Hillcrest Health Care Center
2121 Avenue L · Hawarden, IA · 51023 · 7125511074
64 certified beds For profit - Limited Liability company Chain: The Ensign Group
Why this verdict
- Carries CMS’s abuse warning icon.
- Inspection record is far worse than the national median (deficiency count and severity).
- Staffing levels are well below research benchmarks for safe care.
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Everything on this page plus the full citation-by-citation history with inspector findings, the complete penalty record, staffing vs benchmarks, side-by-side nearby comparisons, and the printable tour checklist. One PDF, emailed in minutes, yours to keep and share with family.
Red flags
CMS abuse warning
CMS flags this facility with its abuse icon: cited for abuse that caused harm in the past year, or potential harm in the past two years.
2 immediate-jeopardy citations in prior inspection cycles
Serious past findings — check whether the underlying problems were fixed and stayed fixed.
1 abuse-related citation at the actual-harm level
Inspectors cited failures in the abuse-prevention rules (F600–F610) that resulted in actual harm to a resident.
69% of nursing staff left within a year
High turnover disrupts continuity of care; the national median is 45%.
If someone you love was harmed at a facility with findings like these, you have options — read this.
Score breakdown
Quality-measure stars are deliberately excluded — they're largely self-reported by facilities. Full method.
CMS ratings & staffing
Overall: 1 of 5 Inspections: 1 of 5 Staffing: 1 of 5 Quality measures: 4 of 5
| Total nurse hours / resident-day | — | 3.48 min · 4.1 strong |
|---|---|---|
| RN hours / resident-day | — | 0.55–0.75 |
| Weekend hours / resident-day | — | ≈ weekday level |
| Nursing turnover / year | 69% | median 45% |
| Fines (3-yr window) | 2 · $25,450 |
Inspection citations (70 in the current record)
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Actual harm · G March 26, 2026 · found via complaint
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Corrected April 8, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D March 26, 2026
Honor the resident's right to manage his or her financial affairs.
Corrected April 8, 2026 · Resident Rights
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Potential for harm · D March 26, 2026
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Corrected April 8, 2026 · Resident Rights
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Potential for harm · D March 26, 2026
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Corrected April 8, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D March 26, 2026
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Corrected April 8, 2026 · Resident Rights
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Potential for harm · D March 26, 2026
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Corrected April 8, 2026 · Resident Assessment and Care Planning
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Potential for harm · D March 26, 2026
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected April 8, 2026 · Resident Assessment and Care Planning
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Potential for harm · E March 26, 2026
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Corrected April 8, 2026 · Quality of Life and Care
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Potential for harm · D March 26, 2026
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Corrected April 8, 2026 · Quality of Life and Care
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Potential for harm · D March 26, 2026
Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Corrected April 8, 2026 · Quality of Life and Care
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Potential for harm · E March 26, 2026
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Corrected April 8, 2026 · Nursing and Physician Services
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Potential for harm · D March 26, 2026
Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Corrected April 8, 2026 · Quality of Life and Care
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Potential for harm · D March 26, 2026
Ensure that residents are free from significant medication errors.
Corrected April 8, 2026 · Pharmacy Service
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Potential for harm · E March 26, 2026
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Corrected April 8, 2026 · Nutrition and Dietary
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Potential for harm · D March 26, 2026
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Corrected April 8, 2026 · Resident Assessment and Care Planning
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Potential for harm · D March 26, 2026
Have a plan that describes the process for conducting QAPI and QAA activities.
Corrected April 8, 2026 · Administration
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Potential for harm · D March 26, 2026
Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Corrected April 8, 2026 · Administration
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Potential for harm · E March 26, 2026
Provide and implement an infection prevention and control program.
Corrected April 8, 2026 · Infection Control
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Potential for harm · D March 26, 2026 · found via complaint
Reasonably accommodate the needs and preferences of each resident.
Corrected April 8, 2026 · Resident Rights
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Potential for harm · D March 26, 2026 · found via complaint
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Corrected April 8, 2026 · Resident Rights
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Potential for harm · E March 26, 2026 · found via complaint
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.
Corrected April 8, 2026 · Resident Rights
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Potential for harm · D March 26, 2026 · found via complaint
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Corrected April 8, 2026 · Freedom from Abuse, Neglect, and Exploitation
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Potential for harm · D March 26, 2026 · found via complaint
Provide care and assistance to perform activities of daily living for any resident who is unable.
Corrected April 8, 2026 · Quality of Life and Care
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Potential for harm · D October 8, 2025 · found via complaint
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Corrected October 13, 2025 · Resident Assessment and Care Planning
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Potential for harm · D March 11, 2025
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Corrected March 28, 2025 · Resident Rights
Showing the 25 most recent. The Safety Report includes every citation with full findings.
Federal penalties
| Date | Type | Amount / length |
|---|---|---|
| July 28, 2024 | Fine | $8,649 |
| January 31, 2024 | Fine | $16,801 |
Family & resident reviews — a separate signal, never mixed into the score
No approved reviews yet. If your family has experience with this facility, yours could be the review that helps the next family decide.
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Source: CMS Care Compare (public domain), data as of June 1, 2026 · CCN 165245 · certified since November 16, 1994. The score is a screen, not a verdict on any one resident's experience — read how it's computed, then visit in person.