2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
Accura Healthcare of Spirit Lake is an 85-bed privately owned skilled nursing facility at 1912 Zenith Avenue in Spirit Lake, Iowa, offering short-term rehabilitation, long-term care, memory care, and respite services to residents in Dickinson County.
The facility holds a 1-star overall CMS rating, driven largely by its health inspection sub-rating — also 1 star and 64.9% below the Iowa average. In August 2024, CMS imposed a $35,000 civil money penalty and a 31-day payment denial for new Medicare and Medicaid admissions, both stemming from the same enforcement action. These findings are significant, and families should weigh them alongside the full inspection record.
Nurse staffing averages 4 hours and 18 minutes per resident per day, matching the Iowa average — a neutral data point in an otherwise below-average profile. Physical therapist staffing is a standout, running double the state average, which matters for short-stay rehabilitation residents. The staff-to-resident ratio, at 1.48:1, is 28% below the Iowa norm of 2.05:1. Short-stay quality measures are above average; long-stay measures are below average. The facility’s current occupancy rate is 66.6%, below Iowa’s average of 75.4%, which suggests availability.
Amenities and services include private short-stay suites, outpatient therapy, a Life Enrichment Program, and outdoor patio and courtyard spaces.
While Accura Healthcare of Spirit Lake may suit short-term post-acute rehabilitation residents who prioritize access to therapy in a smaller Iowa community, families considering long-term placement should carefully review the facility’s inspection history, enforcement actions, and long-stay quality outcomes
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.
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.
| 37m per day | ▼ 16% 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.
| 44m per day | ▲ 29% 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 21m per day | ▼ 7% 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 12m per day | ▼ 5% 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.
| 3m per day | ▲ 29% 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.
| 31m per day | ▲ 4% State avg: 30m per day · National avg: 28m per day |
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
0% compared with State averageState average ratio: 0 : 0
0% compared with State averageState average: 0 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
All 9 RN Staff are full-time employees. No contractors work on this role.
9
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.6 hoursAssists with medical care and medications.
All 11 LPN Staff are full-time employees. No contractors work on this role.
11
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.2 hoursHelps with daily care and mobility.
All 51 CNA Staff are full-time employees. No contractors work on this role.
51
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.7 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
1,075 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 51 | 0 | 51 | 14,048 | 92 | 100% | 7.7 |
| Licensed Practical Nurse | 11 | 0 | 11 | 3,514 | 92 | 100% | 8.2 |
| Registered Nurse | 9 | 0 | 9 | 2,824 | 92 | 100% | 8.6 |
| RN Director of Nursing | 2 | 0 | 2 | 962 | 66 | 72% | 7.7 |
| Nurse Practitioner | 2 | 0 | 2 | 958 | 64 | 70% | 7.8 |
| Dietitian | 1 | 0 | 1 | 453 | 66 | 72% | 6.9 |
| Medication Aide/Technician | 3 | 0 | 3 | 441 | 42 | 46% | 8.7 |
| Dental Services Staff | 1 | 0 | 1 | 426 | 57 | 62% | 7.5 |
| Physical Therapy Assistant | 0 | 5 | 5 | 317 | 73 | 79% | 3.1 |
| Speech Language Pathologist | 0 | 3 | 3 | 286 | 46 | 50% | 6.2 |
| Respiratory Therapy Technician | 0 | 1 | 1 | 265 | 63 | 68% | 4.2 |
| Administrator | 1 | 0 | 1 | 252 | 63 | 68% | 4 |
| Other Dietary Services Staff | 2 | 0 | 2 | 243 | 66 | 72% | 2.6 |
| Qualified Social Worker | 0 | 2 | 2 | 94 | 57 | 62% | 1.7 |
| Occupational Therapy Aide | 0 | 1 | 1 | 66 | 13 | 14% | 5.1 |
| Occupational Therapy Assistant | 0 | 2 | 2 | 29 | 3 | 3% | 9.8 |
| Medical Director | 0 | 1 | 1 | 15 | 6 | 7% | 2.5 |
| Physical Therapy Aide | 0 | 1 | 1 | 2 | 1 | 1% | 2.4 |
Includes penalties issued in 2024
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 (Data as of Jan 2026)
28% lower than State averageState average: $48K
41% fewer fines than State averageState average: 1.7
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
1 
88% more payment denials than State averageState average: 0.5
Penalties are imposed by CMS for violations of federal nursing home regulations.
2 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Aug 22, 2024
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Aug 22, 2024Last updated: Jan 2026
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.
13.0
27% worse than State averageState average: 10.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
23.7
10% worse than State averageState 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
21.3%
13% worse than State averageState average: 18.8%
Percent of long-stay residents whose ability to move independently worsened
19.1%
In line with State averageState average: 19.7%
Percent of low risk long-stay residents who lose control of their bowels or bladder
30.6%
17% worse than State averageState average: 26.2%
Percent of long-stay residents experiencing one or more falls with major injury
5.8%
61% worse than State averageState average: 3.6%
Percent of long-stay high risk residents with pressure ulcers
6.7%
52% worse than State averageState average: 4.4%
Percent of long-stay residents with a urinary tract infection
0.9%
64% better than State averageState average: 2.5%
Percent of long-stay residents who lose too much weight
12.2%
145% worse than State averageState average: 5.0%
Percent of long-stay residents who have depressive symptoms
6.7%
72% worse than State averageState average: 3.9%
Percent of long-stay residents who received an antipsychotic medication
18.0%
5% better than State averageState average: 19.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
99.6%
5% better than State averageState average: 94.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
98.3%
In line with State averageState average: 95.3%
Number of hospitalizations per 1,000 long-stay resident days.
2.22
50% worse than State averageState average: 1.48
Number of outpatient emergency department visits per 1,000 long-stay resident days.
2.81
34% worse than State averageState 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
97.0%
14% better than State averageState average: 85.1%
Percent of short-stay residents who newly received an antipsychotic medication
1.5%
18% better than State averageState average: 1.8%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
90.9%
24% better than State averageState average: 73.3%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
20.0%
6% better than State averageState average: 21.3%
Percentage of short-stay residents who had an outpatient emergency department visit.
16.1%
23% worse than State averageState average: 13.1%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than State averageState average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
49.5%
8% worse than State averageState average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
56.3%
11% better than State averageState average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
54% of new residents, usually for short-term rehab.
39% of new residents, often for short stays.
7% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
67Data 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 Accura Healthcare of Spirit Lake from 2011–2023, based on CMS SNF Cost Reports.
Based on CMS SNF Cost Report for fiscal year ending in 12/2023.
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs.
Rank #119 / 251Payroll — State benchmarkedThis home is ranked 119th out of 251 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.Rankings are based only on facilities in Iowa that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay.
Rank #122 / 251Payroll % — State benchmarkedThis home is ranked 122nd out of 251 homes in Iowa. Shows payroll as a percentage of revenue versus the Iowa average. Well-run Iowa facilities typically land around 61–69% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Rankings are based only on facilities in Iowa that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
Most residents typically stay for a few weeks or months before returning home or moving on.
Most new residents arrive under Medicare (54% of admissions), and a typical Medicare stay runs around 22 days.
Coverage residents most often arrive under.
Coverage residents most often leave under.
0.0 miles from city center
Estimated distance in miles from Spirit Lake's city center to Accura Healthcare of Spirit Lake's address, calculated via Google Maps.
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The information below is reported by the Iowa Department of Inspections, Appeals, and Licensing.
| Accura Healthcare of Spirit Lake | NH HC MC PC RC | Spirit Lake | - | 80 | - | 76 | - |
| Ramsey Village Continuing Care | NH AL IL MC RC | Des Moines (Drake) | - | 78 | - | 38 | 1 bed / 2 bed |
| Rotary Senior Living | NH AL IL MC | Eagle Grove | - | 40 | - | 24 | Private Rooms |
| Calvin Community | NH AL IL MC | Des Moines (Beaverdale) | - | 59 | - | 61 | 1 Bed |
| The Summit at Bettendorf | NH AL IL MC | Bettendorf | - | 40 | - | 11 | Studio / 1 Bed / 2 Bed |
Accura Healthcare of Spirit Lake has a walk score of 76. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
Accura Healthcare of Spirit Lake's occupancy is 66.6%.
Accura Healthcare of Spirit Lake is registered as a for-profit.
Yes — there are 4 photos of Accura Healthcare of Spirit Lake in the photo gallery on this page.
Accura Healthcare of Spirit Lake is located at 1912 Zenith Avenue, Spirit Lake, Ia 513601000.
(712) 336-3300 will put you in contact with the team at Accura Healthcare of Spirit Lake.
Yes — Accura Healthcare of Spirit Lake is a CMS-certified provider of Medicare and Medicaid.
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