Mississippi Valley
500 Messenger Road · Keokuk, IA · 52632 · 3195245321
83 certified beds For profit - Limited Liability company
Why this verdict
- 4 citations involved actual harm to residents.
- Staffing hours comfortably above national benchmarks.
- Inspection results have improved across recent cycles.
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.
Red flags
No red flags in the current CMS record. Genuinely good news — pair it with an in-person tour before deciding.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 3 of 5 Inspections: 3 of 5 Staffing: 3 of 5 Quality measures: 4 of 5
| Total nurse hours / resident-day | 5.38 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 1.43 | 0.55–0.75 |
| Weekend hours / resident-day | 4.15 | ≈ weekday level |
| Nursing turnover / year | 42% | median 45% |
| Fines (3-yr window) | 2 · $19,663 |
Inspection citations (25 in the current record)
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Actual harm · G March 12, 2026 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected March 23, 2026 · Quality of Life and Care
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Actual harm · G June 19, 2024
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected June 20, 2024 · Quality of Life and Care
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Potential for harm · D June 19, 2024
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 20, 2024 · Resident Assessment and Care Planning
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Potential for harm · D June 19, 2024
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected June 20, 2024 · Quality of Life and Care
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Potential for harm · D June 19, 2024
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected June 20, 2024 · Quality of Life and Care
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Potential for harm · D June 19, 2024
Ensure each resident’s drug regimen must be free from unnecessary drugs.
Corrected June 20, 2024 · Pharmacy Service
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Actual harm · G January 24, 2024 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected February 16, 2024 · Quality of Life and Care
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Potential for harm · E December 6, 2023 · 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 December 29, 2023 · Nursing and Physician Services
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Actual harm · G February 23, 2023
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected March 24, 2023 · Resident Rights
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Potential for harm · D February 23, 2023
Allow residents to self-administer drugs if determined clinically appropriate.
Corrected March 24, 2023 · Resident Rights
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Potential for harm · D February 23, 2023
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Corrected March 24, 2023 · Resident Rights
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Potential for harm · D February 23, 2023
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected March 24, 2023 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D February 23, 2023
Respond appropriately to all alleged violations.
Corrected March 24, 2023 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E February 23, 2023
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Corrected March 24, 2023 · Resident Rights
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Potential for harm · D February 23, 2023
Assess the resident when there is a significant change in condition
Corrected March 24, 2023 · Resident Assessment and Care Planning
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Potential for harm · E February 23, 2023
Ensure each resident receives an accurate assessment.
Corrected March 24, 2023 · Resident Assessment and Care Planning
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Potential for harm · D February 23, 2023
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected March 24, 2023 · Resident Assessment and Care Planning
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Potential for harm · E February 23, 2023
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 24, 2023 · Resident Assessment and Care Planning
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Potential for harm · D February 23, 2023
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Corrected March 24, 2023 · Quality of Life and Care
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Potential for harm · D February 23, 2023
Ensure each resident must receive and the facility must provide necessary behavioral health care and services.
Corrected March 24, 2023 · Quality of Life and Care
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Potential for harm · D February 23, 2023
Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.
Corrected March 24, 2023 · Pharmacy Service
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Potential for harm · D February 23, 2023
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Corrected March 24, 2023 · Pharmacy Service
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Potential for harm · E February 23, 2023
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected March 24, 2023 · Nutrition and Dietary
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Potential for harm · D February 23, 2023
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Corrected March 24, 2023 · Administration
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Potential for harm · E February 23, 2023
Provide and implement an infection prevention and control program.
Corrected March 24, 2023 · Infection Control
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| June 19, 2024 | Fine | $10,839 |
| January 24, 2024 | Fine | $8,824 |
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 165151 · certified since March 25, 1989. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.