nursing home in Decorah, IA
The Highlands
607 Highland Drive, Decorah, IA 52101 · (563) 382-3603
★★★★★2
Below average
CMS overall star rating
CMS overall star rating
- Health inspections★★★★★2
- Staffing★★★★★4
- Quality measures★★★★★3
Source: Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. We refresh our information from this source. About our data
The Highlands at a glance
The Highlands is a 86-bed non-profit nursing home in Decorah, Iowa (Winneshiek County).
CMS gives it 2 out of 5 stars on its overall star rating, worse than the Iowa average of 3.1.
Residents receive about 3.9 hours of nursing care per day (0.4 of them from registered nurses), close to the state average of 3.8 hours.
Its most recent standard health inspection (July 22, 2026) found 7 health citations. The Iowa average is 6.5.
Federal regulators fined it 2 times in the past three years, totaling $93,839.
Nursing staff turnover is 53.3% per year (state average 44%).
Facility details
- Type
- Nursing home
- Ownership
- Non Profit - Corporation
- Beds
- 86
- Certified for
- Medicare and Medicaid
- Medicare-certified since
- January 1, 1993
- Continuing care retirement community
- Yes
- Resident/family council
- Resident
- County
- Winneshiek County
- CMS Certification Number
- 165178
Ratings
| Measure | This facility | Iowa avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Overall star rating ⓘ (higher is better) | 2 / 5 | 3.1 / 5 | 3 / 5 | Worse |
| Health inspection rating ⓘ (higher is better) | 2 / 5 | 2.8 / 5 | 2.8 / 5 | Worse |
| Staffing rating ⓘ (higher is better) | 4 / 5 | 3.7 / 5 | 2.9 / 5 | Better |
| Quality measures rating ⓘ (higher is better) | 3 / 5 | 3.3 / 5 | 3.6 / 5 | Worse |
| Long-stay quality rating (higher is better) | 2 / 5 | 3.3 / 5 | 3.8 / 5 | Worse |
| Short-stay (rehab) quality rating (higher is better) | 4 / 5 | 3.3 / 5 | 3.3 / 5 | Better |
Staffing
| Measure | This facility | Iowa avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Total nurse staff hours per resident per day ⓘ (higher is better) | 3.90 hrs | 3.82 hrs | 3.86 hrs | Average |
| Registered nurse hours per resident per day (higher is better) | 0.44 hrs | 0.74 hrs | 0.69 hrs | Worse |
| Nurse aide hours per resident per day (higher is better) | 2.79 hrs | 2.52 hrs | 2.32 hrs | Better |
| Weekend nurse staff hours per resident per day (higher is better) | 3.59 hrs | 3.37 hrs | 3.42 hrs | Average |
| Nursing staff turnover (yearly) (lower is better) | 53.3% | 44% | 45.8% | Worse |
| Registered nurse turnover (yearly) (lower is better) | 44.4% | 42.1% | 42.9% | Average |
| Administrators who left in the past year (lower is better) | 1 | 0 | 1 | Worse |
Inspections
| Measure | This facility | Iowa avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Health citations in the most recent inspection (lower is better) | 7 | 6 | 9 | Better |
| Citations from complaint investigations (latest cycle) (lower is better) | 3 | 3 | 3 | Worse |
| Weighted health inspection score ⓘ (lower is better) | 62.8 | 54.5 | 80.6 | Better |
Penalties
| Measure | This facility | Iowa avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Fines in the past 3 years (lower is better) | 2 | 1 | 1 | Worse |
| Total fines in the past 3 years (lower is better) | $93,839 | $19,286 | $30,972 | Worse |
| All federal penalties in the past 3 years (lower is better) | 3 | 1 | 1 | Worse |
Size
| Measure | This facility | Iowa avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Certified beds | 86 | 65 | 107 | |
| Average residents per day | 75 | 52 | 86 | |
| Occupancy | 87.7% | 81.5% | 80.9% |
Long-stay residents
| Measure | This facility | Iowa avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Long-stay residents with a fall causing major injury (lower is better) | 2.1% | 3.8% | 3.2% | Better |
| Long-stay residents with pressure ulcers (lower is better) | 4.1% | 4.2% | 4.6% | Better |
| Long-stay residents given antipsychotic medication (lower is better) | 25.6% | 19.5% | 15.4% | Worse |
| Long-stay residents with a urinary tract infection (lower is better) | 0% | 2.4% | 1.6% | Better |
| Long-stay residents with a catheter left in the bladder (lower is better) | 1.2% | 1.5% | 0.8% | Worse |
| Long-stay residents needing more help with daily activities (lower is better) | 27.6% | 17.1% | 13.9% | Worse |
| Long-stay residents whose walking worsened (lower is better) | 24% | 16.6% | 14.1% | Worse |
| Long-stay residents who lose too much weight (lower is better) | 4% | 4.6% | 5.2% | Better |
| Long-stay residents with depressive symptoms (lower is better) | 0.9% | 4.2% | 12.8% | Better |
| Long-stay residents who were physically restrained (lower is better) | 0% | 0.2% | 0.1% | Better |
| Long-stay residents given anti-anxiety or sleep medication (lower is better) | 17.9% | 20.8% | 19.5% | Better |
| Long-stay residents with new or worse incontinence (lower is better) | 26% | 25.6% | 19% | Worse |
| Long-stay residents given a flu vaccine (higher is better) | 95.2% | 95.3% | 95.5% | Average |
| Long-stay residents given a pneumonia vaccine (higher is better) | 89.5% | 94% | 93.6% | Average |
Short-stay residents
| Measure | This facility | Iowa avg. | U.S. avg. | vs. U.S. |
|---|---|---|---|---|
| Short-stay residents newly given antipsychotic medication (lower is better) | 0% | 2.1% | 1.6% | Better |
| Short-stay residents given a pneumonia vaccine (higher is better) | 46.8% | 84% | 82% | Worse |
Inspection citations
State inspectors cited this home for 26 health deficiencies and 28 fire safety deficiencies in the inspection records CMS currently publishes. 3 citations involved actual harm, including 1 rated "immediate jeopardy".
| Date | Citation | Severity | Status |
|---|---|---|---|
| July 22, 2026 Fire safety | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Tag K0321 | F Potential harm, widespread | Corrected July 27, 2026 |
| July 22, 2026 Fire safety | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Tag K0918 | F Potential harm, widespread | Corrected July 27, 2026 |
| July 22, 2026 Fire safety | Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Tag K0712 | F Potential harm, widespread | Corrected August 14, 2026 |
| July 22, 2026 Fire safety | Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. Smoke Deficiencies · Tag K0354 | F Potential harm, widespread | Corrected July 27, 2026 |
| July 22, 2026 Fire safety | Follow proper procedures when the fire alarm was out of service for more than 4 hours. Smoke Deficiencies · Tag K0346 | F Potential harm, widespread | Corrected July 27, 2026 |
| July 22, 2026 Fire safety | Provide a written emergency evacuation plan. Miscellaneous Deficiencies · Tag K0711 | E Potential harm, pattern | Corrected July 27, 2026 |
| July 22, 2026 Standard | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Tag F0812 | E Potential harm, pattern | Corrected August 3, 2026 |
| July 22, 2026 Standard | Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. Resident Rights Deficiencies · Tag F0578 | D Potential harm, isolated | Corrected August 10, 2026 |
| July 22, 2026 Standard | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. Resident Assessment and Care Planning Deficiencies · Tag F0644 | D Potential harm, isolated | Corrected August 10, 2026 |
| July 22, 2026 Standard | Assess the resident when there is a significant change in condition Resident Assessment and Care Planning Deficiencies · Tag F0637 | D Potential harm, isolated | Corrected July 27, 2026 |
| June 18, 2026 Complaint | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Tag F0689 | D Potential harm, isolated | Corrected July 1, 2026 |
| September 23, 2025 Complaint | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Tag F0550 | E Potential harm, pattern | Corrected September 24, 2025 |
| September 23, 2025 Complaint | Have enough outside ventilation via a window or mechanical ventilation, or both. Environmental Deficiencies · Tag F0923 | E Potential harm, pattern | Corrected September 24, 2025 |
| June 12, 2025 Fire safety | Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Tag K0712 | F Potential harm, widespread | Corrected June 25, 2025 |
| June 12, 2025 Fire safety | Develop a communication plan. Emergency Preparedness Deficiencies · Tag E0029 | F Potential harm, widespread | Corrected June 24, 2025 |
| June 12, 2025 Fire safety | Conduct testing and exercise requirements. Emergency Preparedness Deficiencies · Tag E0039 | F Potential harm, widespread | Corrected June 24, 2025 |
| June 12, 2025 Fire safety | Install emergency lighting that can last at least 1 1/2 hours. Egress Deficiencies · Tag K0291 | F Potential harm, widespread | Corrected June 20, 2025 |
| June 12, 2025 Fire safety | Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Tag K0345 | F Potential harm, widespread | Corrected June 25, 2025 |
| June 12, 2025 Fire safety | Inspect, test, and maintain automatic sprinkler systems. Smoke Deficiencies · Tag K0353 | F Potential harm, widespread | Corrected June 25, 2025 |
| June 12, 2025 Fire safety | Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. Smoke Deficiencies · Tag K0354 | F Potential harm, widespread | Corrected June 30, 2025 |
| June 12, 2025 Fire safety | Provide a written emergency evacuation plan. Miscellaneous Deficiencies · Tag K0711 | F Potential harm, widespread | Corrected June 30, 2025 |
| June 12, 2025 Standard | Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0943 | D Potential harm, isolated | Corrected June 26, 2025 |
| June 12, 2025 Standard | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. Resident Rights Deficiencies · Tag F0582 | D Potential harm, isolated | Corrected June 26, 2025 |
| June 12, 2025 Standard | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Tag F0641 | B No harm, pattern | Corrected June 26, 2025 |
| December 9, 2024 Complaint | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Tag F0684 | J Immediate jeopardy, isolated | Corrected December 10, 2024 |
| September 25, 2024 Complaint | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Tag F0684 | D Potential harm, isolated | Corrected September 26, 2024 |
| September 25, 2024 Complaint | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. Resident Rights Deficiencies · Tag F0580 | D Potential harm, isolated | Corrected September 26, 2024 |
| July 25, 2024 Fire safety | Develop and maintain an Emergency Preparedness Program (EP). Emergency Preparedness Deficiencies · Tag E0004 | F Potential harm, widespread | Corrected August 31, 2024 |
| July 25, 2024 Fire safety | Ensure that testing and maintenance of electrical equipment is performed. Gas, Vacuum, and Electrical Systems Deficiencies · Tag K0921 | F Potential harm, widespread | Corrected August 31, 2024 |
| July 25, 2024 Fire safety | Have generator or other power source capable of supplying service within 10 seconds. Gas, Vacuum, and Electrical Systems Deficiencies · Tag K0918 | F Potential harm, widespread | Corrected August 6, 2024 |
| July 25, 2024 Fire safety | Have simulated fire drills held at unexpected times. Miscellaneous Deficiencies · Tag K0712 | F Potential harm, widespread | Corrected August 31, 2024 |
| July 25, 2024 Fire safety | Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours. Smoke Deficiencies · Tag K0354 | F Potential harm, widespread | Corrected August 31, 2024 |
| July 25, 2024 Fire safety | Properly provide smoke detection systems in areas open to corridors. Smoke Deficiencies · Tag K0347 | F Potential harm, widespread | Corrected August 15, 2024 |
| July 25, 2024 Fire safety | Have approved installation, maintenance and testing program for fire alarm systems. Smoke Deficiencies · Tag K0345 | F Potential harm, widespread | Corrected August 7, 2024 |
| July 25, 2024 Fire safety | Install emergency lighting that can last at least 1 1/2 hours. Egress Deficiencies · Tag K0291 | F Potential harm, widespread | Corrected August 31, 2024 |
| July 25, 2024 Fire safety | Conduct testing and exercise requirements. Emergency Preparedness Deficiencies · Tag E0039 | F Potential harm, widespread | Corrected August 28, 2024 |
| July 25, 2024 Fire safety | List the names and contact information of those in the facility. Emergency Preparedness Deficiencies · Tag E0030 | F Potential harm, widespread | Corrected August 31, 2024 |
| July 25, 2024 Fire safety | Establish roles under a Waiver declared by secretary. Emergency Preparedness Deficiencies · Tag E0026 | F Potential harm, widespread | Corrected August 16, 2024 |
| July 25, 2024 Fire safety | Conduct risk assessment and an All-Hazards approach. Emergency Preparedness Deficiencies · Tag E0006 | F Potential harm, widespread | Corrected August 15, 2024 |
| July 25, 2024 Fire safety | Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system. Smoke Deficiencies · Tag K0321 | D Potential harm, isolated | Corrected August 31, 2024 |
| July 25, 2024 Fire safety | To conduct inspection, testing and maintenance of fire doors by qualified individuals. Miscellaneous Deficiencies · Tag K0761 | D Potential harm, isolated | Corrected August 31, 2024 |
| July 25, 2024 Standard | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Tag F0689 | G Actual harm, isolated | Corrected July 26, 2024 |
| July 25, 2024 Standard | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. Nutrition and Dietary Deficiencies · Tag F0802 | E Potential harm, pattern | Corrected July 26, 2024 |
| July 25, 2024 Standard | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. Nutrition and Dietary Deficiencies · Tag F0812 | E Potential harm, pattern | Corrected July 26, 2024 |
| July 25, 2024 Standard | Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. Nutrition and Dietary Deficiencies · Tag F0800 | E Potential harm, pattern | Corrected July 26, 2024 |
| July 25, 2024 Standard | Provide appropriate treatment and care according to orders, resident’s preferences and goals. Quality of Life and Care Deficiencies · Tag F0684 | D Potential harm, isolated | Corrected July 26, 2024 |
| July 25, 2024 Standard | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. Resident Assessment and Care Planning Deficiencies · Tag F0644 | D Potential harm, isolated | Corrected July 26, 2024 |
| July 25, 2024 Standard | Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician. Nutrition and Dietary Deficiencies · Tag F0801 | C No harm, widespread | Corrected July 26, 2024 |
| February 7, 2024 Complaint | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. Quality of Life and Care Deficiencies · Tag F0689 | G Actual harm, isolated | Corrected February 8, 2024 |
| February 7, 2024 Complaint | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. Resident Rights Deficiencies · Tag F0550 | D Potential harm, isolated | Corrected February 8, 2024 |
| February 7, 2024 Complaint | Honor 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. Resident Rights Deficiencies · Tag F0584 | D Potential harm, isolated | Corrected February 8, 2024 |
| February 7, 2024 Complaint | Ensure each resident receives an accurate assessment. Resident Assessment and Care Planning Deficiencies · Tag F0641 | D Potential harm, isolated | Corrected February 8, 2024 |
| February 7, 2024 Complaint | Ensure services provided by the nursing facility meet professional standards of quality. Resident Assessment and Care Planning Deficiencies · Tag F0658 | D Potential harm, isolated | Corrected February 8, 2024 |
| February 7, 2024 Complaint | Provide care and assistance to perform activities of daily living for any resident who is unable. Quality of Life and Care Deficiencies · Tag F0677 | D Potential harm, isolated | Corrected February 8, 2024 |
Severity letters follow the CMS scope-and-severity grid: A–C no actual harm with potential for minimal harm; D–F potential for more than minimal harm; G–I actual harm; J–L immediate jeopardy to resident health or safety. How to read inspection citations.
Fines and payment denials
CMS reports 3 federal penalties in the past three years, including $93,839 in fines.
| Date | Penalty | Amount / length |
|---|---|---|
| December 9, 2024 | Fine | $50,211 |
| July 25, 2024 | Payment Denial | 10 days from August 21, 2024 |
| July 25, 2024 | Fine | $43,628 |
Owners and managers
Individuals and organizations reported to CMS as owning or operating this nursing home.
| Name | Role | Share | Since |
|---|---|---|---|
| SCHMIDT, JEFFREY Individual | corporate director | NOT APPLICABLE | 05/20/2013 |
| CONTINUUM HEALTH CARE SERVICES LLC Organization | operational/managerial control | NOT APPLICABLE | 01/17/2013 |
| BJELLAND, SUSAN Individual | w-2 managing employee | NOT APPLICABLE | 02/22/2010 |
| ELSBERND, NANCY Individual | w-2 managing employee | NOT APPLICABLE | 02/22/2010 |
Other nursing homes near The Highlands
- ★★★★★4Above average
- ★★★★★2Below average
Green Lea Senior Living
115 North Lyndale, Rr 2 Box 49, Mabel, MN 55954 · 13.3 mi
For-profit · 41 beds · Part of Accura Healthcare
★★★★★1Much below averageNorthgate Care Center
960 4th Street NW, Waukon, IA 52172 · 15.8 mi
For-profit · 50 beds · Part of Legacy Healthcare
- Special Focus candidate
★★★★★1Much below averageGood Samaritan - Waukon
21 East Main Street, Waukon, IA 52172 · 16.3 mi
Non-profit · 60 beds · Part of Good Samaritan Society
★★★★★2Below averageEvans Senior Living Community
1010 North Elm Street, Cresco, IA 52136 · 16.8 mi
Non-profit · 43 beds · Part of Edgewood Convalescent Home
- CMS high performer
★★★★★5Much above average
Frequently asked questions
What is The Highlands's rating?
The Highlands has 2 out of 5 stars on the CMS overall star rating. The average for Iowa nursing homes is 3.1 stars.
How many inspection citations did The Highlands receive?
Its most recent standard health inspection found 7 citations, compared with a Iowa average of 6.5. Every citation is listed on this page with its severity.
Does The Highlands accept Medicare and Medicaid?
CMS lists it as certified for: Medicare and Medicaid. Call the facility to confirm bed availability and whether it accepts your specific plan.
Who owns The Highlands?
It is non profit - corporation. The ownership section on this page lists the owners and managers reported to CMS.
Where is The Highlands and how do I contact it?
The Highlands is at 607 Highland Drive, Decorah, IA 52101. Phone: (563) 382-3603.
About this data
Ratings and measures come from the Centers for Medicare & Medicaid Services (CMS), Medicare Care Compare. They're based on state inspections, patient surveys and facility reports, and they describe the past. Facilities change, so visit in person and confirm details directly. About our data · Spotted an error? Let us know.