Map showing the location of Friendship Home Association in Audubon, Iowa
714 Division, Audubon, IA, 50025

Overall Score

CMS Five-Star Quality Rating
5/5Much above averageCMS Five-Star overall rating
  1. Much below average
  2. Below average
  3. Average
  4. Above average
  5. Much above average

Where it ranks

  • IowaAbove 78% of peers388 rated homes · average 3.1★
  • United StatesAbove 80% of peers14,574 rated homes · average 3.0★

How the rating is built

  • Health inspectionsStarting point4★+1.1 vs IA avg
  • StaffingCan add or remove a star4★+0.5 vs IA avg
  • Quality measuresCan add or remove a star5★+1.6 vs IA avg

CMS starts from the health inspection stars, then adds or subtracts a star for staffing and for quality measures. Stars are assigned relative to other facilities in the same state.

Ratings & measures

Tap a row to see what it means
Health inspection ratingCMS stars from the last three on-site inspection cycles4★Above 65% of peersIA avg2.9★U.S. avg2.8★
What is health inspection rating?

Stars assigned from the last three standard surveys and every complaint investigation in that window, weighted toward the most recent and the most serious findings. CMS assigns these stars relative to other facilities in the same state.

Why it matters

It carries the most weight in the overall rating and is the only domain based on what trained inspectors saw on site rather than what the facility reported.

Staffing ratingCMS stars from payroll-reported hours and turnover4★Above only 43% of peersIA avg3.5★U.S. avg2.9★
What is staffing rating?

Nurse and aide hours per resident day from payroll records CMS collects every quarter, adjusted for how much care residents need, plus staff turnover and weekend coverage.

Why it matters

More hours and lower turnover are the strongest predictors of fewer falls, pressure sores, and avoidable hospital stays.

Quality measures ratingCMS stars from clinical outcomes and resident assessments5★Above 78% of peersIA avg3.4★U.S. avg3.6★
What is quality measures rating?

Clinical outcomes from resident assessments and Medicare claims: falls with injury, pressure ulcers, hospitalizations, antipsychotic use, and more, for both short-stay and long-stay residents.

Why it matters

It shows whether care is working, but part of it comes from the facility’s own assessments, so read it alongside the inspection results.

Total nurse hoursPer resident per day, all nursing staff3.69hrsAbove only 49% of peersIA avg3.83Benchmark4.10
What is total nurse hours?

All licensed nurse and aide hours worked, divided by the number of residents, on an average day. Reported from payroll, not self-reported.

Why it matters

Federal research links 4.1 hours a day to fewer avoidable harms. Below about 3 hours, residents wait longer for help with basics like toileting and repositioning.

RN hoursPer resident per day, registered nurses only0.70hrsAbove 54% of peersIA avg0.73Benchmark0.75
What is rn hours?

Registered nurse hours only. RNs assess residents, manage medications, and catch changes in condition; LPNs and aides deliver most hands-on care.

Why it matters

RN coverage is the staffing measure most tied to fewer hospital transfers and infections, and it is where thinly staffed facilities cut first.

Nursing staff turnoverShare of nursing staff who left within a year · lower is better52%Above only 25% of peersIA avg44%RN turnover20%
What is nursing staff turnover?

The share of nursing staff who left within the past year, from the same payroll data.

Why it matters

High turnover means residents are cared for by people who do not know them, and it is one of the strongest predictors of inspection problems.

Fines in the last three yearsCivil money penalties imposed by CMS · lower is better$30,227Above only 19% of peersIA avg$21,037Fines · denials5 · 0
What is fines in the last three years?

Civil money penalties CMS imposed after serious or uncorrected deficiencies, and denials of Medicare payment for new admissions.

Why it matters

Penalties follow the worst inspection findings. A recent fine is the clearest sign that inspectors found real harm.

Inspection history

Last three inspection cycles
15citations
4inspection dates
1actual harm (G–I)
0immediate jeopardy (J–L)
Sep 4, 2025most recent

Citations by monthJul 2023 – Sep 2025

  • No actual harm (D–F)
  • Actual harm (G–I)
  • Immediate jeopardy (J–L)
  • $Fine or payment denial

Click a month or a year to filter the findings below. Arrow keys move between months; Esc clears.

Sep 4, 20252 citationsCycle 1worst D · no actual harm
  1. F580Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.Resident RightsD · isolatedCorrected Sep 5, 2025
  2. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareD · isolatedCorrected Sep 5, 2025
Aug 1, 20244 citationsCycle 2worst E · no actual harm
  1. F578Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.Resident RightsD · isolatedCorrected Aug 22, 2024
  2. F607Develop and implement policies and procedures to prevent abuse, neglect, and theft.Freedom from Abuse, Neglect, and ExploitationE · patternCorrected Aug 22, 2024
  3. F803Ensure 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 DietaryE · patternCorrected Aug 22, 2024
  4. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryE · patternCorrected Aug 22, 2024
Nov 9, 20235 citationsCycle 3worst E · no actual harm$2,797
  1. F880Provide and implement an infection prevention and control program.Infection ControlD · isolatedCorrected Dec 19, 2023
  2. F804Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.Nutrition and DietaryE · patternCorrected Dec 4, 2023
  3. F812Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.Nutrition and DietaryE · patternCorrected Dec 4, 2023
  4. F836Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.AdministrationD · isolatedCorrected Dec 4, 2023
  5. F868Have the Quality Assessment and Assurance group have the required members and meet at least quarterlyAdministrationD · isolatedCorrected Dec 4, 2023
Jul 20, 20234 citationsCycle 3worst G · actual harm$18,691
  1. F689Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.Quality of Life and CareG · isolatedCorrected Aug 16, 2023
  2. F755Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.Pharmacy ServiceD · isolatedCorrected Aug 16, 2023
  3. F760Ensure that residents are free from significant medication errors.Pharmacy ServiceD · isolatedCorrected Aug 16, 2023
  4. F677Provide care and assistance to perform activities of daily living for any resident who is unable.Quality of Life and CareD · isolatedCorrected Aug 16, 2023

Staffing

From quarterly payroll reports

Hours per resident per day

  • All nursing staffRNs, LPNs and aides combined3.69hrsAbove only 49% of peers−0.14 vs IA avg
  • Registered nursesRN hours only0.70hrsAbove 54% of peers−0.03 vs IA avg
  • Licensed practical nursesLPN hours0.61hrs
  • Nurse aidesCNA hours2.39hrs
  • Weekend nursingAll staff on Saturdays and Sundays3.17hrs
  • Iowa average
  • Research benchmark (4.10 total, 0.75 RN)

Turnover & capacity

  • Nursing staff turnoverShare who left within a year · lower is better52%Above only 25% of peersIA avg 44%
  • RN turnoverRegistered nurses only20%Not ranked by CMS
  • Administrators who leftIn the past year1Leadership changed
  • Occupancy46 certified beds · ~43 residents a day94%Top 10%IA avg 81%

Fines & penalties

Roughly the past three years

Enforcement summary

  • $30,227In fines
  • 5Fines
  • 0Payment denials
  • $21,037IA avg in fines
Above only 19% of peersFewer fines than 19% of rated homes in Iowa

Actions on record

  1. Nov 6, 2023Civil money penalty$2,797
  2. Oct 30, 2023Civil money penalty$2,447
  3. Oct 23, 2023Civil money penalty$2,098
  4. Oct 2, 2023Civil money penalty$4,194
  5. Jul 20, 2023Civil money penalty$18,691

Ownership

As filed with CMS

Structure

Ownership type
Non profit - Corporation
Chain
Independent
Certification
Medicare and Medicaid
Location type
Rural
Ownership change
None in the last 12 months

People and entities on file

Operational or managerial control
  • Jessica Andersen
Corporate directors
  • Melinda Alt
  • Jessica Andersen
  • Timothy Andersen
  • Genelle Deist
  • Jeffrey Edwards
  • Pattie Frolich
  • Mark Jones
  • Karen Nelsen
  • +1 more
Corporate officers
  • Timothy Andersen
  • Genelle Deist
  • Jeffrey Edwards
Managing employees
  • Jessica Andersen

Person Organization

Sources & notes

Public data, updated quarterly

Data sources

  • CMS Care Compare · Provider InformationStar ratings, staffing hours, turnover, penalties and flags · processed February 2026.
  • CMS Health CitationsEvery deficiency from the last three inspection cycles, with scope, severity and inspection cycle.
  • CMS Penalties and Ownership filesCivil money penalties, payment denials, and the owners and managers on file.

Notes

  • CMS Certification Number 165232 · 714 Division, Audubon, IA, 50025.
  • Percentiles compare this facility with every rated nursing home in Iowa and Audubon County. Turnover and fines are inverted so a high percentile is always good.
  • This is an informational summary of public data, not medical, legal, or placement advice. Facilities cannot pay to change it; a facility that believes a record is wrong can dispute it with CMS.

Own or manage a facility?

Claim your free listing to correct details, reply to reviews, and show your verified badge.

Claim your facility

Read our latest articles