All states › Iowa › Decorah › The Highlands
607 Highland Drive Decorah, IA 52101 · Winneshiek County
All 2 nursing homes in Decorah, IA (2 take Medicaid)
CMS certification number 165178 · See this home on Medicare Care Compare
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.
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.
About this nursing home
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.
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.
DAssess the resident when there is a significant change in condition
DCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
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.
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.
EHave enough outside ventilation via a window or mechanical ventilation, or both.
June 12, 2025 · 3 citations
DGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
DGive their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
BEnsure each resident receives an accurate assessment.
December 9, 2024 · 1 citation, includes immediate jeopardy · includes complaint inspection
JProvide appropriate treatment and care according to orders, resident’s preferences and goals.
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.
DProvide appropriate treatment and care according to orders, resident’s preferences and goals.
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.
EProvide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
EProvide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
EProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
DCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
DProvide appropriate treatment and care according to orders, resident’s preferences and goals.
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.
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.
DHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
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.
DEnsure each resident receives an accurate assessment.
DEnsure services provided by the nursing facility meet professional standards of quality.
DProvide care and assistance to perform activities of daily living for any resident who is unable.
Questions to ask on a tour of The Highlands
- 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?
- CMS cited the home under its abuse and neglect rules on June 12, 2025. How are staff trained, and how are concerns reported?
- Nursing staff turnover was 56.9% a year. How many of the staff come from agencies?
- Do you have a Medicaid bed open now, and will you admit someone whose Medicaid application is still pending?
- 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.
| Date | Type | Amount 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 month | Overall | Inspection | Staffing | Quality |
|---|---|---|---|---|
| October 2026 | 2/5 | 2/5 | 4/5 | 3/5 |
| August 2026 | 2/5 | 2/5 | 4/5 | 3/5 |
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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.
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2.2 mi
Winnmed DecorahEmergency room ★★★★☆ Medicare overall 4 of 5Median ER visit 1h 54m for patients treated and sent home
-
16.3 mi
Veterans Memorial Hospital WaukonEmergency roomMedian ER visit 1h 37m for patients treated and sent home
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17.0 mi
Regional Health Services of Howard County CrescoEmergency room ★★★★☆ Medicare overall 4 of 5Median 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
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Higher-rated nursing homes within 10 miles
- Wellington Place · Decorah · 5 stars · 2.9 mi
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.