Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before around December 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at River Hills Village In Keokuk during CMS and state inspections, most recent first.
A resident with diabetes received insulin without the pen being primed, as observed during a medication administration task. The LPN administering the insulin was not aware of the correct priming procedure, which was later clarified by the DON. The facility's policy did not address insulin pen use, contributing to the oversight.
A resident with a history of stroke and hemiplegia suffered a leg fracture due to improper transfer by a CNA who failed to use the prescribed Manual Stand Aid. The CNA mistakenly performed a stand pivot transfer, leading to the resident's leg getting caught and twisted. The incident was not immediately reported, and an X-ray confirmed a fracture. The facility's investigation revealed a lack of adherence to the care plan and communication breakdown among staff.
Failure to Prime Insulin Pen Before Administration
Penalty
Summary
The facility failed to ensure proper insulin administration procedures were followed for a resident with diabetes, specifically regarding the priming of an insulin pen. The resident, who had severely impaired cognition as indicated by a score of 4 out of 15 on a mental status exam, was observed receiving insulin without the pen being primed. This observation was made during a medication administration task by an LPN who did not perform the necessary priming step before administering the insulin. The LPN explained that she was informed by the Assistant Director of Nursing (ADON) that priming was not necessary if the bubble was in a specific place in the pen. However, the Director of Nursing (DON) later clarified that the correct procedure involved priming the pen with two units of insulin. The facility's policy on insulin administration did not address the use of insulin pens, and additional documentation provided by the DON outlined the correct priming procedure, which was not followed in this instance.
Failure to Use Prescribed Transfer Equipment Results in Resident Injury
Penalty
Summary
The facility failed to use the necessary transfer equipment when assisting a resident in the bathroom, resulting in a lower leg fracture. Resident #2, who had a history of stroke, arthritis, and hemiplegia affecting the right side, was assessed as dependent on staff for toileting hygiene and chair/bed to chair transfers. The care plan specified the use of a Manual Stand Aid with assistance from one staff member for transfers. However, during a transfer from the toilet to the wheelchair, the CNA used a stand pivot transfer instead of the prescribed Manual Stand Aid, leading to the resident's leg getting caught and twisted, causing pain and a subsequent fracture. The incident occurred when Staff B, a CNA, mistakenly identified Resident #2 as another resident and performed a stand pivot transfer instead of using the stand aid. This error was compounded by the CNA's failure to immediately report the incident to the nursing staff, as she was preoccupied with other duties. The resident expressed pain in her right hip and leg following the transfer, and an X-ray later confirmed a comminuted fracture through the proximal fibula. The facility's investigation revealed that the CNA was not familiar with the resident's transfer status and had not checked the care plan or the whiteboard in the nurse's station where such information was posted. Interviews with staff and the resident highlighted the communication breakdown and lack of adherence to the care plan. Staff A, an RN, and the ADON were informed of the incident after the resident's family raised concerns. The CNA admitted to confusing Resident #2 with another resident and acknowledged her mistake. The facility's Safe Resident Handling Policy emphasized the importance of assessing residents for safe handling and ensuring staff were aware of the correct transfer methods, which were not followed in this case.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Keokuk
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Southeast Iowa Healthcare Center | 0.8 mi | — | 6 | 0 |
| Mississippi Valley | 1.2 mi | — | 1 | 0 |
| Montrose Health Center | 6.4 mi | — | 4 | 0 |
| Birkwood Village Of Fort Madison | 13.4 mi | — | 6 | 0 |
| Clark County Nursing Home | 16.1 mi | — | 1 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.