-34.2%	-43.8%	-31.1%
Medicare %	5.6%	5.1%	7.1%	6.0%	6.5%	2.7%	1.6%	1.6%	4.8%	5.3%	6.4%	3.8%	3.6%
Medicaid %	26.8%	41.5%	38.1%	37.2%	37.6%	18.6%	13.3%	14.5%	49.9%	47.1%	44.1%	45.8%	56.3%
Private %	67.6%	53.4%	54.8%	56.8%	55.9%	78.7%	85.0%	83.9%	45.2%	47.5%	49.5%	50.4%	40.1%
Net Patient Revenue/Day	$186	$188	$204	$211	$219	$134	$96	$99	$362	$395	$406	$446	$324
Cost/Day	$203	$203	$216	$209	$234	$150	$107	$108	$384	$472	$545	$641	$425
Avg Length of Stay	55.5 days	66.4 days	66.7 days	66.6 days	61.1 days	182.0 days	178.0 days	184.4 days	175.2 days	112.3 days	213.6 days	176.9 days	193.5 days

Finances and operations

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

Net patient revenue

$5.0M

Net patient income

-$1.6M

Nonprofit Nonprofit Corporation

Net patient revenue

$5.0M

Net patient income

-$1.6M

Other income

$112.1K

Payroll costs

$2.8M 55.9% of net patient revenue

Other operating costs

$3.8M

Total costs

$6.6M

TYPE OF STAY

Mostly long-term care residents

Most residents stay for extended periods and receive ongoing daily care.

New residents most often arrive under Medicaid (48% of admissions), and a typical Medicaid stay runs around 7 - 8 months.

Coverage residents most often arrive under.

Medicare 40%

Private pay 13%

Medicaid 48%

Coverage residents most often leave under.

Medicare 26%

Private pay 31%

Medicaid 43%

0.0 miles from city center Estimated distance in miles from Madrid's city center to Madrid Home for the Aging's address, calculated via Google Maps.

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


Friendship Village	NH AL IL MC SNF	Waterloo	-	72	-	52	2 Bed / 3 Bed
Mount Carmel Bluffs	NH IL MC	Dubuque (South Switch Junction)	-	60	-	2	1 Bed / 2 Bed
Calvin Community	NH AL IL MC SNF	Des Moines (Beaverdale)	-	59	-	61	1 Bed
Thornton Heights Assisted Living	NH AL	Lansing (Main Street)	-	26	-	14	1 Bed / 2 Bed
Madrid Home for the Aging	NH AL IL MC SNF	Madrid	-	64	-	52	-

Nursing Home Explorer

Is Madrid Home for the Aging in a walkable area?

Madrid Home for the Aging has a walk score of 52. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.

What is the license number of Madrid Home for the Aging?

According to IA state health department records, Madrid Home for the Aging's license number is 80797.

What is the occupancy rate at Madrid Home for the Aging?

Madrid Home for the Aging's occupancy is 81%.

What is the best email address for Madrid Home for the Aging?

The team at Madrid Home for the Aging can be reached at rick.colby@westernhome.org.

Does Madrid Home for the Aging operate as a for-profit or non-profit?

Madrid Home for the Aging is registered as a non-profit in IA.

Who is the administrator of Madrid Home for the Aging?

Rick Colby is the administrator of Madrid Home for the Aging.

How many beds does Madrid Home for the Aging have?

Madrid Home for the Aging has 64 beds.

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Madrid Home for the Aging

Overview of Madrid Home for the Aging

Quality ratings

Staffing hours breakdown

Capacity and availability

About this community

Occupancy

License Details

Ownership & Operating Entity

Therapy & Rehabilitation

Additional Services

Contact Information

Amenities & Lifestyle

Contact Madrid Home for the Aging

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

34 Certified Nursing Assistant

17 Medication Aide/Technician

11 Licensed Practical Nurse

16 Registered Nurse

6 Respiratory Therapy Technician

2 Dental Services Staff

2 Nurse Practitioner

1 RN Director of Nursing

1 Administrator

1 Dietitian

7 Speech Language Pathologist

1 Clinical Nurse Specialist

6 Physical Therapy Aide

1 Qualified Social Worker

3 Physical Therapy Assistant

1 Occupational Therapy Aide

1 Medical Director

1 Occupational Therapy Assistant

2 Other Dietary Services Staff

Penalties and fines

Fines amount comparison

Fines amount comparison

Penalty History

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

CCRC

Active Resident Council

Financial Trends

Financial Performance

Payroll & Labor Costs

Payer Mix (percentage)

Finances and operations

Who this home usually serves

Mostly long-term care residents

Admissions

Discharges

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