F

The Highlands

607 Highland Drive, Decorah, IA 52101
Score: 12 / 100

With a score of 12/100, The Highlands ranks in the bottom tier of Iowa nursing facilities, earning an F grade. CMS data highlights significant concerns that prospective residents and families should thoroughly evaluate.

Staffing levels are a potential concern at The Highlands, with 3.31 total nursing hours per resident per day — below the national average of 3.8 hours. Lower staffing can impact care quality and staff responsiveness.

Recent CMS inspections identified 38 deficiencies at The Highlands, including 2 classified as serious — among the most concerning citation levels. The most notable finding involved: honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights..

Score Breakdown

Overall CMS Rating 8 / 40 pts
1 ★ CMS rating
Health Inspections 5 / 25 pts
1 ★ inspection rating
Staffing 12 / 20 pts
3 ★ staffing rating
Quality Measures 12 / 15 pts
4 ★ quality measures

🏥 Staffing Details

Staff Type Hours/Resident/Day National Avg Comparison
Total Nursing 3.31 3.8 Below Average
Registered Nurses (RN) 0.53 0.7 Below Average
Licensed Practical Nurses (LPN) 0.58 0.7 Below Average
Certified Nursing Assistants (CNA) 2.19 2.4 Average
Weekend Total Nursing 2.78 3.8 Below Average
Weekend RN Hours 0.34 0.7 Below Average

🔍 Inspection & Deficiency History

38
Total Deficiencies
Sep 22, 2025
Most Recent Inspection
⚪ 3 Minor 🟠 33 Moderate 🔴 2 Serious
View recent deficiencies (5 shown)
  • Tag 0550 Severity E
    Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
    Sep 22, 2025 · Resident Rights Deficiencies
  • Tag 0923 Severity E
    Have enough outside ventilation via a window or mechanical ventilation, or both.
    Sep 22, 2025 · Environmental Deficiencies
  • Tag 0582 Severity D
    Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
    Jun 11, 2025 · Resident Rights Deficiencies
  • Tag 0943 Severity D
    Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
    Jun 11, 2025 · Freedom from Abuse, Neglect, and Exploitation Deficiencies
  • Tag 0684 Severity J
    Provide appropriate treatment and care according to orders, resident’s preferences and goals.
    Dec 8, 2024 · Quality of Life and Care Deficiencies

📊 Resident Outcome Measures

Based on CMS quality measure data. Lower percentages are better for most metrics.

Measure This Facility Nat'l Avg
Residents with pressure ulcers 4.3% 4.5% Average
Falls with major injury 0.9% 3.0% Better
On antipsychotic medication 22.1% 14.5% Worse
Urinary tract infections 0.0% 2.5% Better
ADL decline (daily activities) 25.9% 14.0% Worse
Excessive weight loss 6.2% 7.5% Better
New/worsened incontinence 24.9% 45.0% Better

⚠️ Penalties & Fines

3 penalties recorded by CMS

Total fines: $153,679

How This Grade Was Calculated

This facility's grade of F is based on a score of 12 out of 100, calculated from official CMS Nursing Home Compare data:

  • Overall CMS Rating: 1★ → 8 pts (max 40)
  • Health Inspection Rating: 1★ → 5 pts (max 25)
  • Staffing Rating: 3★ → 12 pts (max 20)
  • Quality Measures Rating: 4★ → 12 pts (max 15)
  • Penalty deductions: -15 pts
  • Fine deductions: -10 pts

Grades: A=85+, B=70–84, C=55–69, D=40–54, F=below 40

Facility Details

Ownership
Non profit - Corporation
Certified Beds
86
Provider Type
Medicare and Medicaid
Resident Council
Yes
Family Council
No
Sprinkler System
Yes
Last Inspection
Jun 11, 2025
Deficiencies (Cycle 1)
5

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