Birkwood Village of Fort Madison
1702 41st Street, Fort Madison, IA 52627 · Lee County · (319) 372-8021
80 certified beds, about 61 residents a day · For profit - Limited Liability company · Medicare and Medicaid since 1993
Part of a continuing care retirement community Certified for Medicaid Certified for Medicare
Overall
3 of 5
Health inspections
3 of 5
Staffing
3 of 5
Quality measures
4 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 165227 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on April 16, 2026, inspectors cited 2 health deficiencies (the Iowa average is 6.5, the national average 9.2).
Of 25 health citations since January 2024, 1 was rated as actual harm or immediate jeopardy to residents.
CMS lists no fines against this home in the last three years.
Nurses and nurse aides worked 4.52 hours per resident per day, against 3.82 across Iowa and 3.86 nationally. Registered nurses accounted for 0.79 of those hours.
52.5% of nursing staff left within the year CMS measured (Iowa average 44.0%).
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.
101/24
1206/24
110/24
804/25
102/26
204/26
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
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 25 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
1G
0H
0I
Potential for more than minimal harm
20D
4E
0F
Potential for minimal harm
0A
0B
0C
April 16, 2026Standard inspection · 2 citations
- E Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observations, facility policy review and staff interviews, the facility failed to ensure kitchen staff followed safe food handling practices during the preparation and serving for the noon meal. The facility reported a census of 64 residents.
- 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.
Inspectors wroteBased on observations, clinical record review, facility housekeeping checklist, facility policy review, resident and staff interviews, the facility failed to clean resident's room daily for 1 of 2 residents reviewed for environment (Resident #1). The facility reported a census of 64 residents.
February 18, 2026Complaint inspection · 1 citation
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, clinical record review, staff interviews, and the facility policy, the facility failed to use hand hygiene in an effort to minimize the risk of spreading infections during the completion of personal, wound and catheter care for 1 of 1 resident (Resident #2) reviewed for infection control. The facility reported a census of 63 residents.
April 24, 2025Standard inspection · 8 citations
- E Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure proper labeling and dating of all food items, failed to discard food items in appropriate time frames, and failed to ensure proper use of beard restraints. The facility reported a census of 54 residents.
- D Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Inspectors wroteBased on clinical record review and staff interviews, the facility failed to issue the Notice of Medicare Non-Coverage (NOMNC) Form 10123 for 2 of 3 residents reviewed for beneficiary notices (Resident #36 and Resident #51). The facility reported a census of 54 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 interviews, the facility failed to update the Care Plan and initiate Specialized Services for a resident as directed per the PASRR (Preadmission Screening and Resident Review) Level II for 1 of 1 (Resident #10) residents reviewed. The facility reported a census 54 residents.
- D 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 interviews, the facility failed to address the reason and the trigger areas for the resident's diagnoses of PTSD (post traumatic stress disorder) for 1 of 5 residents reviewed for unnecessary medications (Resident #33). The facility reported a census of 54 residents.
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure timely follow up for a resident with history of constipation who had not had a bowel movement (BM) in multiple days for one of one resident reviewed for constipation (Resident #21). The facility reported a census of 54 residents.
- D 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.
Inspectors wroteBased on observation, clinical record review and staff interviews, the facility failed to ensure competent nursing staff provided wound care and applied a wound VAC (vacuum assisted closure) for 1 of 1 resident reviewed with pressure wounds (Resident #55). The facility reported a census of 54 residents.
- D 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.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure documentation of targeted behaviors and behavioral monitoring for the use of an antipsychotic medication for one of five residents reviewed for unnecessary medications (Resident #54). The facility reported a census of 54 residents.
- D Ensure that residents are free from significant medication errors.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure insulin administered per physician order for two of three residents reviewed for insulin (Resident #28, Resident #47). The facility reported a census of 54 residents.
October 30, 2024Complaint inspection · 1 citation
- G Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Inspectors wroteBased on record review and staff interviews, the facility failed to evaluate the placement of the urinary catheter after a routine catheter change with little to no urine output along with bloody urine for 2 days and then continued to have bloody urine for an additional 2 days before sending the resident to the hospital 4 days where it was found the balloon inserted in the urethra causing trauma and the resident diagnosed with a UTI (Urinary Tract Infection) for 1 of 3 residents reviewed for urinary catheters (Resident #1). The facility reported a census of 59 residents.
June 20, 2024Standard inspection, Complaint inspection · 12 citations
- E Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Inspectors wroteBased on observations, clinical record review, facility policy review, and staff interviews the facility failed to ensure adequate food temperatures prior to service and hold an appropriate after delivering of food to the resident for 2 of 2 dietary services reviewed for food temperatures and for 1 of 1 residents reviewed for food. The facility reported a census of 59 residents.
- E Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure adequate infection control practices implemented during medication administration when staff handled medications, including stock medication and resident specific medication for Resident #38, with bare hands for 1 of 3 residents reviewed for medication administration. The facility reported a census of 59 residents.
- D Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Inspectors wroteBased on interviews, clinical record review, and facility Human Resources documentation, the facility failed to ensure residents were treated in a dignified manner while speaking to residents and during incontinent care for 1 of 3 residents reviewed (Resident #50). The facility reported a census of 59 residents.
- D Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Inspectors wroteBased on clinical record review, facility policy review, and staff interviews, the facility failed to follow their abuse policy when staff did not notify management of concerns with potential abuse of 1 of 2 residents reviewed (Resident #50). The facility reported a census of 59 residents.
- D Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on staff interview, clinical record review, and facility policy review, the facility failed to ensure documented assessment of pain and symptoms timely upon presentation for one of one resident reviewed for professional standards of practice (Resident #109). The facility reported a census of 59 residents.
- D Provide enough food/fluids to maintain a resident's health.
Inspectors wroteBased on clinical record review, observations, and staff interviews review the facility failed to ensure residents maintained acceptable nutritional standards and identify a weight loss, for one resident (Resident #31) out of three residents reviewed for weight loss. The facility reported a census of 59 residents.
- D Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Inspectors wroteBased on observation, clinical record review, and staff interview, the facility failed to ensure adequate number of staff to assist residents with dining for two of two residents reviewed for dining assistance (Resident #20, Resident #40). The facility reported a census of 59 residents.
- D 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.
Inspectors wroteBased on clinical record review, interviews, and facility policy review the facility failed to ensure targeted behaviors and triggers are identified for the antipsychotic medication olanzapine for 1of 5 residents reviewed for unnecessary medications (Resident #4). The facility reported a census of 59 residents.
- D Ensure medication error rates are not 5 percent or greater.
Inspectors wroteBased on observation, staff interview, and record review, the facility failed to ensure a medication error rate less than five percent when two medication errors were observed from a total of thirty-two opportunities for 2 of 3 residents reviewed for medication administration (Resident #36, Resident #41). The facility reported a census of 59 residents.
- D Provide or obtain dental services for each resident.
Inspectors wroteBased on clinical record review, resident and staff interviews the facility failed to ensure timely dental care for 1 of 1 residents (Resident #6) reviewed. The facility reported a census of 59 residents.
- D Provide special eating equipment and utensils for residents who need them and appropriate assistance.
Inspectors wroteBased on observation, interview, and record review, the facility failed to ensure assistive devices for eating to include a straw were utilized per the resident's diet order for 1 of 2 residents (Resident #8) reviewed for assistive devices for dining. The facility reported a census of 59 residents.
- D Implement a program that monitors antibiotic use.
Inspectors wroteBased on clinical review, staff interview, and facility policy review, facility staff failed to follow infection control practices in reducing the use of antibiotics when test results indicate unnecessary or inappropriate antibiotic use. The facility reported a census of 59 residents.
January 22, 2024Complaint inspection · 1 citation
- D Plan the resident's discharge to meet the resident's goals and needs.
Inspectors wroteBased on record review, and staff, resident and resident's responsible party interviews, the facility failed to coordinate and communicate physician orders that included essential medication prescriptions for the resident's continued care when transferred from the facility, for 1 of 3 residents reviewed that required mechanical ventilation (Resident #6). The facility reported a census of 56 residents.
Fire safety inspections
24 fire safety citations on file: 3 on April 16, 2026, 9 on April 24, 2025, 12 on June 20, 2024.
Every fire safety citation24 citations
- F Conduct risk assessment and an All-Hazards approach.
- F Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- E Install corridor and hallway doors that block smoke.
- F Conduct testing and exercise requirements.
- F Have approved installation, maintenance and testing program for fire alarm systems.
- F Follow proper procedures when the fire alarm was out of service for more than 4 hours.
- F Properly provide smoke detection systems in areas open to corridors.
- 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 Have generator or other power source capable of supplying service within 10 seconds.
- F Ensure that testing and maintenance of electrical equipment is performed.
- E Have corridors or aisles that are unobstructed and are at least 8 feet in width.
- F Install emergency lighting that can last at least 1 1/2 hours.
- F Have a complete alarm system manually initiated and initiated by fire sprinkler system connection.
- F Have approved installation, maintenance and testing program for fire alarm systems.
- F Properly provide smoke detection systems in areas open to corridors.
- F Inspect, test, and maintain automatic sprinkler systems.
- 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 To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F Have generator or other power source capable of supplying service within 10 seconds.
- F Ensure that testing and maintenance of electrical equipment is performed.
- F Ensure that personnel concerned with handling of medical gases and cylinders are trained on the risk.
- E Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
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) | 4.52 | 3.82 | 3.86 |
| Registered nurses | 0.79 | 0.74 | 0.69 |
| All nursing staff on weekends | 3.77 | 3.37 | 3.42 |
| Nurse aides | 2.81 | ||
| Licensed practical nurses | 0.92 | ||
| Nursing staff turnover (share who left in a year) | 52.5% | 44.0% | 45.8% |
| Registered nurse turnover | 73.3% | 42.1% | 42.9% |
| Administrators who left | 1 |
CMS expects 4.18 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 4.82 on weekdays and 3.77 on weekends, 22% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 8.7% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.67 in April to June 2025 to 4.52 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 | 4.52 | 0.79 | 4.82 | 3.77 | 8.7% | 0 of 90 | 61 |
| Oct to Dec 2025 | 4.10 | 0.56 | 4.36 | 3.45 | 13.2% | 0 of 92 | 64 |
| Jul to Sep 2025 | 4.48 | 0.60 | 4.79 | 3.72 | 8.8% | 1 of 92 | 61 |
| Apr to Jun 2025 | 4.67 | 0.59 | 4.99 | 3.86 | 7.7% | 0 of 91 | 59 |
| 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 | 18.9 | 17.1 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 1.8 | 1.5 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 4.8 | 2.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 5.7 | 3.8 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 3.0 | 2.1 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 13.3 | 16.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 10.2 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 8.3 | 19.4 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 13.8 | 20.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 8.2 | 13.2 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 0.3 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.0 | 2.1 | 1.8 |
Owners and operators
Legal business name: FORT MADISON HEALTH CENTER OPERATIONS LLC.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Holtkamp, Mark | 5% or greater direct ownership interest | Individual | 50% | 03/01/2020 |
| Kidwell, Kevin | 5% or greater direct ownership interest | Individual | 50% | 03/01/2020 |
| Lee County Bank | 5% or greater security interest | Organization | 03/01/2020 | |
| Fullhart, Dawn | W-2 managing employee | Individual | 10/14/2022 | |
| Holtkamp, Mark | Corporate director | Individual | 03/01/2020 | |
| Kidwell, Kevin | Corporate director | Individual | 03/01/2020 | |
| Holtkamp, Mark | Corporate officer | Individual | 03/01/2020 |
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.
- Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 4 problems in this area, most recently on April 16, 2026: "Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards."
- When is the care plan meeting, and can family attend it?Inspectors cited 4 problems in this area, most recently on April 24, 2025: "Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed."
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 4 problems in this area, most recently on April 24, 2025: "Provide appropriate treatment and care according to orders, resident’s preferences and goals."
- How are medications reviewed, and how often are antipsychotic or sedating drugs used?Inspectors cited 4 problems in this area, most recently on April 24, 2025: "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."
- How long has the current administrator been here?CMS counts 1 administrator who left in the period it measured.
Other nursing homes nearby
- Montrose Health Center Montrose, 7.3 mi · 3 of 5 stars · 15 citations
- West Point Care Center Inc West Point, 8.1 mi · 5 of 5 stars · 9 citations
- River Hills Village in Keokuk Keokuk, 13.4 mi · 3 of 5 stars · 8 citations
- Mississippi Valley Keokuk, 14.1 mi · 3 of 5 stars · 12 citations
- Southeast Iowa Healthcare Center Keokuk, 14.2 mi · 4 of 5 stars · 7 citations
- Oakview Nursing and Rehabilitation Burlington, 15.9 mi · 3 of 5 stars · 17 citations
- Southeast Iowa Regional Medical - Klein Center West Burlington, 16.3 mi · 2 of 5 stars · 19 citations
- New London Specialty Care New London, 20.8 mi · 2 of 5 stars · 8 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 Birkwood Village of Fort Madison's Medicare star rating?
- CMS rates Birkwood Village of Fort Madison 3 out of 5 stars overall, with 3 for health inspections, 3 for staffing and 4 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Birkwood Village of Fort Madison get at its last inspection?
- 2 health deficiencies at the standard inspection on April 16, 2026. The Iowa average is 6.5.
- Has Birkwood Village of Fort Madison been fined?
- CMS lists no fines in the last three years.
- Does Birkwood Village of Fort Madison 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 Birkwood Village of Fort Madison?
- CMS lists 7 owners and managers. Legal business name: FORT MADISON HEALTH CENTER OPERATIONS 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.