Avoca Specialty Care

610 East York Street · Avoca, IA · 51521 · 7123436398

46 certified beds Non profit - Corporation Chain: Care Initiatives

  • No federal fines or payment denials in CMS’s 3-year window.
  • Inspection results have improved across recent cycles.

The composite number cleared 72 points, but Recommended is gated: inspection record below the Recommended bar; CMS rates its health inspections "much below average". That rule is part of the published method.

The complete Safety Report — $19

Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.

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Red flags

72% of nursing staff left within a year

High turnover disrupts continuity of care; the national median is 45%.

Score breakdown

Inspection record 30% of score 43
Serious harm & abuse 20% 94
Staffing 20% 61
Federal penalties 15% 100
Trend 10% 82
Context 5% 100

Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.

CMS ratings & staffing

Overall: 1 of 5 Inspections: 1 of 5 Staffing: 2 of 5 Quality measures: 3 of 5

Total nurse hours / resident-day3.283.48 min · 4.1 strong
RN hours / resident-day0.810.55–0.75
Weekend hours / resident-day2.94≈ weekday level
Nursing turnover / year72%median 45%
Fines (3-yr window)none

Inspection citations (68 in the current record)

  • Potential for harm · D March 5, 2026

    Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.

    Corrected March 23, 2026 · Resident Rights

  • Potential for harm · D March 5, 2026

    Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.

    Corrected March 23, 2026 · Resident Rights

  • Potential for harm · E March 5, 2026

    Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.

    Corrected March 23, 2026 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D March 5, 2026

    Ensure each resident receives an accurate assessment.

    Corrected March 23, 2026 · Resident Assessment and Care Planning

  • Potential for harm · D March 5, 2026

    Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

    Corrected March 23, 2026 · Resident Assessment and Care Planning

  • Potential for harm · E March 5, 2026

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

    Corrected March 23, 2026 · Resident Assessment and Care Planning

  • Potential for harm · D March 5, 2026

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Corrected March 23, 2026 · Resident Assessment and Care Planning

  • Potential for harm · D March 5, 2026

    Ensure services provided by the nursing facility meet professional standards of quality.

    Corrected March 23, 2026 · Resident Assessment and Care Planning

  • Potential for harm · D March 5, 2026

    Provide care and assistance to perform activities of daily living for any resident who is unable.

    Corrected March 23, 2026 · Quality of Life and Care

  • Potential for harm · D March 5, 2026

    Provide safe and appropriate respiratory care for a resident when needed.

    Corrected March 23, 2026 · Quality of Life and Care

  • Potential for harm · E March 5, 2026

    Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

    Corrected March 23, 2026 · Nursing and Physician Services

  • Potential for harm · D March 5, 2026

    Provide and implement an infection prevention and control program.

    Corrected March 23, 2026 · Infection Control

  • Potential for harm · D October 7, 2025 · found via complaint

    Ensure services provided by the nursing facility meet professional standards of quality.

    Corrected November 29, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D June 16, 2025 · found via complaint

    Provide care and assistance to perform activities of daily living for any resident who is unable.

    Corrected June 29, 2025 · Quality of Life and Care

  • Potential for harm · D May 16, 2025 · found via complaint

    Develop and implement policies and procedures to prevent abuse, neglect, and theft.

    Corrected May 28, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D May 16, 2025 · found via complaint

    Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

    Corrected May 28, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D May 16, 2025 · found via complaint

    Respond appropriately to all alleged violations.

    Corrected May 28, 2025 · Freedom from Abuse, Neglect, and Exploitation

  • Potential for harm · D May 16, 2025 · found via complaint

    Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

    Corrected June 2, 2025 · Resident Assessment and Care Planning

  • Potential for harm · E May 16, 2025 · found via complaint

    Provide care and assistance to perform activities of daily living for any resident who is unable.

    Corrected June 1, 2025 · Quality of Life and Care

  • Potential for harm · E May 16, 2025 · found via complaint

    Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

    Corrected June 2, 2025 · Nursing and Physician Services

  • Potential for harm · D May 16, 2025 · found via complaint

    Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.

    Corrected June 2, 2025 · Quality of Life and Care

  • Potential for harm · D May 16, 2025 · found via complaint

    Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.

    Corrected June 2, 2025 · Pharmacy Service

  • Potential for harm · E May 16, 2025 · found via complaint

    Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.

    Corrected June 2, 2025 · Resident Assessment and Care Planning

  • Potential for harm · D January 30, 2025

    Ensure each resident receives an accurate assessment.

    Corrected February 5, 2025 · Resident Assessment and Care Planning

  • Potential for harm · E January 30, 2025

    Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

    Corrected February 7, 2025 · Nursing and Physician Services

Showing the 25 most recent. The Safety Report includes every citation with full findings.

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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 165294 · certified since August 1, 1996. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.