Quick answers
- Where is Avoca Specialty Care?
- 610 East York Street, Avoca, IA 51521, in Pottawattamie County, Iowa.
- What is the phone number of Avoca Specialty Care?
- (712) 343-6398, as listed by Medicare (CMS).
- What is the Medicare star rating of Avoca Specialty Care?
- Medicare overall rating: 2 out of 5 stars (CMS data updated 2026-10-01).
- Has Avoca Specialty Care been fined?
- Medicare lists no fines for Avoca Specialty Care.
- What did inspectors find at Avoca Specialty Care?
- In its last three inspection cycles (February 1, 2024 to March 5, 2026), Medicare lists 59 health citations; the most serious was level F. See the list below (CMS data updated 2026-10-01).
Medicare ratings, explained
Star ratings are one piece of information. Visit, ask questions and talk with your doctor about what matters for your care.
Inspections, fines and staffing
In its last three inspection cycles (February 1, 2024 to March 5, 2026), Avoca Specialty Care had 59 health citations; the most serious was level F (no actual harm, potential for more than minimal harm). Medicare lists no fines or payment denials for it in the last three years. Nurse staffing is 3.03 hours per resident per day; the Iowa average is 3.86 and the national average is 3.90.
Source: Medicare (CMS) Provider Data Catalog, data updated October 1, 2026, retrieved November 13, 2026.
Inspection history: last three cycles
State inspectors visit about once a year and also investigate complaints. Each citation (deficiency) has a tag number and a letter, A to L. The letter shows how serious the problem was and how many residents it affected.
What the letters A to L mean
| Seriousness | Isolated (a few residents) | Pattern (some) | Widespread (many) |
|---|---|---|---|
| No actual harm, potential for minimal harm | A | B | C |
| No actual harm, potential for more than minimal harm | D | E | F |
| Actual harm to residents | G | H | I |
| Immediate jeopardy to resident health or safety | J | K | L |
Source: the scope and severity grid Medicare (CMS) uses for nursing home citations.
Most recent cycle: March 5, 2026 — 13 health citations
Inspections in this cycle: October 7, 2025 (complaint investigation); March 5, 2026 (standard health inspection).
Show 13 citations (levels A to F, no actual harm)
F0605 Level E
“Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.”
F0656 Level E
“Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.”
F0725 Level E
“Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.”
F0578 Level D
“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.”
F0584 Level D
“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.”
F0641 Level D
“Ensure each resident receives an accurate assessment.”
F0644 Level D
“Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.”
F0657 Level D
“Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.”
F0658 Level D
“Ensure services provided by the nursing facility meet professional standards of quality.”
F0677 Level D
“Provide care and assistance to perform activities of daily living for any resident who is unable.”
F0695 Level D
“Provide safe and appropriate respiratory care for a resident when needed.”
F0880 Level D
“Provide and implement an infection prevention and control program.”
F0658 Level D
“Ensure services provided by the nursing facility meet professional standards of quality.”
Previous cycle: January 30, 2025 — 13 health citations
Inspections in this cycle: January 30, 2025 (standard health inspection); May 16, 2025 (complaint investigation); June 16, 2025 (complaint investigation).
Show 13 citations (levels A to F, no actual harm)
F0677 Level E
“Provide care and assistance to perform activities of daily living for any resident who is unable.”
F0725 Level E
“Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.”
F0842 Level E
“Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.”
F0725 Level E
“Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.”
F0677 Level D
“Provide care and assistance to perform activities of daily living for any resident who is unable.”
F0607 Level D
“Develop and implement policies and procedures to prevent abuse, neglect, and theft.”
F0609 Level D
“Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.”
F0610 Level D
“Respond appropriately to all alleged violations.”
F0657 Level D
“Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.”
F0744 Level D
“Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.”
F0761 Level D
“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.”
F0641 Level D
“Ensure each resident receives an accurate assessment.”
F0880 Level D
“Provide and implement an infection prevention and control program.”
Earlier cycle: February 1, 2024 — 33 health citations
Inspections in this cycle: February 1, 2024 (standard health inspection); July 1, 2024 (complaint investigation).
Show 33 citations (levels A to F, no actual harm)
F0801 Level F
“Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.”
F0868 Level F
“Have the Quality Assessment and Assurance group have the required members and meet at least quarterly”
F0677 Level E
“Provide care and assistance to perform activities of daily living for any resident who is unable.”
F0725 Level E
“Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.”
F0801 Level E
“Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.”
F0812 Level E
“Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.”
F0657 Level E
“Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.”
F0726 Level E
“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.”
F0761 Level E
“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.”
F0803 Level E
“Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.”
F0805 Level E
“Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.”
F0812 Level E
“Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.”
F0880 Level E
“Provide and implement an infection prevention and control program.”
F0921 Level E
“Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.”
F0550 Level D
“Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.”
F0689 Level D
“Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.”
F0814 Level D
“Dispose of garbage and refuse properly.”
F0926 Level D
“Have policies on smoking.”
F0559 Level D
“Honor the resident's right to share a room with spouse or roommate of choice and receive written notice before a change is made.”
F0580 Level D
“Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.”
F0584 Level D
“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.”
F0641 Level D
“Ensure each resident receives an accurate assessment.”
F0656 Level D
“Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.”
F0658 Level D
“Ensure services provided by the nursing facility meet professional standards of quality.”
F0676 Level D
“Ensure residents do not lose the ability to perform activities of daily living unless there is a medical reason.”
F0677 Level D
“Provide care and assistance to perform activities of daily living for any resident who is unable.”
F0686 Level D
“Provide appropriate pressure ulcer care and prevent new ulcers from developing.”
F0692 Level D
“Provide enough food/fluids to maintain a resident's health.”
F0693 Level D
“Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.”
F0698 Level D
“Provide safe, appropriate dialysis care/services for a resident who requires such services.”
F0759 Level D
“Ensure medication error rates are not 5 percent or greater.”
F0760 Level D
“Ensure that residents are free from significant medication errors.”
F0804 Level D
“Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.”
Citation descriptions are Medicare’s official wording. “From a complaint” means the citation came from a complaint investigation instead of the regular yearly inspection.
Full inspection reports on Medicare Care Compare →
Fire safety citations (19)
E0004 Level F
“Develop and maintain an Emergency Preparedness Program (EP).”
E0039 Level F
“Conduct testing and exercise requirements.”
K0353 Level F
“Inspect, test, and maintain automatic sprinkler systems.”
K0712 Level F
“Have simulated fire drills held at unexpected times.”
K0324 Level E
“Provide properly protected cooking facilities.”
K0712 Level F
“Have simulated fire drills held at unexpected times.”
K0914 Level F
“Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.”
K0741 Level E
“Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.”
K0761 Level E
“To conduct inspection, testing and maintenance of fire doors by qualified individuals.”
E0004 Level F
“Develop and maintain an Emergency Preparedness Program (EP).”
K0291 Level F
“Install emergency lighting that can last at least 1 1/2 hours.”
K0324 Level F
“Provide properly protected cooking facilities.”
K0353 Level F
“Inspect, test, and maintain automatic sprinkler systems.”
K0712 Level F
“Have simulated fire drills held at unexpected times.”
K0914 Level F
“Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.”
K0918 Level F
“Have generator or other power source capable of supplying service within 10 seconds.”
E0026 Level E
“Establish roles under a Waiver declared by secretary.”
K0232 Level E
“Have corridors or aisles that are unobstructed and are at least 8 feet in width.”
K0741 Level D
“Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.”
Staffing
Hours of nursing care per resident per day, from the payroll records nursing homes send to Medicare, next to the state and national averages.
| Measure | This home | Iowa | National |
|---|---|---|---|
| Registered nurse (RN) hours per resident per day | 0.83 | 0.74 | 0.69 |
| Licensed practical nurse (LPN) hours per resident per day | 0.14 | 0.56 | 0.86 |
| Nurse aide hours per resident per day | 2.06 | 2.56 | 2.35 |
| Total nurse staff hours per resident per day | 3.03 | 3.86 | 3.90 |
| Total nurse staff hours per resident per day on the weekend | 2.74 | 3.38 | 3.43 |
| RN hours per resident per day on the weekend | 0.68 | 0.51 | 0.48 |
| Nursing staff turnover (per year) | 59.5% | 44.1% | 45.3% |
| RN turnover (per year) | 20.0% | 42.1% | 42.5% |
| Administrators who left in the last year | 1.0 | 0.4 | 0.5 |
Source: Medicare (CMS) Provider Information and State US Averages, data updated October 1, 2026.
Owners and operator
Part of a group of 43 nursing homes: Care Initiatives.
Legal business name: Care Initiatives.
Owners and managers Medicare lists (1)
| Name | Role | Share | Since |
|---|---|---|---|
| Care Initiatives | Direct owner | 100% | August 1, 2012 |
Source: Medicare (CMS) Ownership file, data updated October 1, 2026. Only owners with an ownership interest and management companies are shown.
Compare with other nursing homes
Key facts
| Type | Nursing home |
|---|---|
| Certified beds | 46 |
| Average residents per day | 33.5 |
| Takes part in | Medicare and Medicaid |
| Ownership | Non-profit – corporation |
| Group or chain (affiliated entity) | Care Initiatives |
| Legal business name | Care Initiatives |
| First approved by Medicare/Medicaid | 1996-08-01 |
| Resident and family councils | Resident council |
| Sprinklers in all required areas | Yes |
| Changed ownership in the last 12 months | No |
| Address | 610 East York Street, Avoca, IA 51521 |
| County | Pottawattamie County |
| State | Iowa |
| Phone | (712) 343‑6398 |
| CMS Certification Number | 165294 |
| Corrections | Report an error or suggest an update → |
What to ask when you call or visit
A general checklist for any nursing home, not advice about this one. Medicare also publishes guides on medicare.gov.
- Is the home certified by Medicare and/or Medicaid, and does it have a bed for the care you need (short-term rehab or long-term care)?
- Can you see the latest state inspection report? Ask how any problems found were fixed.
- How many nurses and aides work on each shift, at night and on weekends? Is there a registered nurse on site at all times?
- Which doctors see residents, and how often? What happens in a medical emergency, and which hospital is used?
- What therapy (physical, occupational, speech) is offered, and how many days a week?
- Are residents clean, dressed and taking part in activities? Do staff speak to them kindly and answer call lights quickly?
- What do the daily rate and extra services cost, and what do Medicare, Medicaid or your insurance pay? Ask for it in writing.
- Is there a resident council and a family council? How are complaints handled? Ask for the long-term care ombudsman’s contact.
- Are meals appetizing, and can the home meet special diets, language needs and religious or cultural preferences?
- Visit more than once, including at a mealtime or in the evening, without an appointment.
Other nursing homes nearby
By straight-line distance (not driving distance).
- Elm Crest Retirement Community10 mi · Harlan, IA · 2 of 5 stars
- Oakland Manor13 mi · Oakland, IA · 1 of 5 stars
- Salem Lutheran Home18 mi · Elk Horn, IA · 2 of 5 stars
- Heritage House21 mi · Atlantic, IA · 4 of 5 stars
- Atlantic Specialty Care22 mi · Atlantic, IA · 2 of 5 stars
Nearest hospital emergency rooms
- Myrtue Medical Center10 mi · Harlan, IA · Critical Access Hospital
- Cass County Memorial Hospital22 mi · Atlantic, IA · Critical Access Hospital
- CHI Health Missouri Valley26 mi · Missouri Valley, IA · Critical Access Hospital
Sources
- Provider Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-01, retrieved 2026-11-13
- Medicare Care Compare — official Medicare profile of this provider
- Health Deficiencies — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Fire Safety Deficiencies — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Penalties — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Ownership — CMS, data updated 2026-10-01, retrieved 2026-11-13
- State US Averages — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Survey Summary — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Citation Code Look-up — CMS, data updated 2026-10-01, retrieved 2026-11-13
- Inspection Dates — CMS, data updated 2026-10-01, retrieved 2026-11-13