Avoca Specialty Care
Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.
based on 11 Google reviews
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Quality Concerns Identified
Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.
- Low overall rating (1/5 stars)
- Above-median deficiencies (14 vs median 5)
- High staff turnover (62%)
- High RN turnover (100%)
Bottom 25% in IA · Below recommended RN staffing · Worst in CARE INITIATIVES chain · No penalties on record
What this means for your family
While Avoca Specialty Care previously held a strong reputation for cleanliness and nutrition, the facility has seen a sharp decline in quality over the last three years. Families should be extremely cautious and conduct an unannounced visit to observe staff behavior and response times, as recent reports of neglect and unprofessional conduct are severe.
Google Reviews
Google Reviews
11 reviews on Google“Avoca Specialty Care presents a stark contrast between older, highly positive reviews and recent, deeply concerning reports of neglect. While past visitors praised the facility for its cleanliness and attentive staff, recent feedback highlights serious issues regarding hygiene, staff professionalism, and patient dignity.”
Quality Themes
Tap a score for detailsStrengths
- Clean and well-maintained facility
- Nutritious and accommodating meal options
- Historically kind and dedicated nursing staff
Concerns
- Neglect of basic hygiene and wound care (mentioned by 2 reviewers)
- Unprofessional and rude staff behavior (mentioned by 2 reviewers)
- Poor communication and lack of responsiveness to family inquiries (mentioned by 2 reviewers)
Rating Trends
Tap a year to see what changed
Distribution · 11 analyzed
How They Respond to Reviews
This facility responds to some reviews.
Questions for Your Tour
- 1I noticed your team is very active in responding to family feedback online; how do you use that communication loop to ensure families feel heard and updated regarding their loved one’s daily care?
- 2Given the recent focus on improving clinical outcomes, what specific protocols have you implemented to ensure consistent monitoring and documentation of wound care and hygiene?
- 3With a capacity of 46 residents, how do you foster a supportive culture among the staff to ensure that every interaction remains professional and compassionate, especially during high-stress times?
- 4What steps are being taken to improve the responsiveness of the nursing team when families reach out with questions or concerns about their loved one’s health?
- 5Since medication management is a top priority for our family, could you walk us through your current process for ensuring accuracy and timely administration for residents?
- 6What does a typical day look like for residents here, and how do you tailor activities to keep everyone engaged and socially connected?
Personalized based on this facility's data
Key Review Excerpts
“I was able to locate her on social media in terms her was posting my family member and she's actually making videos using peoples medicine and names in them”
“She hurt the employees yell at the other patients and when she had to use the bed pan she laid in her pen feces for 30 minutes after she hit the nurses button”
“The care that my mother is receiving there is beyond anything I could have imagined. My mother was smiling, clean, well fed (with AMAZING food), medications given personally”
Staffing
Staffing Hours
per resident/day · Medicare 2026Total nursing hours are below minimum, though RN coverage is adequate. This may mean fewer aides for daily tasks like bathing and mobility.
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 17 measures
9
measures
4
measures
4
measures
Residents on antipsychotic medication
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents whose bladder or bowel control got worse
Residents on anti-anxiety or sleep medication
Residents whose walking got worse
Residents vaccinated for pneumonia
Short-stay residents vaccinated for pneumonia
Short-stay residents vaccinated for the flu
Short-stay residents newly given antipsychotics
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
Families have filed numerous complaints about this facility, triggering many of the 87 total deficiencies found across 8 surveys. Persistent problems include nursing care quality, medication management, and food service safety, with the same issues recurring across multiple years despite corrections. Recent complaints in 2025 involved serious concerns about abuse prevention policies and daily care assistance, indicating ongoing operational challenges that families should carefully consider.
Mar 5, 2026Routine17
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Smoke Deficiencies
Provide properly protected cooking facilities.
Resident Rights Deficiencies
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.
Resident Rights Deficiencies
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.
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Oct 7, 2025Complaint1
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Jun 16, 2025Complaint1
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
May 16, 2025Complaint9
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Resident Assessment and Care Planning Deficiencies
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Respond appropriately to all alleged violations.
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Quality of Life and Care Deficiencies
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Pharmacy Service Deficiencies
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Jan 30, 2025Routine7
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Miscellaneous Deficiencies
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Jul 1, 2024Complaint8
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Nursing and Physician Services Deficiencies
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nutrition and Dietary Deficiencies
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Nutrition and Dietary Deficiencies
Dispose of garbage and refuse properly.
Environmental Deficiencies
Have policies on smoking.
State Inspection History
State Inspections
Source: Iowa Dept. of Inspections, Appeals & Licensing
May 15, 2026ComplaintClean
Fed violations: 0, State violations: 0
Apr 1, 2026InspectionClean
Fed violations: 0, State violations: 0
Mar 5, 2026InspectionClean
Fed violations: 12, State violations: 0
Dec 11, 2025ComplaintClean
Fed violations: 0, State violations: 0
Oct 7, 2025ComplaintClean
Fed violations: 1, State violations: 0
Jul 1, 2025ComplaintClean
Fed violations: 0, State violations: 0
Jun 16, 2025ComplaintClean
Fed violations: 1, State violations: 0
Jun 2, 2025ComplaintClean
Fed violations: 0, State violations: 0
Ownership & Operations
Who Operates This Facility
Avoca Specialty Care
for profit
Chain Affiliation
Care Initiatives
43 facilities nationwide
Chain avg rating: 3.0/5 · Rank 42 of 43 (Worst)
Ownership & Management
Owners
Care Initiatives
Owner · Organization
Key personnel
Contact
Get in Touch
Contact this facility directly and verify the details that matter most to your family.
References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
11 reviews from families & visitors
Official Website
Visit careinitiatives.org
Medicare data downloads
Original nursing home datasets
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Safer Alternatives Nearby
Based on current clinical data, we identified 3 nearby facilities within 10 miles that may offer a stronger care environment. We encourage families to compare options carefully.