Avoca Specialty Care
Avoca Specialty Care
2.9 (11 reviews)
Skilled Nursing Facility • 46 Licensed Beds
610 East York Street, Avoca, IA
CMS Medicare Ratings
Overall
Inspection
Staffing
Quality
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Avoca Specialty Care

Skilled Nursing Facility • 46 Licensed Beds
610 East York Street,
Avoca, IA
CMS Medicare Ratings
Overall
Inspection
Staffing
Quality
View details →
About

Avoca Specialty Care – Medicare Certified Since 1996

Avoca Specialty Care is a Medicare and Medicaid certified skilled nursing facility located in Avoca, Iowa. This facility has been serving the community for 30 years. A Medicare-certified skilled nursing facility provides 24-hour nursing care, rehabilitation services, and assistance with activities of daily living for patients who need skilled nursing or rehabilitation services on a daily basis.

This facility has 46 certified beds with a current occupancy rate of 73% (averaging 34 residents per day), which is moderate. Skilled nursing facilities provide 24-hour nursing care for patients who need rehabilitation services after a hospital stay or ongoing care for chronic conditions. Services include skilled nursing, physical therapy, occupational therapy, speech therapy, and assistance with daily activities.

Staffing Levels: Based on CMS payroll data, this facility provides approximately 2.67 hours of total nursing care per resident per day (1.62 hours from CNAs, 0.64 hours from LPNs, 0.41 hours from RNs). Physical therapy staffing is 0.04 hours per resident per day. Higher staffing levels are generally associated with better quality outcomes.

Medicare Quality Ratings: According to CMS, Avoca Specialty Care has an overall quality rating of 1 out of 5 stars, which is much below average compared to other nursing homes nationwide. Individual category ratings are: health inspection: 1 stars, staffing: 1 stars, quality measures: 2 stars.

Medicare Coverage: Medicare covers skilled nursing facility care for up to 100 days following a qualifying hospital stay of at least 3 days. Days 1-20 are fully covered by Medicare, days 21-100 require a daily coinsurance payment. Many residents also use Medicaid, private insurance, or pay privately for long-term stays.

Questions to Ask: When visiting a nursing home, ask about: staff-to-resident ratios and RN coverage around the clock, how they handle medical emergencies, activities and therapy programs, how they communicate with families, their approach to falls prevention, and policies for managing resident complaints.

Visit Medicare Care Compare to view detailed ratings, inspection reports, staffing data, and compare this facility with others in the area.

Quality ratings and facility data are updated periodically by CMS. We recommend verifying current information at Medicare Care Compare.

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Local Comparison Snapshot

How Avoca Specialty Care compares to 51 facilities in Omaha-Council Bluffs, NE-IA

Click a measure name to jump to details • Hover over for definitions

Measure
This Facility
Area Avg
Comparison
Overall Rating
Medicare 5-star rating
1
2.4
Quality Measures
Clinical outcomes & safety
2
2.8
Health Inspections
State survey results
1
2.2
Staffing
Nurse-to-resident ratio
1
3.1
Staffing Hours (per resident/day)
RN Hours
Registered nurses
0.41 hrs
0.68 hrs
LPN/LVN Hours
Licensed practical nurses
0.64 hrs
0.69 hrs
CNA Hours
Certified nursing assistants
1.62 hrs
2.75 hrs
Total Nursing Hours
CNA + LPN + RN combined
2.68 hrs
4.12 hrs
Agency/Contractor Usage
Lower agency use often indicates more stable, consistent care
RN Agency Use
% of RN hours from contractors
0 %
10.9 %
LPN/LVN Agency Use
% of LPN hours from contractors
0 %
20.3 %
CNA Agency Use
% of CNA hours from contractors
0 %
8.6 %
Staff Stability & Occupancy
Staff Turnover
Annual nursing staff turnover
66 %
46 %
Occupancy Rate
Percentage of beds filled
73 %
73 %
Financial Estimate
Based on CMS Cost Report data (for reference only)
Est. Daily Rate
Average cost per day
$467
$371
Estimate Only: This figure is calculated from cost reports and is for informational purposes only. Actual rates vary significantly. See details or contact the facility.
Better than Area
Near Average
Below Area Average

Data from CMS Medicare Compare and Payroll-Based Journal. Area averages based on 51 facilities in Omaha-Council Bluffs, NE-IA.
Ratings and staffing data typically reflect the most recent quarterly reporting period available.

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Medicare Star Ratings

Official CMS ratings based on health inspections, staffing, and quality measures

Data as of December 2025

What do Medicare star ratings measure?
Medicare rates nursing homes on a 1-5 star scale based on three key areas: health inspection results, staffing levels, and quality measures like falls and infections.
How often are ratings updated?
CMS updates nursing home ratings monthly. Ratings can change based on new inspection results, staffing data from payroll records, and clinical quality outcomes.
Overall Rating
1/5
Quality Measures
2/5
Health Inspections
1/5
Staffing
1/5

Star Ratings History

Quarterly performance from 2013-2026

View on Medicare.gov
Overall
Health Inspections
Quality
Staffing
Source: Centers for Medicare & Medicaid Services

How Does This Facility Compare?

Compared to 51 other nursing homes in Omaha-Council Bluffs, NE-IA

Why compare to local facilities?
Local comparisons account for regional staffing markets and demographics. A facility performing above local averages often indicates strong management and quality care relative to area standards.
Avoca Specialty Care
Omaha-Council Bluffs, NE-IA Average

Based on CMS Medicare star ratings. Higher ratings indicate better performance.

Staffing Hours per Resident Day

Avoca Specialty Care
Omaha-Council Bluffs, NE-IA Average

Staffing data from CMS Payroll-Based Journal. Higher hours generally indicate more direct care time.

Staff Turnover Rate

Avoca Specialty Care
Omaha-Council Bluffs, NE-IA Average

Lower turnover rates generally indicate a more stable workforce and better continuity of care.

Agency/Contract Staff Usage

Avoca Specialty Care
Omaha-Council Bluffs, NE-IA Average

Lower agency usage often indicates better staff retention. High agency rates (>30%) may suggest staffing challenges.

Agency Staff Trends

Historical agency/contract staff usage by role

What does agency usage indicate?
Agency/contract staff fill temporary staffing gaps. Lower percentages typically indicate a stable, permanent workforce. Facilities with consistently high agency usage (>30%) may face staff retention challenges, though temporary spikes can occur during seasonal illness or transitions.
CNA
LPN
RN

Data from CMS Payroll-Based Journal (PBJ). Agency % = contractor hours / total hours.

Direct Care Staffing

Average minutes of direct nursing care per resident per day

Data as of December 2025

Understanding staffing levels: Higher staffing is associated with better quality outcomes. Research suggests around 4.1 hours of total nursing care per resident per day as a quality benchmark. Compare this facility's staffing to local averages to assess relative care levels.
97
minutes/day
CNAs
Certified Nursing Assistants
38
minutes/day
LPNs
Licensed Practical Nurses
25
minutes/day
RNs
Registered Nurses
3
minutes/day
PTs
Physical Therapists

Staffing Trends

Direct care minutes per resident per day

CNAs
LPNs
RNs
PTs
Source: Centers for Medicare & Medicaid Services

Occupancy Rate History

Average daily residents as a percentage of certified beds

Understanding occupancy: Higher occupancy can indicate strong community reputation and demand. Very low occupancy may affect financial stability, while extremely high occupancy could mean limited bed availability.
Avoca Specialty Care
Omaha-Council Bluffs, NE-IA Average (72.5%)

Data from CMS Provider Info files. Occupancy = Average Residents per Day / Certified Beds.

Staff Turnover History

Annual percentage of nursing staff who left the facility

Data as of December 2025

Understanding turnover: Lower turnover rates generally indicate a more stable workforce and better continuity of care. High turnover can affect care quality and resident relationships. The national average for nursing homes is around 50-60%.
All Nursing Staff
Registered Nurses (RN)
Area Average

Data from CMS Payroll-Based Journal. Turnover = staff who left during the year / total staff.

Average Daily Rate

Average daily charge for care at this facility

Based on CMS Cost Report data (inpatient revenue ÷ total patient days)

FY 2023 Daily Rate
$467
per resident per day
Compared to 51 facilities in your area
Above local median ($371)
Daily Rate Trend (2018-2023)
Contact Facility for Actual Rates
This figure is an average calculated from cost reports and is for informational purposes only. Actual rates vary significantly based on level of care needed, room type, payer source (Medicare, Medicaid, private pay), and other factors. Please contact the facility directly for current pricing and availability.
How This Is Calculated
This average daily rate is calculated from CMS Cost Reports by dividing total inpatient revenue by total patient days. It represents an average across all payers and care levels. Higher rates may indicate more intensive care, specialized services, or regional cost factors.

Data Source: Financial data from CMS Skilled Nursing Facility Cost Reports. Data typically lags 1-2 years. This information is for educational purposes only and should not be the sole basis for financial or care decisions. CareListings does not guarantee accuracy.

Financial Health

Comprehensive financial indicators from CMS Cost Reports

Data from fiscal year 2023 (most recent available - cost report data lags ~2 years)

Nonprofit Facility

Financial Summary

Metric This Facility Local Median Comparison
Operating Margin
Profitability ratio
-8% -4% Below
Net Income
Annual profit or loss
$-310,716 $-149,213 Below
Staff Cost per Resident
Daily salary expense per resident
$121/day $164/day Lower
Occupancy Rate
Bed utilization percentage
73% 76% Lower
Est. Daily Rate
Average revenue per patient day
$467/day $371/day Higher
Total Beds
Licensed bed capacity
46 97 Smaller

Local comparisons based on 51 skilled nursing facilities in the Omaha-Council Bluffs, NE-IA metro area

Revenue & Expenses

Net Patient Revenue
After adjustments & allowances
$3,468,506
Operating Expenses
Total operating costs
$3,734,210
Total Salaries
Staff compensation
$1,627,012
Contract Labor
Agency & temp staff
$279,593

Payer Mix

Medicare
8%
Medicaid
57%
Private Pay & Other
36%

Operating Margin Trend (2018-2023)

Understanding Financial Health
Operating Margin: Percentage of revenue remaining after operating costs. Positive = profitable operations.
Staff Investment: Higher spending per resident often correlates with better care quality.
Payer Mix: Shows revenue sources. Higher Medicare % typically means more post-acute/rehab care; higher Medicaid % indicates more long-term care residents.
Nonprofit/Government: May operate with lower margins while still providing quality care due to community mission.

Data Source: All financial data on this page comes from CMS Skilled Nursing Facility Cost Reports submitted by the facility to the Centers for Medicare & Medicaid Services. This information is provided for educational purposes only and should not be the sole basis for any financial or care decisions. Cost report data typically lags 1-2 years. CareListings does not guarantee the accuracy of this data.

Who Stays Here

Breakdown of residents by payment type

Based on fiscal year 2023 cost report data

Total Days
13,456
Medicare
Short-term skilled nursing
8%
Medicaid
Long-term care residents
57%
Private Pay / Other
Self-pay, insurance, VA
36%
Higher Medicare %
Indicates more short-term rehabilitation residents. Medicare typically covers up to 100 days of skilled nursing care after a hospital stay.
Higher Medicaid %
Indicates more long-term care residents. Medicaid covers nursing home care for those who qualify financially.

Average Length of Stay

How long residents typically stay at this facility

Based on fiscal year 2023 cost report data

Overall Average
160.19
days
Medicare Stays
42.67
days
Medicaid Stays
400.79
days
Total Admissions
89
Total Discharges
84
Medicare (Short-Term)
Medicare covers skilled nursing for rehabilitation after a hospital stay. Typical stays are 20-30 days for recovery from surgery, stroke, or illness.
Medicaid (Long-Term)
Medicaid covers long-term nursing home care for those who qualify. Many residents stay months or years, receiving ongoing daily care and support.

Services

Comprehensive skilled nursing services, rehabilitation programs, and medical care in AVOCA

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AVOCA, IA
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Reviews

2.9 (11 reviews)
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Jimmy Morgan's profile photo
Jimmy Morgan a year ago

Took my mother there after she broke her femur, she got treated like trash. 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 and told them that she is done. I even called told them it was uncalled for and they lied to her saying that she was waiting 45 minutes and never hit the nurses button. I seen how these nurses treated the patients first hand as well when I visited. Makes me sick on how they are still in business.

Mak Velli's profile photo
Mak Velli 6 months ago

Im sorry as much as I want my family member to still live there,seeing the nurse that's there on the weekends constantly on her phone,being rude to residents and employees we have decided this isn't a great fit and are seeking a new facility for our family member,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 Total violation and shame on the facility to allow this to go on,Do better with nurses,cause this nurse doesn't take pride in her job Sincerely a concerned member

Brittney Burns's profile photo
Brittney Burns 2 years ago

Let my mother go home still not healed of her wounds. Still can’t take care of herself. Said they’d help and didn’t. Dr lied to her and us about being better she is not. Whoever works ssi said over and over she’d help us get her in somewhere that could handle her and didn’t. No calls for updates on her. Would call every other day and majority of the time get put on hold and no one would answer. Was told they never cleaned the room nor bathroom nor did they bathe her which is the whole reason she’s in this mess. Sent her home to an almost 90 year old man that just lost his wife for him to take care of her because of pure negligence and lies knowing this and knowing there’s no where for her to go. Didn’t even send her home with medicine for wound care. Was also told they’d keep her till she was healed and they didn’t obviously.

Susan Pelis's profile photo
Susan Pelis 6 years ago

A few weeks ago, I surprised my mother with an early Christmas visit at Avoca Specialty Care. I cannot begin to describe what I experienced in this very special place. The care that my mother is receiving there is beyond anything I could have imagined. My following words not only reflect my mother's care, but the care of the other residents, from my observations. My mother was smiling, clean, well fed (with AMAZING food), medications given personally, wounds and health issues taken care of daily, exercise, faith needs met, and most importantly..........given constant respect and kind words by ALL the staff. Continual conversations and socialization are a daily routine there for all the residents. Every one of them is special to each member of the staff and this is apparent in the atmosphere of the whole facility. Avoca Specialty Care is truly a blessing. Thank you to all of you!

Deb Lottinville's profile photo
Deb Lottinville 6 years ago

I want to tell anyone that might have a loved one contemplating Avoca Speciality Care how impressed I have been with the care of my family member. Avoca Speciality Care is very clean and neat. All the staff have been nothing but kind and caring, and I mean exceptionally! They have worked with me too, as I have travel this road to LTC for a family member. The meals are very nutritious and tasty, and they cater to a variety of dietary needs. Activities are numerous and they help my loved one so he can interact with others and feel included. My family member may not be the closest to me in distance but it is worth the drive to see him so well cared for.

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