The Highlands is certified as a Medicare and Medicaid facility and has been approved to provide these services since 1993-01-01. Medicare covers short-term skilled nursing care (typically up to 100 days after a qualifying hospital stay). Medicaid covers long-term care for residents who meet financial eligibility requirements. Contact the facility at (563) 382-3603 or your local Medicaid office to verify current eligibility.

The Highlands holds an overall CMS (Centers for Medicare & Medicaid Services) rating of 1 out of 5 stars. This is made up of three components: Health Inspection (1★), Staffing (3★), and Quality of Resident Care (4★). Our independent composite quality score — which uses the raw underlying CMS numbers to break ties between similarly-rated facilities — is 65.5/100, placing it #10150 of 14703 facilities nationally and #253 of 390 in Iowa. Star ratings are a useful starting point, but the composite score and individual sub-ratings give a more complete picture for families comparing facilities.

Each resident at The Highlands receives a reported average of 3 hours 18 minutes of total nurse staffing per day. This breaks down as: Registered Nurse (RN) coverage — 32 minutes; Licensed Practical Nurse (LPN) — 35 minutes; Nurse Aide — 2 hours 12 minutes. On weekends, total nurse staffing is 2 hours 47 minutes per resident per day. The CMS Staffing Rating for this facility is 3 out of 5. The national average for total nursing hours is approximately 3.5 hrs/day. Total nursing staff turnover is 58.9%. Families are encouraged to ask about current staffing schedules during their facility visit.

In the current reporting period, the facility received 3 fine(s) totaling $153,679. 33 substantiated complaints were recorded across the 5-year period — families should request details from the facility or review CMS inspection findings. There were 1 Medicare payment denial(s) in the current period. In the most recent CMS reporting period, the facility received 3 fine(s) totaling $153,679, and 1 Medicare payment denial(s). Total penalties: 4. The Total Weighted Health Survey Score is 95.5 (lower scores are better). Full inspection history and complaint details are available at medicare.gov/care-compare.

Nationally, The Highlands ranks 10150th out of 14,703 facilities (composite score: 65.5/100), placing it in the below average nationwide. Within IA, it ranks 253rd out of 390 nursing homes. In Decorah, it ranks 1st out of 2 facilities. Among facilities sharing its ZIP code, it ranks 1st of 2. For 2026 staffing: total nurse hours rank #11,024 nationally and RN hours rank #7,998 nationally (#270 in IA). Our composite quality score of 65.5/100 weighs health inspections, quality of resident care, staffing hours, compliance record, and five-year performance trends — giving a more complete picture than CMS star ratings alone, which can place hundreds of facilities in the same 5-star bucket. To browse and compare all nursing homes in Decorah, visit: https://nursinghomesnearme.org/iowa/decorah/