Everystep
A home health agency in Creston, Iowa 50801
221 W Adams St, Creston, Iowa 50801. (855) 867-4592.
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The short answer
Record last released by CMS on Oct 21, 2026.
- 3of 5 quality of patient care rating
- 4of 5 patient survey rating
- 1 deficiencies cited in the last three years
Each figure’s source sits beside it, in its section below.
What these words mean3
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
What did inspectors find?
The last inspection on record was on Jul 22, 2026: a complaint inspection.
1 deficiency cited in the last three years.
CMS, QCOR home health inspection reports. Released Oct 20, 2026. Updated monthly.
When those deficiencies happened
1 deficiency in 1 month of the last 36. Last cited Jul 2026. Most serious: Element-level. The last 3 years, to Oct 24, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
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| 2023 | Nov | Dec | ||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
Each deficiency, as cited
Rule titles as CMS’s inspectors cite them, set in sentence case.
CMS, QCOR home health inspection reports. Released Oct 20, 2026. Updated monthly.
Jul 22, 2026: complaint inspection1 deficiency
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Plan Of Care Must Include The Following
The inspectors’ words, 655 words
“Plan of care must include the following CFR(s): 484.60(a)(2)(i-xvi) The individualized plan of care must include the following: (i) All pertinent diagnoses; (ii) The patient’s mental, psychosocial, and cognitive status; (iii) The types of services, supplies, and equipment required; (iv) The frequency and duration of visits to be made; (v) Prognosis; (vi) Rehabilitation potential; (vii) Functional limitations; (viii) Activities permitted; (ix) Nutritional requirements; (x) All medications and treatments; (xi) Safety measures to protect against injury; (xii) A description of the patient’s risk for emergency department visits and hospital re-admission, and all necessary interventions to address the underlying risk factors. (xiii) Patient and caregiver education and training to facilitate timely discharge; (xiv) Patient-specific interventions and education; measurable outcomes and goals identified by the HHA and the patient; (xv) Information related to any advanced directives; and (xvi) Any additional items the HHA or physician or allowed practitioner may choose to include. This Element is not met as evidenced by: Based on home visit observations, patient interviews, clinical record reviews and agency policy reviews, the agency failed to ensure the accurate completion of all components comprising the Plan of Care, including safety measures to protect against injury for 1 of 6 sampled patients (Patient #5). Failure to maintain complete and accurate Plans of Care with current orders placed patients at risk to not receive services, medications, supplies and/or treatments according to assessed needs and physician orders. Findings include: According to the agency policy titled Plan of Care, last reviewed 4/10/25, each patient’s needs are reflected in an individualized plan of care that is specific to needs and contains all required elements. The plan of care, developed in consultation with the care team, covers all pertinant diagnosis, including mental status, types of services and equipment required, frequencly of visits, prognosis, rehabilitation potential, functional limitations, activities permitted, nutritional requirements, medications and treatments, any safety measures to protect against injury, instructions for timely discharge or referral and any other appropriate items. 1.Patient #5 had a start of care date of 9/4/25 and discharge date of 4/14/26. Clinical record review revealed the following: a. The plans of care (POC’s), dated 9/4/25 to 11/2/25 and 3/3/26 to 5/1/26, identified the patient had a diagnosis of severe lewy body dementia with agitation. The POC included interventions to assess/instruct patinet/caregiver regarding satety of home environment/potential hazards and removal of hazards. b. The comprehensive assessment at the start of care, dated 9/4/26, Staff E, RN, (Registered Nurse) indentified the patient had a Brief Interview for Mental Status (BIMS) of 8 on a scale of 0 to 15 points, which idicataed the patient had moderate cognitive impairment. The assessment documented the patient alone-most of the time, declines lifeline, has telephone access, no functional factors of concern, and is aware of safety recommendations. The assessment lacked documentation the caregiver instructed due to the BIMS score of 8, the patient is not to be left alone. c. The skilled nurse note, dated 9/17/25, Staff E, RN, documented the patient left home alone while the spouse going out of town. Staff E notified the primary care provider and he stated the patient not able to be left alone. The patient transported to the hospital to stay while the spouse out of town. d. During an interview on 7/21/26 at 1:20 PM the primary caregiver stated agency staff did not provide instruction to not leave the patient alone. e. During an interview on 7/22/26 at 8:37 AM, Staff E stated she was sure she had talked with primary caregiver to not leave the patient alone for safety, prior to the incident on 9/17/25. Staff E further stated the documentation on the assessment at start of care incorrect. She stated the spouse never left the patient alone prior to the incident on 9/17/25. The agency failed to include education on the POC and oral education to not leave the patient alone. The above findings reviewed with the Administrator, Director and Clinical Manager.”
The one inspection in the last three years
| Date | Visit | What the record says |
|---|---|---|
| Jul 22, 2026 | Complaint inspection | 1 deficiency cited |
Is it certified?
- Medicare-certified home health agency since Oct 26, 2016.
- Ownership: non-profit.
- No For hospices, home health agencies, hospitals and dialysis facilities, CMS writes deficiencies at two levels. Standard is the usual one; condition-level is the more serious, when a problem is serious enough that the provider doesn’t meet a whole condition of taking part in Medicare. Source: CMS, State Operations Manual. deficiency on record in the last three years.
CMS, Home Health Care Agencies. Released Oct 21, 2026. Updated quarterly.
CMS, QCOR home health inspection reports. Released Oct 20, 2026. Updated monthly.
Has anything been proven against it?
- CMS doesn’t publish fines or other penalties for home health agencies, so none are shown.
- 1 deficiency cited in the last three years came from an inspection that included a complaint investigation.
CMS, QCOR home health inspection reports. Released Oct 20, 2026. Updated monthly.
Who does the caring?
- Offers nursing care, physical therapy, occupational therapy, speech pathology, medical social services and home health aide services.
- CMS doesn’t publish staffing levels for home health agencies.
CMS, Home Health Care Agencies. Released Oct 21, 2026. Updated quarterly.
Who owns it?
- 27 owners or officers are people: Tyra Stull (managing employee (on the payroll)); Tyra Stull (runs it (operational or managerial control)); Steve J Schaaf (corporate director); Pamela J Schoffner (corporate director); Lindsay Racey (corporate director); Tray A Wade (corporate officer); Tray A Wade (managing employee (on the payroll)); Judith A Ralston-Hansen (corporate director); Jonathan W. Lefrandt (corporate director); Coralynn B. Trewet (corporate director); Mark J Hasek (corporate director); Phillip G Stover (corporate director); Leigh Smith (managing employee (on the payroll)); Leigh Smith (runs it (operational or managerial control)); Paul A. Brown (corporate director); Leann Uhlenhopp (managing employee (on the payroll)); Thomas W Mouser (managing employee (on the payroll)); Stephanie L. Drey (corporate director); Kristyn Mercer (managing employee (on the payroll)); Crystal N. Edwards (corporate director); David E Bridgewater (corporate officer); David E Bridgewater (corporate director); Danielle L. Martin (corporate officer); Danielle L. Martin (managing employee (on the payroll)); Kerry Adaway (corporate director); Jackie B. Rolow (corporate director); Amber N. Tate (managing employee (on the payroll)).
- No private-equity firm among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, Home Health Agency All Owners and Home Health Agency Enrollments. Released Sep 29, 2026. Updated quarterly.
How do patients fare?
- CMS rates its quality of patient care 3 of 5.
- Patients rate it 4 of 5 in CMS’s patient survey (212 surveys completed): 89% rated it 9 or 10 out of 10, and 89% would definitely recommend it.
- CMS compares it with the national rate: discharged to the community, better; potentially preventable hospital stays, the same; potentially preventable readmissions after discharge, the same.
CMS, Home Health Care Agencies and Home Health Patient Survey. Released Oct 21, 2026. Updated quarterly.
| Measure | Rating |
|---|---|
| Quality of patient care ratingCMS star rating, 1 to 5 in half stars | 3 of 5 |
| Patient survey ratingCMS star rating from its survey of the agency’s patients, 1 to 5 | 4 of 5 |
| Discharged to the communityCMS’s risk-adjusted rate, compared with the national rate | 89.10% (better than the national rate) |
| Potentially preventable hospital staysCMS’s risk-adjusted rate, compared with the national rate | 9.07% (same as the national rate) |
| Potentially preventable readmissions after dischargeCMS’s risk-adjusted rate, compared with the national rate | 3.86% (same as the national rate) |
How does it compare nearby?
- Of the 3 agencies CMS’s data show serving patients in ZIP code 50801, where this agency’s office is, 3 have a quality of patient care rating; the middle one is 3.5 of 5, and this one is rated 3 of 5.
CMS, Home Health ZIP Codes and Home Health Care Agencies. Released Oct 21, 2026. Updated quarterly.
| Place | Quality rating |
|---|---|
| Everystep This home health agency | 3 |
| Unitypoint at Home | 3.5 |
| Angels Care Home Health of Iowa | 4 |
What the record doesn’t say
- CMS doesn’t publish fines or other penalties for home health agencies, so none are shown.
- Only complaints that led to a citation appear; complaints that didn’t aren’t published.
- QCOR says some of its home health reports are accurate or available only through May 19, 2021, because of a systems migration.
- Many home health agencies are inspected by a private accrediting organisation instead of the state, and QCOR’s home health file doesn’t appear to include those inspections: no inspection on record here doesn’t mean none took place.
Sources
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Centers for Medicare & Medicaid Services, Home Health Care Agencies (6jpm-sxkc).
Released Oct 21, 2026 and checked Oct 24, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Home Health Patient Survey (ccn4-8vby).
Released Oct 21, 2026 and checked Oct 24, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, QCOR home health inspection reports (HHA_2567s_2018_to_2026YTD.xlsx).
Released Oct 20, 2026 and checked Oct 24, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Home Health Agency All Owners (fc009b2d-7846-44b1-b4a1-692f0c143879).
Released Sep 29, 2026 and checked Oct 24, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Home Health Agency Enrollments (15f64ab4-3172-4a27-b589-ebd67a6d28aa).
Released Sep 29, 2026 and checked Oct 24, 2026. Updated quarterly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Home Health ZIP Codes (m5eg-upu5).
Released Oct 21, 2026 and checked Oct 24, 2026. Updated quarterly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Oct 24, 2026.
From the agency
The public record above comes first. Anything the agency adds will appear here, below it, and say who wrote it.
Replies
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Paid listing
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