Twilight Acres
600 West 6th Street · Wall Lake, IA · 51466 · 7126642488
39 certified beds Non profit - Corporation
Why this verdict
- Inspection results are getting worse cycle over cycle, not better.
- Staffing hours comfortably above national benchmarks.
- No federal fines or payment denials in CMS’s 3-year window.
The complete Safety Report — $19
Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
No red flags in the current CMS record. Genuinely good news — pair it with an in-person tour before deciding.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 5 of 5 Inspections: 4 of 5 Staffing: 5 of 5 Quality measures: 4 of 5
| Total nurse hours / resident-day | 4.23 | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | 0.98 | 0.55–0.75 |
| Weekend hours / resident-day | 3.80 | ≈ weekday level |
| Nursing turnover / year | 36% | median 45% |
| Fines (3-yr window) | none |
Inspection citations (7 in the current record)
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Potential for harm · D March 5, 2026 · found via complaint
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Corrected March 18, 2026 · Quality of Life and Care
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Potential for harm · E December 18, 2025
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 January 17, 2026 · Resident Rights
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Potential for harm · D December 18, 2025
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Corrected January 17, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · E December 18, 2025
Develop and implement policies and procedures for flu and pneumonia vaccinations.
Corrected January 17, 2026 · Infection Control
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Potential for harm · D December 12, 2024
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected December 13, 2024 · Quality of Life and Care
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Potential for harm · D October 19, 2023
Assess the resident when there is a significant change in condition
Corrected October 20, 2023 · Resident Assessment and Care Planning
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Potential for harm · D October 19, 2023
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Corrected October 20, 2023 · Administration
Family & resident reviews — a separate signal, never mixed into the score
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 165488 · certified since September 1, 2003. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.