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.

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Red flags

No red flags in the current CMS record. Genuinely good news — pair it with an in-person tour before deciding.

Score breakdown

Inspection record 30% of score 74
Serious harm & abuse 20% 100
Staffing 20% 86
Federal penalties 15% 100
Trend 10% 18
Context 5% 100

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-day4.233.48 min · 4.1 strong
RN hours / resident-day0.980.55–0.75
Weekend hours / resident-day3.80≈ weekday level
Nursing turnover / year36%median 45%
Fines (3-yr window)none

Inspection citations (7 in the current record)

  • 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

  • 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

  • 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

  • Potential for harm · E December 18, 2025

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

    Corrected January 17, 2026 · Infection Control

  • 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

  • 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

  • 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.