The Highlands

607 Highland Drive, Decorah, IA 52101 · CCN 165178 · 86 certified beds · Data as of 2026-07-01

CMS overall2 of 5CMS inspections2 of 5CMS staffing4 of 5CMS quality3 of 5

Star ratings are issued by CMS (the federal Centers for Medicare & Medicaid Services), not by NursingHomeLens. We report them; we do not rate or rank facilities.

State inspectors recorded 1 immediate-jeopardy citation(s) here in the last three years — CMS's most serious level.

Serious inspection findings

2024-12-09 IMMEDIATE JEOPARDY (tag F0684, severity J)
Quality of Life and Care Deficiencies · correction not recorded in CMS data
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
2024-07-25 ACTUAL HARM (tag F0689, severity G)
Quality of Life and Care Deficiencies · correction not recorded in CMS data
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2024-02-07 ACTUAL HARM (tag F0689, severity G)
Quality of Life and Care Deficiencies · correction not recorded in CMS data
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
2023-07-11 IMMEDIATE JEOPARDY (tag F0684, severity J)
Quality of Life and Care Deficiencies · correction not recorded in CMS data
Provide appropriate treatment and care according to orders, resident’s preferences and goals.

Staffing, from payroll records

Nursing hours / resident / day

3.43

state median 3.10

Weekend staffing gap

−4%

fewer nursing hours on weekends · state median −7%

RN hours / resident / day

0.32

registered nurses only

Contract (agency) staff

40%

share of all nursing hours

Nursing staff turnover

53%

per year, per CMS

Source: CMS Payroll-Based Journal, 2026Q1, 90 reported days — actual payroll data, not the facility's own estimates.

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Penalties and enforcement

3 enforcement action(s), totaling $93,839 in fines.

DateTypeAmount
2024-12-09Fine$50,211
2024-07-25Fine$43,628
2024-07-25Payment Denialpayment denial

Ownership

Ownership type: Non profit - Corporation.

Full citation history

By severity: No harm, potential for minimal harm: 3 · Actual harm: 2 · Potential for more than minimal harm: 27 · Immediate jeopardy: 2

Survey dateTagCategorySeverityCorrected
2025-09-23F0550Resident Rights DeficienciesEnot recorded
2025-09-23F0923Environmental DeficienciesEnot recorded
2025-06-12F0582Resident Rights DeficienciesDnot recorded
2025-06-12F0641Resident Assessment and Care Planning DeficienciesBnot recorded
2025-06-12F0943Freedom from Abuse, Neglect, and Exploitation DeficienciesDnot recorded
2024-12-09F0684Quality of Life and Care DeficienciesJnot recorded
2024-09-25F0580Resident Rights DeficienciesDnot recorded
2024-09-25F0684Quality of Life and Care DeficienciesDnot recorded
2024-07-25F0644Resident Assessment and Care Planning DeficienciesDnot recorded
2024-07-25F0684Quality of Life and Care DeficienciesDnot recorded
2024-07-25F0689Quality of Life and Care DeficienciesGnot recorded
2024-07-25F0800Nutrition and Dietary DeficienciesEnot recorded
2024-07-25F0801Nutrition and Dietary DeficienciesCnot recorded
2024-07-25F0802Nutrition and Dietary DeficienciesEnot recorded
2024-07-25F0812Nutrition and Dietary DeficienciesEnot recorded
2024-02-07F0550Resident Rights DeficienciesDnot recorded
2024-02-07F0584Resident Rights DeficienciesDnot recorded
2024-02-07F0641Resident Assessment and Care Planning DeficienciesDnot recorded
2024-02-07F0658Resident Assessment and Care Planning DeficienciesDnot recorded
2024-02-07F0677Quality of Life and Care DeficienciesDnot recorded
2024-02-07F0689Quality of Life and Care DeficienciesGnot recorded
2023-09-18F0550Resident Rights DeficienciesDnot recorded
2023-09-18F0578Resident Rights DeficienciesDnot recorded
2023-09-18F0582Resident Rights DeficienciesBnot recorded
2023-09-18F0656Resident Assessment and Care Planning DeficienciesDnot recorded
2023-09-18F0684Quality of Life and Care DeficienciesDnot recorded
2023-09-18F0880Infection Control DeficienciesEnot recorded
2023-07-11F0580Resident Rights DeficienciesDnot recorded
2023-07-11F0584Resident Rights DeficienciesEnot recorded
2023-07-11F0656Resident Assessment and Care Planning DeficienciesDnot recorded
2023-07-11F0677Quality of Life and Care DeficienciesEnot recorded
2023-07-11F0684Quality of Life and Care DeficienciesJnot recorded
2023-07-11F0725Nursing and Physician Services DeficienciesEnot recorded
2023-07-11F0880Infection Control DeficienciesDnot recorded

Sources: CMS Provider Information, Health Deficiencies, Penalties, and Ownership datasets (data.cms.gov/provider-data), processed 2026-07-01; CMS Payroll-Based Journal daily staffing. Find this facility on Care Compare: search “The Highlands, Decorah” at medicare.gov/care-compare.