Cycle 1
Health 2025-10-02 · Fire 2025-10-02
5 health deficiencies
Top issue: Nutrition and Dietary (3 deficiencies)
2 fire-safety deficiencies
Top issue: Smoke (2 deficiencies)
Spirit Lake, IA
Accura Healthcare of Spirit Lake
2-star overall rating with 2-star inspections with $34,567 in total fines with 5 recent health deficiencies with 2 fire-safety deficiencies in the latest cycle
1912 Zenith Avenue, Spirit Lake, IA
(712) 336-3300
Overall
2 / 5
CMS overall stars
Health inspections
2 / 5
Survey and complaint cycles
Staffing
4 / 5
RN + nurse staffing
Quality measures
3 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
80
Certified beds
Average residents
66
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
Accura Healthcare
Operator or chain grouping
Approved since
2004-04-22
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
Chain footprint
37 facilities
Chain averages 2 overall / 2 health / 3 staffing / 3 quality stars
Changed ownership
No
Within the last 12 months
Family council
No
Resident and family council reported
Sprinklers
Yes
Automatic sprinklers in all required areas
Staffing
Hours and turnover
RN hours / resident day
0.59
Registered nurse staffing · state 0.73 · national 0.68
LPN hours / resident day
0.78
Licensed practical nurse staffing · state 0.57 · national 0.87
Aide hours / resident day
2.51
Nurse aide staffing · state 2.53 · national 2.35
Total nurse hours
3.88
All reported nurse hours · state 3.83 · national 3.89
Licensed hours
1.37
RN + LPN hours · state 1.30 · national 1.54
Weekend hours
3.42
Weekend nurse staffing · state 3.35 · national 3.43
Weekend RN hours
0.49
Weekend registered nurse coverage · state 0.50 · national 0.47
Physical therapist
0.06
Reported PT staffing · state 0.04 · national 0.07
Adjusted RN hours
0.65
CMS adjusted RN staffing hours
Adjusted total hours
4.27
CMS adjusted total nurse staffing hours
Case-mix index
1.24
Higher values indicate more complex resident acuity
RN turnover
27%
Annual RN turnover · state 44% · national 45%
Total nurse turnover
39%
Annual nurse turnover · state 44% · national 46%
SNF VBP
Value-based purchasing
Program rank
5,121
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
37.32
Composite VBP score used to determine payment impact.
Payment multiplier
0.9906
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
6.95
Baseline 19.62% · Performance 18.21% · Measure score 6.95 · Achievement 6.95 · Improvement 4.94
Healthcare-associated infections
0
Baseline 6.84% · Performance 7.71% · Measure score 0 · Achievement 0 · Improvement 0
Total nurse turnover
4.32
Performance 46.03% · Measure score 4.32 · Achievement 4.32 · This facility did not have sufficient data to calculate a baseline period measure result.
Adjusted total nurse staffing
3.66
Baseline 3.78 hours · Performance 4.12 hours · Measure score 3.66 · Achievement 3.66 · Improvement 1.19
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 10.29% |
10.72%
0.4 pts better
|
No Different than the National Rate · Eligible stays 202 · Observed rate 7.92% · Lower 95% interval 7.55% |
| Discharge to community | 56.25% |
50.57%
5.7 pts better
|
No Different than the National Rate · Eligible stays 157 · Observed rate 56.69% · Lower 95% interval 49% |
| Medicare spending per beneficiary | 0.79 |
1.02
0.2 pts better
|
|
| Drug regimen review with follow-up | 98.2% |
95.27%
2.9 pts better
|
Numerator 109 · Denominator 111 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 111 |
| Discharge self-care score | 49.5% |
53.69%
4.2 pts worse
|
Numerator 50 · Denominator 101 |
| Discharge mobility score | 62.38% |
50.94%
11.4 pts better
|
Numerator 63 · Denominator 101 |
| Pressure ulcers or injuries, new or worsened | 0% |
2.29%
2.3 pts better
|
Numerator 0 · Denominator 111 · Adjusted rate 0% |
| Healthcare-associated infections requiring hospitalization | 7.71% |
7.12%
0.6 pts worse
|
No Different than the National Rate · Eligible stays 107 · Observed rate 6.54% · Lower 95% interval 4.62% |
| Staff COVID-19 vaccination coverage | 4.26% |
8.2%
3.9 pts worse
|
Numerator 4 · Denominator 94 |
| Staff flu vaccination coverage | 12% |
42%
30 pts worse
|
Numerator 12 · Denominator 100 |
| Discharge function score | 58.42% |
56.45%
2 pts better
|
Numerator 59 · Denominator 101 |
| Transfer of health information to provider | Not Available |
95.95%
|
Numerator Not Available · Denominator 11 · Too few residents or stays to report publicly. |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 63 · Denominator 63 |
| Resident COVID-19 vaccinations up to date | 3.51% |
25.2%
21.7 pts worse
|
Numerator 2 · Denominator 57 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 2.2 |
1.5
0.7 pts worse
|
1.9
0.3 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.2 · Observed 2.2 · Expected 1.8 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 2.8 |
2.1
0.7 pts worse
|
1.8
1 pts worse
|
Long Stay · 20240701-20250630 · Adjusted 2.8 · Observed 2.9 · Expected 1.7 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 99.6% |
94.0%
5.6 pts better
|
93.4%
6.2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 100.0% · Q2 98.3% · Q3 100.0% · Q4 100.0% · 4Q avg 99.6% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 98.3% |
95.2%
3.1 pts better
|
95.5%
2.8 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 98.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 5.8% |
3.7%
2.1 pts worse
|
3.3%
2.5 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 7.7% · Q2 5.1% · Q3 5.3% · Q4 5.3% · 4Q avg 5.8% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 5.6% |
4.0%
1.6 pts worse
|
11.4%
5.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.1% · Q2 7.0% · Q3 3.8% · Q4 5.5% · 4Q avg 5.6% |
| Percentage of long-stay residents who lose too much weight | 11.8% |
4.9%
6.9 pts worse
|
5.4%
6.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 8.7% · Q2 20.4% · Q3 10.9% · Q4 6.7% · 4Q avg 11.8% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 8.0% |
20.6%
12.6 pts better
|
19.6%
11.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.5% · Q2 8.0% · Q3 8.7% · Q4 8.7% · 4Q avg 8.0% |
| Percentage of long-stay residents who received an antipsychotic medication | 15.1% |
19.8%
4.7 pts better
|
16.7%
1.6 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 11.9% · Q2 13.3% · Q3 16.7% · Q4 18.6% · 4Q avg 15.1% · Used in QM five-star |
| Percentage of long-stay residents who were physically restrained | 0.0% |
0.2%
0.2 pts better
|
0.1%
0.1 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 0.0% · 4Q avg 0.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | 20.6% |
18.5%
2.1 pts worse
|
16.3%
4.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 21.0% · Q2 21.4% · Q3 15.2% · Q4 25.2% · 4Q avg 20.6% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 19.3% |
18.3%
1 pts worse
|
14.9%
4.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 17.4% · Q2 14.0% · Q3 23.9% · Q4 22.2% · 4Q avg 19.3% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 2.4% |
1.7%
0.7 pts worse
|
1.0%
1.4 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 1.8% · Q2 1.4% · Q3 2.8% · Q4 3.7% · 4Q avg 2.4% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 0.9% |
2.5%
1.6 pts better
|
1.7%
0.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 1.9% · Q2 1.7% · Q3 0.0% · Q4 0.0% · 4Q avg 0.9% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 33.9% |
26.0%
7.9 pts worse
|
19.8%
14.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 30.4% · Q2 40.2% · Q3 21.5% · Q4 43.3% · 4Q avg 33.9% |
| Percentage of long-stay residents with pressure ulcers | 5.4% |
4.3%
1.1 pts worse
|
5.1%
0.3 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 3.8% · Q2 9.6% · Q3 4.9% · Q4 3.2% · 4Q avg 5.4% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 97.8% |
84.3%
13.5 pts better
|
81.7%
16.1 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 97.2% · Q2 97.0% · Q3 97.0% · Q4 100.0% · 4Q avg 97.8% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 16.1% |
13.1%
3 pts worse
|
12.0%
4.1 pts worse
|
Short Stay · 20240701-20250630 · Adjusted 16.1% · Observed 14.3% · Expected 9.9% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 1.9% |
1.9%
About the same
|
1.6%
0.3 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 3.7% · Q2 0.0% · Q3 0.0% · Q4 4.0% · 4Q avg 1.9% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 90.9% |
73.3%
17.6 pts better
|
79.7%
11.2 pts better
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 90.9% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 20.0% |
21.3%
1.3 pts better
|
23.9%
3.9 pts better
|
Short Stay · 20240701-20250630 · Adjusted 20.0% · Observed 15.4% · Expected 18.3% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2024-08-22 · Fire 2024-08-22
12 health deficiencies
Top issue: Nutrition and Dietary (4 deficiencies)
4 fire-safety deficiencies
Top issue: Smoke (3 deficiencies)
Cycle 3
Health 2023-08-03 · Fire 2023-08-03
4 health deficiencies
Top issue: Quality of Life and Care (3 deficiencies)
3 fire-safety deficiencies
Top issue: Miscellaneous (2 deficiencies)
Fire safety
Fire-safety citations
F · Potential for more than minimal harm
2025-10-02
K355 · Smoke Deficiencies
Fire Safety
Properly select, install, inspect, or maintain portable fire extinguishes.
Corrected 2025-10-03
F · Potential for more than minimal harm
2025-10-02
K372 · Smoke Deficiencies
Fire Safety
Ensure smoke barriers are constructed to a 1 hour fire resistance rating.
Corrected 2025-10-02
F · Potential for more than minimal harm
2024-08-22
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2024-08-30
F · Potential for more than minimal harm
2024-08-22
K363 · Smoke Deficiencies
Fire Safety
Install corridor and hallway doors that block smoke.
Corrected 2024-09-29
F · Potential for more than minimal harm
2024-08-22
K374 · Smoke Deficiencies
Fire Safety
Install smoke barrier doors that can resist smoke for at least 20 minutes.
Corrected 2024-09-04
F · Potential for more than minimal harm
2024-08-22
K761 · Miscellaneous Deficiencies
Fire Safety
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Corrected 2024-09-29
F · Potential for more than minimal harm
2023-08-03
K712 · Miscellaneous Deficiencies
Fire Safety
Have simulated fire drills held at unexpected times.
Corrected 2023-09-01
E · Potential for more than minimal harm
2023-08-03
K353 · Smoke Deficiencies
Fire Safety
Inspect, test, and maintain automatic sprinkler systems.
Corrected 2023-09-01
D · Potential for more than minimal harm
2023-08-03
K741 · Miscellaneous Deficiencies
Fire Safety
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
Corrected 2023-08-09
Inspection history
Recent health citations
E · Potential for more than minimal harm
2025-10-02
F804 · Nutrition and Dietary Deficiencies
Health
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected 2025-11-26
E · Potential for more than minimal harm
2025-10-02
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2025-11-26
D · Potential for more than minimal harm
2025-10-02
F628 · Resident Rights Deficiencies
Health
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Corrected 2025-11-26
D · Potential for more than minimal harm
2025-10-02
F690 · Quality of Life and Care Deficiencies
Health
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected 2025-11-26
D · Potential for more than minimal harm
2025-10-02
F805 · Nutrition and Dietary Deficiencies
Health
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Corrected 2025-11-26
K · Immediate jeopardy
2024-08-22
F610 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Respond appropriately to all alleged violations.
Corrected 2024-08-23
F · Potential for more than minimal harm
2024-08-22
F812 · Nutrition and Dietary Deficiencies
Health
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected 2024-09-14
E · Potential for more than minimal harm
2024-08-22
F800 · Nutrition and Dietary Deficiencies
Health
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
Corrected 2024-09-14
E · Potential for more than minimal harm
2024-08-22
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-08-23
D · Potential for more than minimal harm
2024-08-22
F580 · Resident Rights Deficiencies
Health
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected 2024-08-27
D · Potential for more than minimal harm
2024-08-22
F600 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected 2024-08-23
D · Potential for more than minimal harm
2024-08-22
F609 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected 2024-08-23
D · Potential for more than minimal harm
2024-08-22
F644 · Resident Assessment and Care Planning Deficiencies
Health
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected 2024-08-23
D · Potential for more than minimal harm
2024-08-22
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2024-08-27
D · Potential for more than minimal harm
2024-08-22
F804 · Nutrition and Dietary Deficiencies
Health
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected 2024-09-14
D · Potential for more than minimal harm
2024-08-22
F811 · Nutrition and Dietary Deficiencies
Health
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.
Corrected 2024-09-14
D · Potential for more than minimal harm
2024-08-22
F842 · Resident Assessment and Care Planning Deficiencies
Health
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected 2024-08-23
D · Potential for more than minimal harm
2023-08-03
F657 · Resident Assessment and Care Planning Deficiencies
Health
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected 2023-08-21
D · Potential for more than minimal harm
2023-08-03
F677 · Quality of Life and Care Deficiencies
Health
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected 2023-08-21
D · Potential for more than minimal harm
2023-08-03
F684 · Quality of Life and Care Deficiencies
Health
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected 2023-08-21
D · Potential for more than minimal harm
2023-08-03
F689 · Quality of Life and Care Deficiencies
Health
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected 2023-08-21
Penalties and ownership
What sits behind the stars
$34,567
2024-08-22
Fine
Fine · fine $34,567
Fine
$0
2024-08-22
Payment Denial
Payment Denial · denial start 2024-09-19 · 31 days
31 day denial
Ownership
Accura Healthcare
5% Or Greater Indirect Ownership Interest · Organization
Accura Midwest Healthcare LLC
5% Or Greater Indirect Ownership Interest · Organization
American Healthcare Management Services LLC
Operational/Managerial Control · Organization
Butcher, Daren
W-2 Managing Employee · Individual
Leneave, Ted
Corporate Officer · Individual
Olson, Brett
W-2 Managing Employee · Individual
Toti, Lisa
Corporate Officer · Individual
Toti, Lisa
W-2 Managing Employee · Individual
Nearby options
Other facilities in reach
#1
Accura Healthcare of Milford
Milford, IA
5-star overall rating with 5-star inspections with 2 fire-safety deficiencies in the latest cycle
#2
Good Samaritan Society - Estherville
Estherville, IA
1-star overall rating with 2-star inspections with 6 recent health deficiencies with 10 fire-safety deficiencies in the latest cycle
#3
Good Samaritan Society - Jackson
Jackson, MN
4-star overall rating with 3-star inspections with 3 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
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