Iowa › Winneshiek County › Decorah
The Highlands
607 Highland Drive, Decorah, IA 52101
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 86 beds, The Highlands serves Decorah in Winneshiek County, Iowa and has taken Medicare and Medicaid residents since 1993.
CMS gives it 2 of 5 stars overall, below the Iowa median of 3; the health inspection rating is 2, staffing 4 and quality measures 3.
Inspectors recorded 28 health deficiencies across the three most recent survey cycles (6, 10, 12 by cycle, most recent first), 3 of them at the actual-harm or immediate-jeopardy level. That is 32.6 per 100 beds, about the same as the state median of 27.5.
CMS lists 3 penalties in the period covered: fines totalling $94K and 1 payment denial.
Reported nurse staffing is 3.9 hours per resident per day (0.4 RN), close to the Iowa median of 3.7; nursing staff turnover is 53.3%.
Compared with county, state and nation
| Measure | This facility | Winneshiek Co. median | Iowa median | US average |
|---|---|---|---|---|
| Overall star rating | 2 | 2 | 3 | 3.0 |
| Health citations, 3 cycles | 28 | 19 | 16 | 28.7 |
| Citations per 100 beds | 32.6 | 32.6 | 27.5 | 26.8 |
| Total nurse hours per resident day | 3.9 | 3.9 | 3.7 | 3.9 |
| RN hours per resident day | 0.4 | 0.6 | 0.7 | 0.7 |
| Nursing staff turnover | 53.3% | 48.1% | 41.9% | 45.8% |
| Fines listed | $93,839 | $0 | $0 | — |
County and state figures are medians across facilities (3 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: 12 Jun 2025, 25 Jul 2024.
Severity mix: J ×1 G ×2 D ×16 E ×6 B ×2 C ×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)
| Survey date | Tag | What the tag requires | Severity | Type | Corrected |
|---|---|---|---|---|---|
| 18 Jun 2026 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | D | Complaint investigation | 1 Jul 2026 |
| 23 Sep 2025 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | E | Complaint investigation | 24 Sep 2025 |
| 23 Sep 2025 | F0923 | Have enough outside ventilation via a window or mechanical ventilation, or both. | E | Complaint investigation | 24 Sep 2025 |
| 12 Jun 2025 | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | D | Standard survey | 26 Jun 2025 |
| 12 Jun 2025 | F0943 | Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation. | D | Standard survey | 26 Jun 2025 |
| 12 Jun 2025 | F0641 | Ensure each resident receives an accurate assessment. | B | Standard survey | 26 Jun 2025 |
| 9 Dec 2024 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | J | Complaint investigation | 10 Dec 2024 |
| 25 Sep 2024 | 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 | 26 Sep 2024 |
| 25 Sep 2024 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Complaint investigation | 26 Sep 2024 |
| 25 Jul 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | Standard survey | 26 Jul 2024 |
| 25 Jul 2024 | F0800 | Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs. | E | Standard survey | 26 Jul 2024 |
| 25 Jul 2024 | F0802 | Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service. | E | Standard survey | 26 Jul 2024 |
| 25 Jul 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 | 26 Jul 2024 |
| 25 Jul 2024 | F0644 | Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed. | D | Standard survey | 26 Jul 2024 |
| 25 Jul 2024 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Standard survey | 26 Jul 2024 |
| 25 Jul 2024 | 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. | C | Standard survey | 26 Jul 2024 |
| 7 Feb 2024 | F0689 | Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents. | G | Complaint investigation | 8 Feb 2024 |
| 7 Feb 2024 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Complaint investigation | 8 Feb 2024 |
| 7 Feb 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 | Complaint investigation | 8 Feb 2024 |
| 7 Feb 2024 | F0641 | Ensure each resident receives an accurate assessment. | D | Complaint investigation | 8 Feb 2024 |
| 7 Feb 2024 | F0658 | Ensure services provided by the nursing facility meet professional standards of quality. | D | Complaint investigation | 8 Feb 2024 |
| 7 Feb 2024 | F0677 | Provide care and assistance to perform activities of daily living for any resident who is unable. | D | Complaint investigation | 8 Feb 2024 |
| 18 Sep 2023 | F0880 | Provide and implement an infection prevention and control program. | E | Standard survey | 29 Sep 2023 |
| 18 Sep 2023 | F0550 | Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights. | D | Standard survey | 29 Sep 2023 |
| 18 Sep 2023 | F0578 | 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. | D | Standard survey | 29 Sep 2023 |
| 18 Sep 2023 | 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 | 29 Sep 2023 |
| 18 Sep 2023 | F0684 | Provide appropriate treatment and care according to orders, resident’s preferences and goals. | D | Standard survey | 29 Sep 2023 |
| 18 Sep 2023 | F0582 | Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered. | B | Standard survey | 29 Sep 2023 |
Penalties
| Date | Type | Amount | Detail |
|---|---|---|---|
| 9 Dec 2024 | Fine | $50,211 | |
| 25 Jul 2024 | Payment denial | — | 10 days |
| 25 Jul 2024 | Fine | $43,628 |
Staffing
Hours per resident per day as reported through the Payroll-Based Journal; grey bars are the Iowa average. Turnover: nursing staff 53.3%, RNs 44.4%; 1 administrator 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 | 27.6% | 16.8% | 12.6% |
| Percentage of long-stay residents with a catheter inserted and left in their bladder | Long Stay | 1.2% | 0.8% | 0.3% |
| Percentage of long-stay residents with a urinary tract infection | Long Stay | 0.0% | 1.8% | 0.9% |
| Percentage of long-stay residents experiencing one or more falls with major injury | Long Stay | 2.1% | 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 | 24.0% | 15.9% | 12.5% |
| Percentage of long-stay residents with pressure ulcers | Long Stay | 4.1% | 3.6% | 4.2% |
| Percentage of long-stay residents who received an antipsychotic medication | Long Stay | 25.6% | 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: non-profit, corporation. Legal business name: Aase Haugen Homes, Inc..
| Organisation | Role in the CMS record | Interest | Since |
|---|---|---|---|
| Continuum Health Care Services LLC | Operational/managerial control | NOT APPLICABLE | 01/17/2013 |
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 Winneshiek County
| Facility | City | Beds | Overall | Health | Staffing | Citations | Per 100 beds | Fines | Last survey |
|---|---|---|---|---|---|---|---|---|---|
| Wellington Place | Decorah | 56 | 3 | 4 | 4 | 3 | 5.4 | — | 10 Aug 2023 |
| Ossian Care Center | Ossian | 46 | 2 | 2 | 4 | 19 | 41.3 | — | 7 May 2026 |
All 3 facilities in Winneshiek County
Questions and answers
How many deficiencies has The Highlands been cited for?
28 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 The Highlands been fined?
Yes. CMS lists fines totalling $94K in the period covered, plus 1 payment denial.
How does staffing at The Highlands compare?
Reported total nurse staffing is 3.9 hours per resident per day against a Iowa median of 3.7 and a national average of 3.9.
Who operates The Highlands?
Ownership type is non-profit, corporation. Organisations in the CMS ownership record include Continuum Health Care Services LLC. Individual owners and managers are not listed on this site.
When was The Highlands last inspected?
The most recent survey or investigation in the CMS record is dated 18 Jun 2026; the most recent standard health survey was 12 Jun 2025.
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.