Friendship Home Association
714 Division, Audubon, IA 50025 · Audubon County · (712) 563-2651
46 certified beds, about 37 residents a day · Non profit - Corporation · Medicare and Medicaid since 1994
CMS Care Compare ratings, data as of September 1, 2026 · CCN 165232 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on June 19, 2025, inspectors cited 0 health deficiencies (the Iowa average is 6.5, the national average 9.2).
None of its 14 health citations since November 2023 was rated as actual harm or immediate jeopardy.
CMS lists 4 fines totaling $11,536 in the last three years; the largest was $4,194, and the latest is dated November 6, 2023.
Nurses and nurse aides worked 3.92 hours per resident per day, against 3.82 across Iowa and 3.86 nationally. Registered nurses accounted for 0.54 of those hours.
60.5% 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.
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 14 health citations on file.
July 30, 2026Complaint inspection · 3 citations
- E Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Inspectors wroteBased on clinical record review, and staff interviews, the facility failed to ensure the completion of comprehensive discharge summaries-specifically the recapitulation of stay-for 3 of 3 residents sampled (Resident #43, #44, and #45). The facility failed to ensure that mandatory discharge elements, including a summary of diagnoses, course of illness, treatment, therapy, and pertinent diagnostic results, were generated and maintained in the medical record for residents upon discharge. The facility reported a census of 41 residents.
- E Ensure each resident receives an accurate assessment.
Inspectors wroteBased on clinical record review, staff interviews and guidance from the 2025 Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User's Manual, the facility failed to accurately complete Section P (Restraints and Alarms) of the Minimum Data Set (MDS) for 5 of 5 residents sampled (Residents #1, #3, #7, #26, #35). Specifically, the facility erroneously coded the use of bed rails as physical restraints on the MDS assessments. The facility reported a census of 41 residents.
- D Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on clinical record review, resident and staff interviews, facility reported incident documentation, and facility policy review, the facility failed to conduct a thorough investigation following a resident's fall with injury for 1 of 3 residents reviewed for falls (Resident #3). Specifically, the facility neglected to analyze the circumstances of the incident or interview the involved staff, resulting in an incomplete root cause analysis, hindering the facility's ability to prevent future falls. The facility reported a census of 41 residents.
September 4, 2025Complaint inspection · 2 citations
- D Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Inspectors wroteBased on Electronic Health Records (EHR) review, observation, document review, Medication Administration Record - Treatment Administration Record (MAR-TAR), staff interview and family interview the facility failed to notify the resident's representative / family / Power of Attorney (POA) for a new physicians order and change in condition when a wander guard was placed on the resident for 2 of 3 residents (Residents #2 and #3) reviewed. The facility reported a census of 42 residents.
- D Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on clinical Medication Administration Records - Treatment Administration Records (MAR-TAR), Electronic Health Records (EHR) review, document review, family interview, staff interview, and policy review the facility failed to provide adequate nursing supervision when a resident left the facility from a Chronic Confusion or Dementia Illness (CCDI) unit and walked outside into the back yard of a neighboring resident unknown to the staff for 1 of 3 residents (Resident #1) reviewed. The facility reported a census of 42.
June 19, 2025Standard inspection · 0 citations
August 1, 2024Standard inspection · 4 citations
- E Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Inspectors wroteBased on personnel document review, facility document review, staff interview, and policy review the facility failed to implement the abuse and neglect policy by not completing background checks prior to staff employment. The facility reported a census of 40 residents.
- 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.
Inspectors wroteBased on facility document review, observations, staff interview and policy review the facility failed to ensure that residents were served the food as listed on the menu, and failed to accurately measure the pureed food items for 3 of 3 residents reviewed. The facility reported a census of 40 residents.
- 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, staff interviews and policy review the facility failed to ensure that open containers of food had been dated. Staff failed to provide safe hand hygiene procedures during meal service. The facility reported a census of 40 residents.
- 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.
Inspectors wroteBased on clinical document review, staff interview, and policy review the facility failed to have the correct documentation of residents choice related to advanced directives for 1 of 5 residents (Resident #27) reviewed. The facility reported a census of 40 residents.
November 9, 2023Standard inspection · 5 citations
- E Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Inspectors wroteBased on observation, staff interview, and policy review, the facility failed to provide food served by a method to maintain a safe and appetizing temperature. The facility reported a census of 43.
- 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, document review, staff interview, and policy review the facility failed to store food and follow proper sanitation to prevent cross contamination and the spread of illness in accordance with professional standards. The facility reported a census of 43 residents.
- D Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.
Inspectors wroteTHE FOLLOWING DEFICIENCIES RELATE TO THE IOWA ADMINISTRATIVE CODE (IAC) CHAPTER 58. VA State Rule 58.12(1)l Within 30 days of a resident's admission to a health care facility receiving reimbursement through the medical assistance program under Iowa Code chapter 249 A, the facility shall ask the resident or the resident's personal representative whether the resident is a veteran and shall document the response. If the facility determines that the resident is a veteran, the facility shall report the resident's name along with the names of the resident's spouse and any dependent children, as well as the name of the contact person for this information, to the Iowa department of veteran's affairs. [...]
- D Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Inspectors wroteBased on record review and staff interview, the facility failed to ensure the required members attended the Quality Assessment and Assurance committee (QAA). The required members included: 1. The Nursing Home Administer (NHA) or representative; 2. Director of Nursing (DON); 3. The Medical Director (MD) or representative; 4. The Infection Preventionist; and 5. two other members of the facility's staff present on a minimum of a quarterly basis. The facility reported a census of 43.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, record review, policy review, and staff interview the facility failed to provide appropriate infection prevention practices when providing suprapubic catheter cares for 1 of 2 residents (Resident #26).
Fire safety inspections
16 fire safety citations on file: 5 on June 19, 2025, 9 on August 1, 2024, 2 on November 9, 2023.
Every fire safety citation16 citations
- F Properly install and monitor supervisory attachments on automatic sprinkler systems.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Ensure that testing and maintenance of electrical equipment is performed.
- E Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.
- E To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F Install a fire alarm system that can be heard throughout the facility.
- 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.
- E Inspect, test, and maintain automatic sprinkler systems.
- D Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D Install an approved automatic sprinkler system.
- D Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- D Have properly installed electrical wiring and gas equipment.
- E Ensure proper usage of power strips and extension cords.
- D Inspect, test, and maintain automatic sprinkler systems.
Fines and payment denials
| Date | Penalty | Amount or length |
|---|---|---|
| November 6, 2023 | Fine | $2,797 |
| October 30, 2023 | Fine | $2,447 |
| October 23, 2023 | Fine | $2,098 |
| October 2, 2023 | Fine | $4,194 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
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) | 3.92 | 3.82 | 3.86 |
| Registered nurses | 0.54 | 0.74 | 0.69 |
| All nursing staff on weekends | 3.34 | 3.37 | 3.42 |
| Nurse aides | 2.66 | ||
| Licensed practical nurses | 0.71 | ||
| Nursing staff turnover (share who left in a year) | 60.5% | 44.0% | 45.8% |
| Registered nurse turnover | 60.0% | 42.1% | 42.9% |
| Administrators who left | 0 |
CMS expects 2.83 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 4.16 on weekdays and 3.34 on weekends, 20% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 26.3% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.74 in April to June 2025 to 3.92 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 | 3.92 | 0.54 | 4.16 | 3.34 | 26.3% | 0 of 90 | 37 |
| Oct to Dec 2025 | 3.73 | 0.64 | 3.97 | 3.11 | 21.9% | 0 of 92 | 40 |
| Jul to Sep 2025 | 3.69 | 0.70 | 3.89 | 3.17 | 22.3% | 0 of 92 | 43 |
| Apr to Jun 2025 | 3.74 | 0.58 | 3.90 | 3.35 | 23.1% | 0 of 91 | 45 |
| 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.
Staff pay reports
Staff pay at this home
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.
Official wage estimates for Iowa
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Iowa, all employers | |||
| CNAs (nursing assistants) | $18.92 | $17.96 to $21.95 | 22,670 |
| LPNs and LVNs | $30.11 | $27.12 to $34.06 | 5,510 |
| Registered nurses | $37.80 | $32.83 to $41.32 | 34,420 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
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 | 17.9 | 17.1 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 1.5 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 4.9 | 2.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 1.2 | 3.8 | 3.2 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 12.7 | 16.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 0.7 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 36.5 | 19.4 | 15.4 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.3 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 3.3 | 2.1 | 1.8 |
Short-term rehab results
For a stay to recover after a hospital visit, these are the results CMS publishes for Friendship Home Association's Medicare short-stay residents. How to read these, and what Medicare pays for.
CMS reports none of these results for this home: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Owners and operators
Legal business name: FRIENDSHIP HOME ASSOCIATION.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Andersen, Jessica | W-2 managing employee | Individual | 08/24/2018 | |
| Alt, Melinda | Corporate director | Individual | 08/01/2021 | |
| Andersen, Jessica | Corporate director | Individual | 08/24/2018 | |
| Andersen, Timothy | Corporate director | Individual | 03/01/2015 | |
| Deist, Genelle | Corporate director | Individual | 06/01/2018 | |
| Edwards, Jeffrey | Corporate director | Individual | 03/01/2016 | |
| Frolich, Pattie | Corporate director | Individual | 08/01/2020 | |
| Jones, Mark | Corporate director | Individual | 08/01/2021 | |
| Nelsen, Karen | Corporate director | Individual | 01/01/2022 | |
| Wede, Susan | Corporate director | Individual | 03/01/2010 | |
| Andersen, Timothy | Corporate officer | Individual | 03/01/2015 | |
| Deist, Genelle | Corporate officer | Individual | 06/01/2018 | |
| Edwards, Jeffrey | Corporate officer | Individual | 03/01/2016 | |
| Andersen, Jessica | Operational/managerial control | Individual | 08/24/2018 |
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 August 1, 2024: "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."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 3 problems in this area, most recently on July 30, 2026: "Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies."
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 2 problems in this area, most recently on July 30, 2026: "Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents."
- Who is the administrator and director of nursing, and how long have they been in the job?Inspectors cited 2 problems in this area, most recently on November 9, 2023: "Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.34 hours per resident per day, below the Iowa average of 3.37.
Other nursing homes nearby
- Exira Care Center Exira, 9.3 mi · 2 of 5 stars · 21 citations
- Salem Lutheran Home Elk Horn, 10.8 mi · 1 of 5 stars · 46 citations
- Thomas Rest Haven Coon Rapids, 16.9 mi · 2 of 5 stars · 18 citations
- Caring Acres Nursing and Rehab Center Anita, 21.1 mi · 1 of 5 stars · 52 citations
- Elm Crest Retirement Community Harlan, 21.1 mi · 2 of 5 stars · 19 citations
- Heritage House Atlantic, 22.2 mi · 5 of 5 stars · 11 citations
- Atlantic Specialty Care Atlantic, 22.7 mi · 3 of 5 stars · 42 citations
- The New Homestead Care Center Guthrie Center, 23 mi · 3 of 5 stars · 21 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 Friendship Home Association's Medicare star rating?
- CMS rates Friendship Home Association 3 out of 5 stars overall, with 3 for health inspections, 4 for staffing and 3 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Friendship Home Association get at its last inspection?
- 0 health deficiencies at the standard inspection on June 19, 2025. The Iowa average is 6.5.
- Has Friendship Home Association been fined?
- Yes. CMS lists 4 fines totaling $11,536 in the last three years.
- Does Friendship Home Association 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 Friendship Home Association?
- CMS lists 14 owners and managers. Legal business name: FRIENDSHIP HOME ASSOCIATION.
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.