1409 West Main Street, Lake City, IA 51449 · Calhoun County · (712) 464-3106
46 certified beds, about 41 residents a day · For profit - Corporation · Medicare and Medicaid since 1968
CMS Care Compare ratings, data as of September 1, 2026 · CCN 165082 · See it on Medicare.gov · Compare with other homes
At its most recent standard inspection, on April 23, 2026, inspectors cited 2 health deficiencies (the Iowa average is 6.5, the national average 9.2).
Of 40 health citations since September 2023, 2 were rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 1 fine totaling $35,341 in the last three years; the largest was $35,341, and the latest is dated January 9, 2025.
Nurses and nurse aides worked 3.69 hours per resident per day, against 3.82 across Iowa and 3.86 nationally. Registered nurses accounted for 0.35 of those hours.
37.0% of nursing staff left within the year CMS measured (Iowa average 44.0%).
CMS links it to Accura Healthcare, an affiliated group of 41 nursing homes.
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 40 health citations on file.
Inspectors wroteBased on observation, facility policy, and the Food and Drug Administration (FDA) food code the facility failed to serve food under sanitary conditions, in order to reduce the risk of contamination and foodborne illness during one of one meal service observed. Facility staff also failed to cover facial hair (beard) while serving food. The facility reported a census of 38 residents.
Inspectors wroteBased on clinical record review, staff interview and policy review the facility failed to develop a care plan to address anticoagulant medication usage, opioid medication usage, antidepressant medication usage and diuretic medication usage and side effects to watch for in 1 out of 12 residents (Resident #6) reviewed for comprehensive care plans . The facility reported a census of 38 residents.
Inspectors wroteBased on observation, record review and staff interview, the facility failed to follow the physician's orders for oxygen for 1 resident (Resident #1), failed to ensure staff used professional standards during med pass, including observing the consumption of medication for 2 of 9 residents (Resident #3 and #4), and infection control practices for 1 of 9 residents reviewed (Resident #8), and failed to store meds properly. The facility reported a census of 41 residents.
Inspectors wroteBased on record review and staff interview, the facility failed to have sufficient staff to complete restorative as planned for 3 of 3 residents (Resident #4, #5, and #7), and ensure residents received at least 2 baths a week for 3 residents reviewed (Resident #1, #3, and #6). The facility reported a census of 41 residents.
Inspectors wroteBased on observation, review of menus, and staff interview, the facility failed to provide food and drink that was palatable, attractive, and at a safe and appetizing temperature. The facility reported a census of 41 residents.
Inspectors wroteBased on observations, staff interviews, and facility policy reviews the facility failed to ensure food was stored and prepared under sanitary conditions. The facility identified a census of 39 residents.
Inspectors wroteBased on observation, record review and staff interview the facility failed to ensure adequate supervision to prevent elopement for 1 of 3 residents reviewed (Resident #1). The facility reported a census of 38 residents. The facility took action to correct this deficiency prior to the surveyor entrance and is considered past non-compliance.
Inspectors wroteBased on clinical record review and staff interviews, the facility failed to notify the family or responsible party when a resident had a change of condition for 2 of 15 residents reviewed (Residents #34 and #18). The facility reported a census of 41 residents.
Inspectors wroteBased on clinical record review, observations, and staff interviews the facility failed to implement care plan interventions to reduce the risk for falls for 1 out of 4 residents (Resident #25) reviewed. The facility reported a census of 41 residents.
Inspectors wroteBased on observations, clinical record review, staff interviews, and policy review, the facility failed to provide care and services according to accepted standards of clinical practice for 2 of 15 residents reviewed (Residents #21 and #23). The facility reported a census of 41 residents.
Inspectors wroteBased on clinical record review, staff interview and policy review the facility failed to provide bathing assistance for 2 of 2 residents reviewed for bathing (Residents #1 and #13). The facility reported a census of 41 residents.
Inspectors wroteBased on record review, staff interviews and facility policy the facility failed to put proper interventions in place to prevent a stage 2 pressure ulcer to the right heel consistent with professional standards of practice for 1 of 1 residents reviewed (Resident #38). The facility reported a census of 41 residents.
Inspectors wroteBased on clinical record reviews, staff interviews and policy review, the facility failed to put effective interventions in place and provide adequate nursing supervision to prevent accident and injuries from falls for 1 of 1 residents reviewed (Resident #18). Resident #18 had a risk for falls with a history of repeated falls. Resident #18 had his thirteenth fall on 3/5/25 in a three-month period of time. On 1/9/25 Resident #18 had an unwitnessed fall in his room, resulting in a fracture to his left hand.
Inspectors wroteBased on clinical record review, staff interview and facility policy review, the facility failed to complete a gradual dose reduction (GDR) for 2 out of 5 residents reviewed for unnecessary medications. (Residents #5 and #19). The facility reported a census of 41 residents.
Inspectors wroteBased on record review and staff interview, the facility failed to provide adequate supervision to ensure timely intervention during a choking incident for 1 resident (Resident #1) and failed to ensure appropriately trained staff supervised and fed residents at risk for choking for 2 of 2 residents (Resident #1 and #3). On 12/4/24, while at supper in the assisted area, Staff A, Noncertified Nurse Aide (NCNA), assisted Resident #3 eat and observed Resident #1. Resident #1 choked. At the time, the only people in the assisted dining room were Staff A and the 2 residents. Staff A couldn't do the Heimlich and the walkie talkie failed to work to summon help timely. Staff A yelled for help. After hearing Staff A, Staff D Dietary Aide responded and learned they needed assistance. Staff D left the dining room to find additional staff to assist Resident #1. [...]
Inspectors wroteBased on observation, and staff and resident interview, the facility failed to maintain an effective pest control program. The facility reported a census of 46 residents.
Inspectors wroteBased on personnel file review and staff interview the facility failed to ensure sufficient nursing staff with appropriate training to provide supervision during a meal for 1 of 2 staff reviewed (Staff A). The facility reported a census of 46 residents.
Inspectors wroteBased on personnel file review and staff interview, the facility failed to ensure an individual applying for a position as a nurse aide could prove that he or she had recently successfully completed a training and competency evaluation program, or was a full time employee in a training and competency program approved by the State for 1 of 2 staff reviewed (Staff A). The facility reported a census of 46 residents.
Inspectors wroteBased on record review and staff interview, the facility failed maintain a system of drug reconciliation to identify disposition of a missing pill for 1 of 3 residents reviewed (Resident #4). The facility reported a census of 46 residents.
Inspectors wroteBased on clinical record review and staff interviews, the facility failed to assess and provide interventions necessary for the care and services, to maintain the residents' highest practical physical well- being for 1 of 3 residents reviewed (Resident #3). The facility failed to assess and document fall and neurological assessments after an unwitnessed fall for Resident #3. The facility reported a census of 38 residents.
Inspectors wroteBased on observation, staff interviews, and facility record review, the facility failed to make sure the environment remained free from accident hazards as the door to laundry room was broke and 11 residents that are mobile had access to it and failed to provide adequate nursing supervision for 1 of 1 residents reviewed (Resident #7). The facility reported a total census of 39 residents.
Inspectors wroteBased on clinical record review, staff interviews, and facility record review, the facility failed to report an allegation of abuse to the Iowa Department of Inspections, Appeals and Licensing (DIAL) for 1 of 1 residents reviewed for abuse who reported a Certified Nursing Assistant (CNA) was being rough with (Resident #2). The facility reported a census of 39 residents.
Inspectors wroteBased on resident, staff and record review, the facility failed to ensure staff answered resident call lights and responded to resident needs in a timely manner, within fifteen minutes, for 2 out of 2 residents interviewed (Residents #4 and #6). The facility reported a census of 39 residents.
Inspectors wroteBased on employee file review, facility record review, staff interviews and policy review the facility failed to have cardiopulmonary resuscitation (CPR, life saving measures in case the heart stops beating) certified staff member present on all shifts 24/7. The facility reported a census of 39 residents.
Inspectors wroteBased on observation, staff interviews, and policy reviews the facility failed to prepare, serve, distribute, and store food in accordance with professional standards. The facility reported a census of 39 residents.
Inspectors wroteBased on clinical record review and staff interviews, the facility failed to have an accurate advanced directive (instructions on what to do in case their heart stops beating or they stop breathing) for 1 out of 16 residents reviewed (Resident #13).
Inspectors wroteBased on personnel file reviews, staff interviews, and facility policy review, the facility failed to wait for the completion of a criminal background check prior to start of employment for 2 of 5 current employees sampled Staff I, Certified Nursing Assistant (CNA), and Staff J Licensed Practical Nurse (LPN).
Inspectors wroteBased on clinical record review, staff interviews and facility policy review the facility failed to provide a notice of bed hold for 2 of 2 residents reviewed (Resident #2 and #19) for discharge to the hospital.
Inspectors wroteBased on record review, staff interview and Resident Assessment Instrument (RAI) the facility failed to complete a Significant Change in Status (SCSA) Minimum Data Set (MDS) assessment within 14 days of discharge from hospice for 1 of 1 resident (Resident #2) reviewed for hospice services.
Inspectors wroteBased on clinical record review and staff interviews the facility failed to complete a comprehensive Care Plan for 1 of 2 residents reviewed (Residents #13) with a catheter.
Inspectors wroteBased on observation, clinical record review, and staff interview, the facility failed to review and revise the Care Plan to reflect the resident's current status for 1 of 6 residents reviewed (Resident #33).
Inspectors wroteBased on clinical record review and staff interviews, the facility failed to provide care and services according to accepted standards of clinical practice for 2 of 2 resident reviewed (Resident #14 and #20). The facility failed to obtain an INR blood test (International normalized ratio) (blood test to determine how long it takes for the blood to clot) per Physician order and failed to check/document the code alert (wander guard bracelet) per physician order. The facility also failed to administer medications per standard of practice during the medication administration task.
Inspectors wrote2. According to the Minimum Data Set (MDS) assessment dated [DATE] Resident #33 scored 8 on the Brief Interview for Mental Status (BIMS), indicating moderate impairment. Resident #33 required partial to moderate assistance with transfers, mobility, bed mobility, dressing, and bathing. The resident utilized a walker and wheelchair. The MDS included diagnoses of bilateral primary osteoarthritis of the knee and tobacco use. Resident #33's physician orders dated 1/19/24 directed to not remove the urinary catheter and connect to drainage. Do not remove without a physician order. Use the urinary catheter care per facility guidelines, an 18 French (FR), 10 milliliters (mL) balloon. [...]
Inspectors wroteBased on clinical record review, observations, and staff interviews the facility failed to provide respiratory care and services in accordance with professional standards of practice for 1 of 1 resident reviewed, requiring the use of oxygen (Resident #8).
Inspectors wroteBased on staff observation, and staff interview, the facility failed to administer medications in a sanitary manner for 2 of 5 residents reviewed (Resident #15 and Resident #187).
Inspectors wroteBased on personnel file review, facility policy review and staff interview the facility failed to provide dependent adult abuse training within 6 months of hire for 1 of 5 employees reviewed (Staff F, Cook). The facility identified a census of 39 residents.
Inspectors wroteBased on clinical record reviews, wound center record review and staff interviews the facility failed to assure that a resident with a pressure ulcer received treatment and services, consistent with professional standards of practice, to promote healing of a stage three pressure ulcer for 1 of 1 resident reviewed (Resident #2). The facility reported a census of 34 residents.
Inspectors wroteBased on facility record review, staff interviews, and policy review, the facility failed to implement a system to consistently and accurately reconcile all controlled medications. The facility failed to count a schedule 4 controlled medication for 1 of 1 resident (#5) reviewed taking tramadol. The facility reported a census of 34 residents.
Inspectors wroteBased on staff interviews, review of facility documents and policy review, the facility failed to provide safe and secured storage of controlled substances to limit access, minimize loss and prevent diversion. The facility did not have the medication cart keys which included the key to the narcotic drawers in a secured location or in possession of an authorized person. The facility reported a census of 34 residents.
Inspectors wroteBased on staff interviews, clinic record review, and policy review, the facility failed to administer medication appropriately for 1 out of 5 residents (Resident #7) reviewed. The facility administered morphine without a physician order. The facility reported a census of 34 residents.
9 fire safety citations on file: 1 on April 23, 2026, 2 on April 3, 2025, 6 on February 22, 2024.
| Date | Penalty | Amount or length |
|---|---|---|
| January 9, 2025 | Fine | $35,341 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Iowa | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.69 | 3.82 | 3.86 |
| Registered nurses | 0.35 | 0.74 | 0.69 |
| All nursing staff on weekends | 3.25 | 3.37 | 3.42 |
| Nurse aides | 2.51 | ||
| Licensed practical nurses | 0.83 | ||
| Nursing staff turnover (share who left in a year) | 37.0% | 44.0% | 45.8% |
| Registered nurse turnover | 77.8% | 42.1% | 42.9% |
| Administrators who left | not reported |
CMS expects 2.87 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 3.87 on weekdays and 3.25 on weekends, 16% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 27.8% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 4.02 in April to June 2025 to 3.69 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.69 | 0.35 | 3.87 | 3.25 | 27.8% | 0 of 90 | 41 |
| Oct to Dec 2025 | 3.68 | 0.37 | 3.86 | 3.23 | 2.8% | 0 of 92 | 41 |
| Jul to Sep 2025 | 3.85 | 0.50 | 4.06 | 3.33 | 0.0% | 0 of 92 | 40 |
| Apr to Jun 2025 | 4.02 | 0.63 | 4.25 | 3.46 | 4.1% | 0 of 91 | 40 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Iowa, Jan to Mar 2026 | 3.80 | 0.71 | 3.98 | 3.36 | 4.7% | 0.3% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Iowa, all employers | |||
| CNAs (nursing assistants) | $18.92 | $17.96 to $21.95 | 22,670 |
| LPNs and LVNs | $30.11 | $27.12 to $34.06 | 5,510 |
| Registered nurses | $37.80 | $32.83 to $41.32 | 34,420 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Iowa | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 27.8 | 17.1 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 0.0 | 1.5 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 6.1 | 2.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 11.8 | 3.8 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 2.1 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 26.8 | 16.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 1.5 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 16.8 | 19.4 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 17.2 | 20.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 23.6 | 13.2 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 3.0 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 3.8 | 2.1 | 1.8 |
For a stay to recover after a hospital visit, these are the results CMS publishes for Accura Healthcare of Lake City, LLC's Medicare short-stay residents. On returning residents home or to the community, CMS rates it no different from the national rate (49.3% of residents, after adjusting for how sick they were). How to read these, and what Medicare pays for.
49.3% this home
No different from the national rate
US median of homes 51.5% · Iowa: 28 better, 21 worse
Rate of successful return to home or community from a SNF (risk-standardized discharge to community rate). Higher is better. October 2022 to September 2024. 39 eligible stays.
11.8% this home
No different from the national rate
US median of homes 10.7% · Iowa: 1 better, 1 worse
Rate of potentially preventable hospital readmissions 30 days after discharge from a SNF (risk-standardized rate). Lower is better. October 2022 to September 2024. 45 eligible stays.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
US median of homes 7.1% · Iowa: 0 better, 0 worse
Percentage of infections residents got during their SNF stay that resulted in hospitalization (risk-standardized rate). Lower is better. October 2023 to September 2024. 16 eligible stays.
60.0% this home
Median of homes: Iowa56.7% · US 56.6%
Percentage of residents who are at or above an expected ability to care for themselves and move around at discharge. Higher is better. October 2024 to September 2025. 20 residents counted.
0.0% this home
Median of homes: Iowa0.0% · US 0.0%
Percentage of SNF residents who experience one or more falls with major injury during their SNF stay. Lower is better. October 2024 to September 2025. 24 residents counted.
0.0% this home
Median of homes: Iowa1.8% · US 1.7%
Percentage of residents with pressure ulcers or pressure injuries that are new or worsened (adjusted rate). Lower is better. October 2024 to September 2025. 24 residents counted.
Not reported
CMS note: The number of residents or resident stays is too small to report. Call the facility to discuss this quality measure.
Median of homes: Iowa100.0% · US 98.7%
Percentage of residents where the SNF provided a current medication list to the resident, family, and/or caregiver at final discharge. Higher is better. October 2024 to September 2025. 12 residents counted.
Source: CMS Skilled Nursing Facility Quality Reporting Program - Provider Data, released 2026-09-30. Better, no different and worse are CMS's own comparisons with the national rate, after adjusting for how sick residents were. Medians of homes and the state counts are worked out by us from the same file.
Legal business name: ACCURA HEALTHCARE OF LAKE CITY LLC. CMS links this home to Accura Healthcare, a group of 41 nursing homes averaging 2.5 stars overall.
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Accura Healthcare of the Heartland LLC | 5% or greater direct ownership interest | Organization | 100% | 07/01/2023 |
| Duncan, Derek | W-2 managing employee | Individual | 04/01/2024 | |
| Lindgren, Taesa | W-2 managing employee | Individual | 04/01/2024 | |
| Toti, Lisa | W-2 managing employee | Individual | 07/01/2023 | |
| Leneave, Ted | Corporate officer | Individual | 07/01/2023 | |
| Toti, Lisa | Corporate officer | Individual | 07/01/2023 | |
| American Healthcare Management Services LLC | Operational/managerial control | Organization | 07/01/2023 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Chosen from this home's own inspection record.
These are the official offices in Iowa. NursingHomeClear cannot take or act on complaints.