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CHAPTERS COUNCIL BLUFFS OPCO LLC

Council Bluffs, IA · Pottawattamie County · Non profit - Corporation · 102 certified beds

📍 3000 Risen Son Blvd, Council Bluffs, IA 51503  ·  📞 (712) 366-9655

Medicare ID: 165466  ·  Last Medicare inspection: Jan 30, 2026

Special Focus Facility (SFF)
CMS has identified this as a facility with a history of serious quality issues that requires enhanced oversight and more frequent inspections.
Overall Safety Score
41
out of 100
Concerning
Component Scores
17
Inspection
20
Staffing
✓ Clean
Enforcement
Complaints
79
Quality
📋 Last inspected: January 30, 2026 📦 CMS data as of: May 2026

Score Breakdown

Inspection
17
Staffing
20
Enforcement
100
Complaints
0
Quality Outcomes
79

What the numbers mean

CHAPTERS COUNCIL BLUFFS OPCO LLC scored 41 out of 100 — 25 points below the state average of 66.

📋 Inspections: 31 citations over the last 36 months — 12 more than the state average (19). 1 was rated serious (G+) — an inspector determined it caused or risked harm to a resident.

🚨 Staffing: Staffing levels are well below average — this is a serious concern. Understaffing leads to worse resident outcomes. We strongly recommend asking for staffing schedules and speaking with current residents or family members before making any decision.

⚖️ Penalties & enforcement: No significant federal fines or enforcement actions on record — a positive indicator of consistent regulatory compliance.

⚠️ Complaints: Above-average complaint activity. Complaint surveys are unannounced and targeted — they often surface problems that routine annual inspections miss. Ask management about the nature of complaints filed and how each was resolved.

📊 Resident quality outcomes: Quality outcome measures are in an acceptable range. Some measures are at or near national benchmarks. Review the quality section in the full report for specifics.

What inspectors found (last 3 surveys)

31
Total citations
State avg: 18.8
1
Serious (G+)
State avg: 1.3
0
Repeat findings

Top concern areas

31

⚖ 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.

No federal penalties on record. CMS has not issued civil monetary penalties or payment denials against this facility in the current reporting period.
📋 Enforcement Context Analysis
Clean enforcement record — No significant federal enforcement actions or fines on record for this facility. This is a positive indicator.
✅ No enforcement actions on record. This facility's enforcement score of 100/100 reflects a clean enforcement history in the current CMS reporting cycle.

📅 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
2.3% lower is better
Share of long-stay residents given antipsychotic drugs. High use can signal residents being over-medicated rather than receiving attentive care.
Re-hospitalized after discharge
34.6% lower is better
How often short-stay residents who went home ended up back in the hospital within 30 days. Risk-adjusted for resident health.
Hospitalization rate
12.9% lower is better
How often long-stay residents were hospitalized over the past year. Adjusted for how sick residents were.

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 — Serious Concerns  ·  41/100
This facility has notable issues in the federal inspection record that require careful evaluation.
What to do next: Do not choose without thoroughly reviewing all citations below and getting answers in writing from management.
🛑
CMS Special Focus Facility
CMS has placed this facility on its Special Focus Facility list — a designation reserved for nursing homes with a persistent pattern of serious problems and substandard care. These facilities receive more frequent inspections and are under enhanced federal oversight. This is one of the most serious designations a nursing home can receive.

What this facility's data shows

📋 Inspections
Inspection record is well below average. Multiple or serious deficiencies found.
👥 Staffing
Staffing is below recommended levels. Ask about RN coverage on nights and weekends.
⚖ Penalties
No significant federal enforcement actions or fines in the record.
💬 Complaints
Higher-than-average complaint volume. Complaint surveys are often triggered by serious resident concerns.
Quality outcomes are acceptable overall but some measures are below benchmarks. See the How Are Residents Doing section.
⚠ 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 20
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 17
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 100
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 0
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 79
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.
41 66 ▼ Worse than state avg
Inspection score
How well the facility performs on standard health surveys.
17 53 ▼ Worse than state avg
Staffing score
RN hours, total nurse hours, and staff turnover from CMS payroll data.
20 60 ▼ Worse than state avg
Penalty score
Fines, payment denials, and enforcement actions on file.
100 75 ▲ Better than state avg
Complaint score
Volume of complaint surveys and substantiated complaints.
0 88 ▼ Worse than state avg
Quality score
Resident clinical outcomes vs national benchmarks: falls, antipsychotics, pain, vaccination, hospitalizations.
79 57 ▲ Better than state avg
Citations (3 yrs)
Total number of deficiencies cited in the last 36 months.
31 18.8 ▼ Worse than state avg
Serious citations
Citations rated severity G or higher (actual harm or immediate jeopardy).
1 1.3 ✓ At 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.

2026-01-30
6 citations  (1 serious)
2025-11-12
3 citations
2025-06-13
11 citations
2025-01-09
8 citations
2024-01-10
3 citations
2022-11-02
12 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: 2026-01-30 6 citation(s) — 1 serious
F0686 Immediate danger
Pressure ulcer prevention & treatment
F0657 No harm, could worsen
Care plan timing & review
F0689 No harm, could worsen
Accident & hazard prevention
F0572 No harm, could worsen
F0572
F0677 No harm, could worsen
Personal hygiene & grooming assistance
F0684 No harm, could worsen
Quality of care
Survey: 2025-11-12 3 citation(s)
F0690 No harm, could worsen
Bowel & bladder care
F0658 No harm, could worsen
Services meet professional standards
F0880 No harm, could worsen
Infection prevention & control
Survey: 2025-06-13 11 citation(s)
F0684 No harm, could worsen
Quality of care
F0882 No harm, could worsen
Antibiotic stewardship
F0838 No harm, could worsen
Facility assessment update
F0725 No harm, could worsen
Adequate & competent nursing staff
F0686 No harm, could worsen
Pressure ulcer prevention & treatment
F0610 No harm, could worsen
Investigate & correct violations
F0584 No harm, could worsen
F0584
F0842 No harm, could worsen
Medical records accuracy & security
F0657 No harm, could worsen
Care plan timing & review
F0656 No harm, could worsen
Comprehensive care plan
F0609 No harm, could worsen
Timely reporting of alleged violations
Survey: 2025-01-09 8 citation(s)
F0812 No harm, could worsen
Food sanitation & safety
F0943 No harm, could worsen
F0943
F0658 No harm, could worsen
Services meet professional standards
F0550 No harm, could worsen
Resident rights & dignity
F0641 No harm, could worsen
Accuracy of resident assessment
F0660 No harm, could worsen
F0660
F0880 No harm, could worsen
Infection prevention & control
F0684 No harm, could worsen
Quality of care
🩹

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.

🕐 Mixed picture: Some quality measures look good, others warrant a closer look. Use the details below to identify which specific areas to ask about during your visit.

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
5.4% 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
12.5% 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
2.3% 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…
2.3% lower is better
Percentage of long-stay residents experiencing one or more falls with major injury
★ Star rating
Percentage of long-stay residents with pressure u…
15.7% lower is better
Percentage of long-stay residents with pressure ulcers
★ Star rating
Percentage of long-stay residents who received an…
39.3% lower is better
Percentage of long-stay residents who received an antipsychotic medication
Physical restraints used
0.0% 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
0.0% 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…
86.4% lower is better
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine
Pneumonia vaccination rate
18.9% 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 with new or wor…
28.8% lower is better
Percentage of long-stay residents with new or worsened bowel or bladder incontinence
Short Stay Residents — 2025Q1-2025Q4
★ Star rating
Worsening depression symptoms
1.1% lower is better
Share of long-stay residents whose depression got measurably worse over the past year — despite being in a care facility.
Percentage of short-stay residents assessed and a…
94.2% lower is better
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine
Emergency room visits (short-stay)
84.0% lower is better
Share of short-stay residents sent to the ER during their recovery stay. ER visits are disruptive for recovering patients and sometimes avoidable with better on-site clinical management.

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.

Short Stay Residents — 20241001-20250930
★ Star rating
Re-hospitalized after going home
34.6% risk-adjusted rate
Actual: 28.6% Expected: 19.7%
▲ Higher than expected — worth asking about
How often short-stay residents who went home ended up back in the hospital within 30 days. A high rate suggests residents were discharged before they were ready, or that the facility didn't coordinate follow-up care well. Risk-adjusted so facilities treating sicker residents aren't unfairly penalized.
★ Star rating
Hospitalization rate (long-stay)
12.9% risk-adjusted rate
Actual: 12.2% Expected: 10.6%
About the same as similar facilities
How often long-stay residents were hospitalized over the past year, adjusted for how ill they were. A high rate relative to expectations suggests the facility may be sending residents to the hospital for issues that skilled nursing staff should be able to manage on-site.

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. CMS data shows this facility is significantly below the state average for total nurse hours and RN-specific hours per resident day. What is the actual RN coverage on evenings, nights, and weekends — not the regulatory minimum, but what residents consistently receive?
  3. What is your 90-day CNA and nurse turnover rate? How do you ensure a resident sees the same familiar caregivers across a given week?
  4. Complaint data shows a higher-than-average volume of formal complaints filed with the state. What were the most common categories last year, and how does your resolution process work from the moment a complaint is filed?
  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

  • No significant penalty history — a positive indicator of consistent compliance
  • No pattern of repeat violations detected

⚠ Areas to probe

  • Inspection score is low — ask for the most recent state survey results
  • Staffing concerns — request staffing schedules and ask about agency nurse use
  • Elevated complaint activity — ask how resident concerns are investigated
  • 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
41 — Concerning

🏢 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.

🔗 SHARP, DAVID operates 3 facilities across NE.
Owner / Operator Role Ownership % Effective
SHARP, DAVID Individual 1970-01-01
ABRAMCZYK, SOLOMON Individual 1970-01-01
WALKER, SHYANN Individual 1970-01-01
STRICKER, DANIEL 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.