The Highlands
607 Highland Drive, Decorah, IA 52101 · (563) 382-3603
Non profit - Corporation · 86 certified beds
The Highlands has a 2-star overall rating from Medicare, out of 5. Its last standard inspection, in July 2026, found 4 citations (the Iowa average is 6.5). It was fined 2 times in the last three years, $93,839 in all.
Medicare ratings
| Overall ratingStarts from the health inspection rating, then goes up or down a star for a 5-star or 1-star staffing or quality rating. | ★★★★★ 2 out of 5 stars · Below average |
| Health inspectionsFrom the two most recent standard inspections and three years of complaint inspections, compared with other homes in the same state. | ★★★★★ 2 out of 5 stars · Below average |
| Quality measuresFrom 15 measures of how residents do, such as falls with major injury, pressure ulcers, hospital stays and getting home after a short stay. | ★★★★★ 3 out of 5 stars · Average |
| StaffingFrom payroll records of nurse hours per resident, adjusted for how much care residents need, and staff turnover. | ★★★★★ 4 out of 5 stars · Above average |
How to read a nursing home's star ratings
Most recent health inspection
The standard health inspection on July 22, 2026 found 4 citations. What an inspection citation means
- Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.July 22, 2026 · F0812 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
- Honor 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.July 22, 2026 · F0578 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
- Assess the resident when there is a significant change in conditionJuly 22, 2026 · F0637 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
- Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.July 22, 2026 · F0644 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
Complaint inspections, last three years
Inspections after complaints found 12 citations.
- Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.June 18, 2026 · F0689 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
- Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.September 23, 2025 · F0550 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
- Have enough outside ventilation via a window or mechanical ventilation, or both.September 23, 2025 · F0923 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Some
- Provide appropriate treatment and care according to orders, resident’s preferences and goals.December 9, 2024 · F0684 · Level of harm: Immediate jeopardy to resident health or safety · Residents affected: Few
- Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.September 25, 2024 · F0580 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
- Provide appropriate treatment and care according to orders, resident’s preferences and goals.September 25, 2024 · F0684 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
- Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.February 7, 2024 · F0550 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
- Honor 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.February 7, 2024 · F0584 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
- Ensure each resident receives an accurate assessment.February 7, 2024 · F0641 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
- Ensure services provided by the nursing facility meet professional standards of quality.February 7, 2024 · F0658 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
- Provide care and assistance to perform activities of daily living for any resident who is unable.February 7, 2024 · F0677 · Level of harm: Minimal harm or potential for actual harm · Residents affected: Few
- Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.February 7, 2024 · F0689 · Level of harm: Actual harm · Residents affected: Few
Fines and payment denials
- Fine of $50,211December 9, 2024
- Fine of $43,628July 25, 2024
- Medicare payment denial for 10 daysStarting August 21, 2024
Nurse staffing
Hours of nursing care per resident per day, as the home reports them to Medicare through payroll records.
| Hours per resident per day | This home | Iowa average | U.S. average |
|---|---|---|---|
| Total nurse staffing | 3.90 | 3.82 | 3.86 |
| Registered nurses (RN) | 0.44 | 0.74 | 0.69 |
| Licensed practical nurses (LPN) | 0.66 | 0.56 | 0.86 |
| Nurse aides | 2.79 | 2.52 | 2.32 |
| Total nursing staff turnover | 53.3% | 44% | 45.8% |
About this home
| Ownership | Non profit - Corporation |
| Certified beds | 86 |
| Average residents per day | 75.4 |
| Inside a hospital | No |
| Continuing care retirement community | Yes |
Nursing homes nearby
- Wellington Place Decorah · ★★★★★ 4 out of 5 stars
- Ossian Care Center Ossian · ★★★★★ 2 out of 5 stars
- Evans Senior Living Community Cresco · ★★★★★ 5 out of 5 stars
- Maple Crest Manor Fayette · ★★★★★ 3 out of 5 stars
- Thornton Manor Nursing and Care Center Lansing · ★★★★★ 5 out of 5 stars
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Data from Medicare (CMS), updated October 2026, from The Highlands on Medicare's Care Compare and the CMS Provider Data Catalog. ParentNextStep isn't affiliated with Medicare or CMS.