PlainNursing
CMS Nursing Home Compare · March 2026

Hillcrest Health Care Center

Hillcrest Health Care Center is a for profit - limited liability company facility in Hawarden, IA with 64 certified beds and a 1-star overall CMS rating. The inspection file holds 50 deficiency records. Total penalties: $25K.

2121 Avenue L, Hawarden, IA 51023

Phone: 7125511074

Overall CMS Rating

1/5

vs 3.0 national avg

The verdict

Hillcrest Health Care Center holds a 1-star CMS overall rating — below the 3.0-star national average, with nurse staffing below the national norm. 2 inspection findings reached the actual-harm or immediate-jeopardy level.

1 / 5
CMS overall rating (nat'l avg 3.0)
3.15
Nursing hrs/resident-day (nat'l 3.89)
50
Inspection findings on file · 2 serious
$25K
Federal penalties (2)

CMS combines health inspections, nurse-staffing levels, and clinical quality measures into the overall star rating. Read the components below — they often tell a sharper story than the headline.

Health Inspection

1/5

Staffing

2/5

Quality Measures

3/5

Long-Stay Quality

3/5

Facility Information

Provider Number
165245
Ownership
For profit - Limited Liability company
Provider Type
Medicare and Medicaid
Beds
64
Residents
41
In Hospital
No
County
Sioux
Last Inspection
Mar 11, 2025

Staffing Data

RN Hours
0.56 (nat'l avg: 0.68)
LPN Hours
0.75
CNA Hours
1.85
Total Nursing Hours
3.15 (nat'l avg: 3.89)
PT Hours
0.12
Nursing Turnover
56.1%

What the CMS Record Reveals About Hillcrest Health Care Center

Hillcrest Health Care Center operates 64 certified beds in Hawarden, IA with approximately 41 residents currently in care, and carries a CMS overall rating of 1 out of 5 stars. The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results (1★), staffing levels (2★), and quality measures (3★). Because CMS caps the overall score at the health-inspection tier and then adjusts up or down based on staffing and quality, the sub-scores often tell a sharper story than the headline star count alone — a 3-star facility with weak inspection history reads differently from one held back by thin staffing.

The inspection file contains 50 deficiency records from recent surveys, of which 2 reached the actual-harm or immediate-jeopardy threshold on the CMS scope-and-severity grid. On the enforcement side, CMS has assessed 2 penalties totaling $25K against this provider, a tangible indicator that regulators moved beyond citation into financial consequence. Staffing is reported at 3.15 total nursing hours per resident day (national average 3.89), with RN coverage at 0.56 per resident day — the single staffing metric most strongly tied to resident outcomes in peer-reviewed literature.

Classified as "For profit - Limited Liability company" ownership and operating as a "Medicare and Medicaid" provider, Hillcrest Health Care Center falls into a category where comparative context matters. National research consistently shows that ownership structure, staffing hours, and turnover are the three operational levers that correlate most strongly with resident outcomes — ratings and fines are lagging indicators of those upstream choices. Reported nursing turnover at this facility is 56.1%, above the level where continuity of care typically begins to suffer. For families evaluating this facility, the CMS record should be read alongside a site visit, direct conversation with current residents and their families, and review of the state health department's most recent inspection report — the star rating is a starting point, not a verdict. All data on this page is sourced from CMS Provider Data and the Nursing Home Compare program; always verify details directly with the facility or your state survey agency before making placement decisions.

Deficiency History (50 most recent)

D — Isolated - Minimal harm Oct 8, 2025 Tag: 0657

Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Oct 13, 2025

D — Isolated - Minimal harm Mar 11, 2025 Tag: 0689

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Category: Quality of Life and Care Deficiencies

Corrected: Mar 28, 2025

D — Isolated - Minimal harm Mar 11, 2025 Tag: 0684

Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Category: Quality of Life and Care Deficiencies

Corrected: Mar 28, 2025

E — Pattern - Minimal harm Mar 11, 2025 Tag: 0677

Provide care and assistance to perform activities of daily living for any resident who is unable.

Category: Quality of Life and Care Deficiencies

Corrected: Mar 28, 2025

D — Isolated - Minimal harm Mar 11, 2025 Tag: 0880

Provide and implement an infection prevention and control program.

Category: Infection Control Deficiencies

Corrected: Mar 28, 2025

E — Pattern - Minimal harm Mar 11, 2025 Tag: 0801

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.

Category: Nutrition and Dietary Deficiencies

Corrected: Mar 28, 2025

D — Isolated - Minimal harm Mar 11, 2025 Tag: 0758

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Category: Pharmacy Service Deficiencies

Corrected: Mar 28, 2025

D — Isolated - Minimal harm Mar 11, 2025 Tag: 0656

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Mar 28, 2025

E — Pattern - Minimal harm Mar 11, 2025 Tag: 0625

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

Category: Resident Rights Deficiencies

Corrected: Mar 28, 2025

D — Isolated - Minimal harm Mar 11, 2025 Tag: 0584

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.

Category: Resident Rights Deficiencies

Corrected: Mar 28, 2025

D — Isolated - Minimal harm Mar 11, 2025 Tag: 0582

Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Category: Resident Rights Deficiencies

Corrected: Mar 28, 2025

E — Pattern - Minimal harm Jul 28, 2024 Tag: 0880

Provide and implement an infection prevention and control program.

Category: Infection Control Deficiencies

Corrected: Aug 13, 2024

E — Pattern - Minimal harm Jul 28, 2024 Tag: 0809

Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.

Category: Nutrition and Dietary Deficiencies

Corrected: Aug 13, 2024

D — Isolated - Minimal harm Jul 28, 2024 Tag: 0806

Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.

Category: Nutrition and Dietary Deficiencies

Corrected: Aug 13, 2024

J — Isolated - Jeopardy Jul 28, 2024 Tag: 0805

Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

Category: Nutrition and Dietary Deficiencies

Corrected: Aug 7, 2024

E — Pattern - Minimal harm Jul 28, 2024 Tag: 0804

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Category: Nutrition and Dietary Deficiencies

Corrected: Aug 13, 2024

E — Pattern - Minimal harm Jul 28, 2024 Tag: 0803

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

Category: Nutrition and Dietary Deficiencies

Corrected: Aug 13, 2024

D — Isolated - Minimal harm Jul 28, 2024 Tag: 0725

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Category: Nursing and Physician Services Deficiencies

Corrected: Aug 13, 2024

D — Isolated - Minimal harm Jul 28, 2024 Tag: 0690

Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.

Category: Quality of Life and Care Deficiencies

Corrected: Aug 13, 2024

D — Isolated - Minimal harm Jul 28, 2024 Tag: 0689

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Category: Quality of Life and Care Deficiencies

Corrected: Aug 13, 2024

D — Isolated - Minimal harm Jul 28, 2024 Tag: 0558

Reasonably accommodate the needs and preferences of each resident.

Category: Resident Rights Deficiencies

Corrected: Aug 13, 2024

D — Isolated - Minimal harm Jul 28, 2024 Tag: 0550

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Category: Resident Rights Deficiencies

Corrected: Aug 13, 2024

D — Isolated - Minimal harm Jan 31, 2024 Tag: 0758

Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.

Category: Pharmacy Service Deficiencies

Corrected: Feb 14, 2024

D — Isolated - Minimal harm Jan 31, 2024 Tag: 0658

Ensure services provided by the nursing facility meet professional standards of quality.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Feb 14, 2024

D — Isolated - Minimal harm Jan 31, 2024 Tag: 0883

Develop and implement policies and procedures for flu and pneumonia vaccinations.

Category: Infection Control Deficiencies

Corrected: Feb 14, 2024

F — Widespread - Minimal harm Jan 31, 2024 Tag: 0880

Provide and implement an infection prevention and control program.

Category: Infection Control Deficiencies

Corrected: Feb 14, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0868

Have the Quality Assessment and Assurance group have the required members and meet at least quarterly

Category: Administration Deficiencies

Corrected: Feb 14, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0865

Have a plan that describes the process for conducting QAPI and QAA activities.

Category: Administration Deficiencies

Corrected: Feb 14, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0812

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Category: Nutrition and Dietary Deficiencies

Corrected: Feb 14, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0809

Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.

Category: Nutrition and Dietary Deficiencies

Corrected: Feb 14, 2024

K — Pattern - Jeopardy Jan 31, 2024 Tag: 0805

Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.

Category: Nutrition and Dietary Deficiencies

Corrected: Feb 8, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0804

Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.

Category: Nutrition and Dietary Deficiencies

Corrected: Feb 14, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0803

Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.

Category: Nutrition and Dietary Deficiencies

Corrected: Feb 14, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0802

Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.

Category: Nutrition and Dietary Deficiencies

Corrected: Feb 14, 2024

D — Isolated - Minimal harm Jan 31, 2024 Tag: 0760

Ensure that residents are free from significant medication errors.

Category: Pharmacy Service Deficiencies

Corrected: Feb 14, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0726

Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.

Category: Nursing and Physician Services Deficiencies

Corrected: Feb 14, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0725

Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

Category: Nursing and Physician Services Deficiencies

Corrected: Feb 14, 2024

D — Isolated - Minimal harm Jan 31, 2024 Tag: 0656

Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Feb 14, 2024

D — Isolated - Minimal harm Jan 31, 2024 Tag: 0644

Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Feb 14, 2024

D — Isolated - Minimal harm Jan 31, 2024 Tag: 0641

Ensure each resident receives an accurate assessment.

Category: Resident Assessment and Care Planning Deficiencies

Corrected: Feb 14, 2024

D — Isolated - Minimal harm Jan 31, 2024 Tag: 0625

Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.

Category: Resident Rights Deficiencies

Corrected: Feb 14, 2024

D — Isolated - Minimal harm Jan 31, 2024 Tag: 0623

Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.

Category: Resident Rights Deficiencies

Corrected: Feb 14, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0607

Develop and implement policies and procedures to prevent abuse, neglect, and theft.

Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies

Corrected: Feb 14, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0585

Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.

Category: Resident Rights Deficiencies

Corrected: Feb 14, 2024

D — Isolated - Minimal harm Jan 31, 2024 Tag: 0584

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.

Category: Resident Rights Deficiencies

Corrected: Feb 14, 2024

E — Pattern - Minimal harm Jan 31, 2024 Tag: 0550

Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Category: Resident Rights Deficiencies

Corrected: Feb 14, 2024

D — Isolated - Minimal harm Aug 17, 2023 Tag: 0689

Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Category: Quality of Life and Care Deficiencies

Corrected: Jun 14, 2023

D — Isolated - Minimal harm Nov 10, 2022 Tag: 0883

Develop and implement policies and procedures for flu and pneumonia vaccinations.

Category: Infection Control Deficiencies

Corrected: Dec 10, 2022

D — Isolated - Minimal harm Nov 10, 2022 Tag: 0880

Provide and implement an infection prevention and control program.

Category: Infection Control Deficiencies

Corrected: Dec 10, 2022

E — Pattern - Minimal harm Nov 10, 2022 Tag: 0812

Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Category: Nutrition and Dietary Deficiencies

Corrected: Dec 10, 2022

Quality Measures

Measure Type Score Used in Rating
Percentage of long-stay residents whose need for help with daily activities has increased Long Stay 26.8% Yes
Percentage of long-stay residents who lose too much weight Long Stay 6.8% No
Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay 0.0% Yes
Percentage of long-stay residents with a urinary tract infection Long Stay 1.2% Yes
Percentage of long-stay residents who have depressive symptoms Long Stay 22.9% No
Percentage of long-stay residents who were physically restrained Long Stay 0.0% No
Percentage of long-stay residents experiencing one or more falls with major injury Long Stay 8.3% Yes
Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine Long Stay 86.3% No
Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine Short Stay 48.2% No
Percentage of short-stay residents who newly received an antipsychotic medication Short Stay 0.0% Yes
Percentage of long-stay residents whose ability to walk independently worsened Long Stay 21.0% Yes
Percentage of long-stay residents who received an antianxiety or hypnotic medication Long Stay 20.0% No
Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine Long Stay 95.9% No
Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine Short Stay 43.5% No
Percentage of long-stay residents with pressure ulcers Long Stay 4.0% Yes
Percentage of long-stay residents with new or worsened bowel or bladder incontinence Long Stay 31.6% No
Percentage of long-stay residents who received an antipsychotic medication Long Stay 17.9% Yes

Penalty History 2 penalties totaling $25K

Date Type Amount
Jul 28, 2024 Fine $9K
Jan 31, 2024 Fine $17K

Frequently Asked Questions

What is the overall CMS rating for Hillcrest Health Care Center?
Hillcrest Health Care Center has an overall CMS rating of 1 out of 5 stars. This rating combines health inspection results (1★), staffing levels (2★), and quality measures (3★).
What are the staffing levels at Hillcrest Health Care Center?
Hillcrest Health Care Center reports 3.15 total nursing hours per resident day (national average: 3.89). RN hours are 0.56 per resident day (national average: 0.68). Nursing staff turnover is 56.1%.
How many beds does Hillcrest Health Care Center have?
Hillcrest Health Care Center has 64 certified beds with approximately 41 residents. The facility is located at 2121 Avenue L, Hawarden, IA 51023.
Does Hillcrest Health Care Center have any deficiencies on record?
Yes, Hillcrest Health Care Center has 50 deficiencies on record from recent inspections. Of these, 2 are classified as causing actual harm or jeopardy.
Has Hillcrest Health Care Center received any fines or penalties?
Yes, Hillcrest Health Care Center has received 2 penalties totaling $25K.
Who owns Hillcrest Health Care Center?
Hillcrest Health Care Center is classified as "For profit - Limited Liability company" ownership. The facility type is "Medicare and Medicaid".
When was Hillcrest Health Care Center last inspected?
The most recent health inspection for Hillcrest Health Care Center was on Mar 11, 2025. The facility received a health inspection rating of 1 out of 5 stars.
What quality measures are tracked for Hillcrest Health Care Center?
Hillcrest Health Care Center is evaluated on 17 quality measures, of which 8 are used in the CMS star rating calculation. These include measures for both long-stay and short-stay residents covering areas like infections, falls, pressure ulcers, and medication use.

Data Sources

Data source: CMS Nursing Home Compare. Ratings, staffing, deficiency, quality measure, and penalty data are from CMS Provider Data. For informational purposes only. Always verify information directly with the facility or your state health department.

Source: CMS Nursing Home Compare provider data (data.cms.gov). See our methodology for how this page is compiled. Ratings, staffing, health-inspection deficiency, and Civil Money Penalty records are published by the Centers for Medicare & Medicaid Services under a public-domain (CC0) license.