Federal inspection record · CMS data as of October 1, 2026
North Crest Living Center
34 Northcrest Drive, Council Bluffs, IA · (712) 328-2333
- Certified beds
- 62
- Residents per day
- 56
- Ownership
- For-Profit
- Chain
- No chain reported
- Medicare / Medicaid
- Medicare + Medicaid
- Certified since
- August 1, 1996
1
How this home got 1 star
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.
-
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.
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Overall
★★★★★1 of 5
Matches the rating CMS publishes on Care Compare.
2
Where it sits among Iowa homes
North Crest Living Center carries 94 inspection points. That is fewer than 17% 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
34 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 Rights9D
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- D
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
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
- D
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
- D
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
- D
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Infection Control8F
- D
Provide and implement an infection prevention and control program.
- F
Provide and implement an infection prevention and control program.
- E
Implement a program that monitors antibiotic use.
- D
Develop and implement policies and procedures for flu and pneumonia vaccinations.
- D
Educate residents and staff on COVID-19 vaccination, offer the COVID-19 vaccine to eligible residents and staff after education, and properly document each resident and staff member's vaccination status.
- F
Provide and implement an infection prevention and control program.
- D
Provide and implement an infection prevention and control program.
- E
Provide and implement an infection prevention and control program.
Resident Assessment and Care Planning7E
- E
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
- D
Ensure each resident receives an accurate assessment.
- D
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
- D
Ensure services provided by the nursing facility meet professional standards of quality.
- D
Assess the resident when there is a significant change in condition
Quality of Life and Care5E
- 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 safe and appropriate respiratory care for a resident when needed.
- D
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
- E
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
- D
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Nursing and Physician Services2F
- F
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
- D
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Administration1F
- F
Have a plan that describes the process for conducting QAPI and QAA activities.
Nutrition and Dietary1E
- E
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Freedom from Abuse, Neglect, and Exploitation1D
- D
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Inspection history
2025-07-24
14 health deficiencies · 7 fire-safety deficiencies
Top issue: Infection Control (4 deficiencies)
2024-09-19
13 health deficiencies · 6 fire-safety deficiencies
Top issue: Resident Rights (5 deficiencies)
2023-06-08
7 health deficiencies · 3 fire-safety deficiencies
Top issue: Infection Control (2 deficiencies)
4
Nursing time per resident, per day
Each resident here gets about 4 h 7 min of nursing staff time a day, 29 min of it from a registered nurse.
This home
4 h 7 min
Iowa average
3 h 52 min
U.S. average
3 h 54 min
- Registered nurse
- Licensed practical nurse
- Nurse aide
Turnover: 50% of nursing staff and 70% 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 days0.1 pts worse | 1.5 | 1.4 | 1.8 |
| Number of outpatient emergency department visits per 1000 long-stay resident days1.1 pts better | 0.8 | 1.9 | 1.7 |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine38.9 pts worse | 55.3% | 94.2% | 93.7% |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine4.4 pts worse | 91.4% | 95.8% | 95.3% |
| Percentage of long-stay residents experiencing one or more falls with major injury0.2 pts worse | 4.1% | 3.9% | 3.2% |
| Percentage of long-stay residents who have depressive symptoms0.1 pts worse | 4.3% | 4.2% | 13.5% |
| Percentage of long-stay residents who lose too much weight1.8 pts better | 2.6% | 4.4% | 5.1% |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication7.8 pts better | 13.2% | 21.0% | 19.5% |
| Percentage of long-stay residents who received an antipsychotic medication8.7 pts better | 11.1% | 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 worsened2.9 pts worse | 18.1% | 15.2% | 12.7% |
| Percentage of long-stay residents whose need for help with daily activities has increased3 pts worse | 19.6% | 16.6% | 13.5% |
| Percentage of long-stay residents with a catheter inserted and left in their bladderAbout the same | 1.4% | 1.4% | 0.7% |
| Percentage of long-stay residents with a urinary tract infection3.2 pts worse | 5.6% | 2.4% | 1.5% |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence9 pts worse | 34.0% | 25.0% | 18.3% |
| Percentage of long-stay residents with pressure ulcers1.8 pts worse | 5.9% | 4.1% | 4.5% |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine23.3 pts worse | 60.7% | 84.0% | 82.3% |
| Percentage of short-stay residents who had an outpatient emergency department visit0.6 pts better | 12.4% | 13.0% | 11.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication0.1 pts worse | 2.2% | 2.1% | 1.5% |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine3.8 pts worse | 70.6% | 74.4% | 80.1% |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission2 pts better | 18.7% | 20.7% | 23.4% |
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Who owns and runs it
10 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 | 20% | 2 facilities |
| Larison, Audra | 5% Or Greater Direct Ownership Interest · Individual | 20% | 2 facilities |
| Bank Iowa | 5% Or Greater Mortgage Interest · Organization | 0% | 2 facilities |
| Chamley, Steven | W-2 Managing Employee · Individual | 0% | 2 facilities |
| Chamley, Steven | Corporate Director · Individual | 0% | 2 facilities |
| Chamley, Steven | Corporate Officer · Individual | 0% | 2 facilities |
| Goodman, Jenny | W-2 Managing Employee · Individual | 0% | 1 facilities |
| Goracke, Douglas | Corporate Director · Individual | 0% | 2 facilities |
| Hunt, Brenda | W-2 Managing Employee · Individual | 0% | 2 facilities |
| Larison, Audra | Operational/Managerial Control · Individual | 0% | 2 facilities |
·
Fire safety
16 life-safety citations (sprinklers, exits, alarms). These don't count toward the star rating.
Smoke5F
- F
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- E
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D
Provide properly protected cooking facilities.
- D
Inspect, test, and maintain automatic sprinkler systems.
- F
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Miscellaneous4F
- F
Have simulated fire drills held at unexpected times.
- E
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
- D
Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.
- F
Have simulated fire drills held at unexpected times.
Gas, Vacuum, and Electrical Systems4F
- F
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- F
Ensure that testing and maintenance of electrical equipment is performed.
- E
Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.
- D
Have proper medical gas storage and administration areas.
Emergency Preparedness1F
- F
Conduct testing and exercise requirements.
Services1D
- D
Have properly installed electrical wiring and gas equipment.
Egress1D
- D
Install emergency lighting that can last at least 1 1/2 hours.
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