The Highlands
Below-average Medicare ratings — review the inspection history and ask the administrator about recent corrections before visiting.
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Quality Concerns Identified
Medicare inspection and quality data reveal areas that families should carefully evaluate before choosing this facility.
- Low overall rating (1/5 stars)
- High staff turnover (59%)
Bottom 25% in IA · Below recommended RN staffing · $153,679 in fines
What this means for your family
This facility has areas of concern that warrant careful consideration. Registered Nurse hours are only 72% of the national benchmark, which can affect medication management and response times. We recommend asking the administrator directly: "How are you addressing recent staffing shortfalls?" These are not reasons to panic, but they are reasons to ask tough questions and visit in person.
Staffing
Staffing Hours
per resident/day · Medicare 2026Both RN and total nursing hours are below national benchmarks. This can mean less clinical attention per resident, so ask about their staffing plan.
Quality Measures
Quality Measures
Resident outcomes compared with national, state, and local averages · 16 measures
6
measures
9
measures
1
measures
Residents needing more daily help over time
Residents with depression symptoms
Highly dependent on how each facility screens and codes depressive symptoms, so it varies widely between facilities.
Residents on antipsychotic medication
Residents whose bladder or bowel control got worse
Residents whose walking got worse
Residents vaccinated for pneumonia
Short-stay residents vaccinated for pneumonia
Short-stay residents newly given antipsychotics
US average from Medicare published data
Inspection History
Medicare Inspection History
3-year lookback · Medicare 2026
The Highlands has concerning recurring problems, with families filing 22 complaints that triggered federal inspections. The facility repeatedly struggles with providing appropriate treatment and care, maintaining safe and clean environments, and following infection control protocols. While all 64 deficiencies across 9 surveys show correction dates, the pattern of similar issues returning—especially treatment quality problems appearing five times and environment/safety concerns recurring frequently—suggests ongoing operational challenges that families should investigate thoroughly during visits.
Sep 23, 2025Complaint2
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Environmental Deficiencies
Have enough outside ventilation via a window or mechanical ventilation, or both.
Jun 12, 2025Routine11
Emergency Preparedness Deficiencies
Develop a communication plan.
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Smoke Deficiencies
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Miscellaneous Deficiencies
Provide a written emergency evacuation plan.
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
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.
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Dec 9, 2024Complaint1
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Sep 25, 2024Complaint2
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.
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Jul 25, 2024Routine21
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Emergency Preparedness Deficiencies
Conduct risk assessment and an All-Hazards approach.
Emergency Preparedness Deficiencies
Establish roles under a Waiver declared by secretary.
Emergency Preparedness Deficiencies
List the names and contact information of those in the facility.
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Smoke Deficiencies
Have approved installation, maintenance and testing program for fire alarm systems.
Smoke Deficiencies
Properly provide smoke detection systems in areas open to corridors.
Smoke Deficiencies
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Gas, Vacuum, and Electrical Systems Deficiencies
Have generator or other power source capable of supplying service within 10 seconds.
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure that testing and maintenance of electrical equipment is performed.
Nutrition and Dietary Deficiencies
Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
Nutrition and Dietary Deficiencies
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Smoke Deficiencies
Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
Miscellaneous Deficiencies
To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Resident Assessment and Care Planning Deficiencies
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Nutrition and Dietary Deficiencies
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.
Feb 7, 2024Complaint6
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies
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.
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Quality of Life and Care Deficiencies
Provide care and assistance to perform activities of daily living for any resident who is unable.
Federal Penalties
Fine
Dec 9, 2024
$50,211
Fine
Jul 25, 2024
$43,628
Payment Denial
Jul 25, 2024
10-day denial
Fine
Jul 11, 2023
$59,840
State Inspection History
State Inspections
Source: Iowa Dept. of Inspections, Appeals & Licensing
Dec 9, 2025ComplaintClean
Fed violations: 0, State violations: 0
Nov 12, 2025OtherClean
Fed violations: 0, State violations: 0
Sep 23, 2025ComplaintClean
Fed violations: 2, State violations: 0
Jun 26, 2025InspectionClean
Fed violations: 0, State violations: 0
Jun 12, 2025InspectionClean
Fed violations: 3, State violations: 0
Feb 3, 2025ComplaintClean
Fed violations: 0, State violations: 0
Dec 9, 2024ComplaintClean
Fed violations: 1, State violations: 1
Oct 15, 2024ComplaintClean
Fed violations: 0, State violations: 0
Ownership & Operations
Who Operates This Facility
The Highlands
nonprofit
Ownership & Management
Key personnel
Contact
Get in Touch
Contact this facility directly and verify the details that matter most to your family.
References & Resources
Medicare Care Compare
Official Medicare quality ratings, inspections & staffing data
Google Maps
Photos, directions & neighborhood info
Google Reviews
Read reviews from families & visitors
Official Website
Visit aasehaugen.com
Medicare data downloads
Original nursing home datasets
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