Federal inspection record · CMS data as of October 1, 2026
Midlands Living Center L L C
2452 North Broadway, Council Bluffs, IA · (712) 323-7135
- Certified beds
- 94
- Residents per day
- 66
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- October 22, 2001
1
How this home got 5 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.
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Health inspections
★★★★★starting point
Everything starts from what state inspectors found on site. This is a ranking against other homes in Iowa.
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Staffing
★★★★★+1 star
Only a 5-star staffing rating adds a star, and only a 1-star rating removes one. Ratings of 2 to 4 change nothing.
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Quality measures
★★★★★+1 star
Same rule: 5 stars adds one, 1 star takes one away. These measures are mostly reported by the home itself.
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Overall
★★★★★5 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Iowa homes
Midlands Living Center L L C carries 25 inspection points. That is fewer than 61% 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
16 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.
No citation on record at the harm or immediate-jeopardy level.
Everything else, by area of care
Resident Assessment and Care Planning7E
- E
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
- D
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Infection Control3D
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
Resident Rights2D
- D
Allow residents to self-administer drugs if determined clinically appropriate.
- D
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Quality of Life and Care2D
- D
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
- D
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Pharmacy Service1D
- D
Ensure that residents are free from significant medication errors.
Freedom from Abuse, Neglect, and Exploitation1E
- E
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Inspection history
2026-01-08
5 health deficiencies · 0 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
2025-01-15
6 health deficiencies · 0 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
2023-12-21
5 health deficiencies · 0 fire-safety deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 4 h 9 min of nursing staff time a day, 37 min of it from a registered nurse.
This home
4 h 9 min
Iowa average
3 h 52 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 42% of nursing staff and 20% of registered nurses left in the past year.
Reported hours from payroll data the home submits to CMS, divided by its daily resident count. Not adjusted for how sick residents are.
5
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 days0.6 pts better | 0.8 | 1.4 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days1.4 pts better | 0.5 | 1.9 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine2.8 pts better | 97.0% | 94.2% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine2.7 pts better | 98.5% | 95.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury4.6 pts worse | 8.5% | 3.9% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms0.6 pts better | 3.6% | 4.2% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.7 pts better | 2.7% | 4.4% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication12.5 pts better | 8.5% | 21.0% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication8.6 pts better | 11.2% | 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 worsened1.3 pts better | 13.9% | 15.2% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased1.2 pts worse | 17.8% | 16.6% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder0.7 pts worse | 2.1% | 1.4% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection1.1 pts better | 1.3% | 2.4% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence11.4 pts worse | 36.4% | 25.0% | 18.3% |
| Percentage of long-stay residents with pressure ulcers2.4 pts worse | 6.5% | 4.1% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine2.7 pts worse | 81.3% | 84.0% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit5.8 pts better | 7.2% | 13.0% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication1.1 pts better | 1.0% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine4.6 pts better | 79.0% | 74.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission3.3 pts better | 17.4% | 20.7% | 23.4% |
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Who owns and runs it
14 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 |
|---|---|---|---|
| Goracke, Douglas | 5% Or Greater Direct Ownership Interest · Individual | 51% | 2 facilities |
| Busse, Tracy | W-2 Managing Employee · Individual | 0% | 1 facilities |
| Chamley, Steven | Direct Ownership Interest · Individual | 0% | 2 facilities |
| Chamley, Steven | Corporate Officer · Individual | 0% | 2 facilities |
| Chamley, Steven | General Partnership Interest · Individual | 0% | 2 facilities |
| Chamley, Steven | Adp Of The SNF · Individual | 0% | 2 facilities |
| Goracke, Douglas | Corporate Director · Individual | 0% | 2 facilities |
| Goracke, Douglas | Corporate Officer · Individual | 0% | 2 facilities |
| Goracke, Douglas | General Partnership Interest · Individual | 0% | 2 facilities |
| Goracke, Douglas | Adp Of The SNF · Individual | 0% | 2 facilities |
| Mccool, Jessica | Contracted Managing Employee · Individual | 0% | 1 facilities |
| Mccool, Jessica | Adp Of The SNF · Individual | 0% | 1 facilities |
| Tjaden, Jordan | W-2 Managing Employee · Individual | 0% | 2 facilities |
| Tjaden, Jordan | Adp Of The SNF · Individual | 0% | 2 facilities |
·
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