Nursing HomeMedicaid Investigative

Shell Rock Senior Living

Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.

920 North Cherry Street, Shell Rock, IA 50670|41 beds|Licensed & Active

1/5

Medicare

Inspection

Quality

Staffing

Google rating

3.8/5

based on 12 Google reviews

(319) 885-4341 Directions Website

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5/ 10

high Risk

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 (7 vs median 5)
High staff turnover (63%)
High RN turnover (67%)

Bottom 25% in IA · Below recommended RN staffing · Worst in ACCURA HEALTHCARE chain · $17,167 in fines

Source: Medicare data

What this means for your family

While the facility is praised for its therapy services and clean environment, the reports of poor communication and hygiene are significant red flags. We strongly recommend scheduling an unannounced tour to observe the cleanliness of the hallways and asking management specifically how they handle medication documentation and family inquiries.

Google Reviews

12 reviews on Google

“Shell Rock Senior Living receives polarized feedback, with some families praising the high-quality therapy and friendly staff, while others report severe concerns regarding hygiene and professional conduct. Critical issues include reports of unsanitary conditions, poor communication, and inadequate staffing, which contrast sharply with positive accounts of resident well-being and facility cleanliness.”

Quality Themes

Tap a score for details

Strengths

Effective skilled therapy services
Friendly and helpful staff
Clean and well-maintained facility

Concerns

Poor hygiene and sanitation (mentioned by 2 reviewers)
Inadequate communication and responsiveness (mentioned by 2 reviewers)

Rating Trends

Tap a year to see what changed

Distribution · 12 analyzed

How They Respond to Reviews

0%response rate

Questions for Your Tour

1With the current focus on enhancing facility-wide sanitation, what specific protocols are in place to ensure consistent hygiene and cleanliness in residents' private rooms?
2Given the importance of clear communication, what is your standard process for keeping family members updated on changes in a resident's health or daily status?
3How does your nursing team manage medication administration to ensure accuracy and timely delivery for all 41 residents?
4I noticed the dining experience is an area you are looking to improve; could you walk me through how you are currently handling meal service and dietary preferences?
5Since your skilled therapy services are highly regarded, how do those therapists collaborate with the nursing staff to support a resident's overall recovery and daily mobility?
6What is your facility's protocol for handling urgent medical needs or emergencies during the evening and overnight hours?

Personalized based on this facility's data

Key Review Excerpts

“His therapy was top notch and he progressed so well. The entire staff was so helpful and friendly, I can't even describe in a review how wonderful the entire experience was.”

Rehab patient's family · 2019★★★★★

“Dirty, residents clothes are always messed up with other peoples, bugs and more bugs! Seen blood on hallway floors, employee not washing or wearing gloves with someone who has cdiff, employees laying in residents beds, this place is cheap for a reason.”

Visitor · 2017★☆☆☆☆

“Nursing staff sent documents that were illegible and staff informed me they did not have time to go over a patient’s medication list over the phone when a patient was at the hospital I was working at.”

Healthcare professional · 2025★☆☆☆☆

Source: 12 Google reviews

Staffing

Staffing Hours

per resident/day · Medicare 2026

RN Hours

0.50hrs

67%

Registered nurses for medical care

Total Nursing

3.64hrs

89%

All nurses + aides combined

Staff Turnover

62%

Lower is better (< 30% = good)

RN Turnover

50%

Lower is better (< 30% = good)

Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.

Quality Measures

Resident outcomes compared with national, state, and local averages · 17 measures

Medicare Rating

2/ 5

Better Than Avg

measures

Worse Than Avg

measures

Mixed Results

measures

Long-Stay Residents

💊

Residents on antipsychotic medication

↓ Lower is better

This Facility31.0%

Worse than Avg

Here

31.0%

15.5%

19.4%

Butler

15.3%

🚿

Residents whose bladder or bowel control got worse

↓ Lower is better

This Facility33.8%

Worse than Avg

Here

33.8%

19.4%

25.9%

Butler

23.3%

🚶

Residents whose walking got worse

↓ Lower is better

This Facility26.5%

Worse than Avg

Here

26.5%

15.3%

17.5%

Butler

14.6%

😔

Residents with depression symptoms

↓ Lower is better

This Facility7.3%

Mixed vs Avgs

Here

7.3%

12.1%

4.1%

Butler

17.8%

Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.

💊

Residents on anti-anxiety or sleep medication

↓ Lower is better

This Facility15.1%

Better than Avg

Here

15.1%

19.5%

20.7%

Butler

25.2%

🛏️

Residents needing more daily help over time

↓ Lower is better

This Facility23.5%

Worse than Avg

Here

23.5%

14.4%

17.6%

Butler

13.7%

Short-Stay Residents (Rehab / Post-Acute)

💉

Short-stay residents vaccinated for pneumonia

↑ Higher is better

This Facility61.9%

Worse than Avg

Here

61.9%

81.8%

84.1%

Butler

80.9%

💉

Short-stay residents vaccinated for the flu

↑ Higher is better

This Facility82.6%

Better than Avg

Here

82.6%

79.8%

73.3%

Butler

77.4%

💊

Short-stay residents newly given antipsychotics

↓ Lower is better

This Facility4.0%

Worse than Avg

Here

4.0%

1.6%

2.0%

Butler

1.8%

Source: Medicare quality measures

US average from Medicare published data

Inspection History

Medicare Inspection History

3-year lookback · Medicare 2026

7deficiencies

1penalties

Above state avg (6.2)

16 complaint-triggered

$17,167 in fines

Families have filed 16 complaint reports triggering federal inspections, revealing recurring issues with food safety and nutrition, fire safety systems, and nursing staffing. Problems with food handling, emergency equipment, and nurse coverage persist across multiple surveys from 2023-2025, though the facility reports correcting each deficiency when cited.

Sep 4, 2025Routine10 findings

0291Potential for harm · WidespreadCorrected

Egress Deficiencies

Install emergency lighting that can last at least 1 1/2 hours.

0345Potential for harm · WidespreadCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0712Potential for harm · WidespreadCorrected

Miscellaneous Deficiencies

Have simulated fire drills held at unexpected times.

0920Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

0732Potential for harm · PatternCorrected

Nursing and Physician Services Deficiencies

Post nurse staffing information every day.

0880Potential for harm · PatternCorrected

Infection Control Deficiencies

Provide and implement an infection prevention and control program.

0321Potential for harm · PatternCorrected

Smoke Deficiencies

Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

0918Potential for harm · PatternCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have generator or other power source capable of supplying service within 10 seconds.

0637Potential for harm · IsolatedCorrected

Resident Assessment and Care Planning Deficiencies

Assess the resident when there is a significant change in condition

0692Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide enough food/fluids to maintain a resident's health.

Sep 4, 2025Complaint3 findings

0812Potential for harm · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0803Potential for harm · PatternCorrected

Nutrition and Dietary Deficiencies

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

0925Potential for harm · IsolatedCorrected

Environmental Deficiencies

Make sure there is a pest control program to prevent/deal with mice, insects, or other pests.

Sep 15, 2024Routine4 findings

0345Potential for harm · WidespreadCorrected

Smoke Deficiencies

Have approved installation, maintenance and testing program for fire alarm systems.

0918Potential for harm · WidespreadCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Have generator or other power source capable of supplying service within 10 seconds.

0920Potential for harm · IsolatedCorrected

Gas, Vacuum, and Electrical Systems Deficiencies

Ensure proper usage of power strips and extension cords.

0641Minimal · PatternCorrected

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

Sep 15, 2024Complaint3 findings

0727Potential for harm · WidespreadCorrected

Nursing and Physician Services Deficiencies

Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.

0685Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Assist a resident in gaining access to vision and hearing services.

0688Potential for harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.

Jul 19, 2024Complaint2 findings

0812Immediate jeopardy · WidespreadCorrected

Nutrition and Dietary Deficiencies

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

0550Potential for harm · IsolatedCorrected

Resident Rights Deficiencies

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

May 9, 2024Complaint1 finding

0689Actual harm · IsolatedCorrected

Quality of Life and Care Deficiencies

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Federal Penalties

Fine

Jul 19, 2024

$17,167

State Inspection History

State Inspections

Source: Iowa Dept. of Inspections, Appeals & Licensing

10total

16deficiencies

Nov 18, 2025InspectionNo deficiencies

Clean