{"schema_version":"1.0.0","facility":{"id":"cms-165019","ccn":"165019","name":"Chautauqua Guest Home #2","source_name":"Chautauqua Guest Home #2","facility_types":["skilled_nursing_facility","nursing_home"],"primary_type":"skilled_nursing_facility","universe":"cms_certified_nursing_homes","source_type_label":"Medicare and Medicaid","status":"active","status_label":"Active CMS certification","status_evidence":"VERIFIED","state":"IA","address":{"line1":"602 Eleventh Street","city":"Charles City","state":"IA","zip":"50616","county_name":"Floyd County","county_fips":"19067","county_method":"name_match","ssa_county_code":"330","urban":false},"location":{"lat":43.0527,"lon":-92.678,"method":"cms_published_coordinates"},"phone":"6412282353","certification":{"authority":"CMS","ccn":"165019","program":"Medicare and Medicaid","medicare":true,"medicaid":true,"first_approved":"1967-01-01","certified_beds":53,"resides_in_hospital":false,"evidence_class":"VERIFIED","care_compare_url":"https://www.medicare.gov/care-compare/details/nursing-home/165019"},"licenses":[],"license_note":"State licensure is issued by the state survey agency. State license records are not yet ingested for this facility; the federal CMS certification is shown instead.","capacity":{"certified_beds":53,"avg_residents_per_day":40.1},"ownership_type":"For profit - Corporation","ownership_class":"for_profit","legal_business_name":"CHAUTAUQUA GUEST HOMES INC","flags":{"ccrc":false,"abuse_icon":false,"high_performing":false,"inspection_over_2y":false,"changed_ownership_12mo":false,"resident_family_council":"Resident","sprinklers_all_areas":"Yes"},"ratings":{"overall":{"value":5},"health_inspection":{"value":4},"quality_measures":{"value":5},"long_stay_qm":{"value":4},"short_stay_qm":{"value":5},"staffing":{"value":5},"universe":"cms_certified_nursing_homes"},"staffing":{"nurse_aide_hprd":2.88454,"lpn_hprd":0.34707,"rn_hprd":0.8578,"licensed_hprd":1.20487,"total_nurse_hprd":4.08942,"weekend_total_nurse_hprd":3.71291,"weekend_rn_hprd":0.68603,"pt_hprd":0.0107,"nursing_turnover_pct":37,"rn_turnover_pct":33.3,"administrators_left":0,"case_mix_index":1.18779,"case_mix_index_ratio":0.84226,"case_mix_total_nurse_hprd":3.28552,"adjusted_total_nurse_hprd":4.81721,"source":"Payroll-Based Journal (PBJ), as published by CMS"},"health_survey_score":{"cycle1_date":"2025-09-18","cycle1_deficiencies":2,"cycle1_score":28,"cycle2_date":"2024-09-19","cycle23_deficiencies":0,"cycle23_score":0,"total_weighted_score":21},"cms_penalty_counts":{"fines":0,"fine_total":0,"payment_denials":0,"total":0},"operator_id":"op-chautauqua-guest-homes-inc","first_seen":"2026-11-07T00:15:24.640Z","last_changed":"2026-11-07T00:15:24.640Z","profile_url":"https://www.medicare.gov/care-compare/details/nursing-home/165019","provenance":[{"source_id":"cms_provider_info","source_record_id":"165019","url":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=165019&conditions%5B0%5D%5Boperator%5D=%3D","retrieved_at":"2026-11-07T00:15:24.640Z","source_updated_at":"2026-10-01","effective_date":"2026-10-01","jurisdiction":"US-CMS","fields":["name","address","phone","certification","certified_beds","ownership_type","legal_business_name","chain"],"evidence_class":"VERIFIED","status":"current"},{"source_id":"cms_provider_info","source_record_id":"165019","url":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=165019&conditions%5B0%5D%5Boperator%5D=%3D","retrieved_at":"2026-11-07T00:15:24.640Z","source_updated_at":"2026-10-01","effective_date":"2026-10-01","jurisdiction":"US-CMS","fields":["ratings","staffing","health_survey_score"],"evidence_class":"VERIFIED","status":"current","note":"Five-Star ratings and PBJ staffing apply to the CMS-certified universe only."}],"inspection_summary":{"count":6,"health_count":3,"fire_count":3,"complaint_count":1,"latest_date":"2025-09-18","latest_standard_health":"2025-09-18","earliest_date":"2023-06-22","window_note":"CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years. Older findings leave the dataset; their absence is not evidence they never happened.","evidence_class":"VERIFIED"},"deficiency_summary":{"count":10,"health_count":2,"fire_count":8,"open_count":0,"actual_harm_count":1,"immediate_jeopardy_count":0,"serious_count":1,"complaint_count":1,"by_severity":{"potential":9,"actual_harm":1},"by_scope_severity":{"F":7,"G":1,"E":2},"by_concept":{"environment_life_safety":8,"clinical_care":1,"food_nutrition":1},"type_ids":["cms-k0324","cms-f0697","cms-f0812","cms-k0321","cms-k0353","cms-k0761","cms-k0712","cms-k0918","cms-k0363"],"evidence_class":"VERIFIED"},"penalty_summary":{"count":0,"fines":0,"fine_total":0,"payment_denials":0},"ownership_summary":{"disclosures":33,"organizations":4,"individuals":27,"not_available":false}},"row":{"id":"cms-165019","ccn":"165019","name":"Chautauqua Guest Home #2","types":["skilled_nursing_facility","nursing_home"],"status":"active","state":"IA","city":"Charles City","zip":"50616","county_fips":"19067","county_name":"Floyd County","address":"602 Eleventh Street","beds":53,"residents":40.1,"ownership":"for_profit","operator_id":"op-chautauqua-guest-homes-inc","operator_name":"Chautauqua Guest Homes Inc","lat":43.0527,"lon":-92.678,"overall":5,"health_rating":4,"staffing_rating":5,"qm_rating":5,"nurse_hprd":4.09,"turnover":37,"inspections":6,"last_inspection":"2025-09-18","deficiencies":10,"serious":1,"ij":0,"open":0,"penalties":0,"fines_total":0,"deficiency_type_ids":["cms-k0324","cms-f0697","cms-f0812","cms-k0321","cms-k0353","cms-k0761","cms-k0712","cms-k0918","cms-k0363"],"universe":"cms","state_actions":0,"state_serious":0,"last_changed":"2026-11-07T00:15:24.640Z"},"operator":{"id":"op-chautauqua-guest-homes-inc","name":"Chautauqua Guest Homes Inc","legal_name":"CHAUTAUQUA GUEST HOMES INC","facility_count":2,"states":["IA"],"match_method":"exact_normalized_legal_name","evidence_class":"CORROBORATED"},"ownership":[{"owner_type":"individual","owner_name":"David Ayers","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage":41,"percentage_raw":"41%","association_date":"1970-01-01","owner_name_raw":"AYERS, DAVID"},{"owner_type":"individual","owner_name":"John Ayers","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage":16,"percentage_raw":"16%","association_date":"1970-01-01","owner_name_raw":"AYERS, JOHN"},{"owner_type":"individual","owner_name":"Susan Jespersen","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage":13,"percentage_raw":"13%","association_date":"1970-01-01","owner_name_raw":"JESPERSEN, SUSAN"},{"owner_type":"individual","owner_name":"Judith Mcginley","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage":13,"percentage_raw":"13%","association_date":"1970-01-01","owner_name_raw":"MCGINLEY, JUDITH"},{"owner_type":"individual","owner_name":"Christopher Ayers","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage_raw":"NO PERCENTAGE PROVIDED","association_date":"1999-01-01","owner_name_raw":"AYERS, CHRISTOPHER"},{"owner_type":"individual","owner_name":"Eric Ayers","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage_raw":"NO PERCENTAGE PROVIDED","association_date":"1990-01-01","owner_name_raw":"AYERS, ERIC"},{"owner_type":"individual","owner_name":"Jessica Hoy","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage_raw":"NO PERCENTAGE PROVIDED","association_date":"1990-01-01","owner_name_raw":"HOY, JESSICA"},{"owner_type":"individual","owner_name":"Megan Jespersen","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage_raw":"NO PERCENTAGE PROVIDED","association_date":"1990-01-01","owner_name_raw":"JESPERSEN, MEGAN"},{"owner_type":"individual","owner_name":"Sean Jespersen","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage_raw":"NO PERCENTAGE PROVIDED","association_date":"1990-01-01","owner_name_raw":"JESPERSEN, SEAN"},{"owner_type":"individual","owner_name":"Sarah Meusel","role":"direct_owner","role_raw":"5% OR GREATER DIRECT OWNERSHIP INTEREST","percentage_raw":"NO PERCENTAGE PROVIDED","association_date":"1990-01-01","owner_name_raw":"MEUSEL, SARAH"},{"owner_id":"org-floyd-county-memorial-hospital-commission","owner_type":"organization","owner_name":"Floyd County Memorial Hospital Commission","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2014-06-13"},{"owner_id":"org-ryka-inc","owner_type":"organization","owner_name":"Ryka Incorporated","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2019-10-08"},{"owner_type":"individual","owner_name":"David Ayers","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"1979-07-02","owner_name_raw":"AYERS, DAVID"},{"owner_type":"individual","owner_name":"Kristen Bolkema","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2024-08-01","owner_name_raw":"BOLKEMA, KRISTEN"},{"owner_type":"individual","owner_name":"Misty Hobert","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2005-01-03","owner_name_raw":"HOBERT, MISTY"},{"owner_type":"individual","owner_name":"Angela Parks","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2018-04-23","owner_name_raw":"PARKS, ANGELA"},{"owner_type":"individual","owner_name":"Ginger Schmidt","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"1998-10-02","owner_name_raw":"SCHMIDT, GINGER"},{"owner_type":"individual","owner_name":"Ashley Siemons","role":"managing_control","role_raw":"OPERATIONAL/MANAGERIAL CONTROL","percentage_raw":"NOT APPLICABLE","association_date":"2024-08-29","owner_name_raw":"SIEMONS, ASHLEY"},{"owner_type":"individual","owner_name":"David Ayers","role":"officer_director","role_raw":"CORPORATE DIRECTOR","percentage_raw":"NOT APPLICABLE","association_date":"1970-01-01","owner_name_raw":"AYERS, DAVID"},{"owner_type":"individual","owner_name":"John Ayers","role":"officer_director","role_raw":"CORPORATE DIRECTOR","percentage_raw":"NOT APPLICABLE","association_date":"1970-01-01","owner_name_raw":"AYERS, JOHN"},{"owner_type":"individual","owner_name":"David Ayers","role":"officer_director","role_raw":"CORPORATE OFFICER","percentage_raw":"NOT APPLICABLE","association_date":"2012-03-01","owner_name_raw":"AYERS, DAVID"},{"owner_type":"individual","owner_name":"John Ayers","role":"officer_director","role_raw":"CORPORATE OFFICER","percentage_raw":"NOT APPLICABLE","association_date":"2012-03-01","owner_name_raw":"AYERS, JOHN"},{"owner_type":"individual","owner_name":"Susan Jespersen","role":"officer_director","role_raw":"CORPORATE OFFICER","percentage_raw":"NOT APPLICABLE","association_date":"2012-03-01","owner_name_raw":"JESPERSEN, SUSAN"},{"owner_id":"org-brighton-consulting-group-llc","owner_type":"organization","owner_name":"Brighton Consulting Group LLC","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2004-06-15"},{"owner_id":"org-floyd-county-memorial-hospital-commission","owner_type":"organization","owner_name":"Floyd County Memorial Hospital Commission","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2014-06-13"},{"owner_id":"org-fox-rehab-pt-ia-pllc","owner_type":"organization","owner_name":"Fox Rehab Pt Ia PLLC","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2024-06-01"},{"owner_id":"org-ryka-inc","owner_type":"organization","owner_name":"Ryka Incorporated","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2019-10-08"},{"owner_type":"individual","owner_name":"David Ayers","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"1979-07-02","owner_name_raw":"AYERS, DAVID"},{"owner_type":"individual","owner_name":"Kristen Bolkema","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2024-08-01","owner_name_raw":"BOLKEMA, KRISTEN"},{"owner_type":"individual","owner_name":"Misty Hobert","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2005-01-03","owner_name_raw":"HOBERT, MISTY"},{"owner_type":"individual","owner_name":"Angela Parks","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2018-04-23","owner_name_raw":"PARKS, ANGELA"},{"owner_type":"individual","owner_name":"Ginger Schmidt","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"1998-10-02","owner_name_raw":"SCHMIDT, GINGER"},{"owner_type":"individual","owner_name":"Ashley Siemons","role":"additional_disclosable_party","role_raw":"ADP OF THE SNF","percentage_raw":"NOT APPLICABLE","association_date":"2024-08-29","owner_name_raw":"SIEMONS, ASHLEY"}],"inspections":[{"id":"cms-165019-20250918-fire","ccn":"165019","date":"2025-09-18","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[1],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":1,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-k0324","ss":"F","sl":2,"cs":"corrected","cd":"2025-09-18","std":1,"tv":"New"}]},{"id":"cms-165019-20250918-health","ccn":"165019","date":"2025-09-18","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Complaint","Health Standard"],"cycles":[1,2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":2,"max_severity_level":3,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-f0697","ss":"G","sl":3,"cs":"corrected","cd":"2025-10-08","cmp":1,"std":1},{"t":"cms-f0812","ss":"E","sl":2,"cs":"corrected","cd":"2025-10-15","std":1}]},{"id":"cms-165019-20240919-fire","ccn":"165019","date":"2024-09-19","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":3,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-k0321","ss":"F","sl":2,"cs":"corrected","cd":"2024-10-02","std":1,"tv":"New"},{"t":"cms-k0353","ss":"F","sl":2,"cs":"corrected","cd":"2024-10-02","std":1,"tv":"New"},{"t":"cms-k0761","ss":"F","sl":2,"cs":"corrected","cd":"2024-10-02","std":1,"tv":"New"}]},{"id":"cms-165019-20240919-health","ccn":"165019","date":"2024-09-19","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[2],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":0,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[]},{"id":"cms-165019-20230622-fire","ccn":"165019","date":"2023-06-22","domain":"fire","authority":"CMS / state survey agency","survey_types":["Fire Safety Standard"],"cycles":[3],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":4,"max_severity_level":2,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[{"t":"cms-k0353","ss":"F","sl":2,"cs":"corrected","cd":"2023-07-26","std":1,"tv":"New"},{"t":"cms-k0363","ss":"E","sl":2,"cs":"corrected","cd":"2023-06-27","std":1,"tv":"New"},{"t":"cms-k0712","ss":"F","sl":2,"cs":"corrected","cd":"2023-07-26","std":1,"tv":"New"},{"t":"cms-k0918","ss":"F","sl":2,"cs":"corrected","cd":"2023-07-26","std":1,"tv":"New"}]},{"id":"cms-165019-20230622-health","ccn":"165019","date":"2023-06-22","domain":"health","authority":"CMS / state survey agency","survey_types":["Health Standard"],"cycles":[3],"footnotes":[],"derived_from_citations":false,"kind":"standard","deficiency_count":0,"open_count":0,"provenance_source_ids":["cms_inspection_dates"],"occurrences":[]}],"deficiency_types":{"cms-k0324":{"code":"K-0324","title":"Provide properly protected cooking facilities.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-f0697":{"code":"F-0697","title":"Provide safe, appropriate pain management for a resident who requires such services.","category":"Quality of Life and Care Deficiencies","concept":"clinical_care","concept_label":"Clinical care"},"cms-f0812":{"code":"F-0812","title":"Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.","category":"Nutrition and Dietary Deficiencies","concept":"food_nutrition","concept_label":"Food, nutrition & hydration"},"cms-k0321":{"code":"K-0321","title":"Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0353":{"code":"K-0353","title":"Inspect, test, and maintain automatic sprinkler systems.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0761":{"code":"K-0761","title":"To conduct inspection, testing and maintenance of fire doors by qualified individuals.","category":"Miscellaneous Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0712":{"code":"K-0712","title":"Have simulated fire drills held at unexpected times.","category":"Miscellaneous Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0918":{"code":"K-0918","title":"Have generator or other power source capable of supplying service within 10 seconds.","category":"Gas, Vacuum, and Electrical Systems Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"},"cms-k0363":{"code":"K-0363","title":"Install corridor and hallway doors that block smoke.","category":"Smoke Deficiencies","concept":"environment_life_safety","concept_label":"Environment & life safety"}},"penalties":[],"state_actions":[],"record_urls":{"cms_provider_info":"https://data.cms.gov/provider-data/api/1/datastore/query/4pq5-n9py/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=165019&conditions%5B0%5D%5Boperator%5D=%3D","cms_ownership":"https://data.cms.gov/provider-data/api/1/datastore/query/y2hd-n93e/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=165019&conditions%5B0%5D%5Boperator%5D=%3D","cms_health_deficiencies":"https://data.cms.gov/provider-data/api/1/datastore/query/r5ix-sfxw/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=165019&conditions%5B0%5D%5Boperator%5D=%3D","cms_fire_safety_deficiencies":"https://data.cms.gov/provider-data/api/1/datastore/query/ifjz-ge4w/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=165019&conditions%5B0%5D%5Boperator%5D=%3D","cms_penalties":"https://data.cms.gov/provider-data/api/1/datastore/query/g6vv-u9sr/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=165019&conditions%5B0%5D%5Boperator%5D=%3D","cms_inspection_dates":"https://data.cms.gov/provider-data/api/1/datastore/query/svdt-c123/0?conditions%5B0%5D%5Bproperty%5D=cms_certification_number_ccn&conditions%5B0%5D%5Bvalue%5D=165019&conditions%5B0%5D%5Boperator%5D=%3D"},"compact_keys":{"t":"deficiency_type_id","ss":"scope_severity_code","sl":"severity_level (1–4)","cs":"correction_status","cd":"correction_date","cmp":"complaint","std":"standard survey","ic":"infection control","idr":"under IDR","iidr":"under IIDR","tv":"tag version"},"benchmarks":{"state":{"key":"IA","overall_rating":3.1,"health_inspection_rating":2.8,"qm_rating":3.4,"staffing_rating":3.8,"avg_residents_per_day":52.2,"cycle1_health_deficiencies":6.6,"cycle1_fire_deficiencies":3.6,"nurse_aide_hprd":2.56,"lpn_hprd":0.56,"rn_hprd":0.74471,"licensed_hprd":1.3,"total_nurse_hprd":3.86085,"weekend_total_nurse_hprd":3.38424,"weekend_rn_hprd":0.51,"pt_hprd":0.04,"nursing_turnover_pct":44.1,"rn_turnover_pct":42.1,"administrators_left":0.4,"case_mix_index":1.22602,"fines":0.6,"fine_amount":18804,"processing_note":"CMS State and US Averages"},"nation":{"key":"NATION","overall_rating":3,"health_inspection_rating":2.8,"qm_rating":3.7,"staffing_rating":3,"avg_residents_per_day":85.7,"cycle1_health_deficiencies":9.2,"cycle1_fire_deficiencies":4.4,"nurse_aide_hprd":2.35,"lpn_hprd":0.86,"rn_hprd":0.69164,"licensed_hprd":1.55,"total_nurse_hprd":3.90085,"weekend_total_nurse_hprd":3.43303,"weekend_rn_hprd":0.48,"pt_hprd":0.07,"nursing_turnover_pct":45.3,"rn_turnover_pct":42.5,"administrators_left":0.5,"case_mix_index":1.41025,"fines":0.9,"fine_amount":30351,"processing_note":"CMS State and US Averages"}},"geo":{"state":{"code":"IA","name":"Iowa"},"county":{"fips":"19067","name":"Floyd County"},"zip":"50616","city":"Charles City"},"related":{"same_operator":[{"id":"cms-165243","ccn":"165243","name":"Chautauqua Guest Home #3","address":"302 Ninth Street","city":"Charles City","state":"IA","zip":"50616","beds":57,"overall":5,"inspections":7,"last_inspection":"2026-08-13","deficiencies":6,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"]}],"same_operator_total":1,"same_chain":[],"same_chain_total":0,"same_site_review":[],"nearby":[{"id":"cms-165243","ccn":"165243","name":"Chautauqua Guest Home #3","address":"302 Ninth Street","city":"Charles City","state":"IA","zip":"50616","beds":57,"overall":5,"inspections":7,"last_inspection":"2026-08-13","deficiencies":6,"serious":0,"ij":0,"open":0,"fines_total":0,"status":"active","universe":"cms","state_actions":0,"state_serious":0,"types":["skilled_nursing_facility","nursing_home"],"distance_km":0.4}]}}