The Highlands
607 Highland Drive · Decorah, IA · 52101 · 5633823603
86 certified beds Non profit - Corporation Part of a CCRC
Why this verdict
- Federal penalties on record: $93,839 in fines in the last 24 months.
- Inspection results have improved across recent cycles.
Red flags
2 immediate-jeopardy citations in prior inspection cycles
Serious past findings — check whether the underlying problems were fixed and stayed fixed.
$93,839 in federal fines in the last 24 months
2 fines — CMS fines are reserved for verified, serious non-compliance.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 2 of 5 Inspections: 2 of 5 Staffing: 3 of 5 Quality measures: 4 of 5
| Total nurse hours / resident-day | 3.57 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.54 | 0.55–0.75 |
| Weekend hours / resident-day | 3.14 | ≈ weekday level |
| Nursing turnover / year | 55% | median 45% |
| Fines (3-yr window) | 3 · $153,679 |
Inspection citations (34 in the current record)
-
Potential for harm · E September 23, 2025 · found via complaint
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected September 24, 2025 · Resident Rights
-
Potential for harm · E September 23, 2025 · found via complaint
Have enough outside ventilation via a window or mechanical ventilation, or both.
Corrected September 24, 2025 · Environmental
-
Potential for harm · D June 12, 2025
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Corrected June 26, 2025 · Resident Rights
-
Potential for harm · D June 12, 2025
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Corrected June 26, 2025 · Freedom from Abuse, Neglect, and Exploitation
-
No harm found · B June 12, 2025
Ensure each resident receives an accurate assessment.
Corrected June 26, 2025 · Resident Assessment and Care Planning
-
Immediate jeopardy · J December 9, 2024 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected December 10, 2024 · Quality of Life and Care
-
Potential for harm · D September 25, 2024 · found via complaint
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected September 26, 2024 · Resident Rights
-
Potential for harm · D September 25, 2024 · found via complaint
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected September 26, 2024 · Quality of Life and Care
-
Actual harm · G July 25, 2024
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected July 26, 2024 · Quality of Life and Care
-
Potential for harm · D July 25, 2024
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected July 26, 2024 · Resident Assessment and Care Planning
-
Potential for harm · D July 25, 2024
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected July 26, 2024 · Quality of Life and Care
-
Potential for harm · E July 25, 2024
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
Corrected July 26, 2024 · Nutrition and Dietary
-
Potential for harm · E July 25, 2024
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Corrected July 26, 2024 · Nutrition and Dietary
-
Potential for harm · E July 25, 2024
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Corrected July 26, 2024 · Nutrition and Dietary
-
No harm found · C July 25, 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.
Corrected July 26, 2024 · Nutrition and Dietary
-
Actual harm · G February 7, 2024 · found via complaint
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Corrected February 8, 2024 · Quality of Life and Care
-
Potential for harm · D February 7, 2024 · found via complaint
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected February 8, 2024 · Resident Rights
-
Potential for harm · D February 7, 2024 · found via 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.
Corrected February 8, 2024 · Resident Rights
-
Potential for harm · D February 7, 2024 · found via complaint
Ensure each resident receives an accurate assessment.
Corrected February 8, 2024 · Resident Assessment and Care Planning
-
Potential for harm · D February 7, 2024 · found via complaint
Ensure services provided by the nursing facility meet professional standards of quality.
Corrected February 8, 2024 · Resident Assessment and Care Planning
-
Potential for harm · D February 7, 2024 · found via complaint
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected February 8, 2024 · Quality of Life and Care
-
Potential for harm · D September 18, 2023
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Corrected September 29, 2023 · Resident Rights
-
Potential for harm · D September 18, 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.
Corrected September 29, 2023 · Resident Rights
-
Potential for harm · D September 18, 2023
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Corrected September 29, 2023 · Resident Assessment and Care Planning
-
Potential for harm · D September 18, 2023
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected September 29, 2023 · Quality of Life and Care
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| December 9, 2024 | Fine | $50,211 |
| July 25, 2024 | Fine | $43,628 |
| July 25, 2024 | Payment Denial | 10 days |
| July 11, 2023 | Fine | $59,840 |
Family & resident reviews — a separate signal, never mixed into the score
No approved reviews yet. If your family has experience with this facility, yours could be the review that helps the next family decide.
Sign in to share your family's experience — reviews are moderated and never affect the Safety Score.
Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 165178 · certified since January 1, 1993. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.