CMS PUBLIC RECORD · AUGUST 2026 RELEASERECORDS ARE ONE INPUT—NOT A PLACEMENT RECOMMENDATION
NURSING HOMELEDGERINSPECTIONS · OWNERSHIP · PENALTIES
CMS CCN 1651782026-08-01 PROCESSING DATE

NURSING HOME PUBLIC RECORD

The Highlands

607 Highland Drive · Decorah, IA 52101 · Winneshiek County

CMS OVERALL RATING★★☆☆☆2/5CMS field—not our score or recommendation
Certified beds86CMS provider file
Recent citation rows54current CMS citation release
Penalty rows3current CMS penalties file
Read this record carefully.

The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.

01 / INSPECTION LEDGER

Survey cycles in this release

CycleHealth dateHealth deficienciesFire dateFire deficiencies
Cycle 12025-06-1262025-06-128
Cycle 22024-07-25102024-07-2514
Cycle 32023-09-18122023-09-184
02 / CITATION DETAIL

54 rows in the current release

3 rows carry G–L scope/severity codes; 1 carry J–L. 10 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.

2026-06-18 · HEALTHF0689Severity D · isolated; potential for more than minimal harm

Quality of Life and Care Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2026-07-01 · complaint
2025-09-23 · HEALTHF0550Severity E · pattern; potential for more than minimal harm

Resident Rights Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2025-09-24 · complaint
2025-09-23 · HEALTHF0923Severity E · pattern; potential for more than minimal harm

Environmental Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2025-09-24 · complaint
2025-06-12 · FIREE0029Severity F · widespread; potential for more than minimal harm

Emergency Preparedness Deficiencies

Develop a communication plan.

Correction field: Deficient, Provider has date of correction · 2025-06-24
2025-06-12 · FIREE0039Severity F · widespread; potential for more than minimal harm

Emergency Preparedness Deficiencies

Conduct testing and exercise requirements.

Correction field: Deficient, Provider has date of correction · 2025-06-24
2025-06-12 · HEALTHF0582Severity D · isolated; potential for more than minimal harm

Resident Rights Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2025-06-26
2025-06-12 · HEALTHF0641Severity B · pattern; potential for minimal harm

Resident Assessment and Care Planning Deficiencies

Ensure each resident receives an accurate assessment.

Correction field: Deficient, Provider has date of correction · 2025-06-26
2025-06-12 · HEALTHF0943Severity D · isolated; potential for more than minimal harm

Freedom from Abuse, Neglect, and Exploitation Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2025-06-26
2025-06-12 · FIREK0291Severity F · widespread; potential for more than minimal harm

Egress Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2025-06-20
2025-06-12 · FIREK0345Severity F · widespread; potential for more than minimal harm

Smoke Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2025-06-25
2025-06-12 · FIREK0353Severity F · widespread; potential for more than minimal harm

Smoke Deficiencies

Inspect, test, and maintain automatic sprinkler systems.

Correction field: Deficient, Provider has date of correction · 2025-06-25
2025-06-12 · FIREK0354Severity F · widespread; potential for more than minimal harm

Smoke Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2025-06-30
2025-06-12 · FIREK0711Severity F · widespread; potential for more than minimal harm

Miscellaneous Deficiencies

Provide a written emergency evacuation plan.

Correction field: Deficient, Provider has date of correction · 2025-06-30
2025-06-12 · FIREK0712Severity F · widespread; potential for more than minimal harm

Miscellaneous Deficiencies

Have simulated fire drills held at unexpected times.

Correction field: Deficient, Provider has date of correction · 2025-06-25
2024-12-09 · HEALTHF0684Severity J · isolated immediate jeopardy

Quality of Life and Care Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2024-12-10 · complaint
2024-09-25 · HEALTHF0580Severity D · isolated; potential for more than minimal harm

Resident Rights Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2024-09-26 · complaint
2024-09-25 · HEALTHF0684Severity D · isolated; potential for more than minimal harm

Quality of Life and Care Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2024-09-26 · complaint
2024-07-25 · FIREE0004Severity F · widespread; potential for more than minimal harm

Emergency Preparedness Deficiencies

Develop and maintain an Emergency Preparedness Program (EP).

Correction field: Deficient, Provider has date of correction · 2024-08-31
2024-07-25 · FIREE0006Severity F · widespread; potential for more than minimal harm

Emergency Preparedness Deficiencies

Conduct risk assessment and an All-Hazards approach.

Correction field: Deficient, Provider has date of correction · 2024-08-15
2024-07-25 · FIREE0026Severity F · widespread; potential for more than minimal harm

Emergency Preparedness Deficiencies

Establish roles under a Waiver declared by secretary.

Correction field: Deficient, Provider has date of correction · 2024-08-16
2024-07-25 · FIREE0030Severity F · widespread; potential for more than minimal harm

Emergency Preparedness Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2024-08-31
2024-07-25 · FIREE0039Severity F · widespread; potential for more than minimal harm

Emergency Preparedness Deficiencies

Conduct testing and exercise requirements.

Correction field: Deficient, Provider has date of correction · 2024-08-28
2024-07-25 · HEALTHF0644Severity D · isolated; potential for more than minimal harm

Resident Assessment and Care Planning Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2024-07-26
2024-07-25 · HEALTHF0684Severity D · isolated; potential for more than minimal harm

Quality of Life and Care Deficiencies

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

Correction field: Deficient, Provider has date of correction · 2024-07-26
03 / ENFORCEMENT FILE

Penalties reported by CMS

Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.

DateTypeFine amountPayment-denial days
2024-12-09Fine$50,2110
2024-07-25Fine$43,6280
2024-07-25Payment Denial$010
04 / OWNERSHIP DISCLOSURES

Who appears in the CMS file

  • BJELLAND, SUSANIndividual · W-2 MANAGING EMPLOYEE
    NOT APPLICABLE · since 02/22/2010
  • ELSBERND, NANCYIndividual · W-2 MANAGING EMPLOYEE
    NOT APPLICABLE · since 02/22/2010
  • SCHMIDT, JEFFREYIndividual · CORPORATE DIRECTOR
    NOT APPLICABLE · since 05/20/2013
  • CONTINUUM HEALTH CARE SERVICES LLCOrganization · OPERATIONAL/MANAGERIAL CONTROL
    NOT APPLICABLE · since 01/17/2013

Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.

05 / CMS STAFFING FIELDS

Reported hours and turnover

Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.

Total nurse hours3.90per resident day
RN hours0.44per resident day
Weekend nurse hours3.59per resident day
Staff turnover53.3%CMS reported field
BEFORE A CARE DECISION

Verify the current record and visit in person.

Use this ledger to frame questions—not to choose care on its own. Recheck Medicare Care Compare, contact the state survey agency and long-term care ombudsman, and ask the facility about anything you find.