facebook tracking The Highlands, Decorah IA: CMS Ratings & Inspections
Skip to content

The Highlands

All states › Iowa › Decorah › The Highlands

607 Highland Drive Decorah, IA 52101 · Winneshiek County

(563) 382-3603

All 2 nursing homes in Decorah, IA (2 take Medicaid)

Accepts Medicare Accepts Medicaid 86 certified beds Non profit Continuing care retirement community

CMS certification number 165178 · See this home on Medicare Care Compare

Ratings come from CMS and are updated monthly; these are from October 2026. Check the latest inspection report and visit in person before you decide.

Is The Highlands a good nursing home? Reviews, ratings and inspection record

There are no official resident reviews of nursing homes: Medicare's Care Compare publishes inspections, staffing and quality data instead. Here is what that record shows for The Highlands as of October 2026.

CMS rates it 2 out of 5 stars overall, below the Iowa average of 3.1. Inspectors issued 26 citations in the last three years. CMS imposed 3 penalties, including $93,839 in fines, in that time. For short-term rehab patients CMS rates quality 4 out of 5; for long-term residents, 2 out of 5. Those results differ a lot, so ask about the unit your family member would be on.

Online reviews from families and residents are on Google Maps and other sites; they reflect individual experiences and aren't checked by CMS. The full inspection reports, including what inspectors observed, are on Medicare Care Compare.

Staffing

Nursing staff spend about 3.96 hours per resident per day at The Highlands, above the Iowa median of 3.76 (US median: 3.72). About 0.49 of those hours are from registered nurses. On weekends it falls to 3.62 hours, 9% below its all-week average. 56.9% of nursing staff left within a year (Iowa median 41.7%). High turnover can mean residents see unfamiliar caregivers; ask how long the nurses on the unit have worked there.

Nursing care per resident per day 3.96 hours
Above the Iowa median of 3.76 Registered nurses, licensed practical nurses and aides combined, from payroll records.
Registered nurse hours 0.49 per resident a day RNs handle assessments, medications and changes in condition.
Weekend nursing care 3.62 hours Per resident a day. A big drop from weekdays can mean thin weekend staffing.
Nursing staff turnover 56.9% a year Share of nursing staff who left over a year. Lower usually means steadier care.
Registered nurse turnover 40% a year Share of registered nurses who left over a year.
Administrators who left 1 in the past year Frequent leadership changes are worth asking about on a visit.

About this nursing home

Certified beds86
Residents per day 74 About 86% of beds filled, on average
OwnershipNon profit - Corporation
Payment acceptedMedicare and Medicaid
Certified sinceJanuary 1993
Legal business nameAASE HAUGEN HOMES, INC.

Paying for care at The Highlands: Medicare and Medicaid

The Highlands is certified for both Medicare and Medicaid. Medicare Part A can cover a short skilled-nursing or rehab stay here after a qualifying hospital stay of at least three inpatient days (observation days don't count), for up to 100 days per benefit period. Medicaid can pay for long-term care for residents who meet Iowa's income and asset rules. Being certified doesn't guarantee a Medicaid bed is open, so ask whether the home accepts residents whose Medicaid application is still pending.

In 2026 Medicare covers days 1–20 in full after the Part A deductible ($1,736 per benefit period); for days 21–100 you pay $217 a day; after day 100 you pay all costs. Medicare doesn't pay for long-term custodial care. Medicare's coverage rules.

Health inspections

The most recent standard inspection was on July 22, 2026 and found 4 deficiencies, plus 1 from complaint inspections in the same period. In total, inspectors issued 26 citations in the last three years.

Each citation has a scope and severity letter from A to L. A–C: potential for minimal harm. D–F: potential for more than minimal harm. G–I: actual harm. J–L: immediate jeopardy to resident health or safety.

What the inspections found

Over the last three years, inspectors issued 26 citations at The Highlands across 8 inspection dates, 12 of them from complaint investigations. 1 was at the immediate-jeopardy level (J–L), CMS's most serious category, most recently on December 9, 2024 (complaint inspection). The most common areas cited were quality of life and care (7) and resident assessment and care planning (6). The most serious was cited under the CMS rule to "provide appropriate treatment and care according to orders, resident’s preferences and goals" (tag F0684, level J, December 9, 2024). 1 citation was under CMS's abuse, neglect and exploitation rules.

July 22, 2026 · 4 citations

EProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0812 · Deficient, Provider has date of correction (Aug 3, 2026)

DHonor 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.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0578 · Deficient, Provider has date of correction (Aug 10, 2026)

DAssess the resident when there is a significant change in condition

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0637 · Deficient, Provider has date of correction (Jul 27, 2026)

DCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0644 · Deficient, Provider has date of correction (Aug 10, 2026)

June 18, 2026 · 1 citation · includes complaint inspection

DEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0689 · Complaint inspection · Deficient, Provider has date of correction (Jul 1, 2026)

September 23, 2025 · 2 citations · includes complaint inspection

EHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0550 · Complaint inspection · Deficient, Provider has date of correction (Sep 24, 2025)

EHave enough outside ventilation via a window or mechanical ventilation, or both.

Potential for more than minimal harm · Environmental Deficiencies · Tag F0923 · Complaint inspection · Deficient, Provider has date of correction (Sep 24, 2025)

June 12, 2025 · 3 citations

DGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0582 · Deficient, Provider has date of correction (Jun 26, 2025)

DGive their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.

Potential for more than minimal harm · Freedom from Abuse, Neglect, and Exploitation Deficiencies · Tag F0943 · Deficient, Provider has date of correction (Jun 26, 2025)

BEnsure each resident receives an accurate assessment.

Potential for minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0641 · Deficient, Provider has date of correction (Jun 26, 2025)

December 9, 2024 · 1 citation, includes immediate jeopardy · includes complaint inspection

JProvide appropriate treatment and care according to orders, resident’s preferences and goals.

Immediate jeopardy · Quality of Life and Care Deficiencies · Tag F0684 · Complaint inspection · Deficient, Provider has date of correction (Dec 10, 2024)

September 25, 2024 · 2 citations · includes complaint inspection

DImmediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0580 · Complaint inspection · Deficient, Provider has date of correction (Sep 26, 2024)

DProvide appropriate treatment and care according to orders, resident’s preferences and goals.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0684 · Complaint inspection · Deficient, Provider has date of correction (Sep 26, 2024)

July 25, 2024 · 7 citations, includes actual harm

GEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Actual harm · Quality of Life and Care Deficiencies · Tag F0689 · Deficient, Provider has date of correction (Jul 26, 2024)

EProvide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0800 · Deficient, Provider has date of correction (Jul 26, 2024)

EProvide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0802 · Deficient, Provider has date of correction (Jul 26, 2024)

EProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.

Potential for more than minimal harm · Nutrition and Dietary Deficiencies · Tag F0812 · Deficient, Provider has date of correction (Jul 26, 2024)

DCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0644 · Deficient, Provider has date of correction (Jul 26, 2024)

DProvide appropriate treatment and care according to orders, resident’s preferences and goals.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0684 · Deficient, Provider has date of correction (Jul 26, 2024)

CEmploy sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.

Potential for minimal harm · Nutrition and Dietary Deficiencies · Tag F0801 · Deficient, Provider has date of correction (Jul 26, 2024)

February 7, 2024 · 6 citations, includes actual harm · includes complaint inspection

GEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.

Actual harm · Quality of Life and Care Deficiencies · Tag F0689 · Complaint inspection · Deficient, Provider has date of correction (Feb 8, 2024)

DHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0550 · Complaint inspection · Deficient, Provider has date of correction (Feb 8, 2024)

DHonor 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.

Potential for more than minimal harm · Resident Rights Deficiencies · Tag F0584 · Complaint inspection · Deficient, Provider has date of correction (Feb 8, 2024)

DEnsure each resident receives an accurate assessment.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0641 · Complaint inspection · Deficient, Provider has date of correction (Feb 8, 2024)

DEnsure services provided by the nursing facility meet professional standards of quality.

Potential for more than minimal harm · Resident Assessment and Care Planning Deficiencies · Tag F0658 · Complaint inspection · Deficient, Provider has date of correction (Feb 8, 2024)

DProvide care and assistance to perform activities of daily living for any resident who is unable.

Potential for more than minimal harm · Quality of Life and Care Deficiencies · Tag F0677 · Complaint inspection · Deficient, Provider has date of correction (Feb 8, 2024)

Questions to ask on a tour of The Highlands

  1. Inspectors cited the home at the immediate-jeopardy level on December 9, 2024 under the rule on quality of life and care. What changed afterwards, and can I see the plan of correction?
  2. CMS cited the home under its abuse and neglect rules on June 12, 2025. How are staff trained, and how are concerns reported?
  3. Nursing staff turnover was 56.9% a year. How many of the staff come from agencies?
  4. Do you have a Medicaid bed open now, and will you admit someone whose Medicaid application is still pending?
  5. When is the first care-plan meeting, and can family attend?

Questions come from this home's CMS data: its inspections, staffing and ownership record.

Fines and payment denials

3 penalties in the last three years, including $93,839 in fines.

DateTypeAmount or length
Dec 9, 2024 Fine $50,211
Jul 25, 2024 Fine $43,628
Jul 25, 2024 Payment Denial 10 days of payments denied

Rating history

CMS monthOverallInspectionStaffingQuality
October 2026 2/5 2/5 4/5 3/5
August 2026 2/5 2/5 4/5 3/5
Add this rating badge to your websiteFree. Shows The Highlands's Medicare star rating and updates itself.

Size and colour

Preview

The Highlands Medicare star rating badge

Paste it where the badge should appear: in WordPress, a Custom HTML block or a footer widget; on other sites, any spot that accepts HTML. The badge updates itself when CMS publishes new ratings.

Examples, sizes and help on the badge page ›

Location

Hospitals near The Highlands

The Medicare-certified hospitals closest to this nursing home, with their CMS data. Ask the home which hospital it usually sends residents to.

  • 2.2 mi
    Winnmed Decorah
    Emergency room ★★★★☆ Medicare overall 4 of 5
    Median ER visit 1h 54m for patients treated and sent home
  • 16.3 mi
    Veterans Memorial Hospital Waukon
    Emergency room
    Median ER visit 1h 37m for patients treated and sent home
  • 17.0 mi
    Regional Health Services of Howard County Cresco
    Emergency room ★★★★☆ Medicare overall 4 of 5
    Median ER visit 1h 31m for patients treated and sent home

Hospital ratings, ER visit times and more at Hospitals In Each State
Source: CMS Care Compare. Distances are approximate.

Nearby nursing homes

Wellington Place Decorah · 2.9 mi away ★★★★★ Inspection 5/5 · Staffing 4/5 56 beds · Medicaid
Ossian Care Center Ossian · 12.3 mi away ★★★☆☆ Inspection 2/5 · Staffing 5/5 46 beds · Medicaid
Northgate Care Center Waukon · 15.8 mi away ★☆☆☆☆ Inspection 1/5 · Staffing 4/5 50 beds · Medicaid
Good Samaritan - Waukon Waukon · 16.3 mi away ★★☆☆☆ Inspection 2/5 · Staffing 4/5 60 beds · Medicaid
Evans Senior Living Community Cresco · 16.8 mi away ★★★★★ Inspection 5/5 · Staffing 5/5 43 beds · Medicaid

More nursing homes near The Highlands ›   All nursing homes in Decorah ›

Compare The Highlands with the 3 closest homes side by side ›

Higher-rated nursing homes within 10 miles

Source: CMS Provider Data Catalog (provider information, health deficiencies, penalties), October 2026. Inspection citations and penalties cover the last three years. Nursing Homes In Each State is independent and not affiliated with CMS or Medicare. About the data · Report a problem with this listing. Is this your nursing home? Feature it here.

Compare

https://www.nursinghomesineachstate.com/iowa/decorah/the-highlands/ · Data: CMS, October 2026 · Nursing Homes In Each State, not affiliated with CMS or Medicare.