48.5/100
Below average
607 Highland Drive, Decorah, IA 52101
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.
4 citation(s) involving actual harm or immediate jeopardy
Inspectors found violations at scope/severity G or above, meaning residents were harmed or placed in immediate jeopardy.
$93,839 in federal fines
CMS has fined this facility across 2 penalty action(s).
Every point is shown. Nothing is weighted behind the scenes — the full formula is on How we grade.
Citations from state health inspections over the last three surveys, weighted by how much harm CMS says they caused.
Nursing hours per resident per day, adjusted for how sick the residents are, plus RN cover and weekend consistency.
How much of the nursing team leaves in a year. High turnover means a resident rarely sees the same face twice.
The CMS quality-measure rating, built from resident outcomes like falls, pressure ulcers, infections and antipsychotic use.
Fines and payment denials CMS has imposed. A denial of payment means CMS stopped paying for new admissions.
Grade ceiling applied
Hours 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.
Last standard health inspection: June 12, 2025 (1 year ago).
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
No actual harm, potential for more than minimal harm
Environmental Deficiencies
Have enough outside ventilation via a window or mechanical ventilation, or both.
No actual harm, potential for more than minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
No actual harm, potential for more than minimal harm
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
No actual harm, potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
No actual harm, minimal potential
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Immediate jeopardy to resident health or safety
Resident Rights Deficiencies
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
No actual harm, potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
No actual harm, potential for more than minimal harm
| Owner | Type | Role | Since |
|---|---|---|---|
| BJELLAND, SUSAN | Individual | W-2 MANAGING EMPLOYEE | — |
| ELSBERND, NANCY | Individual | W-2 MANAGING EMPLOYEE | — |
| SCHMIDT, JEFFREY | Individual | CORPORATE DIRECTOR | — |
| CONTINUUM HEALTH CARE SERVICES LLC | Organization | OPERATIONAL/MANAGERIAL CONTROL | — |
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The Highlands holds an ElderGrade of D (48.5 out of 100), which we describe as "below average". The grade combines its inspection citations, nurse staffing levels, staff turnover, resident outcomes and enforcement history from the federal CMS record.
Residents receive an average of 3.90 nursing hours per day across all nursing staff, against a national average of 3.86 hours.
Yes. 4 of the 34 citations on record were scored at scope and severity G or above, meaning inspectors found actual harm to a resident or immediate jeopardy to resident safety.
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.