2651 St. Francis Drive, Waterloo, IA 50702 · Black Hawk County · (319) 232-6808
176 certified beds, about 131 residents a day · Non profit - Corporation · Medicare and Medicaid since 1995
CMS Care Compare ratings, data as of September 1, 2026 · CCN 165251 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on November 17, 2025, inspectors cited 5 health deficiencies (the Iowa average is 6.5, the national average 9.2).
Of 37 health citations since August 2023, 3 were rated as actual harm or immediate jeopardy to residents.
CMS lists 3 fines totaling $48,335 in the last three years; the largest was $22,205, and the latest is dated May 21, 2026.
Nurses and nurse aides worked 3.35 hours per resident per day, against 3.82 across Iowa and 3.86 nationally. Registered nurses accounted for 0.64 of those hours.
30.2% of nursing staff left within the year CMS measured (Iowa average 44.0%).
CMS links it to Care Initiatives, an affiliated group of 43 nursing homes.
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.
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 37 health citations on file.
Inspectors wroteBased on clinical review, staff interview, family interview, facility investigation, incident report, hospital record review, and facility policy the facility failed to ensure safe handling of equipment during resident assistance which resulted with a hematoma, laceration, unnecessary pain, 3 units of blood, prolonged hospitalization, wound assessments, and wound care for 1 out of 3 residents reviewed (Resident #2). The facility reported a census of 137.
Inspectors wroteBased on clinical record review, hospital record review, external clinic record review and staff interview the facility failed to assess a wound and document complete assessments for 1 of 4 residents reviewed (Resident #9). Resident #9 required emergency medical services including a foot amputation. The facility reported a census of 131 residents.
Inspectors wroteBased on clinical record review, resident and staff interview and policy review the facility failed to provide an adequate intervention after a resident fell for 1 of 4 residents reviewed for falls (Resident #1). The facility used a mechanical lift to get Resident #1 off the floor and into his bed despite complaints of hip pain and not wanting to move his leg. Upon assessment, the hospital found a fracture in Resident #1's leg. The facility reported a census of 131 residents.
Inspectors wroteBased on observation, policy review, resident, and staff interviews the facility failed to answer call lights in a timely manner. This resulted in residents to not use the call light, being forgotten on the toilet, and unable to seek assistance when needed for 4 of 5 residents (Residents #1, #3, #10 and a confidential source) reviewed for call lights. The facility reported a census of 131 residents.
Inspectors wroteBased on observation, clinical record review, facility policy review, and staff interviews, the facility failed to maintain effective infection control and isolation procedures for 1 of 3 residents reviewed (Resident #7), specifically regarding contact precautions and hand hygiene during care for a resident with an infectious disease. The facility reported a census of 131 residents.
Inspectors wroteBased on observation, resident interview, staff interview and policy review, the facility failed to ensure call lights were in reach and accessible for 2 of 5 residents (Resident #9 and a confidential source) reviewed for call light use. The facility reported a census of 131 residents.
Inspectors wroteBased on clinical record review, policy review, staff, family, and resident interviews, the facility failed to notify the provider when a resident on an antiplatelet medication developed a nosebleed for 1 of 3 residents reviewed (Resident #5) for medications. The facility reported a census of 131 residents.
Inspectors wroteBased on clinical record review, policy review, resident and staff interviews, the facility failed to ensure staff followed physician orders for dressing changes, failed to provide appropriate assistance to a resident that fell, failed to notify all staff when a resident should be on contact precautions and failed to ensure staff washed their hands properly for 2 of 5 nurses reviewed. The facility reported a census of 131 residents.
Inspectors wroteBased on observation, resident and staff interviews, record review and policy review the facility failed to ensure resident's rooms were clean for 4 of 4 residents who complained about the cleanliness of their rooms (Resident #40, #41, #118 and #122). In addition, the facility failed to keep dirty laundry off of the floor in the laundry room. The facility reported a census of 129 residents.
Inspectors wroteBased on observations, policy review, resident and staff interviews, the facility failed to provide sufficient staffing to ensure resident safety and meet their needs. The facility reported a census of 129 residents.
Inspectors wroteBased on observations, record review, staff interview and policy review, the facility failed to complete an accurate skin assessment for 1 of 2 residents reviewed (Resident #31). The facility reported a census of 129 residents.
Inspectors wroteBased on clinical record review, observation, staff interviews, and policy review, the facility failed to ensure safe and accurate delivery of oxygen therapy for one of one resident reviewed for respiratory care (Resident #95). The facility reported a census of 129 residents.
Inspectors wroteBased on observation, policy review and staff interviews the facility failed to ensure all medications were dated when opened. The facility reported a census of 129.
Inspectors wroteBased on clinical record review, resident, family and staff interview the facility failed to complete oral cares as required for 1 of 4 residents reviewed (Resident #1). The facility census was 120 residents.
Inspectors wroteBased on observation, policy review and staff interviews, the facility failed to date, date, cover, or label items after opening. In addition, the facility failed to have clean dishes when serving the meal. The facility reported a census of 114 residents.
Inspectors wroteBased on clinical record review, policy review, and staff interviews, the facility failed to have a consistent code status between the physician orders, the electronic health record (EHR), and the Care Plan for 1 of 1 resident reviewed for Advanced Directives (Resident #101). The facility reported a census of 116 residents.
Inspectors wroteBased on clinical record review and staff interviews the facility failed to provide the Skilled Nursing Facility Advance Beneficiary Notice of Non coverage form CMS 10055 (SNF ABN) for 1 of 3 residents (Resident #372) reviewed. The facility reported a census of 116.
Inspectors wroteBased on clinical record review and staff interview, the facility failed to submit a Preadmission Screening and Resident Review (PASRR) evaluation for 1 of 2 residents reviewed with a new mental health diagnosis (Resident #63). The facility reported a census of 116 residents.
Inspectors wroteBased on clinical record review, policy review and staff interview the facility failed to ensure staff use the assistance of two certified nursing assistants (CNA) when using the full body mechanical lift (transferring a person using a sling that are dependent upon staff to move from the bed and/or chair) to transfer for 2 of 3 residents sampled (Resident #12 and #34). The facility reported a census of 116 residents.
Inspectors wroteBased on observation, clinical record review, policy review and staff interview, the facility failed to provide clean peri care per the standards of practice for 1 of 2 residents sampled (Resident #65). As the staff provided peri-care to Resident #65, they failed to wipe front to back, change their gloves as completing a dirty task, complete hand hygiene prior to applying gloves, and removing their gloves. The facility identified a census of 116 residents.
Inspectors wroteBased on clinical record review, family and staff interviews the facility failed to complete an informed consent for a psychotropic medication for 1 of 1 resident reviewed (Resident #1). The facility reported a census of 127 residents.
Inspectors wroteBased on clinical record review, staff and resident interviews, and observations, the facility failed to provide comfortable and therapeutic dining accommodations for 1 of 17 residents reviewed (Resident #2). The facility reported a census of 123 residents.
Inspectors wroteBased on observation, policy review and staff interview the facility failed to provide a homelike environment by serving 2 of 3 dining rooms (A wing and B wing dining areas) meals on plastic food serving trays. The facility identified a census of 138 residents. An initial observation of the B wing dining room on 7/31/23 at 11:46 a.m. 15 residents sat in the dining room eating their lunch meals off of black plastic food trays. Observation on 8/01/23 at 7:56 a.m. revealed Resident #11, #60, #119, and #120 seated at their dining room tables eating breakfast off of black plastic food trays. Further observation revealed 12 dirty black food tray on a cart that had been removed from the tables with all dishes contained on the food trays. Observation on 8/01/23 at 8:32 a.m. revealed 13 residents sat in the A wing dining room eating breakfast from black plastic food trays. [...]
Inspectors wroteBased on observation, staff interviews, resident interviews, and policy review, the facility failed to provide 4 of 6 residents reviewed with functioning call system devices to allow resident to staff communication (Resident #7, #10 #12, #32). The facility reported a census of 138.
Inspectors wroteBased on clinical record review, staff and resident interviews, and policy review, the facility failed to assure residents were treated with respect and dignity for 1 of 5 residents reviewed (Resident #123). The facility reported a census of 138 residents.
Inspectors wroteBased on clinical record review, observation, staff and resident interviews, and policy review, the facility failed to accommodate residents needs with assurance of accessibility to call lights within resident's reach and ability to operate for 1 of 1 residents reviewed (Resident #123). The facility reported a census of 138 residents.
Inspectors wroteBased on clinical record review, document review, and staff interview the facility failed to provide the resident or the resident's legal representative with a Skilled Nursing Advance Beneficiary Notice of Non-Coverage (SNF/ABN) and Notice of Medicare Non-Coverage (NOMNC) to document an appeal decision and the date of notification of Medicare non-coverage for 1 of 3 residents sampled (Resident #130). The facility identified a census of 138 residents.
Inspectors wroteBased on record review, resident interviews, staff interviews and policy review the facility failed to make efforts to investigate or resolve resident grievances regarding a lost hearing aid for 1 of 3 resident reviewed (Resident #121). The facility reported a census of 138 residents.
Inspectors wroteBased on clinical record review and staff interview, the facility failed to submit a Level 2 Preadmission Screening and Resident Review (PASRR) evaluation for 1 of 1 residents reviewed with a new mental health diagnosis (Resident #69). The facility reported a census of 138 residents.
Inspectors wroteBased on clinical record review and staff interview, the facility failed to submit a Level 1 Preadmission Screening and Resident Review (PASRR) evaluation to the appropriate state-designated authority prior to the expiration date for 1 of 1 residents reviewed (Resident #17). The facility reported a census of 138 residents.
Inspectors wroteBased on observation, clinical record review, resident and staff interviews, the facility failed to follow the physician ordered wound treatment for 1 of 4 residents sampled (Resident #97). The facility identified a census of 138 residents.
Inspectors wroteBased on observation,clinical record review, policy reviews, and resident and staff interviews, the facility failed to provide cleanliness and grooming by neglecting nail care for dependent residents for 1 of 5 reviewed (Resident #54); failed to complete residents' baths for 2 of 3 residents reviewed for bathing (Resident #123 and Resident #125) and failed to provide appropriate peri care for 1 of 3 residents reviewed (resident #90). The facility reported a census of 138 residents.
Inspectors wroteBased on observation, clinical record review, document review, policy review, and staff interviews, the facility failed to apply a left-hand orthotic device and failed to reposition to prevent contracture and skin breakdown per the care plan for 1 of 3 residents sampled. (Resident #90). The facility identified a census of 138 residents.
Inspectors wroteBased on observation, clinical record review, policy review, and staff interview the facility failed to place a urinal within reach, provide incontinence check and failed to prevent catheter tubing from coming into contact with the floor for 2 of 3 residents sampled (Resident #25 and #34). The Facility identified a census of 138 residents.
Inspectors wroteBased on clinical record review, policy review, and staff interview, the facility failed to limit as needed (PRN) medication to 14 days without a rationale from the physician to extend the medication for 1 of 5 residents reviewed for unnecessary medications (Resident #79). The facility reported a census of 138 residents.
Inspectors wroteBased on observation, policy review, and staff interviews, the facility failed to ensure open items were dated, covered and labeled, refrigerators were kept clean and milk served was in a safe temperature range. The facility reported a census of 138 residents.
Inspectors wroteBased on observations and staff interviews, the facility failed to maintain a clean and sanitary environment for the residents. The facility reported a census of 138 residents. Findings Include: An Interview on 7/31/23 at 1:23 p.m. Resident # 84 reported the carpet down hallways are dirty with stains and feels that the facility is not addressing the carpet. An observation 7/31/23 at 2:00 p.m. of the carpet down the hallways showed it soiled with several stains noted down hallway C and E and the carpet to the general population dining room and the nurses station. Newer carpet down halls F and G noted to have spots of stains. An observation on 8/1/23 at 12:45 p.m. noted spots and stains on carpet to all areas remain. An interview on 8/2/23 at 11:20 a.m. with Staff L, Housekeeping Aide, reported the facility did not have staff that cleans the carpet. The carpet is contracted out. [...]
30 fire safety citations on file: 5 on November 17, 2025, 9 on October 24, 2024, 16 on August 3, 2023.
| Date | Penalty | Amount or length |
|---|---|---|
| May 21, 2026 | Fine | $13,065 |
| May 21, 2026 | Fine | $13,065 |
| May 21, 2026 | Fine | $22,205 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
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) | 3.35 | 3.82 | 3.86 |
| Registered nurses | 0.64 | 0.74 | 0.69 |
| All nursing staff on weekends | 3.07 | 3.37 | 3.42 |
| Nurse aides | 2.17 | ||
| Licensed practical nurses | 0.54 | ||
| Nursing staff turnover (share who left in a year) | 30.2% | 44.0% | 45.8% |
| Registered nurse turnover | 14.3% | 42.1% | 42.9% |
| Administrators who left | 2 |
CMS expects 3.46 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
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 3.46 on weekdays and 3.07 on weekends, 11% 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 3.57 in April to June 2025 to 3.35 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 | 3.35 | 0.64 | 3.46 | 3.07 | 0.0% | 0 of 90 | 131 |
| Oct to Dec 2025 | 3.41 | 0.72 | 3.52 | 3.13 | 0.0% | 0 of 92 | 127 |
| Jul to Sep 2025 | 3.26 | 0.67 | 3.39 | 2.94 | 0.0% | 0 of 92 | 126 |
| Apr to Jun 2025 | 3.57 | 0.74 | 3.72 | 3.18 | 0.0% | 0 of 91 | 118 |
| 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
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.
| 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.
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 | 20.1 | 17.1 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 3.0 | 1.5 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 4.7 | 2.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 3.1 | 3.8 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 1.4 | 2.1 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 18.2 | 16.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 1.8 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 31.5 | 19.4 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 23.0 | 20.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 6.9 | 13.2 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.6 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.3 | 2.1 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Ravenwood Specialty Care's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (41.0% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
41.0% this home
No different from the national rate
US median of homes 51.5% · Iowa: 28 better, 21 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 50 eligible stays.
10.2% this home
No different from the national rate
US median of homes 10.7% · Iowa: 1 better, 1 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 63 eligible stays.
7.9% this home
No different from the national rate
US median of homes 7.1% · Iowa: 0 better, 0 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 37 eligible stays.
27.8% this home
Median of homes: Iowa56.7% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 36 residents counted.
0.0% this home
Median of homes: Iowa0.0% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 42 residents counted.
0.0% this home
Median of homes: Iowa1.8% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 42 residents counted.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Median of homes: Iowa100.0% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 15 residents counted.
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.
Legal business name: CARE INITIATIVES. CMS links this home to Care Initiatives, a group of 43 nursing homes averaging 2.9 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Care Initiatives | 5% or greater direct ownership interest | Organization | 100% | 09/01/2009 |
| Computershare Corporate Trust Company, Na | 5% or greater mortgage interest | Organization | 01/01/2025 | |
| Beal, Michael | Corporate director | Individual | 06/01/2020 | |
| Bowen, Lane | Corporate director | Individual | 01/01/2020 | |
| Carothers, Mary Jane | Corporate director | Individual | 01/01/2023 | |
| Childs, Kevin | Corporate director | Individual | 04/01/2023 | |
| Corless, Peter | Corporate director | Individual | 01/01/2025 | |
| Krein, Keith | Corporate director | Individual | 06/29/2022 | |
| Rust, Elizabeth | Corporate director | Individual | 01/01/2023 | |
| Sturm, Denise | Corporate director | Individual | 01/01/2020 | |
| Upmeyer, Linda | Corporate director | Individual | 01/01/2022 | |
| Beal, Michael | Corporate officer | Individual | 06/01/2020 | |
| Dixon, David | Corporate officer | Individual | 06/01/2016 | |
| Drake, Emily | Corporate officer | Individual | 01/04/2023 | |
| Gilyard, Tanya | Corporate officer | Individual | 05/23/2025 | |
| Kuhn, Jeramy | Corporate officer | Individual | 06/25/2008 | |
| McDyer, Jessica | Corporate officer | Individual | 02/22/2023 | |
| Volm, Johanna | Corporate officer | Individual | 01/01/2021 | |
| Baedke, Charissa | Operational/managerial control | Individual | 01/01/2024 | |
| Dufur, David | Operational/managerial control | Individual | 04/27/2024 | |
| Purdy, Angelena | Operational/managerial control | Individual | 01/03/2025 | |
| Ughetti, Anthony | Operational/managerial control | Individual | 06/23/2025 | |
| Whyms, Brian | Operational/managerial control | Individual | 01/01/2024 | |
| Computershare Corporate Trust Company, Na | Adp of the SNF | Organization | 08/05/2025 | |
| Dufur, David | Adp of the SNF | Individual | 08/05/2025 | |
| Purdy, Angelena | Adp of the SNF | Individual | 08/05/2025 | |
| Ughetti, Anthony | Adp of the SNF | Individual | 08/05/2025 | |
| Whyms, Brian | Adp of the SNF | Individual | 08/05/2025 |
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.
Chosen from this home's own inspection record.
These are the official offices in Iowa. NursingHomeClear cannot take or act on complaints.