Accura Healthcare of Milford
1600 13th Street, Milford, IA 51351 · Dickinson County · (712) 338-4742
46 certified beds, about 44 residents a day · For profit - Corporation · Medicare and Medicaid since 1999
CMS Care Compare ratings, data as of September 1, 2026 · CCN 165402 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on July 31, 2025, inspectors cited 0 health deficiencies (the Iowa average is 6.5, the national average 9.2).
None of its 8 health citations since May 2023 was rated as actual harm or immediate jeopardy.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 3.53 hours per resident per day, against 3.82 across Iowa and 3.86 nationally. Registered nurses accounted for 0.48 of those hours.
30.2% of nursing staff left within the year CMS measured (Iowa average 44.0%).
CMS links it to Accura Healthcare, an affiliated group of 41 nursing homes.
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 8 health citations on file.
July 31, 2025Standard inspection · 0 citations
August 15, 2024Standard inspection · 1 citation
- D Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Inspectors wroteBased on employee file review, staff interview, and policy review, the facility failed to complete a criminal record check and dependent adult/child abuse registry check prior to an employee's hire date for 1 of 5 employee. The facility reported a census of 43.
May 18, 2023Standard inspection · 7 citations
- E Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Inspectors wroteBased on clinical record review and staff interview the facility failed to revise and update care plans to include and address high risk medications and side effects to watch for in 4 out of 13 sampled residents reviewed for comprehensive care plans (Resident #9, #18, #25 and #32). The facility reported a census of 38 residents.
- E Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, facility policy, and staff interview, the facility failed to transport linen in a manner to prevent contamination. The facility reported a census of 38 residents.
- D Ensure each resident receives an accurate assessment.
Inspectors wroteBased on clinical record, facility policy, and staff interview, the facility failed to complete an accurate Minimum Data Set (MDS) assessment for 1 of 13 residents reviewed (Resident #24). The facility reported a census of 38 residents.
- D Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Inspectors wroteBased on clinical record review and staff interview, the facility failed to refer 1 resident with a negative Level I result for the Preadmission Screening and Resident Review (PASRR), who was later identified with newly evident or possible serious mental disorder, intellectual disability, or other related condition, to the appropriate state-designated authority for Level II PASRR evaluation and determination for 1 out of 1 residents reviewed for PASRR requirements, (Resident #18). The facility reported a census of 38 residents.
- D Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Inspectors wroteBased on clinical record, facility policy, and staff interview, the facility failed to develop a care plan to include side effects of high risk medications for 1 of 5 residents reviewed (Resident #28). The facility reported a census of 38 residents.
- D Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on observation, clinical record, facility policy, resident interview, and staff interview, the facility failed to obtain a physician order for a medication and permitted a resident to self administer a medication without assessment or physician order for 1 of 13 residents reviewed (Resident #140). The facility failed to obtain a physician order for a mechanically altered diet for 1 of 1 resident reviewed (Resident #24). The facility reported a census of 38 residents.
- D Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Inspectors wroteBased on observation, clinical record, and staff interview, the facility failed to serve the correct consistency of food for 1 of 1 resident reviewed (Resident #24). The MDS for Resident #24 dated 4/29/23 revealed a Brief Interview of Mental Status score of 7 which indicated severely impaired cognition. The MDS revealed the resident had diagnoses of stroke, diabetes mellitus, dysphagia (difficulty swallowing), dysarthria (difficulty speaking), and anarthria (inability to speak). The MDS revealed the resident required the extensive assistance of 1 person with eating. Observation on 5/17/23 at 12:24 PM revealed the resident ate pureed food for lunch with visible pieces of corn in the puree. The Week 5 Wednesday puree menu for the noon meal revealed pureed cream corn was served. [...]
Fire safety inspections
11 fire safety citations on file: 2 on July 31, 2025, 2 on August 15, 2024, 7 on May 18, 2023.
Every fire safety citation11 citations
- F Inspect, test, and maintain automatic sprinkler systems.
- F Have generator or other power source capable of supplying service within 10 seconds.
- F Provide properly protected cooking facilities.
- E Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- F Follow proper procedures when the fire alarm was out of service for more than 4 hours.
- F Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- F Have simulated fire drills held at unexpected times.
- F Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F Have generator or other power source capable of supplying service within 10 seconds.
- D Inspect, test, and maintain automatic sprinkler systems.
- D Ensure proper usage of power strips and extension cords.
Fines and payment denials
CMS lists no fines or payment denials against this home in the last three years. The national average is 0.9 fines per home.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Iowa | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.53 | 3.82 | 3.86 |
| Registered nurses | 0.48 | 0.74 | 0.69 |
| All nursing staff on weekends | 3.28 | 3.37 | 3.42 |
| Nurse aides | 2.23 | ||
| Licensed practical nurses | 0.82 | ||
| Nursing staff turnover (share who left in a year) | 30.2% | 44.0% | 45.8% |
| Registered nurse turnover | not reported | 42.1% | 42.9% |
| Administrators who left | 0 |
CMS expects 3.63 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.63 on weekdays and 3.28 on weekends, 10% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.0% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.70 in April to June 2025 to 3.53 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.53 | 0.48 | 3.63 | 3.28 | 0.0% | 0 of 90 | 44 |
| Oct to Dec 2025 | 3.53 | 0.48 | 3.64 | 3.23 | 0.0% | 0 of 92 | 43 |
| Jul to Sep 2025 | 3.54 | 0.48 | 3.69 | 3.17 | 0.0% | 0 of 92 | 43 |
| Apr to Jun 2025 | 3.70 | 0.49 | 3.86 | 3.27 | 0.0% | 0 of 91 | 43 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Iowa, Jan to Mar 2026 | 3.80 | 0.71 | 3.98 | 3.36 | 4.7% | 0.3% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Iowa | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 29.5 | 17.1 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 2.3 | 1.5 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 3.3 | 2.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 3.8 | 3.8 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 2.1 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 35.5 | 16.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.7 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 8.4 | 19.4 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 26.2 | 20.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 16.0 | 13.2 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.1 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.5 | 2.1 | 1.8 |
Owners and operators
Legal business name: ACCURA HEALTHCARE OF MILFORD LLC. CMS links this home to Accura Healthcare, a group of 41 nursing homes averaging 2.5 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Accura Midwest Healthcare LLC | 5% or greater indirect ownership interest | Organization | 11/01/2017 | |
| Leneave, Thomas | 5% or greater indirect ownership interest | Individual | 11/01/2017 | |
| Butcher, Daren | W-2 managing employee | Individual | 01/01/2023 | |
| Olson, Brett | W-2 managing employee | Individual | 01/01/2024 | |
| Toti, Lisa | W-2 managing employee | Individual | 01/01/2020 | |
| Leneave, Ted | Corporate director | Individual | 11/01/2017 | |
| Leneave, Thomas | Corporate director | Individual | 11/01/2017 | |
| Toti, Lisa | Corporate director | Individual | 01/01/2020 | |
| Leneave, Ted | Corporate officer | Individual | 11/01/2017 | |
| Leneave, Thomas | Corporate officer | Individual | 11/01/2017 | |
| American Healthcare Management Services LLC | Operational/managerial control | Organization | 11/01/2017 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- When is the care plan meeting, and can family attend it?Inspectors cited 5 problems in this area, most recently on May 18, 2023: "Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals."
- How are allegations of abuse or neglect reported and investigated, and who tells the family?Inspectors cited 1 problem in this area, most recently on August 15, 2024: "Develop and implement policies and procedures to prevent abuse, neglect, and theft."
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 1 problem in this area, most recently on May 18, 2023: "Provide and implement an infection prevention and control program."
- Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 1 problem in this area, most recently on May 18, 2023: "Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.28 hours per resident per day, below the Iowa average of 3.37.
Other nursing homes nearby
- Accura Healthcare of Spirit Lake Spirit Lake, 6.8 mi · 2 of 5 stars · 23 citations
- Spencer Post Acute Rehabilitation Center Spencer, 12.4 mi · 1 of 5 stars · 45 citations
- St. Luke Lutheran Nursing Home Spencer, 14.2 mi · 2 of 5 stars · 24 citations
- Good Samaritan - Estherville Estherville, 17.8 mi · 3 of 5 stars · 26 citations
- Estherville Community Care Center Estherville, 18 mi · 2 of 5 stars · 22 citations
- Ruthven Community Care Center Ruthven, 18.9 mi · 4 of 5 stars · 6 citations
- Community Memorial Health Center Hartley, 19.3 mi · 3 of 5 stars · 18 citations
- Good Samaritan Society - Jackson Jackson, 21.9 mi · 4 of 5 stars · 13 citations
Iowa contacts for a concern about a nursing home
These are the official offices in Iowa. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Iowa Department of Inspections, Appeals, and Licensing, Health Facilities, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: Iowa Office of the State Long-Term Care Ombudsman, 866-236-1430. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
- State inspection reports: Iowa Health Facility Database, Entity Search, where Iowa publishes its own records on licensed homes.
Common questions
- What is Accura Healthcare of Milford's Medicare star rating?
- CMS rates Accura Healthcare of Milford 4 out of 5 stars overall, with 5 for health inspections, 3 for staffing and 1 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Accura Healthcare of Milford get at its last inspection?
- 0 health deficiencies at the standard inspection on July 31, 2025. The Iowa average is 6.5.
- Has Accura Healthcare of Milford been fined?
- CMS lists no fines in the last three years.
- Does Accura Healthcare of Milford accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Accura Healthcare of Milford?
- CMS lists 11 owners and managers, and links the home to Accura Healthcare. Legal business name: ACCURA HEALTHCARE OF MILFORD LLC.
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.