The Highlands
607 Highland Drive, Decorah, IA 52101
The Highlands, a 86-bed non profit - corporation nursing facility in Decorah, IA, holds a 2-star CMS overall rating - below the 3.0-star national average, ranking #268 of 385 rated homes in IA on CMS overall stars (with health+staffing+quality tie-breaks), with nurse staffing above the national norm. 3 inspection findings reached the actual-harm or immediate-jeopardy level.
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.
Phone: 5633823603
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- 2 / 5
- Below average · CMS overall · nat'l 3.0
- #268 of 385
- In-state rank among rated IA homes
- 3.90
- About average · nurse hrs/day · nat'l 3.86
- 28
- Inspection findings · 3 serious
If a nursing-home resident is in immediate danger, call 911.
For elder abuse or neglect concerns, contact your state's Adult Protective Services (search "APS" + your state) or call the Eldercare Locator at 1-800-677-1116. For facility advocacy, reach your Long-Term Care Ombudsman. CMS ratings and inspection data below are a research screen, not an emergency channel.
The verdict
The Highlands, a 86-bed non profit - corporation nursing facility in Decorah, IA, holds a 2-star CMS overall rating - below the 3.0-star national average, ranking #268 of 385 rated homes in IA on CMS overall stars (with health+staffing+quality tie-breaks), with nurse staffing above the national norm. 3 inspection findings reached the actual-harm or immediate-jeopardy level.
- 2 / 5
- CMS overall · national 3.0
- #268 of 385
- In-state rank among rated IA homes
- 3.90
- Nurse hrs/resident-day · national 3.86
- 28
- Inspection findings · 3 serious
CMS force-curves overall stars within each state; read health, staffing, and quality sub-ratings alongside the headline.
In-state ownership mix · peer inventory
How 387 IA nursing homes split by ownership sector
This facility is recorded as Non profit - Corporation. Sector buckets collapse CMS ownership_type into For-profit, Nonprofit, and Government, orthogonal to the RN/LPN/CNA hour bar below.
Health Inspection
Staffing
Quality Measures
Long-Stay Quality
Facility Information
- Provider Number
- 165178
- Ownership
- Non profit - Corporation
- Provider Type
- Medicare and Medicaid
- Beds
- 86
- Residents
- 75
- In Hospital
- No
- County
- Winneshiek
- Last Inspection
- Jun 12, 2025
Staffing Data
How the 3.90 total nursing hours per resident-day are staffed:
- RN Hours
- 0.44 (nat'l avg: 0.69)
- LPN Hours
- 0.66
- CNA Hours
- 2.79
- Total Nursing Hours
- 3.90 (nat'l avg: 3.86)
- PT Hours
- 0.05
- Nursing Turnover
- 53.3%
- RN Turnover
- 44.4%
What the CMS Record Reveals About The Highlands
According to CMS Nursing Home Compare, The Highlands ranks #268 of 385 rated nursing homes in IA on overall stars (tie-broken by health+staffing+quality, then fewer fines). The Highlands operates 86 certified beds in Decorah, IA with approximately 75 residents currently in care, and carries a CMS overall rating of 2 out of 5 stars (health inspection 2★ · staffing 4★ · quality 3★).
The inspection file contains 28 deficiency records from recent surveys, of which 3 reached the actual-harm or immediate-jeopardy threshold on the CMS scope-and-severity grid. This provider has been fined 2 times by CMS, for a combined $94K. Reported nurse staffing runs 3.90 total hours per resident day (national average 3.86); RN hours specifically are 0.44 per resident day.
Classified as "Non profit - Corporation" ownership and operating as a "Medicare and Medicaid" provider, The Highlands falls into a category where comparative context matters. Reported nursing staff turnover at this facility is 53.3% (CMS payroll-based measure).
Why sub-scores and the CMS methodology matter
The overall score is a composite of three weighted sub-ratings published by the Centers for Medicare & Medicaid Services: health inspection results, staffing levels, and quality measures. 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.
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. The staffing metric in particular is the one most strongly tied to resident outcomes in peer-reviewed literature.
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 the same record on Medicare.gov Care Compare and with the facility or your state survey agency before making placement decisions.
Deficiency History (28 most recent)
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: Jul 1, 2026
Have enough outside ventilation via a window or mechanical ventilation, or both.
Category: Environmental Deficiencies
Corrected: Sep 24, 2025
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Category: Resident Rights Deficiencies
Corrected: Sep 24, 2025
Ensure each resident receives an accurate assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Jun 26, 2025
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Category: Freedom from Abuse, Neglect, and Exploitation Deficiencies
Corrected: Jun 26, 2025
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Category: Resident Rights Deficiencies
Corrected: Jun 26, 2025
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Category: Quality of Life and Care Deficiencies
Corrected: Dec 10, 2024
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Category: Quality of Life and Care Deficiencies
Corrected: Sep 26, 2024
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Category: Resident Rights Deficiencies
Corrected: Sep 26, 2024
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: Jul 26, 2024
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Category: Quality of Life and Care Deficiencies
Corrected: Jul 26, 2024
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: Jul 26, 2024
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: Jul 26, 2024
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Category: Nutrition and Dietary Deficiencies
Corrected: Jul 26, 2024
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
Category: Nutrition and Dietary Deficiencies
Corrected: Jul 26, 2024
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: Jul 26, 2024
Provide care and assistance to perform activities of daily living for any resident who is unable.
Category: Quality of Life and Care Deficiencies
Corrected: Feb 8, 2024
Ensure services provided by the nursing facility meet professional standards of quality.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Feb 8, 2024
Ensure each resident receives an accurate assessment.
Category: Resident Assessment and Care Planning Deficiencies
Corrected: Feb 8, 2024
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 8, 2024
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 8, 2024
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: Feb 8, 2024
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Category: Resident Rights Deficiencies
Corrected: Sep 29, 2023
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Category: Quality of Life and Care Deficiencies
Corrected: Sep 29, 2023
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: Sep 29, 2023
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.
Category: Resident Rights Deficiencies
Corrected: Sep 29, 2023
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Category: Resident Rights Deficiencies
Corrected: Sep 29, 2023
Provide and implement an infection prevention and control program.
Category: Infection Control Deficiencies
Corrected: Sep 29, 2023
Quality Measures
| Measure | Type | Score | Used in Rating |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 27.6% | Yes |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 1.2% | Yes |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 0.0% | Yes |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 2.1% | Yes |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 24.0% | Yes |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 4.1% | Yes |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 25.6% | Yes |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 0.0% | Yes |
| Percentage of long-stay residents who lose too much weight | Long Stay | 4.0% | No |
| Percentage of long-stay residents who have depressive symptoms | Long Stay | 0.9% | No |
| Percentage of long-stay residents who were physically restrained | Long Stay | 0.0% | No |
| Percentage of long-stay residents assessed and appropriately given the pneumococcal vaccine | Long Stay | 89.5% | No |
| Percentage of long-stay residents who received an antianxiety or hypnotic medication | Long Stay | 17.9% | No |
| Percentage of long-stay residents assessed and appropriately given the seasonal influenza vaccine | Long Stay | 95.2% | No |
| Percentage of long-stay residents with new or worsened bowel or bladder incontinence | Long Stay | 26.0% | No |
| Percentage of short-stay residents assessed and appropriately given the pneumococcal vaccine | Short Stay | 46.8% | No |
| Percentage of short-stay residents who were assessed and appropriately given the seasonal influenza vaccine | Short Stay | N/A | No |
Penalty History 2 penalties totaling $94K
| Date | Type | Amount |
|---|---|---|
| Dec 9, 2024 | Fine | $50K |
| Jul 25, 2024 | Fine | $44K |
| Jul 25, 2024 | Payment Denial | - |
Nationwide facilities with similar scale or staffing
Two data-derived peer sets for The Highlands, both outside IA so the neighborhoods are not the same-state geography list below.
Similar bed count
Nearest CMS certified bed counts outside IA (86 beds here).
Similar staffing hours
Nearest CMS adjusted total nurse hours per resident day outside IA (4.81 here).
Nearby Nursing Homes in IA
386 other nursing homes are on record in IA; 6 are shown here.
Accura Healthcare of Ames, LLC
Ames, IA
Accura Healthcare of Aurelia, LLC
Aurelia, IA
Accura Healthcare of Bancroft
Bancroft, IA
Accura Healthcare of Carlisle
Carlisle, IA
Accura Healthcare of Carroll
Carroll, IA
Accura Healthcare of Cascade LLC
Cascade, IA
Understanding Nursing Home Data
What the CMS records show for The Highlands
The health, staffing, and quality sub-ratings above often diverge from the CMS overall headline. Use those components and the inspection findings to read the full file, not the overall star alone.
- The IA registry aggregates state averages and the highest-rated homes in this cohort. View IA registry
- Peer homes near 86 beds show how CMS stars vary at a similar scale in IA. Compare a similar-size peer
- CMS publishes separate fields for inspections, nurse staffing hours, and quality measures; the guide explains how each star is computed. How CMS ratings work
CMS refreshes Nursing Home Compare quarterly (current extract: August 2026). PlainNursing describes published records; it does not establish suitability, availability, admissions, or individual outcomes.
Frequently Asked Questions
What is the overall CMS rating for The Highlands?
Where does The Highlands rank among nursing homes in IA?
What are the staffing levels at The Highlands?
How many beds does The Highlands have?
Does The Highlands have any deficiencies on record?
Has The Highlands received any fines or penalties?
Who owns The Highlands?
When was The Highlands last inspected?
What quality measures are tracked for The Highlands?
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. Verify the same CCN on Medicare.gov Care Compare and with the facility or your state health department.
Read our methodology - how this data is sourced, computed, and verified.
