The Highlands: Staffing, Turnover, and Inspection Record
The Highlands is a 86-bed nonprofit nursing home in Decorah, Iowa. In the CMS August 2026 release it reported 2.79 nurse aide hours per resident per day, 11% above the Iowa average of 2.51, and 53.3% nursing staff turnover (Iowa average 44.0%).
The Highlands
607 Highland DriveDecorah, IA 52101
Winneshiek County
CMS Care Compare, August 2026 release
How many staff hours residents get
CMS reports staffing as hours per resident per day, from the payroll records each home submits. At The Highlands, nurse aides logged 2.79 hours per resident per day, 11% above the Iowa average. With about 75 residents a day, that works out to roughly 211 aide hours a day, or about 26 eight-hour aide shifts across day, evening, and night. On weekends, total nursing hours per resident ran 8% below the all-days figure.
| Hours per resident per day | This home | Iowa avg | US avg |
|---|---|---|---|
| Nurse aides (CNAs) | 2.79 | 2.51 | 2.32 |
| Licensed practical nurses | 0.66 | 0.56 | 0.86 |
| Registered nurses | 0.44 | 0.74 | 0.69 |
| All nursing staff | 3.90 | 3.82 | 3.86 |
| All nursing staff, weekends | 3.59 | 3.37 | 3.42 |
CMS Care Compare, August 2026 release: reported staffing hours from Payroll-Based Journal data, and CMS state and US averages.
Staff turnover
53.3% of nursing staff at The Highlands left over the year CMS measured, against a Iowa average of 44.0% and a US average of 45.8%. Registered nurse turnover was 44.4%. 1 administrator left over the same period.
Inspections and penalties
State inspectors last completed a standard health inspection on Jun 12, 2025. The most recent inspection cycle, which also counts complaint and infection-control inspections from the past 12 months, found 6 health deficiencies (Iowa average 6.5). CMS lists 2 fines totaling $93,839 and 1 payment denial in the last three years.
| Inspection date | Penalty | Amount or length |
|---|---|---|
| Dec 9, 2024 | Fine | $50,211 |
| Jul 25, 2024 | Fine | $43,628 |
| Jul 25, 2024 | Payment Denial | 10 days from Aug 21, 2024 |
CMS Penalties file, August 2026 release. A payment denial stops Medicare and Medicaid payment for new admissions for the days shown.
CMS star ratings
CMS rates every nursing home from one to five stars overall and on health inspections, staffing, and quality measures. The Highlands holds 2 of 5 overall; the Iowa average is 3.1.
About The Highlands
- Ownership: Non profit - Corporation
- Legal name: Aase Haugen Homes, Inc.
- Medicare and Medicaid certified since: Jan 1, 1993
- Part of a continuing care retirement community
- Councils: resident council
- Area: rural
Nursing homes near The Highlands
The closest homes by distance, with the same CMS figures. Select a column to sort.
| Wellington Place Decorah | 2.9 | 56 | 2.30 | 3.47 | 48.1% | 3 | None |
| Ossian Care Center Ossian | 12.3 | 46 | 3.15 | 4.63 | 40.7% | 2 | None |
| Green Lea Senior Living Mabel · many days without an RN | 13.3 | 41 | 1.72 | 2.37 | — | 1 | None |
| Northgate Care Center Waukon · SFF candidate | 15.8 | 50 | 2.04 | 2.97 | 34.3% | 1 | $87,160 |
| Good Samaritan - Waukon Waukon | 16.3 | 60 | 1.81 | 3.17 | 43.5% | 2 | $8,281 |
| Evans Senior Living Community Cresco | 16.8 | 43 | 2.17 | 3.66 | 28.9% | 5 | None |
| Tweeten Lutheran Health Care Center Spring Grove · SFF candidate · many days without an RN | 18.2 | 49 | 0.53 | 0.95 | 81.0% | 1 | None |
| Gundersen Harmony Care Center Harmony | 19.0 | 42 | 1.94 | 3.38 | 51.4% | 5 | $12,649 |
Aide hrs and all nurse hrs are staff hours per resident per day. Fines are the CMS total for the last three years. Turnover is the share of nursing staff who left over a year. All figures from CMS Care Compare.
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Source: CMS Care Compare Provider Information, State and US Averages, and Penalties files, August 2026 release. Figures are as CMS publishes them; check Medicare Care Compare for the latest. Methodology.