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The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Midlands Living Center is a 94-bed skilled nursing facility at 2452 North Broadway in Council Bluffs, Iowa. Locally owned and administered by Jordan Tjaden, the community provides short-term rehabilitation, long-term care, and hospice support for residents in Pottawattamie County. The campus is car-dependent with a Walk Score of 14, though it provides medical appointment transportation for its residents.
The facility is CMS-certified and carries an above average 4-star overall rating as of May 2026. Between 2021 and 2025, state inspections yielded an average of 4.3 deficiencies per year, which is 37% below the Iowa state average. While an April 2025 investigation identified a single deficiency related to infection control during catheter care, a September 2025 follow-up found the facility in substantial compliance with zero deficiencies. No federal fines or payment denials have been issued in the past three years.
Staffing levels exceed state averages in several key categories. Total adjusted nursing hours are 4 hours 31 minutes per resident day, with Licensed Practical Nurse (LPN) hours at 48 minutes, 41% above the Iowa average. Weekend nursing coverage is also a strength, performing 5% above the state mean. Quality measures are rated at 4 stars, with long-stay hospitalizations 28% better than average and a 96.4% success rate in managing residents’ physical restraint needs.
The campus offers furnished rooms with in-house laundry and on-site beauty and barber services.Shared clinical amenities include:On-site optometry, podiatry, and dentistry alongside physical, occupational, and speech therapy. The social calendar features recreational and spiritual activities, and the facility maintains an A+ rating with the Better Business Bureau. Medicare, Medicaid, and private pay are accepted, with a current occupancy rate of approximately 72%.
Families should evaluate the current bedside care standards during an on-site visit. It is advisable to ask the administrator for specific details on the corrective actions taken after the 2025 catheter care finding and to confirm that the infection prevention protocols remain in full compliance for 2026.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 80th out of 241 homes in Iowa. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
| Staff type | Hours / Day / Resident | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 42m per day | ▼ 5% State avg: 44m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 48m per day | ▲ 41% State avg: 34m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 2h 27m per day | ▼ 3% State avg: 2h 32m per day · National avg: 2h 20m per day |
|
Weekend Total Nursing
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 3h 27m per day | ▲ 3% State avg: 3h 21m per day · National avg: 3h 26m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 2m per day | ■ Avg State avg: 2m per day · National avg: 4m per day |
|
Weekend RN
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 29m per day | ▼ 3% State avg: 30m per day · National avg: 28m per day |
Similar to the Iowa average: 75.4%Midlands Living Center LLC is administrated by Jordan Tjaden.
Key information about the people who lead and staff this community.
In Iowa, the Department of Inspections, Appeals, and Licensing conducts unannounced health and safety surveys to monitor compliance and protect residents in long-term care settings.
This scorecard compares key inspection, citation, and complaint metrics at this facility against the Iowa state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
Deficiencies
| This Facility | IA Average | vs. IA Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 28 | 27 | This facility has 4% more total deficiencies than a typical Iowa nursing home (28 vs. IA avg 27).↑ 4% worse |
|
Deficiencies per year
Average deficiencies per year since 2020.
| 4.7 | 4.5 | This facility has 4% more deficiencies per year than a typical Iowa nursing home (4.7 vs. IA avg 4.5).↑ 4% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 1.2 | 1.8 | This facility has 33% fewer deficiencies per inspection than a typical Iowa nursing home (1.2 vs. IA avg 1.8).↓ 33% better |
Inspections
| This Facility | IA Average | vs. IA Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 23 | 15 | This facility has 53% more total inspections than a typical Iowa nursing home (23 vs. IA avg 15).↑ 53% worse |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
The most recent inspection on September 2, 2025 found the facility in substantial compliance with no deficiencies. Earlier inspections showed a pattern of deficiencies primarily related to infection control, care planning, and resident rights, including issues with catheter care, comprehensive care plans, and dignity in resident treatment. Several complaint investigations were substantiated, such as failure to maintain infection control during catheter care and inadequate care plan development, but enforcement actions like fines or license suspensions were not listed in the available reports. Most complaint investigations were unsubstantiated or resulted in the facility being found in substantial compliance. The facility’s record shows some improvement over time, with more recent inspections indicating fewer deficiencies and accepted plans of correction restoring compliance.
Read the full inspection reports for this facility, including detailed findings and corrective actions.
Show Inspection ReportsIowa average 4.9
Last Health inspection on Apr 2025
Iowa average 21.7
Iowa average 4.11
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
10 of 14 citations resulted from standard inspections; 2 of 14 resulted from complaint investigations; and 2 of 14 came from combined inspections (standard and complaint).
100% better than Iowa averageIowa average: 0.6
100% better than Iowa averageIowa average: 0.9
Corrected
Corrected
Corrected
Corrected
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
32% worse than Iowa average
5% better than Iowa average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.2 hoursNo contractors work on this role.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.5 hoursNo contractors work on this role.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.1 hoursNo contractors work on this role.
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
1,286 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 36 | 0 | 36 | 13,156 | 92 | 100% | 8.1 |
| Licensed Practical Nurse | 13 | 0 | 13 | 5,098 | 92 | 100% | 8.5 |
| Registered Nurse | 8 | 0 | 8 | 2,294 | 92 | 100% | 8.2 |
| Medication Aide/Technician | 5 | 0 | 5 | 1,895 | 92 | 100% | 8.2 |
| Clinical Nurse Specialist | 4 | 0 | 4 | 1,044 | 68 | 74% | 8 |
| Mental Health Service Worker | 2 | 0 | 2 | 1,000 | 79 | 86% | 7.8 |
| Other Dietary Services Staff | 2 | 0 | 2 | 893 | 70 | 76% | 7.8 |
| Nurse Practitioner | 2 | 0 | 2 | 520 | 65 | 71% | 8 |
| Dietitian | 1 | 0 | 1 | 520 | 64 | 70% | 8.1 |
| Physical Therapy Assistant | 0 | 4 | 4 | 513 | 71 | 77% | 6.4 |
| Administrator | 1 | 0 | 1 | 488 | 61 | 66% | 8 |
| Nurse Aide in Training | 2 | 0 | 2 | 357 | 41 | 45% | 6.9 |
| Speech Language Pathologist | 0 | 2 | 2 | 335 | 64 | 70% | 5.2 |
| Respiratory Therapy Technician | 0 | 2 | 2 | 131 | 41 | 45% | 3.2 |
| Qualified Social Worker | 0 | 1 | 1 | 121 | 59 | 64% | 2.1 |
| Occupational Therapy Aide | 0 | 1 | 1 | 104 | 13 | 14% | 8 |
| RN Director of Nursing | 1 | 0 | 1 | 90 | 11 | 12% | 8.1 |
| Physical Therapy Aide | 0 | 1 | 1 | 62 | 29 | 32% | 2.1 |
| Medical Director | 0 | 1 | 1 | 20 | 13 | 14% | 1.5 |
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database
No penalties in the past 3 years
No civil money penalties or payment denials were reported in the last 3 years.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
8.8
14% better than Iowa averageIowa average: 10.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
19.6
9% better than Iowa averageIowa average: 21.6
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
16.3%
14% better than Iowa averageIowa average: 18.8%
Percent of long-stay residents whose ability to move independently worsened
14.8%
25% better than Iowa averageIowa average: 19.7%
Percent of low risk long-stay residents who lose control of their bowels or bladder
27.8%
6% worse than Iowa averageIowa average: 26.2%
Percent of long-stay residents experiencing one or more falls with major injury
3.9%
7% worse than Iowa averageIowa average: 3.6%
Percent of long-stay high risk residents with pressure ulcers
3.7%
15% better than Iowa averageIowa average: 4.4%
Percent of long-stay residents with a urinary tract infection
2.2%
12% better than Iowa averageIowa average: 2.5%
Percent of long-stay residents who lose too much weight
5.5%
9% worse than Iowa averageIowa average: 5.0%
Percent of long-stay residents who have depressive symptoms
0.0%
100% better than Iowa averageIowa average: 3.9%
Percent of long-stay residents who received an antipsychotic medication
11.8%
38% better than Iowa averageIowa average: 19.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
94.9%
In line with Iowa averageIowa average: 94.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
5% better than Iowa averageIowa average: 95.3%
Number of hospitalizations per 1,000 long-stay resident days.
1.26
15% better than Iowa averageIowa average: 1.48
Number of outpatient emergency department visits per 1,000 long-stay resident days.
0.82
61% better than Iowa averageIowa average: 2.09
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
80.5%
5% worse than Iowa averageIowa average: 85.1%
Percent of short-stay residents who newly received an antipsychotic medication
1.4%
26% better than Iowa averageIowa average: 1.8%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
73.1%
In line with Iowa averageIowa average: 73.3%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
18.3%
14% better than Iowa averageIowa average: 21.3%
Percentage of short-stay residents who had an outpatient emergency department visit.
6.7%
49% better than Iowa averageIowa average: 13.1%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Iowa averageIowa average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
54.9%
In line with Iowa averageIowa average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
55.2%
9% better than Iowa averageIowa average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
48% of new residents, usually for short-term rehab.
30% of new residents, often for short stays.
22% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
64Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
Historical financial and operational data for Midlands Living Center LLC based on CMS SNF Cost Reports.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #96 / 242Payroll — State benchmarkedThis home is ranked 96th out of 242 homes in Iowa. Shows total annual staff payroll benchmarked to the Iowa average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Most residents typically stay for a few weeks or months before returning home or moving on.
0.0 miles from city center
Estimated distance in miles from Council Bluffs's city center to Midlands Living Center LLC's address, calculated via Google Maps.
Add your location
Midlands Living Center LLC is located in Council Bluffs, Iowa.
Here are the financial assistance programs available to residents in Iowa.
The information below is reported by the Iowa Department of Inspections, Appeals, and Licensing.
| Midlands Living Center LLC |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Council Bluffs | 94 | 78.1% | +4% | 4.51 | -23% | +5% | $0 | 14 | 2.8 | - | 69 | A+ | 77 | - | $9.3M | $4.4M | 47% | 165447 | ||||
| Prairie Gate |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Council Bluffs (Kane Township) | 36 | 49.8% | -34% | 5.87 | -9% | +37% | $27.6k | 23 | 3.3 | 2 | 35 | - | 0 | - | $2.8M | $1.1M | 40.1% | 165794 | ||||
| Risen Son Christian Village |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence.
IL Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk. | Council Bluffs (Risen Son Boulevard) | 138 | 31.0% | -59% | 0.03 | -22% | -99% | $0 | 38 | 6.3 | 2 | 26 | A+ | 8 | Allen Burnett | $9.1M | $6.2M | 68.6% | 165466 | ||||
| Bethany Lutheran Home |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Seven Elliott Street | 112 | 73.4% | -3% | 4.89 | +28% | +14% | $30.3k | 51 | 5.1 | 6 | 88 | A+ | 77 | Diana Roberts | $14.7M | $9.7M | 65.7% | 165524 | ||||
| North Crest Living Center |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Council Bluffs | 62 | 86.3% | +14% | 4.18 | -32% | -3% | $0 | 34 | 5.7 | - | 57 | - | 77 | Steven Chamley | $6.2M | $3.6M | 59% | 165290 |
The legal owner and operator of Midlands Living Center LLC is North Crest Living Center(Free Standing NF/SNF) | 780853.
Midlands Living Center LLC has a walk score of 77. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
According to IA state health department records, Midlands Living Center LLC's license number is 780508.
According to IA state health department records, Midlands Living Center LLC's license expires on October 1, 2026.
Midlands Living Center LLC's occupancy is 72%.
The team at Midlands Living Center LLC can be reached at [email protected].
Jordan Tjaden is the administrator of Midlands Living Center LLC.
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