PlainNursing
CMS Nursing Home Compare · March 2026

Mississippi Valley

Mississippi Valley is a for profit - limited liability company facility in Keokuk, IA with 83 certified beds and a 5-star overall CMS rating. The inspection file holds 24 deficiency records. Total penalties: $20K.

500 Messenger Road, Keokuk, IA 52632

Phone: 3195245321

Overall CMS Rating

5/5

vs 3.0 national avg

The verdict

Mississippi Valley holds a 5-star CMS overall rating — well above the 3.0-star national average, with nurse staffing above the national norm. 3 inspection findings reached the actual-harm or immediate-jeopardy level.

5 / 5
CMS overall rating (nat'l avg 3.0)
5.60
Nursing hrs/resident-day (nat'l 3.89)
24
Inspection findings on file · 3 serious
$20K
Federal penalties (2)

CMS combines health inspections, nurse-staffing levels, and clinical quality measures into the overall star rating. Read the components below — they often tell a sharper story than the headline.

Health Inspection

4/5

Staffing

2/5

Quality Measures

5/5

Long-Stay Quality

5/5

Facility Information

Provider Number
165151
Ownership
For profit - Limited Liability company
Provider Type
Medicare and Medicaid
Beds
83
Residents
58
In Hospital
No
County
Lee
Last Inspection
Apr 3, 2025

Staffing Data

RN Hours
1.40 (nat'l avg: 0.68)
LPN Hours
0.85
CNA Hours
3.35
Total Nursing Hours
5.60 (nat'l avg: 3.89)
PT Hours
0.01
Nursing Turnover
43.3%
RN Turnover
33.3%

What the CMS Record Reveals About Mississippi Valley

Mississippi Valley operates 83 certified beds in Keokuk, IA with approximately 58 residents currently in care, and carries a CMS overall rating of 5 out of 5 stars. The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results (4★), staffing levels (2★), and quality measures (5★). Because CMS caps the overall score at the health-inspection tier and then adjusts up or down based on staffing and quality, the sub-scores often tell a sharper story than the headline star count alone — a 3-star facility with weak inspection history reads differently from one held back by thin staffing.

The inspection file contains 24 deficiency records from recent surveys, of which 3 reached the actual-harm or immediate-jeopardy threshold on the CMS scope-and-severity grid. On the enforcement side, CMS has assessed 2 penalties totaling $20K against this provider, a tangible indicator that regulators moved beyond citation into financial consequence. Staffing is reported at 5.60 total nursing hours per resident day (national average 3.89), with RN coverage at 1.40 per resident day — the single staffing metric most strongly tied to resident outcomes in peer-reviewed literature.

Classified as "For profit - Limited Liability company" ownership and operating as a "Medicare and Medicaid" provider, Mississippi Valley falls into a category where comparative context matters. National research consistently shows that ownership structure, staffing hours, and turnover are the three operational levers that correlate most strongly with resident outcomes — ratings and fines are lagging indicators of those upstream choices. Reported nursing turnover at this facility is 43.3%, within a range generally associated with stable care teams. For families evaluating this facility, the CMS record should be read alongside a site visit, direct conversation with current residents and their families, and review of the state health department's most recent inspection report — the star rating is a starting point, not a verdict. All data on this page is sourced from CMS Provider Data and the Nursing Home Compare program; always verify details directly with the facility or your state survey agency before making placement decisions.

Deficiency History (24 most recent)

D — Isolated - Minimal harm Jun 19, 2024 Tag: 0757

Ensure each resident’s drug regimen must be free from unnecessary drugs.

Category: Pharmacy Service Deficiencies

Corrected: Jun 20, 2024

D — Isolated - Minimal harm Jun 19, 2024 Tag: 0690

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Category: Quality of Life and Care Deficiencies

Corrected: Jun 20, 2024

G — Isolated - Actual harm Jun 19, 2024 Tag: 0689

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

Category: Quality of Life and Care Deficiencies

Corrected: Jun 20, 2024

D — Isolated - Minimal harm Jun 19, 2024 Tag: 0677

Provide care and assistance to perform activities of daily living for any resident who is unable.

Category: Quality of Life and Care Deficiencies

Corrected: Jun 20, 2024

D — Isolated - Minimal harm Jun 19, 2024 Tag: 0657

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Jun 20, 2024

G — Isolated - Actual harm Jan 24, 2024 Tag: 0689

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

Category: Quality of Life and Care Deficiencies

Corrected: Feb 16, 2024

E — Pattern - Minimal harm Dec 6, 2023 Tag: 0725

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Category: Nursing and Physician Services Deficiencies

Corrected: Dec 29, 2023

D — Isolated - Minimal harm Feb 23, 2023 Tag: 0740

Ensure each resident must receive and the facility must provide necessary behavioral health care and services.

Category: Quality of Life and Care Deficiencies

Corrected: Mar 24, 2023

G — Isolated - Actual harm Feb 23, 2023 Tag: 0550

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

Category: Resident Rights Deficiencies

Corrected: Mar 24, 2023

E — Pattern - Minimal harm Feb 23, 2023 Tag: 0880

Provide and implement an infection prevention and control program.

Category: Infection Control Deficiencies

Corrected: Mar 24, 2023

D — Isolated - Minimal harm Feb 23, 2023 Tag: 0849

Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.

Category: Administration Deficiencies

Corrected: Mar 24, 2023

E — Pattern - Minimal harm Feb 23, 2023 Tag: 0812

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

Category: Nutrition and Dietary Deficiencies

Corrected: Mar 24, 2023

D — Isolated - Minimal harm Feb 23, 2023 Tag: 0758

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.

Category: Pharmacy Service Deficiencies

Corrected: Mar 24, 2023

D — Isolated - Minimal harm Feb 23, 2023 Tag: 0756

Ensure a licensed pharmacist perform a monthly drug regimen review, including the medical chart, following irregularity reporting guidelines in developed policies and procedures.

Category: Pharmacy Service Deficiencies

Corrected: Mar 24, 2023

D — Isolated - Minimal harm Feb 23, 2023 Tag: 0688

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.

Category: Quality of Life and Care Deficiencies

Corrected: Mar 24, 2023

E — Pattern - Minimal harm Feb 23, 2023 Tag: 0657

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Mar 24, 2023

D — Isolated - Minimal harm Feb 23, 2023 Tag: 0656

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Mar 24, 2023

E — Pattern - Minimal harm Feb 23, 2023 Tag: 0641

Ensure each resident receives an accurate assessment.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Mar 24, 2023

D — Isolated - Minimal harm Feb 23, 2023 Tag: 0637

Assess the resident when there is a significant change in condition

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Mar 24, 2023

E — Pattern - Minimal harm Feb 23, 2023 Tag: 0623

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

Category: Resident Rights Deficiencies

Corrected: Mar 24, 2023

D — Isolated - Minimal harm Feb 23, 2023 Tag: 0610

Respond appropriately to all alleged violations.

Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected: Mar 24, 2023

D — Isolated - Minimal harm Feb 23, 2023 Tag: 0609

Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.

Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected: Mar 24, 2023

D — Isolated - Minimal harm Feb 23, 2023 Tag: 0561

Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.

Category: Resident Rights Deficiencies

Corrected: Mar 24, 2023

D — Isolated - Minimal harm Feb 23, 2023 Tag: 0554

Allow residents to self-administer drugs if determined clinically appropriate.

Category: Resident Rights Deficiencies

Corrected: Mar 24, 2023

Quality Measures

Measure Type Score Used in Rating
Percentage of long-stay residents whose need for help with daily activities has increased Long Stay 8.8% Yes
Percentage of long-stay residents who lose too much weight Long Stay 2.2% No
Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay 0.6% Yes
Percentage of long-stay residents with a urinary tract infection Long Stay 11.0% Yes
Percentage of long-stay residents who have depressive symptoms Long Stay 2.1% No
Percentage of long-stay residents who were physically restrained Long Stay 0.0% No
Percentage of long-stay residents experiencing one or more falls with major injury Long Stay 1.3% Yes
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine Long Stay 100.0% No
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine Short Stay 75.8% No
Percentage of short-stay residents who newly received an antipsychotic medication Short Stay 5.0% Yes
Percentage of long-stay residents whose ability to walk independently worsened Long Stay 9.1% Yes
Percentage of long-stay residents who received an antianxiety or hypnotic medication Long Stay 32.6% No
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine Long Stay 100.0% No
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine Short Stay N/A No
Percentage of long-stay residents with pressure ulcers Long Stay 8.8% Yes
Percentage of long-stay residents with new or worsened bowel or bladder incontinence Long Stay 21.7% No
Percentage of long-stay residents who received an antipsychotic medication Long Stay 10.8% Yes

Penalty History 2 penalties totaling $20K

Date Type Amount
Jun 19, 2024 Fine $11K
Jan 24, 2024 Fine $9K
Feb 23, 2023 Fine $10K

Frequently Asked Questions

What is the overall CMS rating for Mississippi Valley?
Mississippi Valley has an overall CMS rating of 5 out of 5 stars. This rating combines health inspection results (4★), staffing levels (2★), and quality measures (5★).
What are the staffing levels at Mississippi Valley?
Mississippi Valley reports 5.60 total nursing hours per resident day (national average: 3.89). RN hours are 1.40 per resident day (national average: 0.68). Nursing staff turnover is 43.3%.
How many beds does Mississippi Valley have?
Mississippi Valley has 83 certified beds with approximately 58 residents. The facility is located at 500 Messenger Road, Keokuk, IA 52632.
Does Mississippi Valley have any deficiencies on record?
Yes, Mississippi Valley has 24 deficiencies on record from recent inspections. Of these, 3 are classified as causing actual harm or jeopardy.
Has Mississippi Valley received any fines or penalties?
Yes, Mississippi Valley has received 2 penalties totaling $20K.
Who owns Mississippi Valley?
Mississippi Valley is classified as "For profit - Limited Liability company" ownership. The facility type is "Medicare and Medicaid".
When was Mississippi Valley last inspected?
The most recent health inspection for Mississippi Valley was on Apr 3, 2025. The facility received a health inspection rating of 4 out of 5 stars.
What quality measures are tracked for Mississippi Valley?
Mississippi Valley is evaluated on 17 quality measures, of which 8 are used in the CMS star rating calculation. These include measures for both long-stay and short-stay residents covering areas like infections, falls, pressure ulcers, and medication use.

Data Sources

Data source: CMS Nursing Home Compare. Ratings, staffing, deficiency, quality measure, and penalty data are from CMS Provider Data. For informational purposes only. Always verify information directly with the facility or your state health department.

Source: CMS Nursing Home Compare provider data (data.cms.gov). See our methodology for how this page is compiled. Ratings, staffing, health-inspection deficiency, and Civil Money Penalty records are published by the Centers for Medicare & Medicaid Services under a public-domain (CC0) license.