Skilled nursing facility · CMS certification number 165596
NORTH LAKE MANOR
STORM LAKE, Iowa
Download this facility’s record (CSV)
A CSV file of this facility’s record: its name and location, its Medicare cost-report finances year by year, its ownership, its inspections, deficiencies and penalties, and the Care Compare provider information — each figure with the worksheet, line and column or file it came from.
This certification number is not in CMS’s current Care Compare Provider Information file, processed on August 1, 2026.
For this facility: the citable document with full history — $295 · an email when this record changes — $99/month
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 January 1, 2017 to February 27, 2017 — a reporting period of 57 days, not a full year, on form CMS-2540-10, settled, processed by CMS on November 27, 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 December 31, 2016
Cost report for January 1, 2016 to December 31, 2016 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on July 17, 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 December 31, 2015
Cost report for January 1, 2015 to December 31, 2015 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on August 2, 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 December 31, 2014
Cost report for January 1, 2014 to December 31, 2014 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on June 29, 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 December 31, 2013
Cost report for January 1, 2013 to December 31, 2013 — a reporting period of 364 days, on form CMS-2540-10, settled, processed by CMS on July 31, 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 December 31, 2012
Cost report for January 1, 2012 to December 31, 2012 — a reporting period of 365 days, on form CMS-2540-10, settled, processed by CMS on July 29, 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 December 31, 2011
Cost report for August 1, 2011 to December 31, 2011 — a reporting period of 152 days, not a full year, on form CMS-2540-10, settled, processed by CMS on September 27, 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 January 31, 2010
Cost report for September 30, 2009 to January 31, 2010 — a reporting period of 123 days, not a full year, on form CMS-2540-96, settled, processed by CMS on August 30, 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: −$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
Care Compare
Not listed in CMS’s Care Compare data.
Medicare enrollment
No owner listed for this facility in CMS’s Medicare enrollment ownership data.
Changes in ownership
No change in ownership appears in CMS’s ownership data for this facility.
Recent changes on this record
- November 27, 2017: A cost report was filed for fiscal year 2017, on form CMS-2540-10. SNF10FY2017.zip
- July 17, 2017: A cost report was filed for fiscal year 2016, on form CMS-2540-10. SNF10FY2016.zip
- August 2, 2016: A cost report was filed for fiscal year 2015, on form CMS-2540-10. SNF10FY2015.zip
- June 29, 2015: A cost report was filed for fiscal year 2014, on form CMS-2540-10. SNF10FY2014.zip
- July 31, 2014: A cost report was filed for fiscal year 2013, on form CMS-2540-10. SNF10FY2013.zip
- July 29, 2013: A cost report was filed for fiscal year 2012, on form CMS-2540-10. SNF10FY2012.zip
- September 27, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-10. SNF10FY2011.zip
- March 1, 2012: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2011.zip
- August 31, 2011: A cost report was filed for fiscal year 2011, on form CMS-2540-96. SNFFY2010.zip
- August 30, 2010: A cost report was filed for fiscal year 2010, on form CMS-2540-96. SNFFY2009.zip
Inspections
Not listed in CMS’s Care Compare data.
Deficiencies cited
Not listed in CMS’s Care Compare data.
Penalties
Not listed in CMS’s Care Compare data.
Care Compare provider information
Not listed in CMS’s Care Compare data.
Get an email when this record changes
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 November 27, 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.
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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.