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Facility record report · CMS certification number 165528

Accura Healthcare of Spirit Lake

Spirit Lake, Iowa · Medicare and Medicaid

Finances, as filed

From this facility’s Medicare cost reports on form CMS-2540, each figure with the worksheet, line and column it was read from.

Cost report for 1 January 2024 to 31 December 2024 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 14 November 2025.

Revenue and expenses, fiscal year 2024
FigureAs filedWhere it comes from
Total patient revenue$8,621,784CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$794,467CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$7,827,317CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$7,424,318CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$402,999CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$13,158CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$416,157CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $416,157 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2024
FigureAs filedWhere it comes from
Total facility beds, all components85CMS-2540-10 worksheet S300001 line 800 column 100
Bed days available, all components31,110CMS-2540-10 worksheet S300001 line 800 column 200
Medicare (Title XVIII) patient days3,202CMS-2540-10 worksheet S300001 line 800 column 400
Medicaid (Title XIX) patient days8,907CMS-2540-10 worksheet S300001 line 800 column 500
Other-payer patient days11,909CMS-2540-10 worksheet S300001 line 800 column 600
Total patient days, all components24,018CMS-2540-10 worksheet S300001 line 800 column 700
Medicare discharges70CMS-2540-10 worksheet S300001 line 800 column 900
Medicaid discharges2CMS-2540-10 worksheet S300001 line 800 column 1000
Other-payer discharges29CMS-2540-10 worksheet S300001 line 800 column 1100
Total discharges, all components101CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days45.74CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days4,453.5CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days237.8CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1442402, read from the public cost report file SNF10FY2024.zip.

Cost report for 1 January 2023 to 31 December 2023 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 17 September 2024.

Revenue and expenses, fiscal year 2023
FigureAs filedWhere it comes from
Total patient revenue$7,053,735CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$268,098CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,785,637CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$6,312,964CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$472,673CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$52,824CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$525,497CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $525,497 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2023
FigureAs filedWhere it comes from
Total facility beds, all components85CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components20,658CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components268CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days31.8CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days232.11CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days77.08CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1394994, read from the public cost report file SNF10FY2023.zip.

Cost report for 1 January 2022 to 31 December 2022 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 22 August 2023.

Revenue and expenses, fiscal year 2022
FigureAs filedWhere it comes from
Total patient revenue$6,497,972CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$744,096CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$5,753,876CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,986,669CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$232,793CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$192,300CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income−$40,493CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: −$40,493 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2022
FigureAs filedWhere it comes from
Total facility beds, all components85CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components19,455CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components105CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days42.96CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days5,956CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days185.29CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1362773, read from the public cost report file SNF10FY2022.zip.

Cost report for 1 January 2021 to 31 December 2021 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 28 September 2022.

Revenue and expenses, fiscal year 2021
FigureAs filedWhere it comes from
Total patient revenue$5,672,121CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$729,085CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$4,943,036CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,393,082CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients−$450,046CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$1,016,039CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$565,993CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $565,993 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2021
FigureAs filedWhere it comes from
Total facility beds, all components85CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components17,093CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components90CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days42.98CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days1,813.67CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days189.92CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1334401, read from the public cost report file SNF10FY2021.zip.

Cost report for 1 January 2020 to 31 December 2020 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 25 November 2021.

Revenue and expenses, fiscal year 2020
FigureAs filedWhere it comes from
Total patient revenue$7,074,127CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$699,946CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,374,181CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,734,820CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$639,361CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$215,369CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$854,730CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $622,840 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2020
FigureAs filedWhere it comes from
Total facility beds, all components85CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components22,874CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components184CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days49.11CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days311.91CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days124.32CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1305533, read from the public cost report file SNF10FY2020.zip.

Cost report for 1 January 2019 to 31 December 2019 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 11 December 2020.

Revenue and expenses, fiscal year 2019
FigureAs filedWhere it comes from
Total patient revenue$8,909,323CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$2,290,790CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,618,533CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$6,029,084CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$589,449CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$45,938CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$635,387CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $635,387 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2019
FigureAs filedWhere it comes from
Total facility beds, all components98CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components25,138CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components304CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days34.63CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days345.21CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days82.69CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1275836, read from the public cost report file SNF10FY2019.zip.

Cost report for 1 January 2018 to 31 December 2018 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 24 July 2019.

Revenue and expenses, fiscal year 2018
FigureAs filedWhere it comes from
Total patient revenue$7,149,121CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$1,402,912CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$5,746,209CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,569,291CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$176,918CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$128,643CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$305,561CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $305,561 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2018
FigureAs filedWhere it comes from
Total facility beds, all components120CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components24,336CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components200CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days32.73CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days271.92CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days121.68CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1238062, read from the public cost report file SNF10FY2018.zip.

Cost report for 1 November 2017 to 31 December 2017 — a reporting period of 60 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 25 July 2018.

Revenue and expenses, fiscal year 2017
FigureAs filedWhere it comes from
Total patient revenue$981,517CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$48,364CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$933,153CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$904,319CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$28,834CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$5,827CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$34,661CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $34,661 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2017
FigureAs filedWhere it comes from
Total facility beds, all components120CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components4,052CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components88CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days43.33CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days61.57CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days46.05CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1202648, read from the public cost report file SNF10FY2018.zip.

Cost report for 1 January 2016 to 31 December 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 8 August 2017.

Revenue and expenses, fiscal year 2016
FigureAs filedWhere it comes from
Total patient revenue$7,058,442CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$1,042,288CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,016,154CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,772,863CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$243,291CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$17,180CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$260,471CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $260,471 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2016
FigureAs filedWhere it comes from
Total facility beds, all components120CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components26,981CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components114CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days42.04CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days733.93CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days236.68CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1172410, read from the public cost report file SNF10FY2016.zip.

Cost report for 1 January 2015 to 31 December 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 25 July 2016.

Revenue and expenses, fiscal year 2015
FigureAs filedWhere it comes from
Total patient revenue$7,223,719CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$1,011,632CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,212,087CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$6,147,130CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$64,957CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$14,422CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$79,379CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $79,379 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2015
FigureAs filedWhere it comes from
Total facility beds, all components120CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components29,383CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components128CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days35.68CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days674.26CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days229.55CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1137652, read from the public cost report file SNF10FY2015.zip.

Cost report for 1 January 2014 to 31 December 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 25 July 2015.

Revenue and expenses, fiscal year 2014
FigureAs filedWhere it comes from
Total patient revenue$8,019,856CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$1,197,340CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,822,516CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$6,474,166CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$348,350CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$18,042CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$366,392CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $366,392 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2014
FigureAs filedWhere it comes from
Total facility beds, all components120CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components32,381CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components164CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days40.41CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days683.22CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days197.45CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1104397, read from the public cost report file SNF10FY2014.zip.

Cost report for 1 January 2013 to 31 December 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 23 July 2014.

Revenue and expenses, fiscal year 2013
FigureAs filedWhere it comes from
Total patient revenue$7,953,502CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$1,208,068CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,745,434CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$6,205,345CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$540,089CMS-2540-10 worksheet G300000 line 500 column 100
Total other income−$21,623CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$518,466CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $518,466 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2013
FigureAs filedWhere it comes from
Total facility beds, all components120CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components34,636CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components178CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days35.95CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days887.77CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days194.58CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1072100, read from the public cost report file SNF10FY2013.zip.

Cost report for 1 January 2012 to 31 December 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on 23 July 2013.

Revenue and expenses, fiscal year 2012
FigureAs filedWhere it comes from
Total patient revenue$6,804,019CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$606,392CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,197,627CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,901,440CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$296,187CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$173,662CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$469,849CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $469,849 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2012
FigureAs filedWhere it comes from
Total facility beds, all components127CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components35,077CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components153CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days28.23CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days500.21CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days229.26CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1041728, read from the public cost report file SNF10FY2012.zip.

Cost report for 1 January 2011 to 31 December 2011 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on 27 September 2012.

Revenue and expenses, fiscal year 2011
FigureAs filedWhere it comes from
Total patient revenue$7,098,444CMS-2540-10 worksheet G300000 line 100 column 100
Contractual allowances and discounts$616,420CMS-2540-10 worksheet G300000 line 200 column 100
Net patient revenue$6,482,024CMS-2540-10 worksheet G300000 line 300 column 100
Total operating expenses$5,834,510CMS-2540-10 worksheet G300000 line 400 column 100
Net income from service to patients$647,514CMS-2540-10 worksheet G300000 line 500 column 100
Total other income$158,943CMS-2540-10 worksheet G300000 line 2500 column 100
Net income after other income$806,457CMS-2540-10 worksheet G300000 line 2600 column 100

Net income: $806,457 (CMS-2540-10 worksheet G300000 line 3100 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 26 less 27 through 30) on 204,018 of the 204,018 reports filed on Form CMS-2540-10 in publication years 2011-2025 that file every line it is computed from (100%).

Beds, days and discharges, fiscal year 2011
FigureAs filedWhere it comes from
Total facility beds, all components127CMS-2540-10 worksheet S300001 line 800 column 100
Total patient days, all components37,553CMS-2540-10 worksheet S300001 line 800 column 700
Total discharges, all components151CMS-2540-10 worksheet S300001 line 800 column 1200
Average length of stay, Medicare, in days28.73CMS-2540-10 worksheet S300001 line 800 column 1400
Average length of stay, Medicaid, in days448.5CMS-2540-10 worksheet S300001 line 800 column 1500
Average length of stay, all patients, in days248.7CMS-2540-10 worksheet S300001 line 800 column 1600

CMS report record 1012741, read from the public cost report file SNF10FY2011.zip.

Cost report for 1 January 2010 to 31 December 2010 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 26 July 2011.

Revenue and expenses, fiscal year 2010
FigureAs filedWhere it comes from
Net patient revenue$5,930,822CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses$5,285,667CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients$645,155CMS-2540-96 worksheet G300000 line 500 column 100
Total other income$87,037CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $732,192 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2010
FigureAs filedWhere it comes from
Total facility beds, all components127CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components37,553CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components131CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days40.41CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days568.91CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days286.66CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 412857, read from the public cost report file SNFFY2010.zip.

Cost report for 1 January 2009 to 31 December 2009 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 29 June 2010.

Revenue and expenses, fiscal year 2009
FigureAs filedWhere it comes from
Net patient revenue$5,553,624CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses$4,787,107CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients$766,517CMS-2540-96 worksheet G300000 line 500 column 100
Total other income$58,321CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $824,838 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2009
FigureAs filedWhere it comes from
Total facility beds, all components127CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components37,279CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components194CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days51.85CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days466.23CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days192.16CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 379083, read from the public cost report file SNFFY2009.zip.

Cost report for 1 January 2008 to 31 December 2008 — a reporting period of 365 days, on form CMS-2540-96, settled, processed by CMS on 14 July 2009.

Revenue and expenses, fiscal year 2008
FigureAs filedWhere it comes from
Net patient revenue$4,807,736CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses$4,516,824CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients$290,912CMS-2540-96 worksheet G300000 line 500 column 100
Total other income$52,571CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $343,483 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2008
FigureAs filedWhere it comes from
Total facility beds, all components127CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components35,069CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components258CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days11.97CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days386.38CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days135.93CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 349650, read from the public cost report file SNFFY2008.zip.

Cost report for 1 January 2007 to 31 December 2007 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 28 July 2008.

Revenue and expenses, fiscal year 2007
FigureAs filedWhere it comes from
Net patient revenue$5,023,174CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses$4,608,479CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients$414,695CMS-2540-96 worksheet G300000 line 500 column 100
Total other income$59,678CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $474,373 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2007
FigureAs filedWhere it comes from
Total facility beds, all components127CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components38,056CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components237CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days12.89CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days301.39CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days160.57CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 321684, read from the public cost report file SNFFY2007.zip.

Cost report for 1 January 2006 to 31 December 2006 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 23 April 2008.

Revenue and expenses, fiscal year 2006
FigureAs filedWhere it comes from
Net patient revenue$5,175,955CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses$4,632,090CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients$543,865CMS-2540-96 worksheet G300000 line 500 column 100
Total other income$23,855CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $567,720 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2006
FigureAs filedWhere it comes from
Total facility beds, all components127CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components41,731CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components195CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days17.14CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days435.62CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days214.01CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 306954, read from the public cost report file SNFFY2006.zip.

Cost report for 1 January 2005 to 31 December 2005 — a reporting period of 364 days, on form CMS-2540-96, settled, processed by CMS on 31 May 2007.

Revenue and expenses, fiscal year 2005
FigureAs filedWhere it comes from
Net patient revenue$4,848,592CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses$4,632,127CMS-2540-96 worksheet G200002 line 1500 column 100
Net income from service to patients$216,465CMS-2540-96 worksheet G300000 line 500 column 100
Total other income$44,946CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $261,411 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2005
FigureAs filedWhere it comes from
Total facility beds, all components127CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components42,131CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components210CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days14.99CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days494.8CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days200.62CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 280055, read from the public cost report file SNFFY2005.zip.

Cost report for 1 March 2004 to 31 December 2004 — a reporting period of 305 days, on form CMS-2540-96, settled, processed by CMS on 28 March 2006.

Revenue and expenses, fiscal year 2004
FigureAs filedWhere it comes from
Net patient revenue$3,745,354CMS-2540-96 worksheet G300000 line 300 column 100
Total operating expenses$3,473,867CMS-2540-96 worksheet G200002 line 1500 column 200
Net income from service to patients$271,487CMS-2540-96 worksheet G300000 line 500 column 100
Total other income$40,097CMS-2540-96 worksheet G300000 line 2600 column 100

Net income, stated at moderate confidence: $311,584 (CMS-2540-96 worksheet G300000 line 3200 column 100). As filed, net income for the period equals net income from service to patients plus total other income, less total other expenses (Worksheet G-3 lines 5 plus 26 less 31) on 192,460 of the 192,462 reports filed on Form CMS-2540-96 in publication years 1995-2012 that file every line it is computed from (99.99%); on 2 of them the filed figure and that arithmetic differ, by a median of $46,907, and those figures are not shown. A further 2,252 reports file net income without filing net income from service to patients (Worksheet G-3 line 5), so the arithmetic cannot be applied to them and their figure is shown as filed.

Beds, days and discharges, fiscal year 2004
FigureAs filedWhere it comes from
Total facility beds, all components127CMS-2540-96 worksheet S300001 line 900 column 100
Total patient days, all components32,931CMS-2540-96 worksheet S300001 line 900 column 700
Total discharges, all components170CMS-2540-96 worksheet S300001 line 900 column 1200
Average length of stay, Medicare, in days18.57CMS-2540-96 worksheet S300001 line 900 column 1400
Average length of stay, Medicaid, in days403.2CMS-2540-96 worksheet S300001 line 900 column 1500
Average length of stay, all patients, in days193.71CMS-2540-96 worksheet S300001 line 900 column 1600

CMS report record 246074, read from the public cost report file SNFFY2004.zip.

Five facilities of a similar size in Iowa, fiscal year 2024

Chosen for having certified bed counts closest to this facility’s, listed by name. Every one filed for the same fiscal year; the day each year ends differs and is shown. Each figure is that facility’s own filing.

FacilityTotal facility bedsTotal patient daysNet patient revenueTotal operating expensesNet income from service to patientsPeriod ended
ACCURA HEALTHCARE OF SPIRIT LAKE8524,018$7,827,317$7,424,318$402,99931 December 2024
BETTENDORF HEALTH CARE CENTER8622,400$6,810,587$6,949,023−$138,43631 December 2024
DUBUQUE SPECIALTY CARE8421,428$6,234,551$5,786,380$448,17131 December 2024
ENNOBLE SKILLED NURSING AND REHABILI8522,756$7,622,233$7,744,564−$122,33131 December 2024
HERITAGE CARE REHABILITATION CENTER872,508$822,517$901,321−$78,80414 August 2024
WESTWOOD SPECIALTY CARE8528,346$9,878,566$8,611,079$1,267,48731 December 2024

Where each column comes from, on every filing in this table: Total facility beds: CMS-2540-10 worksheet S300001 line 800 column 100 · Total patient days: CMS-2540-10 worksheet S300001 line 800 column 700 · Net patient revenue: CMS-2540-10 worksheet G300000 line 300 column 100 · Total operating expenses: CMS-2540-10 worksheet G300000 line 400 column 100 · Net income from service to patients: CMS-2540-10 worksheet G300000 line 500 column 100.

Ownership, as filed with CMS

Care Compare

As filed in the CMS file dated 1 August 2026 (Care Compare ownership).

Owner or managerRoleTypeOwnership percentageAssociation
ACCURA MIDWEST HEALTHCARE LLC5% OR GREATER INDIRECT OWNERSHIP INTERESTOrganization100%since 11/01/2017
LENEAVE, TEDCORPORATE OFFICERIndividualNOT APPLICABLEsince 11/01/2017
TOTI, LISACORPORATE OFFICERIndividualNOT APPLICABLEsince 01/01/2024
AMERICAN HEALTHCARE MANAGEMENT SERVICES LLCOPERATIONAL/MANAGERIAL CONTROLOrganizationNOT APPLICABLEsince 11/01/2017
BUTCHER, DARENW-2 MANAGING EMPLOYEEIndividualNOT APPLICABLEsince 01/01/2023
OLSON, BRETTW-2 MANAGING EMPLOYEEIndividualNOT APPLICABLEsince 01/01/2024
TOTI, LISAW-2 MANAGING EMPLOYEEIndividualNOT APPLICABLEsince 01/01/2021

Medicare enrollment

As filed in the CMS file dated 1 August 2026 (Medicare enrollment ownership), under the enrollment of ACCURA HEALTHCARE OF SPIRIT LAKE LLC (enrollment ID O20180223000032).

OwnerIndividual or organizationRoleOwnership percentageAssociation dateDescribed in the filing as
ACCURA HEALTHCAREOrganization5% OR GREATER INDIRECT OWNERSHIP INTEREST10011/1/2017
Private equity company: No
Real estate investment trust: No
Holding company: No
ACCURA MIDWEST HEALTHCARE LLCOrganization5% OR GREATER INDIRECT OWNERSHIP INTEREST10011/1/2017
Private equity company: No
Real estate investment trust: No
Holding company: No
LISA TOTIIndividualCORPORATE OFFICERCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.1/1/2024
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
TED A LENEAVEIndividualCORPORATE OFFICERCMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.11/1/2017
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
AMERICAN HEALTHCARE MANAGEMENT SERVICES LLCOrganizationOPERATIONAL/MANAGERIAL CONTROL10011/1/2017
Private equity company: No
Real estate investment trust: No
Holding company: No
BRETT J OLSONIndividualW-2 MANAGING EMPLOYEECMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.1/1/2024
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
DAREN BUTCHERIndividualW-2 MANAGING EMPLOYEECMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.1/1/2023
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
LISA TOTIIndividualW-2 MANAGING EMPLOYEECMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.1/1/2021
Private equity company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Real estate investment trust: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.
Holding company: CMS paused the expanded ownership disclosure on Form CMS-855A in guidance dated December 11, 2025; this field has not been filed under the current cycle.

Changes in ownership

Inspections

Inspection cycleHealth inspectionFire safety inspectionHealth deficienciesFire safety deficiencies
12 October 20252 October 202572
222 August 202422 August 2024124
33 August 20233 August 202343

From the Care Compare inspection summary file NH_SurveySummary_Aug2026.csv, processed on 1 August 2026.

Deficiencies cited

23 deficiencies on file, newest inspection first
Inspection dateInspection typeTagCategoryWhat was citedScope and severityComplaintCorrectedCorrection date
22 April 2026HealthF 0584Resident Rights DeficienciesHonor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.EYesDeficient, Provider has date of correction16 May 2026
22 April 2026HealthF 0690Quality of Life and Care DeficienciesProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.DYesDeficient, Provider has date of correction16 May 2026
2 October 2025HealthF 0628Resident Rights DeficienciesProvide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.DYesDeficient, Provider has date of correction26 November 2025
2 October 2025HealthF 0690Quality of Life and Care DeficienciesProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.DYesDeficient, Provider has date of correction26 November 2025
2 October 2025HealthF 0804Nutrition and Dietary DeficienciesEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.EYesDeficient, Provider has date of correction26 November 2025
2 October 2025HealthF 0805Nutrition and Dietary DeficienciesEnsure each resident receives and the facility provides food prepared in a form designed to meet individual needs.DYesDeficient, Provider has date of correction26 November 2025
2 October 2025HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.EYesDeficient, Provider has date of correction26 November 2025
22 August 2024HealthF 0580Resident Rights DeficienciesImmediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.DYesDeficient, Provider has date of correction27 August 2024
22 August 2024HealthF 0600Freedom from Abuse, Neglect, and Exploitation DeficienciesProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.DYesDeficient, Provider has date of correction23 August 2024
22 August 2024HealthF 0609Freedom from Abuse, Neglect, and Exploitation DeficienciesTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.DYesDeficient, Provider has date of correction23 August 2024
22 August 2024HealthF 0610Freedom from Abuse, Neglect, and Exploitation DeficienciesRespond appropriately to all alleged violations.KYesDeficient, Provider has date of correction23 August 2024
22 August 2024HealthF 0644Resident Assessment and Care Planning DeficienciesCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.DNoDeficient, Provider has date of correction23 August 2024
22 August 2024HealthF 0684Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.DYesDeficient, Provider has date of correction27 August 2024
22 August 2024HealthF 0800Nutrition and Dietary DeficienciesProvide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.ENoDeficient, Provider has date of correction14 September 2024
22 August 2024HealthF 0804Nutrition and Dietary DeficienciesEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.DNoDeficient, Provider has date of correction14 September 2024
22 August 2024HealthF 0811Nutrition and Dietary DeficienciesEnsure that residents are assessed for appropriateness for a feeding assistant program, receive services as per their plan of care, and feeding assistants are trained and supervised.DNoDeficient, Provider has date of correction14 September 2024
22 August 2024HealthF 0812Nutrition and Dietary DeficienciesProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.FNoDeficient, Provider has date of correction14 September 2024
22 August 2024HealthF 0842Resident Assessment and Care Planning DeficienciesSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.DYesDeficient, Provider has date of correction23 August 2024
22 August 2024HealthF 0880Infection Control DeficienciesProvide and implement an infection prevention and control program.ENoDeficient, Provider has date of correction23 August 2024
3 August 2023HealthF 0657Resident Assessment and Care Planning DeficienciesDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.DNoDeficient, Provider has date of correction21 August 2023
3 August 2023HealthF 0677Quality of Life and Care DeficienciesProvide care and assistance to perform activities of daily living for any resident who is unable.DNoDeficient, Provider has date of correction21 August 2023
3 August 2023HealthF 0684Quality of Life and Care DeficienciesProvide appropriate treatment and care according to orders, resident’s preferences and goals.DNoDeficient, Provider has date of correction21 August 2023
3 August 2023HealthF 0689Quality of Life and Care DeficienciesEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.DNoDeficient, Provider has date of correction21 August 2023

From the Care Compare health citations file NH_HealthCitations_Aug2026.csv, processed on 1 August 2026.

Penalties

Penalty dateTypeFine amountPayment denial beganPayment denial, daysFine ID
22 August 2024Fine$34,56779468
22 August 2024Payment Denial19 September 202431

From the Care Compare penalties file NH_Penalties_Aug2026.csv, processed on 1 August 2026.

Care Compare provider information

FieldAs filed
Provider TypeMedicare and Medicaid
Ownership TypeFor profit - Corporation
Legal Business NameACCURA HEALTHCARE OF SPIRIT LAKE LLC
Date First Approved to Provide Medicare and Medicaid Services2004-04-22
Provider Resides in HospitalN
Continuing Care Retirement CommunityN
UrbanN
County/ParishDickinson
Telephone Number7123363300
Chain NameACCURA HEALTHCARE
Chain ID8
Provider Changed Ownership in Last 12 MonthsN
With a Resident and Family CouncilNone
Automatic Sprinkler Systems in All Required AreasYes
Number of Certified Beds80
Average Number of Residents per Day71.0
Overall Rating2
Health Inspection Rating2
QM Rating3
Long-Stay QM Rating2
Short-Stay QM Rating4
Processing Date2026-08-01

From the Care Compare Provider Information file NH_ProviderInfo_Aug2026.csv, processed on 1 August 2026.

Every change on this record

How to read this report

Every figure is printed as the CMS file it came from printed it. Each cost-report figure carries the worksheet, line and column of form CMS-2540 it was read from, so a reader holding the same public file can go to that cell; each Care Compare and Medicare enrollment section names its file and the date CMS stamped on it.

A figure the filing does not carry is left out, and so is a figure whose value the filing’s own arithmetic contradicts. Net income is printed with what the form’s own arithmetic shows about it — plainly where it follows from the lines above it, and, where it does not, beside what the form’s own lines leave unaccounted for. An ownership field left empty carries the dated sentence on CMS’s pause of the expanded Form CMS-855A disclosure. A source that holds nothing for this facility says so in its section.

This report carries no percentile and no score, and it does not place this facility above or below another. The five facilities above are the one comparison it draws: the nearest certified bed counts in the same state at the same fiscal year, listed by name. Nurse staffing is printed in its own section, on its own page, apart from the cost-report figures.

How to cite this report

Velarion Records, Accura Healthcare of Spirit Lake — facility record report, CMS certification number 165528. https://velarionrecords.com/facility/165528/report.

Published by VELARIONAI LLC · Andrew Richardson, founder. Corrections: hello@velarionrecords.com, quoting certification number 165528. Velarion Records publishes these records as filed.

Nurse staffing, quarter by quarter

Hours this facility reported to CMS’s Payroll-Based Journal, one row per quarter, oldest first, each with how its figures are derived and the file it came from.

Nurse staffing hours by quarter
QuarterQuarter endedDays reportedResident daysRegistered nurse hoursLicensed practical nurse hoursNurse aide hoursTotal nurse hours
2017Q131 March 2017906,7685,569.362,818.0216,680.925,068.28
2017Q230 June 2017916,1015,500.352,584.8715,063.9223,149.14
2017Q330 September 2017926,0614,746.452,753.0913,606.3821,105.92
2017Q431 December 2017925,9704,787.92,822.0913,202.7520,812.74
2018Q131 March 2018906,0074,703.412,951.7213,069.5220,724.65
2018Q230 June 2018916,1036,541.743,789.4217,059.4827,390.64
2018Q330 September 2018926,1844,863.452,459.0614,107.4121,429.92
2018Q431 December 2018925,9304,786.513,204.513,654.9621,645.97
2019Q131 March 2019906,1534,668.223,526.6614,866.1923,061.07
2019Q230 June 2019916,1734,159.344,264.5315,348.2323,772.1
2019Q330 September 2019926,0874,574.654,023.6515,009.2323,607.53
2019Q431 December 2019926,4735,066.423,543.114,349.6322,959.15
2020Q230 June 2020915,8645,253.483,034.4314,906.7823,194.69
2020Q330 September 2020925,4014,935.663,187.413,208.5721,331.63
2020Q431 December 2020925,0414,986.163,408.0312,629.3221,023.51
2021Q131 March 2021903,8003,576.772,799.9310,231.0716,607.77
2021Q230 June 2021914,3702,956.213,513.929,244.3515,714.48
2021Q330 September 2021924,4594,171.253,879.3513,618.1221,668.72
2022Q131 March 2022904,4993,676.452,569.0910,259.2316,504.77
2022Q230 June 2022914,7293,304.073,206.411,690.6918,201.16
2022Q330 September 2022925,0392,063.713,575.8512,039.9817,679.54
2022Q431 December 2022925,1692,414.852,667.5611,275.9416,358.35
2023Q131 March 2023905,0382,728.872,649.9112,756.618,135.38
2023Q230 June 2023914,9163,583.52,192.612,768.618,544.7
2023Q330 September 2023925,2883,316.72,511.814,374.720,203.2
2023Q431 December 2023925,4992,5913,33514,325.120,251.1
2024Q131 March 2024915,7103,406.33,821.514,479.421,707.2
2024Q230 June 2024915,9324,025.13,966.414,114.622,106.1
2024Q330 September 2024926,0543,992.684,593.8213,629.3822,215.88
2024Q431 December 2024926,0994,012.464,536.6814,247.4722,796.61
2025Q131 March 2025906,0304,4253,624.314,172.122,221.4
2025Q230 June 2025915,9323,997.83,889.114,988.622,875.5
2025Q330 September 2025926,1043,609.54,732.415,34223,683.9
2025Q431 December 2025926,1463,782.34,476.414,488.522,747.2
2026Q131 March 2026906,3893,502.524,623.7614,482.6422,608.92
Nurse staffing hours per resident day by quarter
QuarterRegistered nurse hours per resident dayLicensed practical nurse hours per resident dayNurse aide hours per resident dayTotal nurse hours per resident day
2017Q10.8228960.4163742.4646723.703942
2017Q20.9015490.423682.469093.794319
2017Q30.7831130.454232.2449073.48225
2017Q40.8019930.4727122.2115163.486221
2018Q10.7829880.491382.1757153.450083
2018Q21.0718890.6209112.7952614.488062
2018Q30.7864570.3976492.2812763.465382
2018Q40.8071690.5403882.3026913.650248
2019Q10.758690.5731612.4160883.747939
2019Q20.6737960.6908362.4863493.85098
2019Q30.7515440.6610232.4657843.878352
2019Q40.78270.5473662.2168443.54691
2020Q20.8958870.5174682.5420843.955438
2020Q30.9138420.590152.4455793.94957
2020Q40.9891210.6760622.505324.170504
2021Q10.9412550.7368242.6923874.370466
2021Q20.6764780.8041012.1154123.595991
2021Q30.9354680.8700043.0540754.859547
2022Q10.817170.5710362.2803363.668542
2022Q20.6986830.6780292.4721273.848839
2022Q30.4095480.7096352.3893593.508541
2022Q40.4671790.5160692.1814553.164703
2023Q10.5416570.5259852.5320763.599718
2023Q20.7289460.4460132.5973563.772315
2023Q30.6272130.4752.7183623.820575
2023Q40.4711770.6064742.6050373.682688
2024Q10.596550.6692642.5357973.801611
2024Q20.678540.6686452.37943.726585
2024Q30.6595110.7588072.2513023.66962
2024Q40.6578880.743842.3360343.737762
2025Q10.7338310.6010452.3502653.685141
2025Q20.6739380.6556142.5267363.856288
2025Q30.5913340.7752952.5134343.880062
2025Q40.6154080.7283442.3573873.701139
2026Q10.5482110.7237062.2668093.538726

How each quarter is derived, and its file

  • 2017Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-03-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. This file names the totals hrs_rn_donadmin, hrs_lpn_admin, hrs_na_trn; they are read as hrs_rndon, hrs_lpnadmin, hrs_natrn. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-03-31.csv
  • 2017Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. This file names the totals hrs_lpn_admin; they are read as hrs_lpnadmin. CMS's file labels its last six hours columns hrs_medaide, hrs_medaide_emp, hrs_rn_donadmin, hrs_na_trn, hrs_natrn_emp, hrs_natrn_ctr; they are read by position as Hrs_MedAide_emp, Hrs_MedAide_ctr, Hrs_NAtrn, Hrs_NAtrn_emp, Hrs_NAtrn_ctr, Hrs_MedAide, the order in which each total equals its employee and contract parts on every row. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-06-30.csv
  • 2017Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. This file names the totals hrs_lpn_admin, hrs_na_trn; they are read as hrs_lpnadmin, hrs_natrn. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-09-30.csv
  • 2017Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. This file names the totals hrs_lpn_admin, hrs_na_trn; they are read as hrs_lpnadmin, hrs_natrn. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2017-12-31.csv
  • 2018Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-03-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-03-31.csv
  • 2018Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-06-30.csv
  • 2018Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-09-30.csv
  • 2018Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-12-13.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2018-12-13.csv
  • 2019Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-03-13.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-03-13.csv
  • 2019Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-06-30.csv
  • 2019Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-09-30.csv
  • 2019Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2019-12-31.csv
  • 2020Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-06-30.csv
  • 2020Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-09-30.csv
  • 2020Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2020-12-31.csv
  • 2021Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-03-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-03-31.csv
  • 2021Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-06-30.csv
  • 2021Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2021-09-30.csv
  • 2022Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-01-01.csv
  • 2022Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-06-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-06-30.csv
  • 2022Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-09-30.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-09-30.csv
  • 2022Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2022-12-31.csv
  • 2023Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-01-01.csv
  • 2023Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-06-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-06-01.csv
  • 2023Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-09-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-09-01.csv
  • 2023Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-12-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2023-12-01.csv
  • 2024Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-01-01.csv
  • 2024Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-04-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-04-01.csv
  • 2024Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-09-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-09-01.csv
  • 2024Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-12-31.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2024-12-31.csv
  • 2025Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-01-01.csv
  • 2025Q2: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-04-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-04-01.csv
  • 2025Q3: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-07-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-07-01.csv
  • 2025Q4: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-10-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2025-10-01.csv
  • 2026Q1: From CMS file Payroll_Based_Journal_Daily_Nurse_Staffing_:_2026-01-01.csv: days_reported = distinct WorkDate rows for this PROVNUM and CY_Qtr; resident_days = sum of MDScensus over those days; hours = each Hrs_* column summed over those days; rn_hours = Hrs_RNDON + Hrs_RNadmin + Hrs_RN; lpn_hours = Hrs_LPNadmin + Hrs_LPN; aide_hours = Hrs_CNA + Hrs_NAtrn + Hrs_MedAide; total_nurse_hours = rn_hours + lpn_hours + aide_hours; each *_hprd = its hours / resident_days, rounded to 6 decimal places, null when resident_days is 0. Payroll_Based_Journal_Daily_Nurse_Staffing_:_2026-01-01.csv

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