Palo Alto County Hospital
3201 First Street, Emmetsburg, IA 50536 · Palo Alto County · (712) 852-5520
22 certified beds, about 22 residents a day · Government - County · Medicaid since 1986
CMS Care Compare ratings, data as of September 1, 2026 · CCN 16E668 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on July 17, 2025, inspectors cited 1 health deficiency (the Iowa average is 6.5, the national average 9.2).
None of its 1 health citation since December 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 3.07 hours per resident per day, against 3.82 across Iowa and 3.86 nationally. Registered nurses accounted for 1.36 of those hours.
17.6% 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 1 health citation on file.
July 17, 2025Standard inspection · 1 citation
- F Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Inspectors wroteBased on the Center of Medicare and Medicaid Services (CMS) Payroll Based Journal (PBJ) Staffing Data Report (January 1- March 31), facility time card records and staff interviews, the facility failed to submit accurate staff data for the PBJ Staffing Data Report. The facility reported a census of 21 residents.
August 29, 2024Standard inspection · 0 citations
December 7, 2023Standard inspection · 0 citations
Fire safety inspections
6 fire safety citations on file: 2 on July 17, 2025, 2 on August 29, 2024, 2 on December 7, 2023.
Every fire safety citation6 citations
- F Have simulated fire drills held at unexpected times.
- F Have generator or other power source capable of supplying service within 10 seconds.
- F Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.
- F Have simulated fire drills held at unexpected times.
- F Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- F Have generator or other power source capable of supplying service within 10 seconds.
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) | 3.07 | 3.82 | 3.86 |
| Registered nurses | 1.36 | 0.74 | 0.69 |
| All nursing staff on weekends | 2.30 | 3.37 | 3.42 |
| Nurse aides | 1.57 | ||
| Licensed practical nurses | 0.13 | ||
| Nursing staff turnover (share who left in a year) | 17.6% | 44.0% | 45.8% |
| Registered nurse turnover | 14.3% | 42.1% | 42.9% |
| Administrators who left | not reported |
CMS expects 3.31 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 3.38 on weekdays and 2.30 on weekends, 32% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 1.3% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.39 in April to June 2025 to 3.07 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 | 3.07 | 1.36 | 3.38 | 2.30 | 1.3% | 0 of 90 | 22 |
| Oct to Dec 2025 | 3.16 | 1.26 | 3.44 | 2.46 | 0.6% | 0 of 92 | 22 |
| Jul to Sep 2025 | 3.48 | 1.53 | 3.86 | 2.53 | 1.7% | 0 of 92 | 22 |
| Apr to Jun 2025 | 3.39 | 1.57 | 3.78 | 2.41 | 1.2% | 0 of 91 | 22 |
| 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. If you work here, your report helps start one.
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 | 23.5 | 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 | 1.2 | 2.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 3.5 | 3.8 | 3.2 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 17.9 | 16.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 1.6 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 6.1 | 19.4 | 15.4 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.0 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.3 | 2.1 | 1.8 |
Short-term rehab results
For a stay to recover after a hospital visit, these are the results CMS publishes for Palo Alto County Hospital's Medicare short-stay residents. How to read these, and what Medicare pays for.
CMS reports none of these results for this home: This nursing home is not required to submit data for the Skilled Nursing Facility Quality Reporting Program.
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: Legal Business Name Not Available.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Ownership data not available |
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.
- Who is the administrator and director of nursing, and how long have they been in the job?Inspectors cited 1 problem in this area, most recently on July 17, 2025: "Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 2.30 hours per resident per day, below the Iowa average of 3.37.
Other nursing homes nearby
- Lakeside Lutheran Home Emmetsburg, 0.4 mi · 3 of 5 stars · 22 citations
- Emmetsburg Care Center Emmetsburg, 1.3 mi · 1 of 5 stars · 22 citations
- Ruthven Community Care Center Ruthven, 10.6 mi · 4 of 5 stars · 6 citations
- West Bend Health and Rehabilitation West Bend, 16.6 mi · 5 of 5 stars · 18 citations
- Estherville Community Care Center Estherville, 20.6 mi · 2 of 5 stars · 22 citations
- Laurens Care Center Laurens, 20.6 mi · 4 of 5 stars · 15 citations
- Good Samaritan - Estherville Estherville, 20.9 mi · 3 of 5 stars · 26 citations
- Valley Vue Care Center Armstrong, 21.7 mi · 5 of 5 stars · 11 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 Palo Alto County Hospital's Medicare star rating?
- CMS rates Palo Alto County Hospital 4 out of 5 stars overall, with 4 for health inspections, 4 for staffing and 4 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Palo Alto County Hospital get at its last inspection?
- 1 health deficiency at the standard inspection on July 17, 2025. The Iowa average is 6.5.
- Has Palo Alto County Hospital been fined?
- CMS lists no fines in the last three years.
- Does Palo Alto County Hospital accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns Palo Alto County Hospital?
- CMS lists 1 owner or manager. Legal business name: Legal Business Name Not Available.
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.