Nursing Care Index

Spencer Post Acute Rehabilitation Center

Spencer, Clay County, Iowa · CCN 165449 · For-profit (Corporation) · part of The Ensign Group (342 facilities, chain average 3.2 stars)

CMS rates Spencer Post Acute Rehabilitation Center 1 of 5 overall as of August 2026. 82 certified beds, 63 residents a day on average. 45 citations on record from the current inspection cycles, 2 at immediate jeopardy; 2 fines totalling $24,706 and 1 payment denial.

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★☆☆☆☆ 1 of 5
Health inspections★☆☆☆☆ 1 of 5
Staffing★★☆☆☆ 2 of 5
Quality measures★★☆☆☆ 2 of 5
Quality: long-stay / short-stay2 / 2 of 5

Staffing

Total nurse staffing3.38483 hours per resident per day
Registered nurses0.55052 hours per resident per day
Weekend total3.04174 hours per resident per day

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2026-06-04
complaint survey
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
G Actual harm that is not immediate jeopardy; isolated Deficient, Provider has date of correction
2026-06-17
2026-03-30
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-01
2025-08-14 Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Resident Rights Deficiencies · tag F0628
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-09-13
2025-08-14 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-09-13
2025-08-14 Honor the resident's right to manage his or her financial affairs.
Resident Rights Deficiencies · tag F0567
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2025-08-14 Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0605
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2025-08-14 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2025-08-14 Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2025-08-14 Provide enough food/fluids to maintain a resident's health.
Quality of Life and Care Deficiencies · tag F0692
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2025-08-14 Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Quality of Life and Care Deficiencies · tag F0693
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2025-08-14 Provide safe, appropriate dialysis care/services for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0698
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2025-08-14 Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies · tag F0759
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2025-08-14 Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · tag F0760
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2025-08-14 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.
Nutrition and Dietary Deficiencies · tag F0803
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2025-08-14 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2025-08-14 Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control Deficiencies · tag F0883
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-09-13
2024-08-22 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-12
2024-08-22 Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services Deficiencies · tag F0725
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-12
2024-08-22 Post nurse staffing information every day.
Nursing and Physician Services Deficiencies · tag F0732
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-12
2024-08-22 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-12
2024-08-22 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-09-12
2024-08-22 Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies · tag F0558
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-12
2024-08-22 Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Resident Assessment and Care Planning Deficiencies · tag F0655
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-12
2024-08-22 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 · tag F0657
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-12
2024-08-22 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-12
2024-08-22 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.
Quality of Life and Care Deficiencies · tag F0688
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-12
2024-08-22 Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Pharmacy Service Deficiencies · tag F0758
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-12
2024-08-22 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.
Nutrition and Dietary Deficiencies · tag F0803
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-09-12
2024-05-20
complaint survey
Provide basic life support, including CPR, prior to the arrival of emergency medical personnel , subject to physician orders and the resident’s advance directives.
Quality of Life and Care Deficiencies · tag F0678
J Immediate jeopardy to resident health or safety; isolated Past Non-Compliance
2024-05-06
2024-03-14
complaint survey
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-04-12
2024-03-14
complaint survey
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-12
2024-03-14
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-04-12
2023-10-30 Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · tag F0760
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2023-11-09
2023-10-30 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-22
2023-10-30 Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-22
2023-10-30 Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-22
2023-10-30 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.
Quality of Life and Care Deficiencies · tag F0688
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-22
2023-10-30 Ensure medication error rates are not 5 percent or greater.
Pharmacy Service Deficiencies · tag F0759
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-22
2023-10-30 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.
Pharmacy Service Deficiencies · tag F0761
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-22
2023-10-30 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-22
2023-10-30 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2023-11-22
2023-10-30 Ensure that each resident is free from the use of physical restraints, unless needed for medical treatment.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0604
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-11-22
2023-10-30 Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Assessment and Care Planning Deficiencies · tag F0644
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-11-22
2023-10-30 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 · tag F0657
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-11-22
2023-10-30 Provide safe, appropriate dialysis care/services for a resident who requires such services.
Quality of Life and Care Deficiencies · tag F0698
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2023-11-22

Fines and payment denials

DatePenaltyAmount
2024-05-20Fine$14,433
2023-10-30Payment denial for 7 days from 2023-11-24
2023-10-30Fine$10,273

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
Dewey Health Holdings LLC
Organization
adp of the snf2024-05-01
Ensign Services Inc.
Organization
adp of the snf2024-05-01
Standard Bearer Healthcare Op, Lp
Organization
adp of the snf2024-05-01
The Ensign Group Inc.
Organization
adp of the snf2024-05-01
Gateway Healthcare LLC
Organization
direct ownership interest2024-02-22
Feldmann, Bruce
Individual
adp of the snf2025-07-05
Koenig, Debra
Individual
adp of the snf2025-04-14
Burnam, Soon
Individual
corporate officer2024-02-22
Jorgensen, David
Individual
individual is an owner, partner or trustee of any adp of the snf2025-09-08
Keetch, Chad
Individual
individual is an owner, partner or trustee of any adp of the snf2025-09-08
Port, Barry
Individual
individual is an owner, partner or trustee of any adp of the snf2025-07-05
Burnam, Soon
Individual
managing control - governing body2024-02-22
Feldmann, Bruce
Individual
managing control - governing body2024-05-01
Koenig, Debra
Individual
managing control - governing body2024-02-22
Feldmann, Bruce
Individual
operational/managerial control2024-05-01
Koenig, Debra
Individual
operational/managerial control2024-02-22

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Clay County.