Federal inspection record · CMS data as of October 1, 2026
Accura Healthcare of Spirit Lake
1912 Zenith Avenue, Spirit Lake, IA · (712) 336-3300
- Certified beds
- 80
- Residents per day
- 71
- Ownership
- For-Profit
- Chain
- Accura Healthcare
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- April 22, 2004
1
How this home got 2 stars
The overall rating isn't an average. CMS starts from the inspection rating and nudges it at most two steps. Here is the arithmetic for this home, using CMS's own rules.
-
Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Iowa.
-
Staffing
★★★★★no change
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
-
Quality measures
★★★★★no change
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
-
Overall
★★★★★2 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Iowa homes
Accura Healthcare of Spirit Lake carries 77.25 inspection points. That is fewer than 21% of Iowa's 385 rated homes.
Inspectors' citations earn points by how serious and how widespread they were (the grid below). CMS then ranks every home in Iowa: the 10% with the fewest points get 5 stars, the 20% with the most get 1 star, and the middle 70% split evenly into 2, 3 and 4.
- 5★ 0–7 pts
- 4★ 7–21 pts
- 3★ 21–41 pts
- 2★ 41–86.5 pts
- 1★ over 86.5 pts
Bars show every rated home in Iowa by its weighted inspection score. CMS recalibrates the cut points monthly but holds a home's rating until its own score changes, so a home can sit just outside today's band.
3
What inspectors found
23 health citations on record since 2023. Each one gets a letter: the row says how badly residents were affected, the column how many.
Immediate jeopardyResidents at risk of serious injury or death
Actual harmA resident was hurt
Potential for harmNo one was hurt, but could have been
Minimal harmPaperwork-level problems
Read the rows, not the total. Most citations nationwide are a D: one problem, nobody hurt. Rows G–I mean a resident was harmed; J–L mean inspectors found residents in immediate danger of serious injury or death.
Small numbers in each cell are the inspection points CMS assigns per citation. Those points are what the state curve above ranks.
Harm and immediate-jeopardy citations (1)
-
K
Respond appropriately to all alleged violations.
Everything else, by area of care
Nutrition and Dietary7F
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- E
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- D
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
- F
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
- E
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
- D
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
- D
Ensure that residents are assessed for appropriateness for a feeding assistant program, receive services as per their plan of care, and feeding assistants are trained and supervised.
Quality of Life and Care6D
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Provide care and assistance to perform activities of daily living for any resident who is unable.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Resident Rights3E
- E
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
- D
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Assessment and Care Planning3D
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Freedom from Abuse, Neglect, and Exploitation2D
- D
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
- D
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Infection Control1E
- E
Provide and implement an infection prevention and control program.
Inspection history
2025-10-02
7 health deficiencies · 2 fire-safety deficiencies
Top issue: Nutrition and Dietary (3 deficiencies)
2024-08-22
12 health deficiencies · 4 fire-safety deficiencies
Top issue: Nutrition and Dietary (4 deficiencies)
2023-08-03
4 health deficiencies · 3 fire-safety deficiencies
Top issue: Quality of Life and Care (3 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 3 h 35 min of nursing staff time a day, 35 min of it from a registered nurse.
This home
3 h 35 min
Iowa average
3 h 52 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 43% of nursing staff and 55% of registered nurses left in the past year, along with 1 administrator.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
Fines and payment denials
$34,567 in federal fines on record over the past three years.
| Date | Penalty | Amount |
|---|---|---|
| 2024-08-22 | Fine | $34,567 |
| 2024-08-22 | Payment Denial · 31 day denial | $0 |
6
Resident outcomes
Quality measures compared with state and national averages. Most come from assessments the home itself reports.
| Measure | This home | State | U.S. |
|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days0.3 pts worse | 1.7 | 1.4 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days0.6 pts better | 1.3 | 1.9 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine5.8 pts better | 100.0% | 94.2% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine4.2 pts better | 100.0% | 95.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury4.7 pts worse | 8.6% | 3.9% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms3.4 pts worse | 7.6% | 4.2% | 13.5% |
| Percentage of long-stay residents who lose too much weight2.1 pts worse | 6.5% | 4.4% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication9.1 pts better | 11.9% | 21.0% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medicationAbout the same | 19.8% | 19.8% | 15.4% |
| Percentage of long-stay residents who were physically restrained0.2 pts better | 0.0% | 0.2% | 0.1% |
| Percentage of long-stay residents whose ability to walk independently worsened7.9 pts worse | 23.1% | 15.2% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased0.4 pts worse | 17.0% | 16.6% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.5 pts better | 0.9% | 1.4% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.5 pts better | 0.9% | 2.4% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence11.2 pts worse | 36.2% | 25.0% | 18.3% |
| Percentage of long-stay residents with pressure ulcers0.2 pts worse | 4.3% | 4.1% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine16 pts better | 100.0% | 84.0% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit2.6 pts worse | 15.6% | 13.0% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.3 pts worse | 3.4% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine10.8 pts better | 85.2% | 74.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission1.7 pts worse | 22.4% | 20.7% | 23.4% |
·
Who owns and runs it
7 owners and managers reported to CMS. The last column counts how many nursing homes each one is tied to.
Show ownership list
| Name | Role | Share | Homes |
|---|---|---|---|
| Accura Midwest Healthcare LLC | 5% Or Greater Indirect Ownership Interest · Organization | 100% | 5 facilities |
| American Healthcare Management Services LLC | Operational/Managerial Control · Organization | 0% | 32 facilities |
| Butcher, Daren | W-2 Managing Employee · Individual | 0% | 2 facilities |
| Leneave, Ted | Corporate Officer · Individual | 0% | 44 facilities |
| Olson, Brett | W-2 Managing Employee · Individual | 0% | 2 facilities |
| Toti, Lisa | W-2 Managing Employee · Individual | 0% | 33 facilities |
| Toti, Lisa | Corporate Officer · Individual | 0% | 33 facilities |
·
Fire safety
9 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke6F
- F
Properly select, install, inspect, or maintain portable fire extinguishes.
- F
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
- F
Inspect, test, and maintain automatic sprinkler systems.
- F
Install corridor and hallway doors that block smoke.
- F
Install smoke barrier doors that can resist smoke for at least 20 minutes.
- E
Inspect, test, and maintain automatic sprinkler systems.
Miscellaneous3F
- F
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- F
Have simulated fire drills held at unexpected times.
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
·
Other homes nearby
-
Accura Healthcare of Milford
Milford, IA · Accura Healthcare
★★★★★- Worst citation, 3 yrs
- D
- Nursing / resident / day
- 3 h 33 min
- Fines
- $0
-
Good Samaritan - Estherville
Estherville, IA · Good Samaritan Society
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 3 h 17 min
- Fines
- $0
-
Good Samaritan Society - Jackson
Jackson, MN · Good Samaritan Society
★★★★★- Worst citation, 3 yrs
- F
- Nursing / resident / day
- 3 h 57 min
- Fines
- $0