The federal government has resumed its practice of disclosing to the public its list of the nation’s worst nursing homes — and four Iowa homes have been added to that list.
Prior to President Donald Trump taking office in January, the federal Centers for Medicare and Medicaid Services had, for 17 years, published a monthly, national list of so-called Special-Focus Facilities. The list was comprised of nursing homes that had experienced a serious recurrence of major regulatory violations related to quality of care.
Once a home was designated a Special-Focus Facility, it received additional oversight and assistance from the government that’s intended to improve resident care.
At any given time, no more than two nursing homes per state were designated a Special-Focus Facility, although the federal list also included hundreds of other nursing homes whose quality-of-care violations made them eligible for enrollment in the program.
After Trump took office, CMS suspended the publication of monthly updates to the list, presumably because of a directive that barred CMS and other federal agencies from issuing any statements or reports to the press or public that hadn’t first been cleared by the White House.
Recently, CMS posted its first update to the list in 2025. It shows that during the 2025 moratorium on updates, four Iowa nursing homes were added to list of facilities that are considered eligible for special-focus status: Accura Healthcare of Pleasantville, Aspire of Perry, Clarion Wellness and Rehabilitation Center, and Harvest Acres Nursing and Rehabilitation Center in Keot
The two Iowa care facilities that are not only eligible for special-focus status, but are actually enrolled in the program and receiving additional oversight and guidance, are unchanged from last year. They are Arbor Court in Mount Pleasant, which has been in the program for two full years; and Aspire of Gowrie, which has been in the program for a year and a half.
In addition to the four Iowa homes added to the eligibility list, there are six Iowa care facilities that remain on the list from 2024 when it was last updated: Garden View Care Center in Shenandoah, which has been on the eligibility list for four months; Greater Southside Health and Rehabilitation in Des Moines, which has been on the list for 32 months; Harmony West in West Des Moines, which has been on the list for 17 months; The Ivy in Davenport, which has been on the list for 18 months; Pine Acres Rehabilitation and Care Center in West Des Moines, which has been on the list for 12 months; and Via of Des Moines, which has been on the list for 12 months.
Here’s a detailed look at the four newly eligible Iowa homes and a few of the issues each has faced in the past two years:
— Accura Healthcare of Pleasantville: This 46-bed facility is a part the for-profit Accura chain of nursing homes. Since April 2023, federal regulators have imposed three denials for payment for new admissions, and state inspectors have cited the business for 36 state and federal violations.
In September 2024, the state imposed an $8,000 fine against the home for failing to protect residents in the midst of a COVID-19 outbreak. According to state records, workers allegedly said the staff didn’t take steps to isolate COVID-positive residents until inspectors entered the home; the home didn’t screen visitors during an outbreak; administrators required several employees to report for work knowing they had tested positive for COVID-19; face masks were not used by the staff during an outbreak; and personal protective equipment such as gowns and eye protection were unavailable to the staff. Protective N95 masks for breathing had not been available for three weeks, inspectors found.
The administrator allegedly told inspectors she was unaware of the equipment shortages and lack of isolation and said facility had been operating “in crisis mode” and so COVID-positive staff were required to work as long as they were free of symptoms. The assistant director of nursing told inspectors no disciplinary action was taken against workers for ignoring infection-control protocols, according to state records.
Inspectors reported that one “very scared” resident who contracted COVID-19 in the home had to be taken to a hospital emergency room for treatment as he was short of breath, with oxygen levels below 90%. The state proposed fines of $8,000 for the infection-control violations and $6,000 for failing to provide sufficient nursing staff to meet residents’ needs. Both state fines were held in suspension. CMS later imposed a federal fine of $44,190 against the home.
— Aspire of Perry: This 35-bed facility is part of the for-profit Aspire chain of care facilities based in Florida. In the past two years, the Perry home has been cited for a total of 81 state and federal violations. In December 2024, it was cited for 32 violations, including resident abuse, and was fined a total of $500 by the state.
The fine was tied to findings that the home had allowed an individual to work with residents as both a nurse aide and a medication aide despite the person having no certification as a medication aide and being listed on the state’s registry of known abusers.
Other violations related to handling medications, management of residents’ funds, failure to provide a safe and clean environment, residents’ assessments and care plans, food service, infection control and dozens of other issues resulted in no penalties.
— Clarion Wellness and Rehabilitation Center: This 76-bed facility is owned or operated by a real estate investment trust based in California. In the past two years, the Clarion home has been cited for a total of 31 state and federal violations.
In October 2024, the state proposed, but held in suspension, a $7,000 fine for a series of errors involving resident medications. Part of the issue was that a male resident of the home didn’t receive his cancer medication as ordered and the staff seemed unsure as to when it was dispensed, according to state records. The manager at the man’s cancer treatment center told inspectors that failure to provide the drug “could be potentially fatal” to the resident.
Also in October 2024, two separate fines of $500 each for resident abuse were held in suspension by the state, according to state records. The alleged abuse involved a kitchen worker who was seen by colleagues entering a female resident’s room as often as eight times per day. The resident later complained the worker had kissed her and rubbed her arms and back and would enter her room uninvited and sit and talk to her. CMS fined the home $37,190, according to federal records.
— Harvest Acres Nursing and Rehabilitation Center of Keota: This 35-bed facility is managed by Mission Health of Florida, according to state records. In the past two years, Harvest Acres has been cited for a total of 45 state and federal violations.
In November 2024, the home was cited for 32 violations. At the time, the state proposed, but held in suspension, five separate fines totaling $21,000. The fines were tied to alleged incidents of resident abuse, failure to intervene and treat residents with changing conditions, and failure to provide residents with their prescribed diets.
Inspectors allege the home failed to adequately assess and treat a resident who fell at the home on Sept. 7, 2024. Two weeks later, on Sept. 22, the resident was admitted to a hospital with stroke-like symptoms. State records show that two days later the resident died, with the cause of death listed as complications from a head injury caused by a fall. CMS fined the home $203,060, according to federal records.
