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ACCURA HEALTHCARE OF CRESTON LLC

Creston, IA · Union County · For profit - Limited Liability company · 31 certified beds

📍 1000 East Howard, Creston, IA 50801  ·  📞 (641) 782-5012

Medicare ID: 165275  ·  Last Medicare inspection: Oct 30, 2025

Overall Safety Score
58
out of 100
Fair
Component Scores
34
Inspection
80
Staffing
48
Enforcement
90
Complaints
30
Quality
📋 Last inspected: October 30, 2025 📦 CMS data as of: May 2026

Score Breakdown

Inspection
34
Staffing
80
Enforcement
48
Complaints
90
Quality Outcomes
30

What the numbers mean

ACCURA HEALTHCARE OF CRESTON LLC scored 58 out of 100 — 8 points below the state average of 66.

📋 Inspections: 33 citations over the last 36 months — 14 more than the state average (19). 2 were rated serious (G+) — inspectors found actual or potential harm to residents. 1 finding recurred across inspection cycles — indicating a problem that was not fixed.

👥 Staffing: Staffing is within an acceptable range but not among the highest-performing facilities. Ask about nurse coverage on evenings, nights, and weekends when you visit.

⚠️ Penalties & enforcement: CMS has recorded 2 enforcement actions totaling $16,801 against this facility. Penalties are only issued after a facility fails two levels of regulatory review — meaning this is a serious escalation beyond a standard citation. Ask for a written explanation of every fine and what corrective actions were taken.

💬 Complaints: Low complaint activity — few formal complaints from residents or families have triggered inspections. Ask if there is a family council you can speak with.

🚨 Resident quality outcomes: Multiple quality measures are well below national benchmarks — residents may experience higher rates of falls, pain, or hospitalizations than at comparable facilities. Ask management about their improvement plans.

What inspectors found (last 3 surveys)

33
Total citations
State avg: 18.8
2
Serious (G+)
State avg: 1.3
1
Repeat findings

Top concern areas

33

⚖ Penalties & Enforcement

Federal civil monetary penalties (CMPs) are only issued after a facility has failed two levels of regulatory review — meaning problems were found on inspection and the facility could not rebut the findings. This is a serious escalation beyond a standard citation.

$16,801
Total federal fines
2
Enforcement actions

⚠ Each enforcement action required CMS to make a separate non-compliance determination — meaning this facility failed two levels of regulatory review before any fine was issued. Ask management specifically what violations triggered these fines and what corrective steps were taken.

📋 Enforcement Context Analysis
📊
Enforcement score: 48/100 — 27 points below the state average of 75/100 — worse than most comparable facilities. A score below 70 indicates a meaningful enforcement history that warrants direct conversation with facility management.
Serious Citations That May Have Triggered Enforcement
Food frequency & variety — Immediate danger · Jul 11, 2024
Food sanitation & safety — No harm, could worsen · Jul 11, 2024
Therapeutic diets — No harm, could worsen · Jul 11, 2024

📅 Per-action enforcement records (date, fine amount, and penalty type for each individual action) are sourced from a separate CMS enforcement dataset and will be added in a future data update.

🩹

Resident Wellbeing — Key Indicators

These are the measures families ask about most. They come from CMS clinical assessments of every resident — not just inspection reports. Stars (★) count toward the official CMS quality star rating.

Antipsychotic medication use
4.1% lower is better
Share of long-stay residents given antipsychotic drugs. High use can signal residents being over-medicated rather than receiving attentive care.
Flu vaccination rate
28.7% higher is better
Share of long-stay residents vaccinated against the flu this season. Higher is better.

Source: CMS MDS Quality Measures & Medicare claims data. Scores shown are the most recent 4-quarter averages for long-stay residents.

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🟡
Overall Assessment — Use Caution  ·  58/100
This facility has mixed results. Some areas need a closer look before you decide.
What to do next: Proceed carefully. Ask management directly about the specific concerns listed in this report.
Federal Penalty: $16,801 (2 separate actions)
CMS has imposed civil monetary penalties totaling $16,801 against this facility. Penalties are only levied after a separate non-compliance determination — meaning a facility must fail two levels of regulatory review before a fine is issued. Ask management specifically what violations triggered these fines and what corrective actions were taken.

What this facility's data shows

📋 Inspections
Inspection record is well below average. Multiple or serious deficiencies found.
👥 Staffing
Staffing levels are adequate — RN hours and nurse-to-resident ratios meet or exceed benchmarks.
⚖ Penalties
Facility has received federal fines or enforcement sanctions. Requires direct explanation from management.
💬 Complaints
Complaint activity is low — few formal complaints filed by residents or families.
Multiple quality measures are below national benchmarks. Ask management directly about resident care practices.
⚠ Serious Findings on Record: 2 citation(s) where inspectors found actual harm or immediate jeopardy to residents. See Section D for the full details and ask management how each was resolved.
Score breakdown — the numbers behind this assessment
👥 Staffing 80
What it measures RN hours per resident per day, total nurse hours, and RN turnover rate.
💡 Understaffing is the strongest single predictor of poor inspection outcomes.
📋 Inspection 34
What it measures Number, severity (A–L), and scope of deficiencies found. Repeat findings carry extra weight.
💡 Every citation in Section D feeds directly into this score.
⚖ Penalties 48
What it measures Whether CMS escalated from a deficiency citation to actual financial or operational sanctions.
💡 A penalty means the facility already failed a second level of regulatory review.
💬 Complaints 90
What it measures Volume of complaint-triggered inspections and the share that were substantiated.
💡 Complaint surveys are unannounced — they often surface issues annual surveys miss.
🎯 Quality outcomes 30
What it measures Resident outcome measures: falls, pressure ulcers, antipsychotic use, weight loss, hospitalizations.
💡 Reflects the lived experience of residents beyond what inspectors observe.

Each pillar scores 0–100 and is combined into the overall score. A strong overall can mask a weak pillar — compare all four and see how they stack against the state average in Section B.

🏗 How This Facility Compares to IA State Averages

Comparing a facility to others in the same state puts its score in context. A facility might have 8 citations and that could be above average in one state and below in another. Green means this facility is doing better than its peers; red means it's falling short.

Metric This facility IA avg vs. State
Overall score
The combined Senior Care Report Card score out of 100.
58 66 ▼ Worse than state avg
Inspection score
How well the facility performs on standard health surveys.
34 53 ▼ Worse than state avg
Staffing score
RN hours, total nurse hours, and staff turnover from CMS payroll data.
80 60 ▲ Better than state avg
Penalty score
Fines, payment denials, and enforcement actions on file.
48 75 ▼ Worse than state avg
Complaint score
Volume of complaint surveys and substantiated complaints.
90 88 ▲ Better than state avg
Quality score
Resident clinical outcomes vs national benchmarks: falls, antipsychotics, pain, vaccination, hospitalizations.
30 57 ▼ Worse than state avg
Citations (3 yrs)
Total number of deficiencies cited in the last 36 months.
33 18.8 ▼ Worse than state avg
Serious citations
Citations rated severity G or higher (actual harm or immediate jeopardy).
2 1.3 ▼ Worse than state avg

📅 Inspection Timeline

State health inspectors visit nursing homes on a regular cycle — typically every 12 to 15 months — and document every deficiency they find. The timeline below shows the date and scale of each inspection visit over the past several years. A pattern of worsening surveys is a red flag even if the most recent visit looks clean.

2025-10-30
2 citations
2024-07-11
25 citations  (1 serious)
2024-05-16
1 citations
2024-03-21
1 citations
2024-02-01
4 citations  (1 serious)

Bar length proportional to citation count. Red = serious findings (severity G+). Orange = elevated. Green = low.

📄 Full Citation Record

Every time state inspectors visit a nursing home, they write up anything that doesn’t meet federal standards. Each write-up is called a citation.

Each citation shows what the problem was and how serious it was, using a color-coded badge:

Green — No residents harmed Yellow — Risk of harm, no injury Orange — A resident was harmed Red — Life or safety in danger

A Repeat tag means the same problem appeared in a previous inspection — it was not fully corrected the first time. Citations shown cover the last two years.

Survey: 2025-10-30 2 citation(s)
F0726 No harm, could worsen
Nurse aide competency
F0658 No harm, could worsen
Services meet professional standards
Survey: 2024-07-11 25 citation(s) — 1 serious
F0805 Immediate danger
Food frequency & variety
F0812 No harm, could worsen
Food sanitation & safety
F0804 No harm, could worsen
Therapeutic diets
F0580 No harm, could worsen
Notification of change in condition
F0941 No harm, could worsen
F0941
F0880 No harm, could worsen
Infection prevention & control
F0945 No harm, could worsen
F0945
F0949 No harm, could worsen
F0949
F0944 No harm, could worsen
F0944
F0657 No harm, could worsen
Care plan timing & review
F0946 No harm, could worsen
Staff training requirements
F0940 No harm, could worsen
F0940
F0942 No harm, could worsen
F0942
F0641 No harm, could worsen
Accuracy of resident assessment
F0644 No harm, could worsen
Accuracy & completeness of assessments
F0637 No harm, could worsen
F0637
F0656 No harm, could worsen
Comprehensive care plan
F0684 No harm, could worsen
Quality of care
F0689 No harm, could worsen
Accident & hazard prevention
F0582 No harm, could worsen
F0582
F0690 No harm, could worsen
Bowel & bladder care
F0695 No harm, could worsen
Respiratory care
F0759 No harm, could worsen
Medication error rate control
F0838 No harm
Facility assessment update
F0843 No harm
F0843
Survey: 2024-05-16 1 citation(s)
F0657 No harm, could worsen
Care plan timing & review
🩹

How Are Residents Doing?

Inspections tell you whether a facility followed the rules. These measures tell you how residents actually fared — whether they fell, experienced pain, lost weight, or were over-medicated. CMS collects this data through regular clinical assessments that nurses complete for every resident. Unlike inspections, which happen once a year, these assessments happen continuously.

⚠ Attention: 2 of 7 star-rated measures show rates above what\'s typically considered acceptable. This means the facility may be struggling in areas that directly affect residents\' day-to-day wellbeing — not just its inspection record.

How to read these cards: Each card shows one measure. Lower percentages are better for most (e.g. fewer falls), but higher is better for vaccination rates and community return. ★ Star rating marks measures CMS uses in its official quality star rating.

Long Stay Residents — 2025Q1-2025Q4
★ Star rating
Daily activity decline
34.4% lower is better
Share of long-stay residents who lost the ability to dress, eat, or move around independently over the past year. Rising rates can signal that residents aren't receiving enough physical therapy or that staffing is too thin to support mobility.
★ Star rating
Urinary tract infections
1.5% lower is better
Share of long-stay residents who had a urinary tract infection. While some UTIs are unavoidable, high rates can point to poor hydration practices, catheter hygiene, or rushed care routines.
★ Star rating
Antipsychotic medication use
4.1% lower is better
Share of long-stay residents given antipsychotic drugs. These medications carry serious risks for older adults. High use often signals that a facility is medicating residents to manage behavior instead of addressing needs through attentive, person-centered care.
★ Star rating
Percentage of long-stay residents experiencing on…
2.1% lower is better
Percentage of long-stay residents experiencing one or more falls with major injury
★ Star rating
Flu vaccination rate
28.7% higher is better
Share of long-stay residents vaccinated against the flu. Nursing homes are high-risk environments for flu outbreaks. Anything below 90% warrants a question about the facility's vaccination policy.
★ Star rating
Percentage of long-stay residents with pressure u…
4.5% lower is better
Percentage of long-stay residents with pressure ulcers
★ Star rating
Percentage of long-stay residents who received an…
21.3% lower is better
Percentage of long-stay residents who received an antipsychotic medication
Physical restraints used
10.3% lower is better
Share of long-stay residents physically restrained (lap belts, side rails). Federal regulations require restraints to be a last resort. High use is a red flag for understaffed facilities cutting corners on behavioral care.
Signs of depression
1.2% lower is better
Share of long-stay residents showing symptoms of depression. Social isolation, lack of meaningful activities, and poor staffing all contribute. This measure reflects the emotional quality of life inside the facility.
Unexplained weight loss
0.0% lower is better
Share of long-stay residents who lost 5% or more of body weight unexpectedly. This can indicate inadequate nutrition, difficulty eating without assistance, or unaddressed medical issues.
Percentage of long-stay residents assessed and ap…
90.7% lower is better
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine
Pneumonia vaccination rate
21.8% higher is better
Share of long-stay residents vaccinated against pneumococcal pneumonia — one of the leading causes of death in older adults. Higher is better.
Percentage of long-stay residents assessed and ap…
96.2% lower is better
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine
Percentage of long-stay residents with new or wor…
38.5% lower is better
Percentage of long-stay residents with new or worsened bowel or bladder incontinence
Short Stay Residents — 2025Q1-2025Q4
Percentage of short-stay residents assessed and a…
78.6% lower is better
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine

Source: CMS MDS Quality Measures (2025Q1-2025Q4). Collected via standardized clinical assessments — not inspector visits.

🏥

Hospitalization & ER Visits

These numbers come directly from Medicare claims — real billing records of every time a resident was hospitalized or sent to the emergency room. They\'re among the most objective measures of care quality because they can\'t be influenced by how a facility writes up an assessment. The adjusted score is the most meaningful number — it\'s been corrected to account for how sick residents were, so a facility treating frailer patients isn\'t unfairly penalized.

What to look for: An adjusted score significantly above the expected score means this facility hospitalizes residents more often than peer facilities with similar patient populations — that gap is worth asking about directly.

Long Stay Residents — 20241001-20250930
★ Star rating
Number of hospitalizations per 1000 long-stay res…
0.5% risk-adjusted rate
Actual: 0.3% Expected: 1.2%
About the same as similar facilities
Number of hospitalizations per 1000 long-stay resident days
★ Star rating
Number of outpatient emergency department visits …
1.5% risk-adjusted rate
Actual: 1.2% Expected: 1.3%
About the same as similar facilities
Number of outpatient emergency department visits per 1000 long-stay resident days

Source: CMS Medicare claims data. Scores are risk-adjusted — they account for how ill residents were when admitted so facilities treating sicker populations aren\'t penalized for it.

💬 Questions to Ask Before Touring

These questions are generated specifically from this facility's score profile and citation history — not a generic checklist. A facility's willingness to answer them openly, and the quality of their answers, is itself an important signal. Bring this list when you tour or call.

  1. Federal inspectors found 2 citations rated as causing actual harm or immediate jeopardy in the public record. Walk us through each incident: what happened, who was affected, and what specific policy or staffing changes have been put in place since?
  2. What is the average response time when a resident presses a call button during the night shift?
  3. This facility has a significant CMS enforcement history. Can you identify each action in the past three years, what it was for, and what systemic — not just procedural — changes were made to prevent recurrence?
  4. Resident quality measures for this facility are well below national benchmarks. What specific initiatives — with measurable targets — are in place to address fall rates, antipsychotic medication use, and pressure wound prevention?
  5. 2 citations in the public record were rated as causing actual harm to a resident. Can you describe what occurred in each case and what specific safeguards are now in place?
  6. Can we speak privately with two or three current residents or their families?

👪 Family Decision Guide

This guide translates this facility's data into practical next steps for families. It is not a recommendation for or against placement — it is a structured framework for the conversations you need to have before making a decision.

✓ Positives to confirm

  • Staffing levels appear adequate — ask about weekend and night coverage
  • Low complaint activity — ask if there is a family council you can speak with
  • No pattern of repeat violations detected

⚠ Areas to probe

  • Inspection score is low — ask for the most recent state survey results
  • Penalty history present — ask what enforcement actions occurred and outcomes
  • Serious-harm citations on record — require a written explanation of corrective action
  • Always speak with at least two current residents or family members independently

📈 Score History

The score is recalculated every time CMS releases updated data (typically monthly). A consistent downward trend is more concerning than a single low score. An improving trend after a period of poor performance may indicate management changes are taking effect. Your subscription will alert you whenever the score changes materially.

2026-05-07
58 — Fair

🏢 Ownership & Operators

Ownership matters because large corporate chains sometimes prioritize cost controls over care quality. CMS requires every nursing home to disclose its owners, operators, and managing employees. Frequent ownership changes can disrupt staffing and operations — which is why we flag facilities that changed ownership in the past 12 months.

🔗 ROHRIG, RICKY operates 1 facility across .
Owner / Operator Role Ownership % Effective
ROHRIG, RICKY Individual 1970-01-01
KLEINSASSER, MEGAN Individual 1970-01-01
LENEAVE, TED Individual 1970-01-01
ACCURA MANAGEMENT CONSULTING SERVICES LLC Organization 1970-01-01
MILLER, DANIEL Individual 1970-01-01
WILLIAMS, CARA Individual 1970-01-01
TOTI, LISA Individual 1970-01-01
GLASER, KRISTOPHER Individual 1970-01-01
ALLEN, BRADY Individual 1970-01-01

🔔 Monthly tracking is now free

We check CMS data monthly. Use the tracking form above and we will email you when new citations appear, scores change, or enforcement actions are added.

📋
Monthly report update
New citation alerts
📈
Score trend tracking
🏠 Verify this data on Medicare.gov
All data in this report comes from the CMS Care Compare database. You can review the official public record directly on Medicare.gov — including the full inspection narrative, star ratings, and any recent enforcement actions.
View on Medicare.gov ↗

This report reflects publicly available CMS data only and is updated monthly. Severity codes and narratives are reproduced directly from the CMS health inspection database. Senior Care Report Card scores are independently computed and are not affiliated with or endorsed by CMS or Medicare.gov.

Data source: CMS Care Compare · Methodology · State Ombudsman

This report uses public CMS nursing home data and simplified scoring to help families ask better questions. It is not a recommendation, ranking, medical opinion, legal opinion, or substitute for an in-person visit. Source data last published by CMS: May 5, 2026.