Titonka Care Center
312 First Avenue Nw, Titonka, IA 50480 · Kossuth County · (515) 928-2600
26 certified beds, about 20 residents a day · Non profit - Corporation · Medicare and Medicaid since 2000
CMS Care Compare ratings, data as of September 1, 2026 · CCN 165431 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on April 30, 2026, inspectors cited 0 health deficiencies (the Iowa average is 6.5, the national average 9.2).
None of its 9 health citations since May 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 4.15 hours per resident per day, against 3.82 across Iowa and 3.86 nationally. Registered nurses accounted for 1.04 of those hours.
25.0% 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 9 health citations on file.
April 30, 2026Standard inspection · 0 citations
April 17, 2025Standard inspection · 7 citations
- F 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 wroteBased on facility record review and staff interviews, the facility failed to employ a licensed Administrator. The facility reported a census of 21 residents.
- F Provide and implement an infection prevention and control program.
Inspectors wroteBased on observation, infection control policy and staff interview, the facility failed to initiate a legionella water program for the facility. The facility reported a total census of 21 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, staff interview and policy review the facility failed to obtain a bed hold notification for 1 of 2 residents reviewed (Resident #2). The facility reported a census of 21.
- D Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on observation, record review, policy review, resident and staff interviews, the facility failed to administer medications per physician orders and failed to accurately record follow up to a medication for 1 of 1 residents reviewed (Resident #9). The facility reported a census of 21 residents.
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on clinical record reviews, staff interviews and policy review, the facility failed to do neurological assessments with unwitnessed falls for 1 of 1 residents reviewed (Resident #1). Resident #1 had 14 falls since May 2024, out of those 14 falls the facility failed to do neurological assessments on 7 of those unwitnessed falls.
- D Provide safe and appropriate respiratory care for a resident when needed.
Inspectors wroteBased on observations, record review, staff interviews and policy reviews, the facility failed to change and label oxygen tubing for 1 of 1 residents reviewed (Resident #2). The facility reported a census of 21.
- 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 record review, interviews, and policy review , the facility failed to ensure residents whom the facility administered psychotropic medications were monitored for targeted behaviors and failed to utilize non-pharmacological interventions for 1 of 5 residents reviewed (Resident #12). The facility reported a census of 21 residents.
May 2, 2024Standard inspection · 2 citations
- F Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Inspectors wroteBased on record review and staff interview, the facility failed to report Payroll Based Journal (PBJ) during the 1st quarter of fiscal year 2024. The facility reported a census of 13 residents.
- F Provide and implement an infection prevention and control program.
Inspectors wroteBased on observations, 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 2 of 2 residents reviewed (Residents #1, #8). The facility failed to complete hand hygiene after removing gloves and did not complete an annual review of the infection control policies/procedures. The facility reported a census of 13 residents.
Fire safety inspections
12 fire safety citations on file: 12 on April 17, 2025.
Every fire safety citation12 citations
- F Develop and maintain an Emergency Preparedness Program (EP).
- F Conduct risk assessment and an All-Hazards approach.
- F Address patient/client population and determine types of services needed.
- F Establish procedures for tracking staff and patients during an emergency.
- F Establish policies and procedures for sheltering.
- F Create arrangements with other facilities to receive patients.
- F Establish roles under a Waiver declared by secretary.
- F List the names and contact information of those in the facility.
- F Provide emergency officials' contact information.
- F Provide primary/alternate means for communication.
- F Provide family notifications of emergency plan.
- F Conduct testing and exercise requirements.
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) | 4.15 | 3.82 | 3.86 |
| Registered nurses | 1.04 | 0.74 | 0.69 |
| All nursing staff on weekends | 3.23 | 3.37 | 3.42 |
| Nurse aides | 2.53 | ||
| Licensed practical nurses | 0.58 | ||
| Nursing staff turnover (share who left in a year) | 25.0% | 44.0% | 45.8% |
| Registered nurse turnover | 20.0% | 42.1% | 42.9% |
| Administrators who left | not reported |
CMS expects 2.93 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 4.52 on weekdays and 3.23 on weekends, 29% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 0.3% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.22 in April to June 2025 to 4.15 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 | 4.15 | 1.04 | 4.52 | 3.23 | 0.3% | 0 of 90 | 20 |
| Oct to Dec 2025 | 3.92 | 1.20 | 4.30 | 2.96 | 0.0% | 0 of 92 | 20 |
| Jul to Sep 2025 | 4.16 | 1.17 | 4.55 | 3.19 | 0.0% | 0 of 92 | 20 |
| Apr to Jun 2025 | 4.22 | 1.17 | 4.60 | 3.27 | 0.1% | 0 of 91 | 20 |
| 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 | 14.5 | 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 | 4.0 | 2.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 9.2 | 3.8 | 3.2 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 18.6 | 16.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 3.5 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 14.6 | 19.4 | 15.4 |
Owners and operators
Legal business name: TITONKA COMMUNITY REST HOME, INC..
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Rasch, Corey | Contracted managing employee | Individual | 10/04/2021 | |
| Anderson Post, Sherri | Corporate director | Individual | 06/04/2018 | |
| Gerzema, Dean | Corporate director | Individual | 06/04/2018 | |
| Rasch, Corey | Corporate director | Individual | 10/04/2021 | |
| Anderson Post, Sherri | Corporate officer | Individual | 06/04/2018 | |
| Buffington-Missman, Tammy | Corporate officer | Individual | 06/04/2018 | |
| Christensen, Wendell | Corporate officer | Individual | 06/04/2018 | |
| Heyer, Steven | Corporate officer | Individual | 06/04/2018 | |
| Larsen, Paul | Corporate officer | Individual | 06/04/2018 | |
| Phelps, Laura | Corporate officer | Individual | 06/04/2018 | |
| Continuum Health Care Services LLC | Operational/managerial control | Organization | 08/01/2006 |
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 2 problems in this area, most recently on April 17, 2025: "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."
- What changed in infection control since the last inspection, and who on staff is the infection preventionist?Inspectors cited 2 problems in this area, most recently on April 17, 2025: "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 2 problems in this area, most recently on April 17, 2025: "Provide appropriate treatment and care according to orders, resident’s preferences and goals."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 1 problem in this area, most recently on April 17, 2025: "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."
- Who is on the floor on Saturday and Sunday, and how many residents does each aide care for?Weekend nurse staffing here was 3.23 hours per resident per day, below the Iowa average of 3.37.
Other nursing homes nearby
- Accura Healthcare of Bancroft Bancroft, 9.1 mi · 5 of 5 stars · 5 citations
- Timely Mission Nursing Home Buffalo Center, 11.5 mi · 5 of 5 stars · 7 citations
- Algona Manor Care Center Algona, 14.3 mi · 5 of 5 stars · 12 citations
- Westview Care Center Britt, 15.4 mi · 5 of 5 stars · 0 citations
- Good Samaritan - Algona Algona, 15.4 mi · 3 of 5 stars · 27 citations
- Good Samaritan - Forest City Forest City, 20.4 mi · 4 of 5 stars · 9 citations
- Kanawha Community Home, Inc. Kanawha, 24.1 mi · 5 of 5 stars · 3 citations
- Concord Care Center Garner, 24.2 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 Titonka Care Center's Medicare star rating?
- CMS rates Titonka Care Center 5 out of 5 stars overall, with 4 for health inspections, 5 for staffing and 4 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did Titonka Care Center get at its last inspection?
- 0 health deficiencies at the standard inspection on April 30, 2026. The Iowa average is 6.5.
- Has Titonka Care Center been fined?
- CMS lists no fines in the last three years.
- Does Titonka 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 Titonka Care Center?
- CMS lists 11 owners and managers. Legal business name: TITONKA COMMUNITY REST HOME, 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.