Pine Acres Rehabilitation and Care Center
1501 Office Park Road · West Des Moines, IA · 50265 · 5152231223
140 certified beds For profit - Limited Liability company
Why this verdict
- On the federal Special Focus list of the most persistently poor performers.
- Inspection record is far worse than the national median (deficiency count and severity).
- Federal penalties on record: $192,175 in fines in the last 24 months.
- 5 citations involved actual harm to residents.
- 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
Special Focus Facility
CMS has designated this facility one of the most persistently poor performers in the country — it is under increased inspection and enforcement.
4 immediate-jeopardy citations in prior inspection cycles
Serious past findings — check whether the underlying problems were fixed and stayed fixed.
1 abuse-related citation at the actual-harm level
Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.
$192,175 in federal fines in the last 24 months
2 fines — CMS fines are reserved for verified, serious non-compliance.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: not rated Inspections: not rated Staffing: not rated Quality measures: not rated
| Total nurse hours / resident-day | 3.40 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.53 | 0.55–0.75 |
| Weekend hours / resident-day | 3.11 | ≈ weekday level |
| Nursing turnover / year | 57% | median 45% |
| Fines (3-yr window) | 3 · $353,109 |
Inspection citations (85 in the current record)
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Potential for harm · D January 8, 2026
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected February 3, 2026 · Resident Assessment and Care Planning
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Potential for harm · E January 8, 2026
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Corrected February 3, 2026 · Pharmacy Service
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Potential for harm · E January 8, 2026
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected February 3, 2026 · Nutrition and Dietary
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Potential for harm · E January 8, 2026
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected February 3, 2026 · Resident Assessment and Care Planning
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Potential for harm · D January 8, 2026
Provide and implement an infection prevention and control program.
Corrected February 3, 2026 · Infection Control
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Potential for harm · D January 8, 2026
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected February 3, 2026 · Infection Control
-
Potential for harm · D January 8, 2026
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
Corrected February 3, 2026 · Infection Control
-
Potential for harm · D January 8, 2026 · found via complaint
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected February 3, 2026 · Resident Rights
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Potential for harm · D January 8, 2026 · found via complaint
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected February 3, 2026 · Resident Assessment and Care Planning
-
Potential for harm · D January 8, 2026 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected February 3, 2026 · Quality of Life and Care
-
Potential for harm · D January 8, 2026 · 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 February 3, 2026 · Nursing and Physician Services
-
Potential for harm · D January 8, 2026 · found via complaint
Ensure that residents are free from significant medication errors.
Corrected February 3, 2026 · Pharmacy Service
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Actual harm · G November 25, 2025 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected December 9, 2025 · Quality of Life and Care
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Potential for harm · D November 25, 2025 · found via complaint
Ensure that residents are free from significant medication errors.
Corrected December 9, 2025 · Pharmacy Service
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Potential for harm · E August 26, 2025 · found via complaint
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 September 19, 2025 · Resident Rights
-
Potential for harm · D August 26, 2025 · found via complaint
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 September 19, 2025 · Quality of Life and Care
-
Potential for harm · E August 26, 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 September 19, 2025 · Nursing and Physician Services
-
Potential for harm · E August 26, 2025 · found via complaint
Provide and implement an infection prevention and control program.
Corrected September 19, 2025 · Infection Control
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Potential for harm · D June 9, 2025
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Corrected July 9, 2025 · Resident Rights
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Potential for harm · D June 9, 2025
Ensure each resident receives an accurate assessment.
Corrected July 9, 2025 · Resident Assessment and Care Planning
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Potential for harm · D June 9, 2025
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected July 9, 2025 · Resident Assessment and Care Planning
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Potential for harm · D June 9, 2025
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected July 9, 2025 · Resident Assessment and Care Planning
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Potential for harm · D June 9, 2025
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected July 9, 2025 · Resident Assessment and Care Planning
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Potential for harm · D June 9, 2025
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Corrected July 9, 2025 · Nursing and Physician Services
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Potential for harm · D June 9, 2025
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 July 9, 2025 · Pharmacy Service
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| December 19, 2024 | Fine | $121,006 |
| October 10, 2024 | Fine | $71,169 |
| October 10, 2024 | Payment Denial | 16 days |
| August 16, 2023 | Fine | $160,934 |
Family & resident reviews — a separate signal, never mixed into the score
No approved reviews yet. If your family has experience with this facility, yours could be the review that helps the next family decide.
Sign in to share your family's experience — reviews are moderated and never affect the Safety Score.
Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 165350 · certified since July 22, 1997. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.