Cycle 1
Health 2025-01-15 · Fire 2025-01-15
6 health deficiencies
Top issue: Resident Assessment and Care Planning (3 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Council Bluffs, IA
Midlands Living Center L L C
4-star overall rating with 3-star inspections with 6 recent health deficiencies
2452 North Broadway, Council Bluffs, IA
(712) 323-7135
Overall
4 / 5
CMS overall stars
Health inspections
3 / 5
Survey and complaint cycles
Staffing
3 / 5
RN + nurse staffing
Quality measures
5 / 5
Resident outcomes and process measures
Quick facts
Facility snapshot
Beds
94
Certified beds
Average residents
67
Average occupied residents
Ownership
For-Profit
Publicly displayed owner type
Chain
No chain reported
Operator or chain grouping
Approved since
2001-10-22
CMS approved date
Coverage
Medicare + Medicaid
Participation flags
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
0.69
Registered nurse staffing · state 0.73 · national 0.68
LPN hours / resident day
0.80
Licensed practical nurse staffing · state 0.57 · national 0.87
Aide hours / resident day
2.45
Nurse aide staffing · state 2.53 · national 2.35
Total nurse hours
3.94
All reported nurse hours · state 3.83 · national 3.89
Licensed hours
1.49
RN + LPN hours · state 1.30 · national 1.54
Weekend hours
3.51
Weekend nurse staffing · state 3.35 · national 3.43
Weekend RN hours
0.48
Weekend registered nurse coverage · state 0.50 · national 0.47
Physical therapist
0.03
Reported PT staffing · state 0.04 · national 0.07
Adjusted RN hours
0.81
CMS adjusted RN staffing hours
Adjusted total hours
4.63
CMS adjusted total nurse staffing hours
Case-mix index
1.16
Higher values indicate more complex resident acuity
RN turnover
0%
Annual RN turnover
Total nurse turnover
0%
Annual nurse turnover
SNF VBP
Value-based purchasing
Program rank
2,296
Lower is better among SNFs in the FY 2026 VBP program.
Performance score
50.41
Composite VBP score used to determine payment impact.
Payment multiplier
1.0045
Above 1.000 increases Medicare payment; below 1.000 reduces it.
Program components
How the VBP score is built
Readmission
5.56
Baseline 19.13% · Performance 18.85% · Measure score 5.56 · Achievement 5.56 · Improvement 0.80
Healthcare-associated infections
5.58
Baseline 5.47% · Performance 6.17% · Measure score 5.58 · Achievement 5.58 · Improvement 0
Total nurse turnover
Not reported
This facility did not meet this measure's case minimum policy requirement and therefore no measure data is publicly reported.
Adjusted total nurse staffing
3.98
Baseline 3.92 hours · Performance 4.21 hours · Measure score 3.98 · Achievement 3.98 · Improvement 1.04
SNF QRP
Medicare quality reporting measures
| Measure | Facility | National | Note |
|---|---|---|---|
| Potentially preventable 30-day readmission | 8.68% |
10.72%
2 pts better
|
No Different than the National Rate · Eligible stays 112 · Observed rate 4.46% · Lower 95% interval 5.65% |
| Discharge to community | 55.23% |
50.57%
4.7 pts better
|
No Different than the National Rate · Eligible stays 98 · Observed rate 51.02% · Lower 95% interval 48.13% |
| Medicare spending per beneficiary | 0.81 |
1.02
0.2 pts better
|
|
| Drug regimen review with follow-up | 100% |
95.27%
4.7 pts better
|
Numerator 99 · Denominator 99 |
| Falls with major injury | 0% |
0.77%
0.8 pts better
|
Numerator 0 · Denominator 99 |
| Discharge self-care score | 54.88% |
53.69%
1.2 pts better
|
Numerator 45 · Denominator 82 |
| Discharge mobility score | 53.66% |
50.94%
2.7 pts better
|
Numerator 44 · Denominator 82 |
| Pressure ulcers or injuries, new or worsened | 6.06% |
2.29%
3.8 pts worse
|
Numerator 6 · Denominator 99 · Adjusted rate 5.92% |
| Healthcare-associated infections requiring hospitalization | 6.17% |
7.12%
1 pts better
|
No Different than the National Rate · Eligible stays 64 · Observed rate 3.13% · Lower 95% interval 3.05% |
| Staff COVID-19 vaccination coverage | 6.98% |
8.2%
1.2 pts worse
|
Numerator 9 · Denominator 129 |
| Staff flu vaccination coverage | 73.01% |
42%
31 pts better
|
Numerator 119 · Denominator 163 |
| Discharge function score | 52.44% |
56.45%
4 pts worse
|
Numerator 43 · Denominator 82 |
| Transfer of health information to provider | 100% |
95.95%
4 pts better
|
Numerator 25 · Denominator 25 |
| Transfer of health information to patient | 100% |
96.28%
3.7 pts better
|
Numerator 43 · Denominator 43 |
| Resident COVID-19 vaccinations up to date | 29.82% |
25.2%
4.6 pts better
|
Numerator 17 · Denominator 57 |
Quality measures
Resident outcomes and process scores
| Measure | Facility | State | National | Note |
|---|---|---|---|---|
| Number of hospitalizations per 1000 long-stay resident days | 1.3 |
1.5
0.2 pts better
|
1.9
0.6 pts better
|
Long Stay · 20240701-20250630 · Adjusted 1.3 · Observed 1.6 · Expected 2.4 · Used in QM five-star |
| Number of outpatient emergency department visits per 1000 long-stay resident days | 0.8 |
2.1
1.3 pts better
|
1.8
1 pts better
|
Long Stay · 20240701-20250630 · Adjusted 0.8 · Observed 0.8 · Expected 1.7 · Used in QM five-star |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | 97.3% |
94.0%
3.3 pts better
|
93.4%
3.9 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 98.3% · Q2 96.2% · Q3 94.6% · Q4 100.0% · 4Q avg 97.3% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | 100.0% |
95.2%
4.8 pts better
|
95.5%
4.5 pts better
|
Long Stay · 2024Q3-2025Q2 · 4Q avg 100.0% |
| Percentage of long-stay residents experiencing one or more falls with major injury | 4.4% |
3.7%
0.7 pts worse
|
3.3%
1.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 1.7% · Q2 1.9% · Q3 5.4% · Q4 8.9% · 4Q avg 4.4% · Used in QM five-star |
| Percentage of long-stay residents who have depressive symptoms | 0.0% |
4.0%
4 pts better
|
11.4%
11.4 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 who lose too much weight | 2.7% |
4.9%
2.2 pts better
|
5.4%
2.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.0% · Q2 2.1% · Q3 0.0% · Q4 0.0% · 4Q avg 2.7% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | 7.8% |
20.6%
12.8 pts better
|
19.6%
11.8 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 8.0% · Q2 8.3% · Q3 6.1% · Q4 8.7% · 4Q avg 7.8% |
| Percentage of long-stay residents who received an antipsychotic medication | 10.0% |
19.8%
9.8 pts better
|
16.7%
6.7 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 9.8% · Q2 8.9% · Q3 11.6% · Q4 9.8% · 4Q avg 10.0% · 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 | 14.3% |
18.5%
4.2 pts better
|
16.3%
2 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 26.5% · Q2 7.7% · Q3 11.0% · Q4 10.6% · 4Q avg 14.3% · Used in QM five-star |
| Percentage of long-stay residents whose need for help with daily activities has increased | 15.8% |
18.3%
2.5 pts better
|
14.9%
0.9 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 12.0% · Q2 14.9% · Q3 18.8% · Q4 17.8% · 4Q avg 15.8% · Used in QM five-star |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | 1.0% |
1.7%
0.7 pts better
|
1.0%
About the same
|
Long Stay · 2024Q4-2025Q3 · Q1 0.0% · Q2 0.0% · Q3 0.0% · Q4 3.9% · 4Q avg 1.0% · Used in QM five-star |
| Percentage of long-stay residents with a urinary tract infection | 1.4% |
2.5%
1.1 pts better
|
1.7%
0.3 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 3.3% · Q2 1.9% · Q3 0.0% · Q4 0.0% · 4Q avg 1.4% · Used in QM five-star |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | 30.9% |
26.0%
4.9 pts worse
|
19.8%
11.1 pts worse
|
Long Stay · 2024Q4-2025Q3 · Q1 33.8% · Q2 20.7% · Q3 25.8% · Q4 42.7% · 4Q avg 30.9% |
| Percentage of long-stay residents with pressure ulcers | 4.7% |
4.3%
0.4 pts worse
|
5.1%
0.4 pts better
|
Long Stay · 2024Q4-2025Q3 · Q1 6.7% · Q2 2.3% · Q3 3.3% · Q4 6.1% · 4Q avg 4.7% · Used in QM five-star |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | 80.4% |
84.3%
3.9 pts worse
|
81.7%
1.3 pts worse
|
Short Stay · 2024Q4-2025Q3 · Q1 80.3% · Q2 80.3% · Q3 80.5% · Q4 80.5% · 4Q avg 80.4% |
| Percentage of short-stay residents who had an outpatient emergency department visit | 6.7% |
13.1%
6.4 pts better
|
12.0%
5.3 pts better
|
Short Stay · 20240701-20250630 · Adjusted 6.7% · Observed 5.7% · Expected 9.6% · Used in QM five-star |
| Percentage of short-stay residents who newly received an antipsychotic medication | 1.1% |
1.9%
0.8 pts better
|
1.6%
0.5 pts better
|
Short Stay · 2024Q4-2025Q3 · Q1 3.0% · Q2 2.6% · Q3 0.0% · Q4 0.0% · 4Q avg 1.1% · Used in QM five-star |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | 73.1% |
73.3%
0.2 pts worse
|
79.7%
6.6 pts worse
|
Short Stay · 2024Q3-2025Q2 · 4Q avg 73.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission | 18.3% |
21.3%
3 pts better
|
23.9%
5.6 pts better
|
Short Stay · 20240701-20250630 · Adjusted 18.3% · Observed 14.9% · Expected 19.5% · Used in QM five-star |
Survey summary
Recent inspection cycles
Cycle 2
Health 2023-12-21 · Fire 2023-12-21
5 health deficiencies
Top issue: Resident Assessment and Care Planning (2 deficiencies)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Cycle 3
Health 2022-10-06 · Fire 2022-10-06
3 health deficiencies
Top issue: Infection Control (1 deficiency)
0 fire-safety deficiencies
No concentrated fire-safety issue counts in this cycle.
Inspection history
Recent health citations
D · Potential for more than minimal harm
2025-04-24
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-05-09
D · Potential for more than minimal harm
2025-01-15
F656 · Resident Assessment and Care Planning Deficiencies
Health
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected 2025-01-16
D · Potential for more than minimal harm
2025-01-15
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 2025-01-16
D · Potential for more than minimal harm
2025-01-15
F658 · Resident Assessment and Care Planning Deficiencies
Health
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected 2025-01-16
D · Potential for more than minimal harm
2025-01-15
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 2025-01-16
D · Potential for more than minimal harm
2025-01-15
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2025-01-16
D · Potential for more than minimal harm
2024-09-30
F550 · Resident Rights Deficiencies
Health
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected 2024-10-11
E · Potential for more than minimal harm
2023-12-21
F943 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
Health
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Corrected 2024-01-08
D · Potential for more than minimal harm
2023-12-21
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 2024-01-08
D · Potential for more than minimal harm
2023-12-21
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 2024-01-08
D · Potential for more than minimal harm
2023-12-21
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2024-01-08
E · Potential for more than minimal harm
2022-10-06
F880 · Infection Control Deficiencies
Health
Provide and implement an infection prevention and control program.
Corrected 2022-11-17
D · Potential for more than minimal harm
2022-10-06
F585 · Resident Rights Deficiencies
Health
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Corrected 2022-11-17
D · Potential for more than minimal harm
2022-10-06
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 2022-11-17
Penalties and ownership
What sits behind the stars
Ownership
Goracke, Douglas
5% Or Greater Direct Ownership Interest · Individual
Chamley, Steven
5% Or Greater Direct Ownership Interest · Individual
Busse, Tracy
W-2 Managing Employee · Individual
Chamley, Steven
General Partnership Interest · Individual
Chamley, Steven
Corporate Officer · Individual
Goracke, Douglas
General Partnership Interest · Individual
Goracke, Douglas
Corporate Director · Individual
Goracke, Douglas
Corporate Officer · Individual
Mccool, Jessica
Contracted Managing Employee · Individual
Tjaden, Jordan
W-2 Managing Employee · Individual
Nearby options
Other facilities in reach
#1
North Crest Living Center
Council Bluffs, IA
1-star overall rating with 1-star inspections with 17 recent health deficiencies with 7 fire-safety deficiencies in the latest cycle
#2
Bethany Lutheran Home
Council Bluffs, IA
1-star overall rating with 1-star inspections with $55,846 in total fines with 14 recent health deficiencies with 4 fire-safety deficiencies in the latest cycle
#3
Prairie Gate
Council Bluffs, IA
2-star overall rating with 2-star inspections with $27,630 in total fines with 7 recent health deficiencies with 1 fire-safety deficiencies in the latest cycle
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