Heartland Care Center
604 East Fenton Po Box 608, Marcus, IA 51035 · Cherokee County · (712) 376-2500
38 certified beds, about 25 residents a day · Non profit - Corporation · Medicare and Medicaid since 1998
CMS high performing icon Certified for Medicaid Certified for Medicare
Overall
5 of 5
Health inspections
3 of 5
Staffing
5 of 5
Quality measures
5 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 165397 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on May 7, 2026, inspectors cited 5 health deficiencies (the Iowa average is 6.5, the national average 9.2).
None of its 18 health citations since April 2024 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 4.45 hours per resident per day, against 3.82 across Iowa and 3.86 nationally. Registered nurses accounted for 1.93 of those hours.
35.5% 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.
704/24
504/25
109/25
505/26
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 18 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
0J
0K
0L
Actual harm
0G
0H
0I
Potential for more than minimal harm
13D
5E
0F
Potential for minimal harm
0A
0B
0C
May 7, 2026Standard inspection · 5 citations
- 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.
Inspectors wroteBased on facility record review, staff interviews, and facility policy, the facility failed to provide nutritional assessments for Resident's #4, #14, #17, #20, #26, #32. The facility reported a census of 27 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 prepare, distribute and serve food in accordance with professional standards for food service safety. The facility identified a census of 27 residents.
- 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 clinical record review, staff interviews and policy review, the facility failed to notify the Physician and/or family when a resident had a significant change of condition for 3 of 3 residents reviewed (Resident #26, #17, #32). The facility reported a census of 27 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 facility records, resident interviews, and staff interviews, the facility failed to provide sufficient staff to care for residents in a timely manner. The facility reported a census of 27 residents.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observations, clinical record review, staff interviews, and policy review, the facility failed to provide a safe and sanitary environment to help prevent the development and transmission of communicable diseases and infections for 1 of 1 resident reviewed (Resident #23) for peri care. The facility reported a census of 27 residents.
September 25, 2025Complaint inspection · 1 citation
- D Provide safe and appropriate respiratory care for a resident when needed.
Inspectors wroteBased on interview, record and policy review the facility failed to provide adequate respiratory care for 1 of 3 residents reviewed. Resident #3 required supplemental oxygen. The staff failed to increase monitoring and failed to consult with the resident and family before requesting a change from scheduled oxygen to an as-needed (PRN) order. The resident experienced low oxygen saturations, increased lethargy and was hospitalized . The facility reported a census of 29 residents.
April 10, 2025Standard inspection · 5 citations
- E 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 and staff interview the facility failed to identify non-pharmacological interventions and targeted behaviors related to high risk medications in 5 out of 5 sampled residents reviewed (Resident #5, #7, #11, #13 and #28). The facility reported a census of 32 residents.
- D Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Inspectors wroteBased on clinical record review, interviews, and facility policy, the facility failed to ensure bed hold notice was signed by residents and or the resident's responsible person when residents transferred out of the facility, or on therapeutic leave, and failed to provide written notice of bed hold for 3 of 3 residents reviewed (Residents #3, #11 and #28). The facility reported a census of 32 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 2 residents (Resident #7) reviewed for PASRR requirements. The facility reported a census of 32 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 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 included in the comprehensive care plans (Resident #5, #7, and #28). The facility reported a census of 32 residents.
- D Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, clinical record review, staff interview, and per the current Centers for Disease Control and Prevention (CDC) guidelines the facility failed to use Enhanced Barrier Precautions (EBP) to prevent the spread of multidrug-resistant organisms (MDROs) during wound care for 1 out 1 resident reviewed (Resident #3). The facility reported a census of 32 residents.
April 4, 2024Standard inspection · 7 citations
- 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 observation, review of the menu, and staff interview, the facility failed to follow the menu as written for 1 meal, and failed to assure menus were reviewed and approved by a dietician. The facility reported a census of 29 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 observation and staff interview, the facility failed to assure they stored, prepared, distributed and served food in accordance with professional standards for food service safety. The facility reported a census of 39 residents.
- D Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Inspectors wroteBased on record review and staff interview, the facility failed to assure a discharged resident had a discharge summary that included a recapitulation of the resident's stay for 1 resident reviewed (Resident #30). The facility reported a census of 29 residents.
- D Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Inspectors wroteBased on record review and staff interview, the facility failed to assure restorative was completed as planned for 1 resident reviewed (Resident #22). The facility reported a census of 29 residents.
- D 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 observation, record review and staff interview, the facility failed to provide a resident with a urinary catheter, care and services to prevent infection for 1 of 3 residents reviewed (Resident #8). The facility reported a census of 29 residents.
- D Develop and implement policies and procedures for flu and pneumonia vaccinations.
Inspectors wroteBased on record review and staff interview the facility failed to assure residents and/or their representatives were educated on the options for the pneumonia vaccination and given the opportunity to accept or decline for 1 of 5 residents reviewed (Resident #18). The facility reported a census of 29 residents.
- D 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.
Inspectors wroteBased on record review and staff interview, the facility failed to assure residents had access to the most recent COVID-19 Vaccine for 1 of 5 residents reviewed (Resident #6). The facility reported a census of 29 residents.
Fire safety inspections
8 fire safety citations on file: 2 on May 7, 2026, 2 on April 10, 2025, 4 on April 4, 2024.
Every fire safety citation8 citations
- E Install corridor and hallway doors that block smoke.
- D Meet requirements for the use and maintenance of medical gas equipment.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Have generator or other power source capable of supplying service within 10 seconds.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Install corridor and hallway doors that block smoke.
- F Have simulated fire drills held at unexpected times.
- F Ensure that testing and maintenance of electrical equipment is performed.
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) | 4.45 | 3.82 | 3.86 |
| Registered nurses | 1.93 | 0.74 | 0.69 |
| All nursing staff on weekends | 3.55 | 3.37 | 3.42 |
| Nurse aides | 1.92 | ||
| Licensed practical nurses | 0.60 | ||
| Nursing staff turnover (share who left in a year) | 35.5% | 44.0% | 45.8% |
| Registered nurse turnover | 14.3% | 42.1% | 42.9% |
| Administrators who left | 0 |
CMS expects 2.94 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 4.81 on weekdays and 3.55 on weekends, 26% 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 3.89 in April to June 2025 to 4.45 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 | 4.45 | 1.93 | 4.81 | 3.55 | 0.0% | 0 of 90 | 25 |
| Oct to Dec 2025 | 4.44 | 1.83 | 4.79 | 3.58 | 0.0% | 0 of 92 | 24 |
| Jul to Sep 2025 | 2.45 | 0.90 | 2.59 | 2.09 | 0.0% | 30 of 92 | 28 |
| Apr to Jun 2025 | 3.89 | 1.19 | 4.16 | 3.22 | 0.0% | 0 of 91 | 30 |
| 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 | 14.7 | 17.1 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 1.3 | 1.5 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.0 | 2.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 6.7 | 3.8 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 3.5 | 2.1 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 16.8 | 16.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 0.0 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 16.9 | 19.4 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 11.5 | 20.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 0.0 | 13.2 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 0.8 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.8 | 2.1 | 1.8 |
Owners and operators
Legal business name: HEARTLAND CARE CENTER INC.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Sioux Valley Memorial Hospital Association | 5% or greater direct ownership interest | Organization | 100% | 07/19/2023 |
| Alesch, Lisa | Managing control - governing body | Individual | 01/01/2026 | |
| Brady, Dennis | Managing control - governing body | Individual | 01/01/2026 | |
| Gross, Rozanne | Managing control - governing body | Individual | 01/01/2026 | |
| Irwin, Kristi | Managing control - governing body | Individual | 01/01/2026 | |
| Jordan, Gary | Managing control - governing body | Individual | 01/01/2026 | |
| Leavitt, Robert | Managing control - governing body | Individual | 01/01/2026 | |
| Schlenger, Edward | Managing control - governing body | Individual | 01/01/2026 | |
| Schneider, John | Managing control - governing body | Individual | 01/01/2026 | |
| Nielsen, Tim | Corporate officer | Individual | 10/20/2025 | |
| Heartland Care Center Inc | Operational/managerial control | Organization | 07/19/2023 | |
| Sioux Valley Memorial Hospital Association | Operational/managerial control | Organization | 07/19/2023 | |
| Geha, Andrew | Operational/managerial control | Individual | 09/19/2019 | |
| Nielsen, Tim | Operational/managerial control | Individual | 10/20/2025 | |
| Heartland Care Center Inc | Adp of the SNF | Organization | 07/19/2023 | |
| Sioux Valley Memorial Hospital Association | Adp of the SNF | Organization | 07/19/2023 | |
| Geha, Andrew | Adp of the SNF | Individual | 09/19/2019 | |
| Nielsen, Tim | Adp of the SNF | Individual | 10/20/2025 |
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 May 7, 2026: "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."
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 4 problems in this area, most recently on May 7, 2026: "Provide and implement an infection prevention and control program."
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 3 problems in this area, most recently on September 25, 2025: "Provide safe and appropriate respiratory care for a resident when needed."
- When is the care plan meeting, and can family attend it?Inspectors cited 3 problems in this area, most recently on April 10, 2025: "Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed."
Other nursing homes nearby
- Happy Siesta Health Care Center Remsen, 8.3 mi · 4 of 5 stars · 5 citations
- Careage Hills Rehabilitation and Healthcare Cherokee, 13.5 mi · 2 of 5 stars · 20 citations
- Cherokee Specialty Care Cherokee, 13.7 mi · 3 of 5 stars · 26 citations
- Accura Healthcare of Cherokee, LLC Cherokee, 14.3 mi · 3 of 5 stars · 11 citations
- Good Samaritan - Lemars Le Mars, 17.5 mi · 4 of 5 stars · 6 citations
- Accura Healthcare of Le Mars Le Mars, 18 mi · 3 of 5 stars · 22 citations
- Prairie Ridge Care Center Orange City, 18 mi · 5 of 5 stars · 10 citations
- Kingsley Specialty Care Kingsley, 18 mi · 1 of 5 stars · 38 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 Heartland Care Center's Medicare star rating?
- CMS rates Heartland Care Center 5 out of 5 stars overall, with 3 for health inspections, 5 for staffing and 5 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Heartland Care Center get at its last inspection?
- 5 health deficiencies at the standard inspection on May 7, 2026. The Iowa average is 6.5.
- Has Heartland Care Center been fined?
- CMS lists no fines in the last three years.
- Does Heartland Care Center 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 Heartland Care Center?
- CMS lists 18 owners and managers. Legal business name: HEARTLAND CARE CENTER INC.
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.