Iowa ›Decorah

The Highlands

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607 Highland Drive, Decorah, IA 52101 (opens Google Maps) · Winneshiek County · (563) 382-3603· 86 certified beds · avg 75 residents/day · certified since Jan 1, 1993 · Medicare and Medicaid certified

Certified for both programmes. Certification means the facility can bill Medicaid — it does not mean a Medicaid-funded bed is free right now, so ask directly. Who pays for nursing home care →

2/5
Health inspection rating (on-site)
inspected Jun 12, 2025
3
Serious findings on record
most recent Dec 9, 2024
$93,839
Fines, last 3 years
4.81
Nurse hours/resident/day (adjusted)

What health inspectors found (on-site government inspections — the most independent evidence available)

New to these records? How to read an inspection report →

Health inspection rating: ★★☆☆☆2/5 · CMS overall rating: 2/5 · how star ratings work →

The health inspection star above is graded on a curve within each state — a set share of each state's facilities gets each star level — so a facility can have few citations and still rate 2–3 stars if others in its state did even better. The overall rating combines that inspection score with staffing and quality measures from resident assessments and claims.

Most serious findings (actual harm or immediate jeopardy)

▲ Immediate jeopardy, isolated · Dec 9, 2024 · F-0684 · triggered by a complaint

The facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals.

Why it matters: Care that strays from doctor's orders or ignores the resident's wishes can lead to declining health and avoidable harm.

Severity (J): Immediate jeopardy to resident health or safety was cited. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Dec 10, 2024 (Deficient, Provider has date of correction)

▲ Actual harm, isolated · Jul 25, 2024 · F-0689

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Jul 26, 2024 (Deficient, Provider has date of correction)

▲ Actual harm, isolated · Feb 7, 2024 · F-0689 · triggered by a complaint

The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls.

Why it matters: This is one of the most common citations and directly relates to falls and injuries, which can be devastating for older adults.

Severity (G): Actual harm was cited, below immediate jeopardy. The scope was isolated: limited residents, staff, or locations were affected. Scope describes the extent of the deficiency, not whether it happened on previous inspections.

Corrected: Feb 8, 2024 (Deficient, Provider has date of correction)

Inspection findings in the public record

Showing the latest 3 of 28 inspection findings. Open the full record below to read every finding.

  1. D · Potential for more than minimal harm, isolated

    The facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint F-0689

  2. E · Potential for more than minimal harm, pattern

    The facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint F-0550

  3. E · Potential for more than minimal harm, pattern

    The facility did not have enough fresh-air ventilation, whether through windows, mechanical systems, or both. · from a complaint F-0923

View all 28 inspection findingsShow only the latest 3 findings

CMS publishes roughly the last three inspection cycles plus recent complaint investigations. Older surveys drop out of the record as new ones are completed — that window is CMS's, not ours. Within it, every citation CMS publishes for this facility is listed here: none excluded.

DateSeverityWhat the facility was cited for
Jun 18, 2026D · Potential for more than minimal harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Sep 23, 2025E · Potential for more than minimal harm, patternThe facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint · F-0550
Sep 23, 2025E · Potential for more than minimal harm, patternThe facility did not have enough fresh-air ventilation, whether through windows, mechanical systems, or both. · from a complaint · F-0923
Jun 12, 2025D · Potential for more than minimal harm, isolatedThe facility did not give residents proper notice about what Medicare or Medicaid covers, or about charges the resident might owe for services that aren't covered. · F-0582
Jun 12, 2025D · Potential for more than minimal harm, isolatedThe facility did not train its staff on dementia care and on recognizing and reporting abuse, neglect, and exploitation. · F-0943
Jun 12, 2025B · Potential for minimal harm, patternThe facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · F-0641
Dec 9, 2024▲ J · Immediate jeopardy, isolatedThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint · F-0684
Sep 25, 2024D · Potential for more than minimal harm, isolatedThe facility did not immediately notify the resident, their doctor, and a family member when something significant happened — such as an injury, a decline in health, or a room change. Families and doctors are entitled to know right away. · from a complaint · F-0580
Sep 25, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · from a complaint · F-0684
Jul 25, 2024▲ G · Actual harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · F-0689
Jul 25, 2024E · Potential for more than minimal harm, patternThe facility did not provide each resident with a nourishing, tasty, well-balanced diet that meets their daily nutritional and special dietary needs. · F-0800
Jul 25, 2024E · Potential for more than minimal harm, patternThe facility did not have enough support staff to safely and effectively run its food and nutrition service. · F-0802
Jul 25, 2024E · Potential for more than minimal harm, patternThe facility did not get its food from approved, safe sources, or did not store, prepare, and serve food according to professional food safety standards. · F-0812
Jul 25, 2024D · Potential for more than minimal harm, isolatedThe facility did not coordinate resident assessments with the state's pre-admission screening program for mental illness and intellectual disabilities, or failed to refer residents for the special services they need. · F-0644
Jul 25, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · F-0684
Jul 25, 2024C · Potential for minimal harm, widespreadThe facility did not employ enough qualified food and nutrition staff, including a qualified dietician, to properly run its food service. · F-0801
Feb 7, 2024▲ G · Actual harm, isolatedThe facility did not keep the environment free of accident hazards, or did not provide enough supervision to prevent accidents like falls. · from a complaint · F-0689
Feb 7, 2024D · Potential for more than minimal harm, isolatedThe facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · from a complaint · F-0550
Feb 7, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide a safe, clean, comfortable, and homelike environment, including safe support for residents' daily living needs. · from a complaint · F-0584
Feb 7, 2024D · Potential for more than minimal harm, isolatedThe facility did not accurately assess a resident's health and needs. Assessments are the foundation for all the care a resident receives. · from a complaint · F-0641
Feb 7, 2024D · Potential for more than minimal harm, isolatedThe facility provided care that did not meet professional standards of quality — the accepted standards that nurses and other clinicians are expected to follow. · from a complaint · F-0658
Feb 7, 2024D · Potential for more than minimal harm, isolatedThe facility did not provide the help residents need with basic daily activities — like bathing, dressing, eating, and using the bathroom — for residents who cannot do these things on their own. · from a complaint · F-0677
Sep 18, 2023E · Potential for more than minimal harm, patternThe facility did not have or follow an effective program to prevent and control infections — such as proper hand washing, cleaning, and isolation practices. This is the most commonly cited deficiency nationwide. · F-0880
Sep 18, 2023D · Potential for more than minimal harm, isolatedThe facility did not treat residents with dignity and respect, or did not honor their rights to make their own decisions and communicate freely. This is one of the most fundamental resident rights. · F-0550
Sep 18, 2023D · Potential for more than minimal harm, isolatedThe facility did not honor residents' rights to request, refuse, or stop treatment, to decline participation in medical research, or to make an advance directive — a written statement of their wishes for future medical care. · F-0578
Sep 18, 2023D · Potential for more than minimal harm, isolatedThe facility did not develop or follow a complete care plan for each resident — the written roadmap covering all of a resident's needs, with measurable goals and timelines. · F-0656
Sep 18, 2023D · Potential for more than minimal harm, isolatedThe facility did not provide treatment and care that follows the doctor's orders and matches the resident's own preferences and goals. · F-0684
Sep 18, 2023B · Potential for minimal harm, patternThe facility did not give residents proper notice about what Medicare or Medicaid covers, or about charges the resident might owe for services that aren't covered. · F-0582

Inspection trend by year

Citations from standard inspections decreased between the last two inspection cycles (7 → 3).

Citations by recorded inspection yearPublished citation counts, not a quality score · Source: CMS, 2026-08-01
All citationsSerious citations (G–L)
2023
All citations: 6
Serious citations (G–L): 0
2024
All citations: 16
Serious citations (G–L): 3
2025
All citations: 5
Serious citations (G–L): 0
2026
All citations: 1
Serious citations (G–L): 0

All bars start at zero. Exact values and supporting details remain below.

YearCitationsSerious (G–L)Worst severity that year
202360E
2024163J ▲
202550E
202610D

Counts reflect the current CMS public record (~3 inspection cycles plus complaint investigations); years with no surveys show no row. Inspection frequency varies, so compare severity as well as counts.

Fines and enforcement (last 3 years)

How to file a complaint about care →

2 fines totaling $93,839, plus 1 Medicare payment denial period.

Every penalty CMS publishes for this facility in the 3-year window is listed —none excluded. The count and the dollar total come from two different CMS datasets and agree for this facility. Penalties older than the window are dropped by CMS before publication, not by us.

DateTypeAmount / length
Dec 9, 2024Fine$50,211
Jul 25, 2024Fine$43,628
Jul 25, 2024Payment Denial10 days from Aug 21, 2024

Nurse staffing (from payroll records, adjusted for how much care residents need)

What these staffing numbers mean →

Nurse time, in contextAdjusted hours per resident per day · Source: CMS, 2026-08-01
This facilityIowa averageU.S. average
Total nurse staffing (hours per resident per day)
This facility: 4.81
Iowa average: 4.37
U.S. average: 3.95
Registered Nurse hours
This facility: 0.55
Iowa average: 0.85
U.S. average: 0.69
Weekend total nurse staffing
This facility: 4.42
Iowa average: 3.86
U.S. average: 3.50

All bars start at zero. Exact values and supporting details remain below.

MeasureThis facilityIowa avgU.S. avgWhere it stands
Total nurse staffing (hours per resident per day)4.814.373.95top 26% in Iowa; top 16% in the U.S.
Registered Nurse hours0.550.850.69bottom 16% in Iowa; bottom 45% in the U.S.
Weekend total nurse staffing4.423.863.50top 20% in Iowa; top 13% in the U.S.
Weekend RN hours (not acuity-adjusted)0.300.510.48bottom 16% in Iowa; bottom 32% in the U.S.
Total nursing staff turnover (%)53.344.045.8bottom 24% in Iowa; bottom 29% in the U.S.
RN turnover (%)44.442.142.9bottom 44% in Iowa; bottom 45% in the U.S.

Hours are per resident per day for the most recent quarter of payroll data in this CMS release (2026-08-01) — the same quarter for every facility — case-mix adjusted by CMS so facilities caring for sicker residents can be compared fairly (same basis as the CMS staffing star). "Top X%" means better than most facilities: more staffing hours, or lower turnover. Raw (unadjusted) reported hours: total 3.90, RN 0.44, weekend 3.59.Comparing with Medicare Care Compare? Care Compare shows the raw figure (3.90 here, displayed there as hours and minutes), not the adjusted one above. Both are correct; they answer different questions. Staffing rating: 4/5.

Quality measures: assessments & claims

Note: CMS combines facility-reported resident assessments (MDS) with claims-based measures. These are different sources from on-site inspection findings. Read the measures alongside inspection and staffing records; a high QM rating does not establish that a home is safe.

Quality measures rating: 3/5 · long-stay residents: 2/5 · short-stay residents: 4/5

Costs & payment

Price evidence · separate from quality

No verified facility-specific private-pay price is available in our data for The Highlands. CMS inspection and staffing records do not tell us what this home will charge you.

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Who owns this facility

How to read ownership records →

Ownership records as published by CMS on 2026-08-01. CMS records when an owner joined but not when they left. Listed here and no longer involved? Tell us →

Non profit - Corporation

Owner / managerTypeRoleStakeSince
Bjelland, SusanIndividualW-2 Managing EmployeeNOT APPLICABLE02/22/2010
Continuum Health Care Services LLCOrganizationOperational/Managerial ControlNOT APPLICABLE01/17/2013
Elsbernd, NancyIndividualW-2 Managing EmployeeNOT APPLICABLE02/22/2010
Schmidt, JeffreyIndividualCorporate DirectorNOT APPLICABLE05/20/2013

All 4 owning or managing parties CMS has on file are shown — none excluded.

Questions to ask on your visit

Full visit checklist →

Print visit checklist

Generated from this facility's actual citation record — bring them to a tour and ask the administrator directly.

  • "How do you make sure each resident's care follows the doctor's orders, and what changed after this citation?"
  • "What is your falls rate, and what specific steps do you take to prevent falls and supervise residents at risk?"
  • "Can you give me examples of how your staff protect residents' dignity in everyday care, like bathing and dressing?"
  • "How is fresh air circulated through the building, and how is the ventilation system maintained?"
  • "Before any service that isn't covered by Medicare or Medicaid, how will you notify us and get our agreement?"
  • "What training do all staff get on dementia care and on spotting and reporting abuse?"
  • "Who completes resident assessments here, and how do you check them for accuracy?"
  • "If my family member falls or their condition changes, exactly when and how will I be notified?"

Also worth asking anywhere

  • "What is your current ratio of nursing staff to residents on day, evening, and weekend shifts?"
  • "Can I see the plan of correction for the findings in your most recent state inspection?"
  • "CMS reports 53% total nursing staff turnover here — who on the care team has been with you longest?"
  • "Can I visit again unannounced, at a mealtime or on a weekend?"

Nearby facilities (within 20 miles)

FacilityDistanceCityOverallInspectionFlags
Wellington Place2.9 miDecorah, IA★★★☆☆4/5
Ossian Care Center12.3 miOssian, IA★★☆☆☆2/5
Green Lea Senior Living13.3 miMabel, MN★☆☆☆☆1/5
Northgate Care Center15.8 miWaukon, IA★☆☆☆☆1/5SFF
Good Samaritan - Waukon16.3 miWaukon, IA★★☆☆☆2/5
Evans Senior Living Community16.8 miCresco, IA★★★★★5/5
Tweeten Lutheran Health Care Center18.2 miSpring Grove, MN★☆☆☆☆1/5SFF
Gundersen Harmony Care Center19.0 miHarmony, MN★★★★★5/5

Compare this facility with the 3 closest →

All facilities in Decorah →

Facility data as of CMS processing date 2026-08-01. CCN 165178.

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