Iowa › Sioux County › Hawarden
Hillcrest Health Care Center
2121 Avenue L, Hawarden, IA 51023
CMS abuse icon
Overall★★★★★
Health inspection★★★★★
Staffing★★★★★
Quality measures★★★★★
Ratings are based on the most recent data available; a facility's ratings may have changed since the last update. The health inspection rating is based on the three most recent standard surveys and complaint investigations. CMS processed this record on 1 Aug 2026. View the Care Compare record.
Certified for 64 beds, Hillcrest Health Care Center serves Hawarden in Sioux County, Iowa and has taken Medicare and Medicaid residents since 1994.
CMS gives it 1 of 5 stars overall, below the Iowa median of 3; the health inspection rating is 1, staffing 2 and quality measures 3.
Inspectors recorded 73 health deficiencies across the three most recent survey cycles (27, 10, 36 by cycle, most recent first), 3 of them at the actual-harm or immediate-jeopardy level. That is 114.1 per 100 beds, more than the state median of 27.5.
CMS lists 4 penalties in the period covered: fines totalling $130K and 1 payment denial.
Reported nurse staffing is 3.1 hours per resident per day (0.6 RN), close to the Iowa median of 3.7; nursing staff turnover is 75.0%.
CMS flags that the facility carries the CMS abuse icon.
73health deficiencies, 3 survey cycles3 at actual harm or worse
$130Kfines listed by CMS4 penalties in period
3.1nurse hours per resident per daystate median 3.7
84%occupancy (residents ÷ beds)54 residents a day
Compared with county, state and nation
| Measure | This facility | Sioux Co. median | Iowa median | US average |
|---|---|---|---|---|
| Overall star rating | 1 | 4 | 3 | 3.0 |
| Health citations, 3 cycles | 73 | 18 | 16 | 28.7 |
| Citations per 100 beds | 114.1 | 18.3 | 27.5 | 26.8 |
| Total nurse hours per resident day | 3.1 | 3.9 | 3.7 | 3.9 |
| RN hours per resident day | 0.6 | 0.8 | 0.7 | 0.7 |
| Nursing staff turnover | 75.0% | 31.0% | 41.9% | 45.8% |
| Fines listed | $130,305 | $0 | $0 | — |
County and state figures are medians across facilities (5 in the county, 387 in the state); the US column is the CMS national average where CMS publishes one.
Citations by survey cycle
Dark bar: this facility. Grey bar: Iowa average per facility for the same cycle, as published by CMS. Standard health survey dates: 26 Mar 2026, 11 Mar 2025.
Severity mix: J ×1 K ×1 G ×1 D ×45 E ×24 F ×1
Health deficiencies
Every health citation in the current CMS record (three survey cycles), most recent first. Tag text is the CMS requirement summary, not the inspection narrative.
Scope and severity letters (A–L)
Isolated
Pattern
Widespread
Immediate jeopardy
J
K
L
Actual harm
G
H
I
Potential for more than minimal harm
D
E
F
Potential for minimal harm
A
B
C
| Survey date | Tag | What the tag requires | Severity | Type | Corrected |
|---|---|---|---|---|---|
| 6 May 2026 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Complaint investigation | 14 May 2026 |
| 6 May 2026 | F0686 | Provide appropriate pressure ulcer care and prevent new ulcers from developing. | D | Complaint investigation | 14 May 2026 |
| 6 May 2026 | F0695 | Provide safe and appropriate respiratory care for a resident when needed. | D | Complaint investigation | 14 May 2026 |
| 26 Mar 2026 | F0600 | Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody. | G | Complaint investigation | 8 Apr 2026 |
| 26 Mar 2026 | F0584 | 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. | E | Complaint investigation | 8 Apr 2026 |
| 26 Mar 2026 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | E | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | E | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0880 | Provide and implement an infection prevention and control program. | E | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | Complaint investigation | 8 Apr 2026 |
| 26 Mar 2026 | F0567 | Honor the resident's right to manage his or her financial affairs. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0580 | Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. | D | Complaint investigation | 8 Apr 2026 |
| 26 Mar 2026 | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0605 | Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0609 | Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities. | D | Complaint investigation | 8 Apr 2026 |
| 26 Mar 2026 | F0628 | Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Complaint investigation | 8 Apr 2026 |
| 26 Mar 2026 | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0693 | Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0744 | Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0760 | Ensure that residents are free from significant medication errors. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0842 | Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0865 | Have a plan that describes the process for conducting QAPI and QAA activities. | D | Standard survey | 8 Apr 2026 |
| 26 Mar 2026 | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | D | Standard survey | 8 Apr 2026 |
| 8 Oct 2025 | F0657 | Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals. | D | Complaint investigation | 13 Oct 2025 |
| 11 Mar 2025 | F0625 | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. | E | Standard survey | 28 Mar 2025 |
| 11 Mar 2025 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | E | Complaint investigation | 28 Mar 2025 |
| 11 Mar 2025 | F0801 | 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. | E | Standard survey | 28 Mar 2025 |
| 11 Mar 2025 | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | Standard survey | 28 Mar 2025 |
| 11 Mar 2025 | F0584 | 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. | D | Standard survey | 28 Mar 2025 |
| 11 Mar 2025 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard survey | 28 Mar 2025 |
| 11 Mar 2025 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint investigation | 28 Mar 2025 |
| 11 Mar 2025 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Complaint investigation | 28 Mar 2025 |
| 11 Mar 2025 | F0758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | Standard survey | 28 Mar 2025 |
| 11 Mar 2025 | F0880 | Provide and implement an infection prevention and control program. | D | Standard survey | 28 Mar 2025 |
| 28 Jul 2024 | F0805 | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | J | Complaint investigation | 7 Aug 2024 |
| 28 Jul 2024 | F0803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | E | Complaint investigation | 13 Aug 2024 |
| 28 Jul 2024 | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Complaint investigation | 13 Aug 2024 |
| 28 Jul 2024 | F0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | E | Complaint investigation | 13 Aug 2024 |
| 28 Jul 2024 | F0880 | Provide and implement an infection prevention and control program. | E | Complaint investigation | 13 Aug 2024 |
| 28 Jul 2024 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Complaint investigation | 13 Aug 2024 |
| 28 Jul 2024 | F0558 | Reasonably accommodate the needs and preferences of each resident. | D | Complaint investigation | 13 Aug 2024 |
| 28 Jul 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Complaint investigation | 13 Aug 2024 |
| 28 Jul 2024 | F0690 | Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections. | D | Complaint investigation | 13 Aug 2024 |
| 28 Jul 2024 | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | D | Complaint investigation | 13 Aug 2024 |
| 28 Jul 2024 | F0806 | Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options. | D | Complaint investigation | 13 Aug 2024 |
| 31 Jan 2024 | F0805 | Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs. | K | Standard survey | 8 Feb 2024 |
| 31 Jan 2024 | F0880 | Provide and implement an infection prevention and control program. | F | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0585 | Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances. | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0607 | Develop and implement policies and procedures to prevent abuse, neglect, and theft. | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0725 | Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift. | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0726 | Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being. | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0803 | Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident. | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0804 | Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature. | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0809 | Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times. | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0812 | Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards. | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0865 | Have a plan that describes the process for conducting QAPI and QAA activities. | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0868 | Have the Quality Assessment and Assurance group have the required members and meet at least quarterly | E | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0584 | 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. | D | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0623 | Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights. | D | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0625 | Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave. | D | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0641 | Ensure each resident receives an accurate assessment. | D | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0656 | Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured. | D | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Complaint investigation | 14 Feb 2024 |
| 31 Jan 2024 | F0758 | Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited. | D | Complaint investigation | 14 Feb 2024 |
| 31 Jan 2024 | F0760 | Ensure that residents are free from significant medication errors. | D | Standard survey | 14 Feb 2024 |
| 31 Jan 2024 | F0883 | Develop and implement policies and procedures for flu and pneumonia vaccinations. | D | Standard survey | 14 Feb 2024 |
| 17 Aug 2023 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Complaint investigation | 14 Jun 2023 |
Penalties
| Date | Type | Amount | Detail |
|---|---|---|---|
| 26 Mar 2026 | Payment denial | — | 22 days |
| 26 Mar 2026 | Fine | $104,855 | |
| 28 Jul 2024 | Fine | $8,649 | |
| 31 Jan 2024 | Fine | $16,801 |
Staffing
Hours per resident per day as reported through the Payroll-Based Journal; grey bars are the Iowa average. Turnover: nursing staff 75.0%, RNs 80.0%; — administrators left in the reporting year.
Quality measures
| Measure | Residents | This facility | Iowa median | US median |
|---|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased | Long Stay | 20.3% | 16.8% | 12.6% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 0.0% | 0.8% | 0.3% |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 1.2% | 1.8% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 4.1% | 3.4% | 2.8% |
| Percentage of short-stay residents who newly received an antipsychotic medication | Short Stay | 0.0% | 1.0% | 1.0% |
| Percentage of long-stay residents whose ability to walk independently worsened | Long Stay | 13.8% | 15.9% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 4.6% | 3.6% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 24.5% | 18.2% | 13.4% |
Four-quarter averages for the measures CMS uses in the quality-measure star rating (2025Q2-2026Q1). Lower is better for every measure listed. Medians are computed across facilities on this site.
Ownership
Ownership type: for-profit, limited liability company. Legal business name: Riverside Healthcare, Inc.. Chain: The Ensign Group (342 facilities).
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Aerofund Holdings Inc | Operational/managerial control | NOT APPLICABLE | 07/18/2011 |
| Blu Medstaff LLC | Operational/managerial control | NOT APPLICABLE | 07/18/2011 |
| Heart Medical Solutions LLC | Operational/managerial control | NOT APPLICABLE | 07/18/2011 |
| Helping Hands Nursing Solution Inc | Operational/managerial control | NOT APPLICABLE | 07/18/2011 |
| Onshift Inc | Operational/managerial control | NOT APPLICABLE | 07/18/2011 |
| Caretrust Gp LLC | Adp of the snf | NOT APPLICABLE | 07/18/2011 |
| Caretrust Reit Inc | Adp of the snf | NOT APPLICABLE | 07/18/2011 |
| Ctr Partnership LP | Adp of the snf | NOT APPLICABLE | 07/18/2011 |
| Ensign Services Inc | Adp of the snf | NOT APPLICABLE | 06/01/2011 |
| The Ensign Group Inc | Adp of the snf | NOT APPLICABLE | 07/29/2002 |
Only organisations are shown. CMS also records individual owners, officers and managing employees; this site does not publish people's names.
Other nursing homes in Sioux County
| Facility | City | Beds | Overall | Health | Staffing | Citations | Per 100 beds | Fines | Last survey |
|---|---|---|---|---|---|---|---|---|---|
| Hegg Memorial Health Center | Rock Valley | 60 | 5 | 4 | 5 | 11 | 18.3 | — | 6 Nov 2025 |
| Prairie Ridge Care Center | Orange City | 95 | 5 | 4 | 5 | 10 | 10.5 | — | 18 Jun 2026 |
| Crown Pointe Estates Care Center | Sioux Center | 99 | 4 | 3 | 5 | 18 | 18.2 | — | 26 Jun 2025 |
| Pleasant Acres Care Center | Hull | 46 | 3 | 3 | 4 | 23 | 50.0 | — | 19 Feb 2026 |
All 5 facilities in Sioux County
Questions and answers
How many deficiencies has Hillcrest Health Care Center been cited for?
73 health deficiencies across the three most recent survey cycles, 3 at the actual-harm or immediate-jeopardy level. The Iowa median is 16 per facility.
Has Hillcrest Health Care Center been fined?
Yes. CMS lists fines totalling $130K in the period covered, plus 1 payment denial.
How does staffing at Hillcrest Health Care Center compare?
Reported total nurse staffing is 3.1 hours per resident per day against a Iowa median of 3.7 and a national average of 3.9.
Who operates Hillcrest Health Care Center?
It is part of the The Ensign Group chain. Ownership type is for-profit, limited liability company. Organisations in the CMS ownership record include Aerofund Holdings Inc, Blu Medstaff LLC and Heart Medical Solutions LLC. Individual owners and managers are not listed on this site.
When was Hillcrest Health Care Center last inspected?
The most recent survey or investigation in the CMS record is dated 6 May 2026; the most recent standard health survey was 26 Mar 2026.
Where does this data come from?
All figures are from the Centers for Medicare & Medicaid Services Care Compare datasets (provider information, health deficiencies, penalties, ownership and quality measures), processed 1 Aug 2026. Ratings and citations may change; the Care Compare record is authoritative.
Provenance
Source: Centers for Medicare & Medicaid Services, Care Compare nursing home datasets (provider information, health deficiencies, penalties, ownership, MDS quality measures, state and national averages), public domain, processed by CMS on 1 Aug 2026. Facility record: Care Compare. Errors in processing are corrected at the next daily build; see corrections.