All states › Iowa › Hawarden › Hillcrest Health Care Center
2121 Avenue L Hawarden, IA 51023 · Sioux County
CMS certification number 165245 · See this home on Medicare Care Compare
Is Hillcrest Health Care Center 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 Hillcrest Health Care Center as of October 2026.
CMS rates it 1 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 3.71 hours per resident per day at Hillcrest Health Care Center, about the same as the Iowa median of 3.76 (US median: 3.72). About 1.06 of those hours are from registered nurses. On weekends it falls to 3.13 hours, 16% below its all-week average. Ask how weekends are staffed. 72.1% 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 Hillcrest Health Care Center: Medicare and Medicaid
Hillcrest Health Care Center 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 March 26, 2026 and found 17 deficiencies, plus 10 from complaint inspections in the same period. In total, inspectors issued 72 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 72 citations at Hillcrest Health Care Center across 6 inspection dates, 26 of them from complaint investigations. 2 were at the immediate-jeopardy level (J–L), CMS's most serious category, most recently on July 28, 2024 (complaint inspection). The most common areas cited were resident rights (17) and nutrition and dietary (13). The most serious was cited under the CMS rule to "ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs" (tag F0805, level K, January 31, 2024). 4 citations were under CMS's abuse, neglect and exploitation rules.
May 6, 2026 · 3 citations · includes complaint inspection
DHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
DProvide appropriate pressure ulcer care and prevent new ulcers from developing.
DProvide safe and appropriate respiratory care for a resident when needed.
March 26, 2026 · 23 citations, includes actual harm · includes complaint inspection
GProtect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
EHonor 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.
EProvide appropriate treatment and care according to orders, resident’s preferences and goals.
EProvide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
EEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.
EProvide and implement an infection prevention and control program.
DReasonably accommodate the needs and preferences of each resident.
DHonor the resident's right to manage his or her financial affairs.
DImmediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
DGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
DPrevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
DTimely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
DProvide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
DCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
DDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
DProvide care and assistance to perform activities of daily living for any resident who is unable.
DProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
DEnsure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
DProvide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
DEnsure that residents are free from significant medication errors.
DSafeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
DHave a plan that describes the process for conducting QAPI and QAA activities.
DHave the Quality Assessment and Assurance group have the required members and meet at least quarterly
October 8, 2025 · 1 citation · includes complaint inspection
DDevelop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
March 11, 2025 · 10 citations · includes complaint inspection
ENotify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
EProvide care and assistance to perform activities of daily living for any resident who is unable.
EEmploy sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
DGive residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
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.
DDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
DProvide appropriate treatment and care according to orders, resident’s preferences and goals.
DEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
DImplement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
DProvide and implement an infection prevention and control program.
July 28, 2024 · 11 citations, includes immediate jeopardy · includes complaint inspection
JEnsure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
EEnsure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
EEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.
EEnsure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
EProvide and implement an infection prevention and control program.
DHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
DReasonably accommodate the needs and preferences of each resident.
DEnsure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
DProvide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
DProvide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
DEnsure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
January 31, 2024 · 24 citations, includes immediate jeopardy · includes complaint inspection
KEnsure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
FProvide and implement an infection prevention and control program.
EHonor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
EHonor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
EDevelop and implement policies and procedures to prevent abuse, neglect, and theft.
EProvide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
EEnsure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
EProvide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
EEnsure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
EEnsure food and drink is palatable, attractive, and at a safe and appetizing temperature.
EEnsure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
EProcure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
EHave a plan that describes the process for conducting QAPI and QAA activities.
EHave the Quality Assessment and Assurance group have the required members and meet at least quarterly
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.
DProvide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
DNotify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
DEnsure each resident receives an accurate assessment.
DCoordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
DDevelop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
DEnsure services provided by the nursing facility meet professional standards of quality.
DImplement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
DEnsure that residents are free from significant medication errors.
DDevelop and implement policies and procedures for flu and pneumonia vaccinations.
Questions to ask on a tour of Hillcrest Health Care Center
- Inspectors cited the home at the immediate-jeopardy level on January 31, 2024 under the rule on nutrition and dietary. What changed afterwards, and can I see the plan of correction?
- CMS cited the home under its abuse and neglect rules on March 26, 2026. How are staff trained, and how are concerns reported?
- Weekend staffing is 16% below the all-week average. Who is on duty on Saturday nights?
- Nursing staff turnover was 72.1% 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
4 penalties in the last three years, including $93,606 in fines.
| Date | Type | Amount or length |
|---|---|---|
| Mar 26, 2026 | Fine | $68,156 |
| Mar 26, 2026 | Payment Denial | 22 days of payments denied |
| Jul 28, 2024 | Fine | $8,649 |
| Jan 31, 2024 | Fine | $16,801 |
Rating history
| CMS month | Overall | Inspection | Staffing | Quality |
|---|---|---|---|---|
| October 2026 | 1/5 | 1/5 | 3/5 | 2/5 |
| August 2026 | 1/5 | 1/5 | 2/5 | 3/5 |
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Location
Hospitals near Hillcrest Health Care Center
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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0.8 mi
Hawarden Community Hospital HawardenEmergency roomMedian ER visit 2h 38m for patients treated and sent home
-
16.6 mi
Hegg Memorial Health Center Rock ValleyEmergency roomMedian ER visit 1h 38m for patients treated and sent home
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16.7 mi
Sioux Center Community Hospital & Health Center Sioux CenterEmergency roomMedian ER visit 2h 1m 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
More nursing homes near Hillcrest Health Care Center › All nursing homes in Hawarden ›
Compare Hillcrest Health Care Center with the 3 closest homes side by side ›
Other The Ensign Group nursing homes in Iowa
- West Bend Health and Rehabilitation · West Bend · 5 stars
- Woodland Health and Rehabilitation · Mount Pleasant · 4 stars
- Rehabilitation Center of Des Moines · Des Moines · 3 stars
- Crystal Heights Care Center · Oskaloosa · 3 stars
- Careage Hills Rehabilitation and Healthcare · Cherokee · 2 stars
- Greater Southside Health and Rehabilitation · Des Moines · 1 stars
Affiliation comes from CMS's affiliated-entity data, October 2026. All 347 The Ensign Group nursing homes ›
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.