Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
89
77 employees · 12 contractors · 40 on an average day Midlands Living Center LLC
Nursing Home, Hospice Care, Respite Care & Skilled Nursing · Council Bluffs, IA
ALM Inspection Grade
A-
ALM's inspection grade is 92 / 100, an A- — 9 points above the Iowa average for CMS-certified facilities (83/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
ALM's inspection grade is 92 / 100, an A- — 9 points above the Iowa average for CMS-certified facilities (83/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
CMS overall rating
5/5
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.
5/5
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.
Midlands Living Center LLC
Nursing Home, Hospice Care, Respite Care & Skilled Nursing · Council Bluffs, IA
ALM Inspection Grade
A-
ALM's inspection grade is 92 / 100, an A- — 9 points above the Iowa average for CMS-certified facilities (83/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
ALM's inspection grade is 92 / 100, an A- — 9 points above the Iowa average for CMS-certified facilities (83/100) · A proprietary Assisted Living Magazine grade.A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. It is not a government rating.
CMS overall rating
5/5
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.
5/5
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.
Midlands Living Center LLC accepts Medicare, Medicaid, and private pay.
Overview of Midlands Living Center
Midlands Living Center is a nursing home in Council Bluffs, Iowa, offering skilled nursing, hospice care, and respite care. Short and long term care support residents who need either a temporary stay or ongoing nursing support, while skilled nursing provides licensed nursing care on site around the clock. Hospice care focuses on comfort for someone nearing the end of life, and respite care provides a short stay when a usual caregiver needs to travel or recover.
The community has 94 beds and accepts Medicare, Medicaid, and private pay. Medicare can cover short term skilled care after a hospital stay, rather than a long term residence, while Medicaid may help families whose savings do not cover an extended stay. Total nurse staffing is 4 hours and 51 minutes per resident each day, representing the daily nurse time available for resident care.
Physical, occupational, and speech therapy are available for residents working on rehabilitation. Medical appointment transportation helps residents travel to those appointments. A salon and spa provide grooming services within the community, while recreational, spiritual, and restorative exercise programs offer structured activities. Jordan Tjaden serves as the administrator. Midlands Living Center may be a good fit for someone who needs short term rehabilitation, ongoing nursing care, or respite while a primary caregiver travels or recovers.
Quality ratings
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.
Staffing
Data period: Q4 2025 (October 1 – December 31, 2025).
Nursing care per resident per day and state rankings: CMS Provider Information.
Headcount, shifts and contractors: CMS Payroll-Based Journal (PBJ).
Resident count: CMS Long-Term Care Facility Characteristics (data as of Jun 2026).
Total nursing care per resident / day
This nursing home is ranked 110th out of 225 nursing homes we track in Iowa for nurse hours. 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.
4h 51m
This nursing home is ranked 110th out of 225 nursing homes we track in Iowa for nurse hours. 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.
4h 51mStandout metric: LPN / LVN is +67% above Iowa average
3 of 6 metrics below Iowa average
Daily care time per resident, by role
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. All 8 are the facility's own employees; no agency contractors work in this role.
8 staff · 8.2-hour shifts
43m
↓ 2% · IA 44mThis facility: 43m per resident per day, 2% below the Iowa average of 44m (among Iowa facilities reporting a recent figure).
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. All 8 are the facility's own employees; no agency contractors work in this role.
8 staff · 8.2-hour shiftsUS average: 41m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 41m
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. All 13 are the facility's own employees; no agency contractors work in this role.
13 staff · 8.5-hour shifts
57m
↑ 67% · IA 34mThis facility: 57m per resident per day, 67% above the Iowa average of 34m (among Iowa facilities reporting a recent figure).
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. All 13 are the facility's own employees; no agency contractors work in this role.
13 staff · 8.5-hour shiftsUS average: 52m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 52m
Certified nursing assistant
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. All 36 are the facility's own employees; no agency contractors work in this role.
36 staff · 8.1-hour shifts
3h 11m
↑ 26% · IA 2h 32mThis facility: 3h 11m per resident per day, 26% above the Iowa average of 2h 32m (among Iowa facilities reporting a recent figure).
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. All 36 are the facility's own employees; no agency contractors work in this role.
36 staff · 8.1-hour shiftsUS average: 2h 20m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 2h 20m
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
↓ 17% · IA 2mThis facility: 2m per resident per day, 17% below the Iowa average of 2m (among Iowa facilities reporting a recent figure).
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.
US average: 4m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 4m
Total nursing, weekends
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.
RN + LPN + aide · Sat–Sun
4h 9m
↑ 24% · IA 3h 21mThis facility: 4h 9m per resident per day, 24% above the Iowa average of 3h 21m (among Iowa facilities reporting a recent figure).
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.
RN + LPN + aide · Sat–SunUS average: 3h 26m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 3h 26m
RN, weekends
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.
Sat–Sun
20m
↓ 33% · IA 30mThis facility: 20m per resident per day, 33% below the Iowa average of 30m (among Iowa facilities reporting a recent figure).
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.
Sat–SunUS average: 28m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 28m
Headcount
Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
89
77 employees · 12 contractors · 40 on an average day
89 total staff / 66 residents. Residents: CMS Long-Term Care Facility Characteristics (data as of Jun 2026); staff: CMS Payroll-Based Journal (Q4 2025).Residents and staff come from two different CMS releases, so the two counts can be a few months apart.
1.35 : 1
↓ 33% · IA 2.02This facility: 1.35 staff per resident, 33% below the Iowa average of 2.02 (among Iowa facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
89 staff ÷ 66 residents
See full Iowa ranking →
Average hours one staff member works on a day they are on shift, across every role.
7.8 h
↑ 4% · IA 7.5 hThis facility: 7.8 h, 4% above the Iowa average of 7.5 h (among Iowa facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
28,641 staff hours this quarter
See full Iowa ranking →95.5% of staff hours were worked by the facility's own employees
Iowa average: 92.3% · Contractors this quarter: Physical Therapy Assistant (4), Speech Language Pathologist (2), Respiratory Therapy Technician (2), Qualified Social Worker (1), Physical Therapy Aide (1), Occupational Therapy Aide (1), Medical Director (1)
Why it matters: employees work here week after week and get to know each resident's routines and needs. Agency contractors often rotate between facilities, so a higher employee share usually means more consistent care.
By The Numbers
Community insights.
Bed count
A smaller, more intimate setting that may offer a quieter environment and closer staff-resident interactions.
94
Rank #28 / 235Bed count — State benchmarked This nursing home is ranked 28th out of 235 nursing homes we track in Iowa for bed count. Shows this facility's certified or reported bed count compared to other Iowa facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
A smaller, more intimate setting that may offer a quieter environment and closer staff-resident interactions.
94
Rank #28 / 235Bed count — State benchmarked This nursing home is ranked 28th out of 235 nursing homes we track in Iowa for bed count. Shows this facility's certified or reported bed count compared to other Iowa facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.Smaller home · May offer a more intimate, personalized care environment.
Years of operating
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care. This is the number of years in operation under current management.
Rank #63 / 116Years in operation — State benchmarked This nursing home is ranked 63rd out of 116 nursing homes we track in Iowa for years in operation. Shows how long this facility has been in operation compared to other Iowa facilities. Longer operating histories may benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care. This is the number of years in operation under current management.
Rank #63 / 116Years in operation — State benchmarked This nursing home is ranked 63rd out of 116 nursing homes we track in Iowa for years in operation. Shows how long this facility has been in operation compared to other Iowa facilities. Longer operating histories may benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
23
years
Walk Score
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
Rank #37 / 249Walk Score — State benchmarked This nursing home is ranked 37th out of 249 nursing homes we track in Iowa for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Iowa facilities. Higher scores benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.
Rank #37 / 249Walk Score — State benchmarked This nursing home is ranked 37th out of 249 nursing homes we track in Iowa for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Iowa facilities. Higher scores benefit residents, families, and staff. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
77
/ 100
Occupancy rate
Occupancy lower than 85% suggests more openings may be available.
Rank #179 / 226Occupancy rate — State benchmarked This nursing home is ranked 179th out of 226 nursing homes we track in Iowa for occupancy. Shows this facility's occupancy rate versus the Iowa average, with its Statewide rank out of 226. Higher occupancy signals strong local demand and financial stability. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Occupancy lower than 85% suggests more openings may be available.
Rank #179 / 226Occupancy rate — State benchmarked This nursing home is ranked 179th out of 226 nursing homes we track in Iowa for occupancy. Shows this facility's occupancy rate versus the Iowa average, with its Statewide rank out of 226. Higher occupancy signals strong local demand and financial stability. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
70.2%
This home usually has availability
Based on 66 residents and 94 beds. Source: state inspection report (Jan 2026)
Lower than the Iowa average: 79.1%
Avg. Length of Stay
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
195
days
BBB Rating
An independent rating from the Better Business Bureau based on factors such as complaint history, transparency, and business practices.
An independent rating from the Better Business Bureau based on factors such as complaint history, transparency, and business practices.
A+
Accredited
How BBB ratings workAbout This Community
Facility TypeFree Standing Nursing Facility / Skilled Nursing Facility
CountyPottawattamie
License Number780508
CMS Certification Number165447
Certification TypeFALSE
Midlands Living Center LLC is administered by Jordan Tjaden.
Owner NameNorth Crest Living Center(Free Standing Nf/Snf) | 780853
Resident Council
Restorative Exercise Program
Physical TherapyListed as: Rehabilitation - physical therapy
Speech Therapy
Doctor on Staff
In-House Visits From Podiatry
Optometry Services
Dentistry Professionals
Dietitian
Respite CareRespite care provides families and unpaid caregivers with short-term relief from caregiving duties. Care can range from a few hours to a few weeks.
Meals
Laundry & LinenListed as: In-house laundry service
TransportationListed as: Medical appointment transportation
Fax7123250289
Pets not allowed
CMS Health Inspection History
ALM Inspection Grade
92 / 100
Calculated from CMS inspection data for this community's nursing-home beds
How it compares
9 points above the Iowa average for CMS-certified facilities (83/100)
Category breakdown
Citations
Typical
30 severity-weighted points (16 deficiencies) · 23% lower than the typical CMS-certified IA facility (median: 39)
Enforcement
Strong
No fines on record · 0 enforcement actions
Persistence
Strong
11 days to fix issues · much faster than the typical CMS-certified IA facility (median: 21)
Total health inspections
5
≈ 0% · IA 5This facility: 5, level with the Iowa average of 5 (among Iowa facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Total health citations
16
Rank #109 / 226Health citations — State benchmarked This nursing home is ranked 109th out of 226 nursing homes we track in Iowa for health citations. Shows this facility's total health deficiency citations benchmarked to the Iowa State average, with a ranking across all 226 IA facilities. Lower citation counts earn a better rank. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.↓ 23% · IA 20.7This facility: 16, 23% below the Iowa average of 20.7 (among Iowa facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Citations per inspection
3.2
Rank #95 / 226Citations per inspection — State benchmarked This nursing home is ranked 95th out of 226 nursing homes we track in Iowa for citations per inspection. Shows average deficiency citations per CMS inspection for this facility versus the Iowa mean across 226 facilities with citation data. Lower is better. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.↓ 17% · IA 3.85This facility: 3.2, 17% below the Iowa average of 3.85 (among Iowa facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Citation severity
100% corrected
16 of 16 citations corrected
Critical
J–L
0
↓ 100% · IA 0.5This facility: 0, 100% below the Iowa average of 0.5 (among Iowa facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Immediate jeopardy
Serious
G–I
0
↓ 100% · IA 0.9This facility: 0, 100% below the Iowa average of 0.9 (among Iowa facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Actual harm
Moderate
D–F
16
↓ 16% · IA 19This facility: 16, 16% below the Iowa average of 19 (among Iowa facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
No harm, more than minimal risk
Minor
A–C
0
↓ 100% · IA 0.4This facility: 0, 100% below the Iowa average of 0.4 (among Iowa facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
No harm, minimal riskLatest inspection: Jan 08, 2026 · 5 citations, all corrected
Most cited category: Resident Assessment & Care Planning, 7 of 16 citations · 6 categories in total
Citations history
Most recent first
Jan 08, 2026
5 citations
Pharmacy moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Resident Rights moderate citation
Corrected
Corrected
Apr 24, 2025
1 citation
Infection Control moderate citation
Corrected
Corrected
Jan 15, 2025
5 citations
Infection Control moderate citation
Corrected
Corrected
Quality of Care moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Sep 30, 2024
1 citation
Resident Rights moderate citation
Corrected
Corrected
Dec 21, 2023
4 citations
Abuse/Neglect moderate citation
Corrected
Corrected
Infection Control moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Care Planning moderate citation
Corrected
Corrected
Top deficiency categories
Share of 16 citations
Resident Assessment & Care Planning
7 deficiencies (44%)
Infection Control
3 deficiencies (19%)
Resident Rights
2 deficiencies (13%)
Quality of Life & Care
2 deficiencies (13%)
Abuse, Neglect & Exploitation
1 deficiency (6%)
Pharmacy Services
1 deficiency (6%)
How citations are counted
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
12 of 16 citations resulted from standard inspections; 2 of 16 resulted from complaint investigations; and 2 of 16 came from combined inspections (standard and complaint).
Includes all CMS health inspection records for this property, which could include management/ownership changes.
Source
Data sourced from CMS Health Deficiencies reports. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.
Show Inspection Reports
Enforcement
Penalties and fines
Penalties and fines
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 Aug 2026
No penalties in the past 3 years
No civil money penalties or payment denials on record since Aug 2023.
Total fines
$0
IA avg $48KIowa average: $47,684. Average among the 157 Iowa facilities with a penalty on record.US avg $67KUS average: $67,417, among the 6,775 US facilities with a penalty on record.
Number of fines
0
IA avg 1.42Iowa average: 1.42. Average among the 157 Iowa facilities with a penalty on record.US avg 1.96US average: 1.96, among the 6,775 US facilities with a penalty on record.
Payment denials
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
IA avg 0.47Iowa average: 0.47. Average among the 157 Iowa facilities with a penalty on record.US avg 0.36US average: 0.36, among the 6,775 US facilities with a penalty on record.
Health Outcomes
Quality of care over time
How residents at this home fare on health outcomes and preventive care, compared with the Iowa average.
CMS star rating for the care of long-stay residents, who live at the home for 100 days or more. It is built from the long-stay quality measures below. 5 stars is the best.
5
/ 5
Significantly above average
↑ 53% · IA 3.3This facility: 5.0, 53% above the IA average of 3.3 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
CMS star rating for the care of short-stay residents, mostly people recovering after a hospital stay for under 100 days. It is built from the short-stay quality measures below. 5 stars is the best.
5
/ 5
Significantly above average
↑ 95% · IA 2.6This facility: 5.0, 95% above the IA average of 2.6 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Average of five long-stay measures: pressure ulcers, falls with major injury, unplanned weight loss, worsening ability to walk, and needing more help with daily activities. Each is the % of residents affected, so lower is better.
9.5
Score · lower is better
↑ 3% · IA 9.2This facility: 9.5, 3% above the IA average of 9.2 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Average of three long-stay measures: needing more help with daily activities, worsening ability to walk, and loss of bowel or bladder control. Each is the % of residents affected, so lower is better.
22.1
Score · lower is better
↑ 12% · IA 19.8This facility: 22.1, 12% above the IA average of 19.8 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.13 long-stay measures: 8 better, 3 worse, 2 near IA average
8 short-stay measures: 3 better, 2 near IA average, 3 compared with US only
Long-stay residents
People who live at the home · 13 measures
Daily care & independence
Needed more help with daily activities
Percent of long-stay residents whose need for help with daily activities has increased
17.7%
↑ 3% · IA 17.1This facility: 17.7, 3% above the IA average of 17.1 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents whose need for help with daily activities has increased
17.7%
↑ 3% · IA 17.1This facility: 17.7, 3% above the IA average of 17.1 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Walking ability worsened
Percent of long-stay residents whose ability to move independently worsened
14.3%
↓ 14% · IA 16.6This facility: 14.3, 14% below the IA average of 16.6 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents whose ability to move independently worsened
14.3%
↓ 14% · IA 16.6This facility: 14.3, 14% below the IA average of 16.6 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Bowel or bladder incontinence (low-risk residents)
Percent of low risk long-stay residents who lose control of their bowels or bladder
34.5%
↑ 35% · IA 25.6This facility: 34.5, 35% above the IA average of 25.6 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of low risk long-stay residents who lose control of their bowels or bladder
34.5%
↑ 35% · IA 25.6This facility: 34.5, 35% above the IA average of 25.6 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Safety & clinical stability
Urinary tract infection
Percent of long-stay residents with a urinary tract infection
1.3%
↓ 44% · IA 2.4This facility: 1.3, 44% below the IA average of 2.4 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents with a urinary tract infection
1.3%
↓ 44% · IA 2.4This facility: 1.3, 44% below the IA average of 2.4 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Falls with major injury
Percent of long-stay residents experiencing one or more falls with major injury
8.7%
↑ 127% · IA 3.8This facility: 8.7, 127% above the IA average of 3.8 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents experiencing one or more falls with major injury
8.7%
↑ 127% · IA 3.8This facility: 8.7, 127% above the IA average of 3.8 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Pressure ulcers (high-risk residents)
Percent of long-stay high risk residents with pressure ulcers
5.4%
↑ 30% · IA 4.2This facility: 5.4, 30% above the IA average of 4.2 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay high risk residents with pressure ulcers
5.4%
↑ 30% · IA 4.2This facility: 5.4, 30% above the IA average of 4.2 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Physical & mental health
Lost too much weight
Percent of long-stay residents who lose too much weight
1.6%
↓ 65% · IA 4.6This facility: 1.6, 65% below the IA average of 4.6 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who lose too much weight
1.6%
↓ 65% · IA 4.6This facility: 1.6, 65% below the IA average of 4.6 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Depressive symptoms
Percent of long-stay residents who have depressive symptoms
2.8%
↓ 33% · IA 4.2This facility: 2.8, 33% below the IA average of 4.2 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who have depressive symptoms
2.8%
↓ 33% · IA 4.2This facility: 2.8, 33% below the IA average of 4.2 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Antipsychotic use
Percent of long-stay residents who received an antipsychotic medication
10.3%
↓ 47% · IA 19.5This facility: 10.3, 47% below the IA average of 19.5 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who received an antipsychotic medication
10.3%
↓ 47% · IA 19.5This facility: 10.3, 47% below the IA average of 19.5 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Preventive care
Pneumococcal vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
96.5%
↑ 3% · IA 94.0This facility: 96.5, 3% above the IA average of 94.0 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
96.5%
↑ 3% · IA 94.0This facility: 96.5, 3% above the IA average of 94.0 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Flu vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
↑ 5% · IA 95.3This facility: 100.0, 5% above the IA average of 95.3 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
100.0%
↑ 5% · IA 95.3This facility: 100.0, 5% above the IA average of 95.3 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Hospital & emergency visits
Hospitalizations per 1,000 days
Number of hospitalizations per 1,000 long-stay resident days.
1.26
↓ 15% · IA 1.48This facility: 1.26, 15% below the IA average of 1.48 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Number of hospitalizations per 1,000 long-stay resident days.
1.26
↓ 15% · IA 1.48This facility: 1.26, 15% below the IA average of 1.48 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
ER visits per 1,000 days
Number of outpatient emergency department visits per 1,000 long-stay resident days.
0.82
↓ 61% · IA 2.09This facility: 0.82, 61% below the IA average of 2.09 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Number of outpatient emergency department visits per 1,000 long-stay resident days.
0.82
↓ 61% · IA 2.09This facility: 0.82, 61% below the IA average of 2.09 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Short-stay residents
Rehab and recovery after a hospital stay · 8 measures
Daily care & independence
Able to care for self at discharge
Percentage of residents at or above expected ability to care for themselves at discharge.
54.9%
↑ 2% · US 53.7This facility: 54.9, 2% above the US average of 53.7 (among US facilities reporting a recent figure).
Percentage of residents at or above expected ability to care for themselves at discharge.
54.9%
↑ 2% · US 53.7This facility: 54.9, 2% above the US average of 53.7 (among US facilities reporting a recent figure).
Returned home or to the community
Rate of successful return to home or community from a skilled nursing facility.
55.2%
↑ 9% · US 50.6This facility: 55.2, 9% above the US average of 50.6 (among US facilities reporting a recent figure).
Rate of successful return to home or community from a skilled nursing facility.
55.2%
↑ 9% · US 50.6This facility: 55.2, 9% above the US average of 50.6 (among US facilities reporting a recent figure).Safety & clinical stability
Falls with major injury
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
↓ 100% · US 0.8This facility: 0.0, 100% below the US average of 0.8 (among US facilities reporting a recent figure).
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
↓ 100% · US 0.8This facility: 0.0, 100% below the US average of 0.8 (among US facilities reporting a recent figure).Physical & mental health
New antipsychotic medication
Percent of short-stay residents who newly received an antipsychotic medication
0.5%
↓ 75% · IA 2.1This facility: 0.5, 75% below the IA average of 2.1 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents who newly received an antipsychotic medication
0.5%
↓ 75% · IA 2.1This facility: 0.5, 75% below the IA average of 2.1 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Preventive care
Pneumococcal vaccine
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
80.4%
↓ 4% · IA 84.0This facility: 80.4, 4% below the IA average of 84.0 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
80.4%
↓ 4% · IA 84.0This facility: 80.4, 4% below the IA average of 84.0 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Flu vaccine
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
73.1%
≈ 0% · IA 73.3This facility: 73.1, level with the IA average of 73.3 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
73.1%
≈ 0% · IA 73.3This facility: 73.1, level with the IA average of 73.3 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Hospital & emergency visits
Re-hospitalized after admission
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
18.3%
↓ 14% · IA 21.3This facility: 18.3, 14% below the IA average of 21.3 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
18.3%
↓ 14% · IA 21.3This facility: 18.3, 14% below the IA average of 21.3 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
ER visits
Percentage of short-stay residents who had an outpatient emergency department visit.
6.7%
↓ 49% · IA 13.1This facility: 6.7, 49% below the IA average of 13.1 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percentage of short-stay residents who had an outpatient emergency department visit.
6.7%
↓ 49% · IA 13.1This facility: 6.7, 49% below the IA average of 13.1 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Arrows show whether a figure is above or below the average. Green is better for residents, red is worse, and yellow means within 5% of the average. Grey compares with the US average only, because CMS publishes no state figure. The line on each bar marks the average.
Quality measures are calculated by CMS from Minimum Data Set (MDS) resident assessments and Medicare claims.
Money and staffing.
Midlands Living Center LLC’s finances from its CMS cost report for the fiscal year ending December 2024, compared with 223 Iowa nursing homes that filed a recent report. Includes all financial data for this property, which could include management/ownership changes.
FY Dec 2024
Is it financially stable?
Profitable on care
14.5% operating margin
−4.0 pts vs prior year
Positive margin in 8 of the last 8 reported years. Net income $0.5M after other income.
Does it invest in staff?
Payroll in line with Iowa homes
58.2% payroll share of revenue
IA average 60.9%Rank #123 / 223Payroll % of net patient revenue — State benchmarked This nursing home is ranked 123rd out of 223 nursing homes we track in Iowa for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Iowa average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Payroll rose $0.3M while revenue rose $0.1M. Check hours per resident in the staffing section to confirm it reaches the floor.
FY 2024 scorecard
Each row shows the FY 2024 figure, the change since the prior report, the trend, and how it compares with Iowa homes.
Revenue & profit
Profitable on care
| Metric | FY 2024 | vs prior year | Trend 2017 → 2024Trend | IA median | Compared with IA homesRank in IA | In short |
|---|---|---|---|---|---|---|
| Net patient revenue What the home earns from resident care, after discounts and bad debt. | $8.0M | +$0.1M | Trend 20172024 | IA median $6.3M | Rank in IA Rank #74 / 223Net patient revenue — State benchmarked This nursing home is ranked 74th out of 223 nursing homes we track in Iowa for net patient revenue. Shows this facility's net patient revenue compared to the Iowa average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 67% of homes | Above IA median Higher net patient revenue than 67% of IA homes that filed a recent report. Revenue mostly follows how big a home is. |
| Operating expenses Everything it costs to run the home: staff, supplies, rent, admin. | $6.8M | +$0.4M | Trend 20172024 | IA median — | Rank in IA Not ranked | Within revenue Operating expenses are lower than net patient revenue, so resident care covers its costs. |
| Net patient income Revenue minus operating expenses. Negative means care loses money. | $1.2M | −$0.3M | Trend 20172024 | IA median — | Rank in IA Not ranked | Profit, shrinking Resident care made money this year, less than in the prior report. |
| Operating margin Net patient income as a share of revenue. The clearest health signal. | 14.5% | −4.0 pts | Trend 20172024 | IA median — | Rank in IA Not ranked | Healthy margin More than 5% of revenue is left after operating expenses. |
| Other income Money not from resident care: investments, grants, services. | $0.0M | — | Trend — | IA median — | Rank in IA Not ranked | Adds to profit Income from outside resident care, on top of the profit from care. |
| Net income The bottom line after other income. | $0.5M | −$0.9M | Trend — | IA median — | Rank in IA Not ranked | Profit The bottom line is above zero after other income. |
Staffing spend
Staff spending in line with Iowa homes
| Metric | FY 2024 | vs prior year | Trend 2017 → 2024Trend | IA median | Compared with IA homesRank in IA | In short |
|---|---|---|---|---|---|---|
| Payroll costs Salaries and wage-related benefits, not counting contract labor. | $4.7M | +$0.3M | Trend 20172024 | IA median $3.8M | Rank in IA Rank #76 / 223Payroll costs — State benchmarked This nursing home is ranked 76th out of 223 nursing homes we track in Iowa for payroll costs. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Iowa average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 66% of homes | Above IA median Higher payroll than 66% of IA homes. Payroll in dollars mostly follows how big a home is, so this compares size, not staffing levels. |
| Payroll share of revenue Payroll divided by revenue. Higher usually means more staff per resident. | 58.2% | +3.0 pts | Trend 20172024 | IA median 59.0% | Rank in IA Rank #123 / 223Payroll % of net patient revenue — State benchmarked This nursing home is ranked 123rd out of 223 nursing homes we track in Iowa for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Iowa average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 45% of homes | Near IA average The IA average is 60.9% of revenue. Within 3 points of it reads as near the average. |
Charts, 2017–2024 2 charts · IA benchmark drawn as a dashed line
Revenue, expenses and income
What the home earned from resident care (net patient revenue), what it cost to run (operating expenses) and the difference between the two (net patient income), for each fiscal year it filed a CMS cost report.
USD, millions
Net patient revenue Operating expenses Net patient income
Where revenue goes
Both lines are a share of net patient revenue. Payroll share is what goes to salaries and wage-related benefits; operating margin is what is left after every operating cost (below 0%, resident care lost money). The dashed line is the Iowa payroll average.
% of net patient revenue
Payroll share Operating margin IA payroll average
Year-by-year data, 2017–2024 every reported year · latest first, scroll sideways
| Metric | 2017 | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 |
|---|---|---|---|---|---|---|---|---|
| Net patient revenue | $6.4M | $6.4M | $6.5M | $6.8M | $6.3M | $7.0M | $7.9M | $8.0M |
| Operating expenses | $6.0M | $6.0M | $5.8M | $6.1M | $5.8M | $6.5M | $6.4M | $6.8M |
| Net patient income | $0.4M | $0.4M | $0.7M | $0.7M | $0.5M | $0.5M | $1.5M | $1.2M |
| Operating margin | 6.3% | 6.5% | 10.7% | 10.1% | 8.4% | 7.3% | 18.5% | 14.5% |
| Net income | $0.2M | $0.2M | $0.5M | $0.4M | $0.3M | $0.2M | $1.3M | $0.5M |
| Payroll costs | $4.0M | $3.9M | $3.8M | $4.0M | $3.7M | $4.2M | $4.4M | $4.7M |
| Payroll share of revenue | 62.7% | 61.2% | 59.2% | 58.5% | 58.4% | 60.5% | 55.2% | 58.2% |
| Beds | 100 | 100 | 100 | 92 | 94 | 94 | 94 | 94 |
| Gross revenue | $7.0M | $6.9M | $7.0M | $7.5M | $6.8M | $7.7M | $8.8M | $9.1M |
| Salaries | $3.5M | $3.4M | $3.4M | $3.4M | $3.4M | $3.7M | $3.8M | $4.0M |
| Wage-related costs | $0.5M | $0.5M | $0.4M | $0.6M | $0.3M | $0.6M | $0.6M | $0.7M |
| Contract labor | $0.4M | $0.5M | $0.5M | $0.5M | $0.6M | — | — | — |
| Other operating costs | $2.0M | $2.1M | $2.0M | $2.1M | $2.1M | $2.2M | $2.1M | $2.2M |
| Net patient revenue per day | $216 | $222 | $227 | $251 | $254 | $263 | $295 | $281 |
| Cost per day | $203 | $208 | $203 | $226 | $233 | $244 | $241 | $240 |
| Average length of stay | 215.6 days | 253.9 days | 226.7 days | 446.2 days | 271.3 days | 285.2 days | 235.2 days | 195.2 days |
Showing 2024–2022 · scroll sideways for 5 earlier years
Earlier and partial years are in the download. Download CSV
Who this home usually serves
Residents split by who pays for their care: Medicare, Medicaid, or private pay and other sources.
Over a year: CMS SNF Cost Report, FY2024
Snapshot: CMS Long-Term Care Facility Characteristics (quarterly), Jun 2026
Arriving
136 admissions · FY2024
Residents admitted during the year.
Medicare
61 · 45%
Medicaid
35 · 26%
Private pay & other
40 · 29%
Resident snapshot
66 residents · Jun 2026
Residents counted on the date of the latest CMS report, which updates quarterly.
Medicare
7 · 11%
Medicaid
30 · 45%
Private pay & other
29 · 44%
Leaving
146 discharges · FY2024
Residents discharged during the year.
Medicare
60 · 41%
Medicaid
40 · 27%
Private pay & other
46 · 32%
Mostly short-term rehab stays
Most residents typically stay for a few weeks or months before returning home or moving on.
Places of interest near Midlands Living Center LLC
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.
Calculate Travel Distance to Midlands Living Center LLC
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Compare Nursing Homes around Council Bluffs
Info below is compiled from CMS reports & the IA Dept. of Inspections, Appeals & Licensing (DIAL), senior community websites & trusted data sources such as Walk Score & BBB.
Communities are listed from highest-ranked to lowest-ranked based on our methodology.
The facility name. Click to view the full profile page on Assisted Living Magazine, including photos, services, and contact info.
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CMS (Centers for Medicare & Medicaid Services, the federal agency that regulates nursing homes) Overall 5-star rating — a composite of Health Inspection, Staffing, and Quality Measures scores. 5 stars = top 10% nationally. 1 star = bottom 10%. The single most important number to start with when comparing facilities.
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Care Types in This Table
AL (Assisted Living):
Housing with help for daily activities like bathing, dressing, and medication, without 24-hour skilled nursing.
NH (Nursing Home):
24/7 skilled nursing care for residents with complex, ongoing medical needs.
SNF (Skilled Nursing Facility):
Round-the-clock nursing care, often for recovery after surgery, injury, or illness.
MC (Memory Care):
Secured, specialized care for people living with Alzheimer's or dementia.
RC (Respite Care):
Short-term temporary care that gives family caregivers a break.
IL (Independent Living):
Community living with dining, activities, and transportation for active seniors who need little personal care.
HOS (Hospice Care):
Comfort-focused care for those with a terminal illness, prioritizing quality of life over treatment.
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Neighborhood or city area where the facility is located. Proximity to family, hospitals, and green space matters for both quality of life and ease of visitation. Consider drive time and transit access when evaluating location.
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Licensed bed capacity. Larger facilities (300+ beds) often have more specialized programs but can feel institutional. Smaller homes (under 150 beds) tend to deliver more personalized care. Compare with Avg Res/Day to understand how full the facility typically runs.
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A 0–100 score of a facility's regulatory inspection record, shown as a letter and compared with other facilities of the same kind in the same state. This is a proprietary Assisted Living Magazine grade. It is not a government rating. A dash means we have no inspection data for that facility.
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Percentage of licensed beds filled on an average day. Color indicates financial health: green (90%+) = operationally strong, typically profitable. Amber (80–89%) = stable but leaving revenue on the table. Orange (70–79%) = financial strain likely, may struggle with fixed costs. Red (<70%) = significant distress, closure or ownership change risk increases sharply.
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This facility's occupancy rate compared to the statewide average for similar facilities. A positive number means above-average demand. Facilities running 5%+ above the state average are typically the most sought-after in their market — a strong proxy for reputation.
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CMS-adjusted total nurse hours per resident per day (RN + LPN + CNA combined). The national average is approximately 3.5 hrs. Higher is better — more direct care time per resident. Below 3.0 is a red flag. CMS weights RN hours more heavily because RNs handle complex clinical decisions that CNAs cannot.
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CMS Health Inspection star rating (1–5 stars), based on the 3 most recent annual state surveys plus any complaint investigations. This is the hardest rating to manipulate — it reflects real surveyor findings on-site. 5 stars = fewest deficiencies found. 1 star = most. It carries the heaviest weight in the Overall CMS rating.
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CMS Staffing star rating (1–5 stars), based on daily nurse staffing hours submitted to CMS via verified payroll data. Compares RN, LPN, and CNA coverage relative to resident acuity level. 5 stars = well above expected staffing. Weekend staffing is evaluated separately, as that's where many facilities quietly reduce coverage.
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CMS Quality Measures star rating (1–5 stars), based on 15 clinical outcome metrics including fall rates, pressure ulcers, antipsychotic drug use, and hospital readmissions. Captures actual resident health outcomes, not just compliance. High QM combined with low Health Inspection scores can indicate a facility with strong care but weak documentation practices.
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Registered Nurse hours per resident/day compared to the statewide average. RNs are the highest-skilled nursing staff — they assess residents, manage medications, and respond to emergencies. A value of +50% means RN coverage is 50% above the state norm. Negative values are a concern for residents with complex or acute medical needs.
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Total nursing staff hours (RN + LPN + CNA combined) per resident/day vs. the statewide average. A broader measure than RN vs State — it captures the entire care team. A facility can have high total staffing but low RN hours, meaning more aides and fewer nurses. Read both columns together for the full picture.
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Total dollar amount of federal monetary fines (civil money penalties) issued by CMS in the past 3 years. Fines are only levied for serious violations — typically actual harm to residents, repeated uncorrected deficiencies, or systemic non-compliance. Even a single fine is noteworthy. Multiple fines strongly suggest a pattern, not isolated incidents.
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Total health deficiency citations from the most recent standard inspection cycle. Minor citations (scope A–C) are common and often administrative in nature. Higher counts aren't always disqualifying, but should be read alongside Severe Citations to understand actual harm levels. Under 10 is strong for a large facility; 30+ warrants a closer look.
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Average deficiency citations per CMS inspection (survey) in the reporting window — total citations divided by the number of inspections. Lower is better; compare alongside total Citations and Severe Citations for context.
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Citations at CMS scope/severity level G or higher — G–I means actual harm occurred; J–L means residents were placed in immediate jeopardy. (D–F is potential for harm only). Examples include unaddressed falls, medication errors causing injury, neglect, or abuse.
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Average number of residents in the building on any given day, derived from annual census data. Reflects true operating scale — a 400-bed facility running 200 residents/day operates very differently from one at 390. Higher resident counts generally mean more funded staffing hours.
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Better Business Bureau rating (A+ to F). Reflects complaint history, business transparency, and how family disputes were resolved. A+ means no significant unresolved complaints. A blank (—) means the facility isn't BBB-accredited, which is common for healthcare providers and not necessarily a negative signal.
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Walk Score® (0–100). Measures walkability of the surrounding area. 90–100 = Walker's Paradise. 70–89 = Very Walkable. 50–69 = Somewhat Walkable. Below 50 = Car-Dependent. Higher scores benefit family visitors, resident outings, and staff commuting.
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The licensed owner or operator of record filed with CMS — the individual or organization legally accountable for the facility. Searching the operator name across other facilities can reveal chain or multi-site ownership, which matters: chain-operated homes tend to have more variable quality outcomes than independently run facilities.
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What the home actually collects for resident care, after contractual allowances, bad debt and discounts — not gross billings. Taken from the latest complete annual cost report, so it is comparable across homes reporting the same period. Revenue alone doesn't indicate care quality, but it funds staffing and capital reinvestment. Pair with Payroll %. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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Staff salaries plus wage-related benefits from the latest complete annual cost report. Contract and agency labour is counted separately, under other operating costs, so a home leaning on agency staff can show a low figure here. Payroll is the cost most directly tied to care quality — compare with Payroll % for full context. Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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Payroll as a share of NET PATIENT REVENUE (not gross revenue). Both figures come from the same cost-report year. A higher figure means more of each revenue dollar goes to staff pay. Read with the Staffing star rating to judge whether spend translates into coverage — and note that homes whose patient revenue covers only part of their operation can read implausibly high. The Iowa average is: 60.9% Figures are from each facility's most recent complete fiscal year — hover a value for the exact year; a * marks homes that report an older period than most facilities.
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CMS Certification Number: the unique federal identifier for this skilled nursing provider.
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|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Midlands Living Center LLC | NH HOS RC SNF | Council Bluffs | 94
Facility
94
IA AVG
66
Rank
#28 / 235 | A- |
70.2%
Facility
70.2%
IA AVG
79.1%
Rank
#179 / 226 | -11% | 4.85
Facility
4.85
IA AVG
4.49
Rank
#110 / 225 | -23% | +8% | $0
Facility
$0
IA AVG
$53.2k
Rank
#1 / 230 | 16
Facility
16
IA AVG
20.7
Rank
#109 / 226 | 3.2
Facility
3.2
IA AVG
3.8
Rank
#95 / 226 | - | 66 | A+ |
77
Facility
77
IA AVG
50
Rank
#37 / 249 | North Crest Living Center(Free Standing Nf/Snf) | 780853 | $8.0MFiscal year ending 12/2024
Facility
$8.0MFiscal year ending 12/2024
IA AVG
$7.4M
Rank
#74 / 223 | $4.7MFiscal year ending 12/2024
Facility
$4.7MFiscal year ending 12/2024
IA AVG
$4.5M
Rank
#76 / 223 | 58.2%Fiscal year ending 12/2024
Facility
58.2%Fiscal year ending 12/2024
IA AVG
60.9%
Rank
#123 / 223 | 165447 | ||||
| North Crest Living Center | NH SNF | Council Bluffs | 62
Facility
62
IA AVG
66
Rank
#100 / 235 | C |
91.0%
Facility
91.0%
IA AVG
79.1%
Rank
#40 / 226 | +15% | 4.91
Facility
4.91
IA AVG
4.49
Rank
#66 / 225 | -32% | +9% | $0
Facility
$0
IA AVG
$53.2k
Rank
#1 / 230 | 34
Facility
34
IA AVG
20.7
Rank
#180 / 226 | 5.7
Facility
5.7
IA AVG
3.8
Rank
#183 / 226 | - | 56 | - |
77
Facility
77
IA AVG
50
Rank
#37 / 249 | Midlands Living Center LLC(Free Standing Nf/Snf) | 780508 | $6.1MFiscal year ending 12/2024
Facility
$6.1MFiscal year ending 12/2024
IA AVG
$7.4M
Rank
#118 / 223 | $2.8MFiscal year ending 12/2024
Facility
$2.8MFiscal year ending 12/2024
IA AVG
$4.5M
Rank
#158 / 223 | 46.8%Fiscal year ending 12/2024
Facility
46.8%Fiscal year ending 12/2024
IA AVG
60.9%
Rank
#210 / 223 | 165290 | ||||
| Bethany Lutheran Home | NH AL MC SNF | Council Bluffs | 112
Facility
112
IA AVG
66
Rank
#14 / 235 | F |
81.1%
Facility
81.1%
IA AVG
79.1%
Rank
#126 / 226 | +3% | 4.65
Facility
4.65
IA AVG
4.49
Rank
#66 / 225 | +28% | +4% | $46.9k
Facility
$46.9k
IA AVG
$53.2k
Rank
#196 / 230 | 43
Facility
43
IA AVG
20.7
Rank
#196 / 226 | 4.8
Facility
4.8
IA AVG
3.8
Rank
#160 / 226 | 5 | 91 | - |
77
Facility
77
IA AVG
50
Rank
#37 / 249 | Diana Roberts | $11.2MFiscal year ending 09/2024
Facility
$11.2MFiscal year ending 09/2024
IA AVG
$7.4M
Rank
#26 / 223 | $7.1MFiscal year ending 09/2024
Facility
$7.1MFiscal year ending 09/2024
IA AVG
$4.5M
Rank
#28 / 223 | 63.5%Fiscal year ending 09/2024
Facility
63.5%Fiscal year ending 09/2024
IA AVG
60.9%
Rank
#63 / 223 | 165524 | ||||
| Prairie Gate | - | NH AL IL MC SNF | Council Bluffs | 36
Facility
36
IA AVG
66
Rank
#217 / 235 | ? |
94.4%
Facility
94.4%
IA AVG
79.1%
Rank
#27 / 226 | +19% | - | - | - | - | - | - | - | - | - | - | 34 | - |
6
Facility
6
IA AVG
50
Rank
#241 / 249 | Natasha Urinko | $1.9M*Fiscal year ending 05/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind. | $3.1M*Fiscal year ending 05/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind. | 160%*Fiscal year ending 05/2022These figures are from this home's most recent complete cost report — an older period than most facilities report. Compare with that in mind. | 165789 |
Rank badges are statewide and care-type specific: each nursing home is ranked against every other IA nursing home we track that reports that metric, not just the 4 on this page. See how we rank facilities
Financial Assistance for
Nursing Home in Iowa
Midlands Living Center LLC is located in Council Bluffs, Iowa.
Here are the financial assistance programs available to residents in Iowa.
Know before you visit
Frequently Asked Questions about Midlands Living Center LLC
Quick answers from public records and the community's own listing.01 Who is the owner of Midlands Living Center LLC?
Midlands Living Center LLC is legally operated by North Crest Living Center(Free Standing NF/SNF) | 780853, and administered by Jordan Tjaden.
02 Is Midlands Living Center LLC in a walkable area?
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.
03 What is the license number of Midlands Living Center LLC?
According to IA state health department records, Midlands Living Center LLC's license number is 780508.
04 What is the occupancy rate at Midlands Living Center LLC?
Midlands Living Center LLC's occupancy is 70.2%.
05 How long has Midlands Living Center LLC been in business?
Midlands Living Center LLC has been operating for approximately 23 years, based on available licensing and registration records.
06 Are pets allowed at Midlands Living Center LLC?
No, Midlands Living Center LLC has a no-pet policy.
07 What is the best email address for Midlands Living Center LLC?
The team at Midlands Living Center LLC can be reached at jtjaden@midlandslivingcenter.com.
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