Skilled nursing facility · CMS certification number 165596
NORTH LAKE MANOR
STORM LAKE, Iowa
This certification number is not in CMS’s current Care Compare Provider Information file, processed on 1 August 2026.
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 2017 to 27 February 2017 — a reporting period of 57 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 27 November 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $72,720 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Net patient revenue | $72,720 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $176,408 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$103,688 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $186 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$103,502 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$107,074 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 34 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Bed days available, all components | 1,530 | CMS-2540-10 worksheet S300001 line 800 column 200 |
| Medicaid (Title XIX) patient days | 193 | CMS-2540-10 worksheet S300001 line 800 column 500 |
| Other-payer patient days | 233 | CMS-2540-10 worksheet S300001 line 800 column 600 |
| Total patient days, all components | 426 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Medicaid discharges | 11 | CMS-2540-10 worksheet S300001 line 800 column 1000 |
| Other-payer discharges | 7 | CMS-2540-10 worksheet S300001 line 800 column 1100 |
| Total discharges, all components | 18 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicaid, in days | 17.55 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 23.67 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1178856, read from the public cost report file SNF10FY2017.zip.
Fiscal year 2016, ended 31 December 2016
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 17 July 2017.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $1,813,587 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $98,509 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,715,078 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $1,917,918 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$202,840 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $5,539 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$197,301 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$258,151 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 45 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 9,423 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 18 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 42.43 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 900.4 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 523.5 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1168654, read from the public cost report file SNF10FY2016.zip.
Fiscal year 2015, ended 31 December 2015
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 2 August 2016.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,080,699 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $129,289 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $1,951,410 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,281,208 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$329,798 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $24,767 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$305,031 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$355,190 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 60 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 10,864 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 51 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 28.11 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 310.05 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 213.02 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1139374, read from the public cost report file SNF10FY2015.zip.
Fiscal year 2014, ended 31 December 2014
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 29 June 2015.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,782,420 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $295,223 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,487,197 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,562,143 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$74,946 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $17,668 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$57,278 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$118,813 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 13,593 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 83 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 29.89 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 359.87 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 163.77 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1100661, read from the public cost report file SNF10FY2014.zip.
Fiscal year 2013, ended 31 December 2013
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 31 July 2014.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,845,647 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $294,363 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,551,284 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,379,063 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $172,221 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,471 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $173,692 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: $108,878 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 14,349 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 74 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 31.93 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 486.94 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 193.91 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1074458, read from the public cost report file SNF10FY2013.zip.
Fiscal year 2012, ended 31 December 2012
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 29 July 2013.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $2,479,325 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $300,965 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $2,178,360 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $2,154,230 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | $24,130 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $1,717 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | $25,847 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$29,846 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 72 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 12,862 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 51 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 44.28 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 857.17 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 252.2 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1044165, read from the public cost report file SNF10FY2012.zip.
Fiscal year 2011, ended 31 December 2011
Cost report for 1 August 2011 to 31 December 2011 — a reporting period of 152 days, not a full year, on form CMS-2540-10, settled, processed by CMS on 27 September 2012.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total patient revenue | $896,288 | CMS-2540-10 worksheet G300000 line 100 column 100 |
| Contractual allowances and discounts | $97,925 | CMS-2540-10 worksheet G300000 line 200 column 100 |
| Net patient revenue | $798,363 | CMS-2540-10 worksheet G300000 line 300 column 100 |
| Total operating expenses | $906,258 | CMS-2540-10 worksheet G300000 line 400 column 100 |
| Net income from service to patients | −$107,895 | CMS-2540-10 worksheet G300000 line 500 column 100 |
| Total other income | $2,736 | CMS-2540-10 worksheet G300000 line 2500 column 100 |
| Net income after other income | −$105,159 | CMS-2540-10 worksheet G300000 line 2600 column 100 |
Net income: −$125,852 (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%).
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 100 | CMS-2540-10 worksheet S300001 line 800 column 100 |
| Total patient days, all components | 4,766 | CMS-2540-10 worksheet S300001 line 800 column 700 |
| Total discharges, all components | 16 | CMS-2540-10 worksheet S300001 line 800 column 1200 |
| Average length of stay, Medicare, in days | 76.17 | CMS-2540-10 worksheet S300001 line 800 column 1400 |
| Average length of stay, Medicaid, in days | 845.67 | CMS-2540-10 worksheet S300001 line 800 column 1500 |
| Average length of stay, all patients, in days | 297.88 | CMS-2540-10 worksheet S300001 line 800 column 1600 |
CMS report record 1012767, read from the public cost report file SNF10FY2011.zip.
Fiscal year 2010, ended 31 January 2010
Cost report for 30 September 2009 to 31 January 2010 — a reporting period of 123 days, not a full year, on form CMS-2540-96, settled, processed by CMS on 30 August 2010.
| Figure | As filed | Where it comes from |
|---|---|---|
| Net patient revenue | $491,587 | CMS-2540-96 worksheet G300000 line 300 column 100 |
| Total operating expenses | $641,352 | CMS-2540-96 worksheet G200002 line 1500 column 200 |
| Net income from service to patients | −$149,765 | CMS-2540-96 worksheet G300000 line 500 column 100 |
| Total other income | $2,859 | CMS-2540-96 worksheet G300000 line 2600 column 100 |
Net income, stated at moderate confidence: −$146,906 (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.
| Figure | As filed | Where it comes from |
|---|---|---|
| Total facility beds, all components | 100 | CMS-2540-96 worksheet S300001 line 900 column 100 |
| Total patient days, all components | 4,845 | CMS-2540-96 worksheet S300001 line 900 column 700 |
| Total discharges, all components | 9 | CMS-2540-96 worksheet S300001 line 900 column 1200 |
| Average length of stay, Medicare, in days | 60.33 | CMS-2540-96 worksheet S300001 line 900 column 1400 |
| Average length of stay, Medicaid, in days | 833.5 | CMS-2540-96 worksheet S300001 line 900 column 1500 |
| Average length of stay, all patients, in days | 538.33 | CMS-2540-96 worksheet S300001 line 900 column 1600 |
CMS report record 386840, read from the public cost report file SNFFY2009.zip.
Nurse staffing
Nurse staffing hours from the Payroll-Based Journal, quarter by quarter, are on this facility’s staffing page, each quarter with the file it came from.
Ownership, as filed with CMS
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Recent changes on this record
- 27 November 2017: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- 17 July 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- 2 August 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- 29 June 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- 31 July 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- 29 July 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- 27 September 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
- 1 March 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2011.zip
- 31 August 2011: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip
- 30 August 2010: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2009.zip
Inspections
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Deficiencies cited
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Penalties
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Care Compare provider information
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One email a day naming what moved on NORTH LAKE MANOR: the field, the value before, the value after, and the date of the file that first showed it.
The facility alert follows this one record: a cost report filed or a figure on one changed, an inspection, a deficiency or a penalty recorded, an owner added or removed. The certification number arrives filled in.
On 27 November 2017: A cost report was filed for fiscal year 2017, on form CMS-2540-10. That is one line of the alert.
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The citable document for NORTH LAKE MANOR
This page shows the record as it stands today. The report is the citable document: the same figures with the cell each came from, and beyond this page — five facilities of a similar size in Iowa at the same fiscal year, listed by name; every change on the record rather than the recent ones below; the inspection and staffing history in blocks of their own; and a citation block naming every CMS file it was read from.
Every figure on this page is printed as it appears in the CMS file named beside it. A figure that does not match its file? Tell us on the corrections page, quoting certification number 165596.