70/100
Above average
The Highlands
607 Highland Drive, Decorah, IA 52101
- Certified beds
- 86
- Occupancy
- 88%
- Ownership
- Non-profit
- Accepts
- Medicare + Medicaid
What to ask about before you visit
These are findings in the public CMS record for this home. They are not our opinion, each one comes straight from a federal inspection or enforcement file.
$93,839 in federal fines
CMS has fined this facility across 2 penalty action(s).
Our read on The Highlands
The Highlands sits in Decorah with 86 certified beds and a nonprofit owner, and the numbers cut two ways. Nurse staffing runs 3.90 hours per resident day, just barely above the national average of 3.86, though weekends dip about 8% below its own weekday level. The bigger concerns show up in the inspection record: 34 deficiencies, four at the harm or jeopardy level, one tied to abuse, and $93,839 in fines across two penalties, with the most recent inspection in June 2025. Staff turnover of 53.3% lands well above the 45.8% national average, which matters for consistency of care. A 4/5 staffing star softens the picture, but the health inspection rating of 2/5 tells you where the trouble lives.
Written from the CMS figures for this home shown further down this page. Nothing here is paid for or supplied by the home.
How this grade was calculated
Every point is shown. Nothing is weighted behind the scenes, the full formula is on How we grade.
A full pentagon is full marks. The shape shows what kind of good or bad a home is, two homes can share a score and look nothing alike.
Inspection safety
30/30Citations from state health inspections over the last three surveys, weighted by how much harm CMS says they caused.
- →No citations recorded in the last 3 years
Staffing
22/30Nursing hours per resident per day, adjusted for how sick the residents are, plus RN cover and weekend consistency.
- →4.81 total nurse hours per resident per day (national median 3.77)
- →0.44 RN hours per resident per day
- →Weekend staffing drops 8% against weekdays
Staff stability
9/15How much of the nursing team leaves in a year. High turnover means a resident rarely sees the same face twice.
- →53% of nursing staff left in the last year
Resident outcomes
9/15The CMS quality-measure rating, built from resident outcomes like falls, pressure ulcers, infections and antipsychotic use.
- →3 of 5 stars on the CMS quality-measure rating
Enforcement history
0/10Fines and payment denials CMS has imposed. A denial of payment means CMS stopped paying for new admissions.
- →$93,839 in federal fines across 2 action(s)
- →-2 for 1 denial(s) of Medicare payment for new admissions
Staffing, against the national average
Full detailHours of nursing care each resident receives per day. The marker on each bar is the national average.
RNs are the licence level most likely to catch a resident deteriorating.
The shift most families visit, and the one thinned first.
The share of nursing staff who left over the last year.
Recent inspection findings
Last standard health inspection: July 22, 2026 (3 months ago). No citations were recorded.
No health-inspection citations on record for this facility in the current CMS release.
What families say
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Common questions about The Highlands
What is the ElderGrade for The Highlands? +
The Highlands holds an ElderGrade of B (70 out of 100), which we describe as "above average". The grade combines its inspection citations, nurse staffing levels, staff turnover, resident outcomes and enforcement history from the federal CMS record.
How many nursing hours does each resident get at The Highlands? +
Residents receive an average of 3.90 nursing hours per day across all nursing staff, against a national average of 3.86 hours.
Has The Highlands been cited for harming residents? +
No. None of the 0 citations on record were scored at the levels CMS uses to indicate actual harm or immediate jeopardy.
Does The Highlands accept Medicaid? +
Yes, The Highlands is certified to accept Medicaid, which is the programme that pays for long-term custodial care once a resident meets their state's income and asset limits.
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