# Avoca Specialty Care Avoca Specialty Care is a Medicare/Medicaid-certified nursing home (Nursing home · SNF / NF) in Avoca, IA, CMS Certification Number 165294, with 46 certified beds and about 34 residents per day. CMS rates it 2/5 overall (health inspections 2/5, staffing 4/5, quality measures 2/5). ## Key facts - Status: Active CMS certification - Address: 610 East York Street, Avoca, IA 51521 (Pottawattamie County) - Ownership type: Non profit - Corporation - Operator (legal business name): [Care Initiatives](https://carefield.site/operator/op-care-initiatives) - CMS chain: [Care Initiatives](https://carefield.site/chain/cms-chain-106) — 43 facilities - Phone: 7123436398 - Medicare Care Compare: https://www.medicare.gov/care-compare/details/nursing-home/165294 ## Inspection record 10 inspections in the CMS window (latest 2026-03-05); 78 citations (59 health, 19 fire safety); 0 at actual harm and 0 at immediate jeopardy; 0 without a verified correction at last report. CMS publishes about the three most recent standard surveys plus complaint and infection-control inspections from the prior three years; no citation in that window is not proof of a clean history. - 2026-03-05 — [E-0004](https://carefield.site/deficiency/cms-e0004) Develop and maintain an Emergency Preparedness Program (EP). — scope/severity F (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [E-0039](https://carefield.site/deficiency/cms-e0039) Conduct testing and exercise requirements. — scope/severity F (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [K-0324](https://carefield.site/deficiency/cms-k0324) Provide properly protected cooking facilities. — scope/severity E (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [K-0353](https://carefield.site/deficiency/cms-k0353) Inspect, test, and maintain automatic sprinkler systems. — scope/severity F (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [K-0712](https://carefield.site/deficiency/cms-k0712) Have simulated fire drills held at unexpected times. — scope/severity F (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0578](https://carefield.site/deficiency/cms-f0578) Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0584](https://carefield.site/deficiency/cms-f0584) Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0605](https://carefield.site/deficiency/cms-f0605) Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. — scope/severity E (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0641](https://carefield.site/deficiency/cms-f0641) Ensure each resident receives an accurate assessment. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0644](https://carefield.site/deficiency/cms-f0644) Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0656](https://carefield.site/deficiency/cms-f0656) Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. — scope/severity E (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0657](https://carefield.site/deficiency/cms-f0657) Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0658](https://carefield.site/deficiency/cms-f0658) Ensure services provided by the nursing facility meet professional standards of quality. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0677](https://carefield.site/deficiency/cms-f0677) Provide care and assistance to perform activities of daily living for any resident who is unable. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0695](https://carefield.site/deficiency/cms-f0695) Provide safe and appropriate respiratory care for a resident when needed. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0725](https://carefield.site/deficiency/cms-f0725) Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. — scope/severity E (No actual harm, potential for more than minimal harm); Corrected - 2026-03-05 — [F-0880](https://carefield.site/deficiency/cms-f0880) Provide and implement an infection prevention and control program. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected - 2025-10-07 — [F-0658](https://carefield.site/deficiency/cms-f0658) Ensure services provided by the nursing facility meet professional standards of quality. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected; complaint survey - 2025-06-16 — [F-0677](https://carefield.site/deficiency/cms-f0677) Provide care and assistance to perform activities of daily living for any resident who is unable. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected; complaint survey - 2025-05-16 — [F-0607](https://carefield.site/deficiency/cms-f0607) Develop and implement policies and procedures to prevent abuse, neglect, and theft. — scope/severity D (No actual harm, potential for more than minimal harm); Corrected; complaint survey - …and 58 more on the source page. ## Penalties No fines or payment denials in the CMS penalties file (about the last three years). ## Staffing (PBJ, hours per resident per day) - Total nurse: 3.02749 (state avg 3.86085, US 3.90085) - RN: 0.83084 - Nursing staff turnover: 59.5% ## Owners and managers of record (CMS disclosures) - [Care Initiatives](https://carefield.site/owner/org-care-initiatives) — Direct owner, 100%, since 2012-08-01 - Destiny Boeve — Operational / managerial control, since 2024-01-01 - Marquita Monroe — Operational / managerial control, since 2025-06-09 ## Nearby nursing homes - [Elm Crest Retirement Community](https://carefield.site/facility/cms-165372) — 16.6 km, CMS overall 2/5 ## Sources - 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=165294&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=165294&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=165294&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=165294&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=165294&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=165294&conditions%5B0%5D%5Boperator%5D=%3D --- Source page: https://carefield.site/facility/cms-165294 · Carefield — Senior Care Intelligence. Facts come from the CMS Provider Data Catalog (Medicare/Medicaid-certified nursing homes). Missing data never means no issue exists.