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Public Record

The Highlands

Nursing HomeDecorah, IACMS 165178
64 citations on record

From CMS

Facility profile

CMS overall rating
2 / 5

*CMS Five-Star

Certified beds
86

*CMS

Avg. residents per day
69.9

*CMS

Inspection record

On record from CMS

Citations on record
64

*CMS

Inspections on file
12

*CMS

Last inspection
2025-09-23

*CMS

Citations

64 citations on record

Each deficiency cited on a CMS health inspection of this facility, sourced from the federal record. Open a report for the raw CMS Scope and Severity grade on each finding.

What do CMS severity letters mean?

Serious (G-L). Actual harm to a resident, or immediate jeopardy. Codes G through I indicate actual harm; J through L indicate immediate jeopardy to resident health or safety.

General (A-F). No actual harm found, or harm that is minimal. The facility must still submit a Plan of Correction. Most CMS citations land here.

Each letter combines severity with scope: how many residents the deficiency affected.

  • 0923Generalpotential for harm

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

  • 0550Generalpotential for harm

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

  • 0345Generalpotential for harm

    Have approved installation, maintenance and testing program for fire alarm systems.

  • 0291Generalpotential for harm

    Install emergency lighting that can last at least 1 1/2 hours.

  • 0039Generalpotential for harm

    Conduct testing and exercise requirements.

  • 0029Generalpotential for harm

    Develop a communication plan.

  • 0641Generalno actual harm

    Ensure each resident receives an accurate assessment.

  • 0353Generalpotential for harm

    Inspect, test, and maintain automatic sprinkler systems.

  • 0943Generalpotential for harm

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

  • 0582Generalpotential for harm

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

  • 0712Generalpotential for harm

    Have simulated fire drills held at unexpected times.

  • 0711Generalpotential for harm

    Provide a written emergency evacuation plan.

  • 0354Generalpotential for harm

    Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.

  • 0684Seriousimmediate jeopardy

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

  • 0684Generalpotential for harm

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

  • 0580Generalpotential for harm

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

  • 0802Generalpotential for harm

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

  • 0644Generalpotential for harm

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

  • 0684Generalpotential for harm

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

  • 0689Seriousactual harm

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

  • 0800Generalpotential for harm

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

  • 0801Generalno actual harm

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

  • 0812Generalpotential for harm

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

  • 0004Generalpotential for harm

    Develop and maintain an Emergency Preparedness Program (EP).

  • 0006Generalpotential for harm

    Conduct risk assessment and an All-Hazards approach.

  • 0026Generalpotential for harm

    Establish roles under a Waiver declared by secretary.

  • 0030Generalpotential for harm

    List the names and contact information of those in the facility.

  • 0039Generalpotential for harm

    Conduct testing and exercise requirements.

  • 0291Generalpotential for harm

    Install emergency lighting that can last at least 1 1/2 hours.

  • 0321Generalpotential for harm

    Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.

  • 0345Generalpotential for harm

    Have approved installation, maintenance and testing program for fire alarm systems.

  • 0347Generalpotential for harm

    Properly provide smoke detection systems in areas open to corridors.

  • 0354Generalpotential for harm

    Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.

  • 0712Generalpotential for harm

    Have simulated fire drills held at unexpected times.

  • 0761Generalpotential for harm

    To conduct inspection, testing and maintenance of fire doors by qualified individuals.

  • 0918Generalpotential for harm

    Have generator or other power source capable of supplying service within 10 seconds.

  • 0921Generalpotential for harm

    Ensure that testing and maintenance of electrical equipment is performed.

  • 0677Generalpotential for harm

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

  • 0658Generalpotential for harm

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

  • 0641Generalpotential for harm

    Ensure each resident receives an accurate assessment.

  • 0584Generalpotential for harm

    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.

  • 0550Generalpotential for harm

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

  • 0689Seriousactual harm

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

  • 0582Generalno actual harm

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

  • 0656Generalpotential for harm

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

  • 0684Generalpotential for harm

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

  • 0511Generalpotential for harm

    Have properly installed electrical wiring and gas equipment.

  • 0920Generalpotential for harm

    Ensure proper usage of power strips and extension cords.

  • 0131Generalpotential for harm

    Meet requirements for sections of health care facilities separated by fire resistive construction.

  • 0222Generalpotential for harm

    Add doors in an exit area that do not require the use of a key from the exit side unless in case of special locking arrangements.

  • 0880Generalpotential for harm

    Provide and implement an infection prevention and control program.

  • 0550Generalpotential for harm

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

  • 0578Generalpotential for harm

    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.

  • 0656Generalpotential for harm

    Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.

  • 0677Generalpotential for harm

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

  • 0684Seriousimmediate jeopardy

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

  • 0725Generalpotential for harm

    Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.

  • 0880Generalpotential for harm

    Provide and implement an infection prevention and control program.

  • 0580Generalpotential for harm

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

  • 0584Generalpotential for harm

    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.

  • 0580Generalpotential for harm

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

  • 0677Generalpotential for harm

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

  • 0584Generalpotential for harm

    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.

  • 0880Generalpotential for harm

    Provide and implement an infection prevention and control program.

Inspection history

Every health inspection on record

Each CMS health inspection of this facility, and the deficiencies the surveyors cited. Where the verbatim Form 2567 statement of deficiencies is on file, it links to the full report.

Showing the 10 most recent inspections. 2 earlier inspections are also on record.

FAQ

Questions and answers

What is The Highlands?
The Highlands is a Medicare- and Medicaid-certified nursing home in Decorah, IA, tracked by the Centers for Medicare & Medicaid Services (CMS). Its CMS Certification Number (CCN) is 165178.
What is the CMS rating for The Highlands?
The Highlands has a CMS overall rating of 2 out of 5 stars. CMS rates nursing homes on health inspections, staffing, and quality measures.
How many beds does The Highlands have?
The Highlands is certified for 86 beds. It serves an average of 69.9 residents per day.
How many citations does The Highlands have?
The Highlands has 64 citations on record from CMS health inspections, each tied to a federal deficiency tag.
When was The Highlands last inspected?
The Highlands was last inspected on September 23, 2025. CMS surveys nursing homes about once a year and after complaints.
What can I do if I have concerns about care at this facility?
Start by raising the concern with the facility administrator or director of nursing. Every state also runs a free long-term care ombudsman program that advocates for residents and families; the federal Eldercare Locator at eldercare.acl.gov can connect you with yours. Complaints about quality of care can also be filed with your state survey agency.

*Sourced from the Centers for Medicare & Medicaid Services (CMS). See the official record on CMS Care Compare. If you believe any information is inaccurate, report it here.

/nursing-home/165178-the-highlands