Twilight Acres: Staffing, Turnover, and Inspection Record
Twilight Acres is a 39-bed nonprofit nursing home in Wall Lake, Iowa. In the CMS August 2026 release it reported 2.44 nurse aide hours per resident per day, 3% below the Iowa average of 2.51, and 34.5% nursing staff turnover (Iowa average 44.0%).
Twilight Acres
600 West 6th StreetWall Lake, IA 51466
Sac 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 Twilight Acres, nurse aides logged 2.44 hours per resident per day, 3% below the Iowa average. With about 28 residents a day, that works out to roughly 67 aide hours a day, or about 8 eight-hour aide shifts across day, evening, and night. On weekends, total nursing hours per resident ran 9% below the all-days figure.
| Hours per resident per day | This home | Iowa avg | US avg |
|---|---|---|---|
| Nurse aides (CNAs) | 2.44 | 2.51 | 2.32 |
| Licensed practical nurses | 0.91 | 0.56 | 0.86 |
| Registered nurses | 0.73 | 0.74 | 0.69 |
| All nursing staff | 4.07 | 3.82 | 3.86 |
| All nursing staff, weekends | 3.73 | 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
34.5% of nursing staff at Twilight Acres left over the year CMS measured, against a Iowa average of 44.0% and a US average of 45.8%. Registered nurse turnover was 28.6%. 1 administrator left over the same period.
Inspections and penalties
State inspectors last completed a standard health inspection on Dec 18, 2025. The most recent inspection cycle, which also counts complaint and infection-control inspections from the past 12 months, found 4 health deficiencies (Iowa average 6.5). CMS lists no fines or payment denials for this home in the last three years.
CMS star ratings
CMS rates every nursing home from one to five stars overall and on health inspections, staffing, and quality measures. Twilight Acres holds 5 of 5 overall; the Iowa average is 3.1.
About Twilight Acres
- Ownership: Non profit - Corporation
- Legal name: Twilight Acres Inc.
- Medicare and Medicaid certified since: Sep 1, 2003
- Councils: resident council
- Area: rural
Nursing homes near Twilight Acres
The closest homes by distance, with the same CMS figures. Select a column to sort.
| Odebolt Specialty Care Odebolt | 7.9 | 38 | 2.18 | 3.73 | 31.0% | 3 | $14,433 |
| Park View Rehabilitation Center Sac City | 11.8 | 77 | 2.20 | 3.62 | 53.2% | 1 | None |
| Accura Healthcare of Carroll Carroll | 17.6 | 65 | 1.71 | 2.93 | 44.2% | 1 | None |
| Accura Healthcare of Lake City, LLC Lake City | 17.6 | 46 | 2.51 | 3.69 | 37.0% | 2 | $38,610 |
| St Anthony Senior Services Carroll · abuse citation | 19.4 | 79 | 2.69 | 3.87 | — | 1 | $12,038 |
| Regency Park Nursing & Rehab Center of Carroll Carroll | 19.4 | 46 | 2.19 | 3.48 | — | 5 | None |
| Denison Care Center Denison | 20.9 | 46 | 2.16 | 3.63 | 28.6% | 4 | None |
| Gracewell, An Eventide Community Denison | 22.1 | 84 | 2.32 | 3.64 | 18.5% | 5 | None |
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.