Elm Crest Senior Living Community
Elm Crest Senior Living Community is a continuing care retirement community in Harlan, IA, offering independent living, assisted living, memory care, nursing home care, and skilled nursing. Independent living provides a private home with community services but no daily care, while assisted living adds help with bathing, dressing, medication, and other daily tasks while the resident keeps an apartment.
Memory care is provided in a secured setting with supervision for someone who may be at risk of wandering. Nursing home and skilled nursing care provide licensed nursing care on site around the clock. With several care levels in one community, Elm Crest can suit a resident whose needs grow over time without requiring a move to a different community.
The community opened in 1958 and has 50 beds. Housing includes studios, one bedroom units, and two bedroom units, with a two bedroom layout potentially suiting a couple moving together or someone who wants a companion. Rehabilitation therapy and short term rehab are available for residents recovering over a temporary period.
A barber, beauty shop, and spa provide grooming services on site, while the chapel and religious services offer an on site setting for worship. Transportation is available for residents who need help traveling beyond the community. The community has 4h 18m of total nurse staffing per resident per day, meaning that amount of daily hands on nursing time is assigned per resident. Payment options are Medicare, Medicaid, and private pay, and Leah Mulbauer serves as the administrator. A Walk Score of 50 places the area in the somewhat walkable band, so some errands can be done on foot and a resident who no longer drives may be able to manage certain local trips independently.
Staffing
Data period: Q2 2026 (April 1 – June 30, 2026).
Nursing care per resident per day and state rankings: CMS Provider Information.
Headcount, shifts and contractors: CMS Payroll-Based Journal (PBJ).
Resident count: CMS Long-Term Care Facility Characteristics (data as of Sep 2026).
Standout metric: Registered nurse (RN) is +43% above Iowa average
2 of 6 metrics below Iowa average
Daily care time per resident, by role
US average: 41m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 41m
US average: 52m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 52m
US average: 2h 21m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 2h 21m
US average: 4m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 4m
US average: 3h 26m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 3h 26m
US average: 29m.Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse. US 29m
Headcount
66.2% of staff hours were worked by the facility's own employees
Iowa average: 92.3% · Contractors this quarter: Certified Nursing Assistant (74), Registered Nurse (8), Licensed Practical Nurse (6), Physical Therapy Assistant (2), Speech Language Pathologist (1), Occupational Therapy Aide (1), Qualified Social Worker (1), Respiratory Therapy Technician (1), Occupational Therapy Assistant (1), Medical Director (1)
Why it matters: employees work here week after week and get to know each resident's routines and needs. Agency contractors often rotate between facilities, so a higher employee share usually means more consistent care.
Community insights.
Smaller home · May offer a more intimate, personalized care environment.
Based on 47 residents and 50 beds. Source: state inspection report (Jan 2026)
About This Community
Elm Crest Senior Living Community is administered by Leah Mulbauer.
Two inspection records, one home. Iowa inspects it under state rules; CMS inspects its nursing-home beds under federal rules.
Inspection History and the Inspection Scorecard below are the state record. CMS Health Inspection History, further down, is the federal record. Each counts its own visits and findings over its own dates, so the totals are not meant to match, and nothing is counted twice.
Inspection History
In Iowa, the Department of Inspections, Appeals, and Licensing conducts unannounced health and safety surveys to monitor compliance and protect residents in long-term care settings.
Inspection Scorecard
This scorecard compares key inspection, violation, and complaint metrics at this facility against the Iowa state average. Metrics rated ≥15% worse than average are highlighted in red; those ≥15% better are highlighted in green.
• Violations (20% above) 1 At Avg Metrics at Iowa average:
• Violations per inspection (at IA avg) 2 Better Metrics better than Iowa average:
• Federal violations (17% below)
• State violations (71% below)
Violations
| This Facility | IA Average | vs. IA Avg |
|---|---|---|---|
|
Violations
| 28 | 23.4 | This facility has 20% more violations than a typical Iowa nursing home (28 vs. IA avg 23.4).↑ 20% worse |
|
Federal violations
| 26 | 31.2 | This facility has 17% fewer federal violations than a typical Iowa nursing home (26 vs. IA avg 31.2).↓ 17% better |
|
State violations
| 2 | 6.9 | This facility has 71% fewer state violations than a typical Iowa nursing home (2 vs. IA avg 6.9).↓ 71% better |
|
Violations per inspection
| 1.6 | 1.6 | This facility has violations per inspection in line with the Iowa average (1.6 vs. IA avg 1.6).— At avg |
Inspections
| This Facility | IA Average | vs. IA Avg |
|---|---|---|---|
|
Total inspections
| 17 | 12.7 | This facility has had 34% more total inspections than the Iowa average (17 vs. IA avg 12.7). More inspections can mean more regulatory scrutiny rather than worse care.↑ 34% more |
CMS Health Inspection History
Federal inspection data published by CMS, covering this home's Medicare and/or Medicaid-certified skilled-nursing/nursing beds only.
Citation severity
Latest inspection: Aug 10, 2026 · 2 citations, all corrected
Most cited category: Quality of Life & Care, 8 of 21 citations · 6 categories in total
Citations history
Most recent firstTop deficiency categories
Share of 21 citationsHow citations are counted
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
13 of 21 citations resulted from standard inspections; 6 of 21 resulted from complaint investigations; and 2 of 21 came from combined inspections (standard and complaint).
Includes all CMS health inspection records for this property, which could include management/ownership changes.
Source
Data sourced from CMS Health Deficiencies reports, which cover the Medicare and/or Medicaid-certified skilled-nursing and nursing beds and no other part of the community. Citation severity codes range from A (least serious) to L (most serious). Immediate Jeopardy (J-L) citations indicate situations where the facility's noncompliance has placed residents at risk of death or serious harm.
Penalties and fines
Federal penalties imposed by CMS for regulatory violations, including civil money penalties (fines) and denials of payment for new Medicare/Medicaid admissions.
Source: CMS Penalties Database · Data as of Oct 2026
2 penalties in the past 3 years
Latest: Jun 10, 2026 · $14,380 civil money penalty
Penalty history · past 3 years
Fine amount comparison
Totals count every penalty on record; the history lists the past 3 years. Iowa and US averages are among facilities with a penalty on record.
A civil money penalty is a fine for noncompliance, per day or per instance. A payment denial stops Medicare/Medicaid payments for new residents until issues are fixed.
Quality of care over time
How residents at this home fare on health outcomes and preventive care, compared with the Iowa average.
13 long-stay measures: 5 better, 6 worse, 2 near IA average
8 short-stay measures: 4 better, 1 worse, 3 compared with US only
Long-stay residents
People who live at the home · 13 measures
Daily care & independence
Safety & clinical stability
Physical & mental health
Preventive care
Hospital & emergency visits
Short-stay residents
Rehab and recovery after a hospital stay · 8 measures
Daily care & independence
Safety & clinical stability
Physical & mental health
Preventive care
Hospital & emergency visits
Arrows show whether a figure is above or below the average. Green is better for residents, red is worse, and yellow means within 5% of the average. Grey compares with the US average only, because CMS publishes no state figure. The line on each bar marks the average.
Quality measures are calculated by CMS from Minimum Data Set (MDS) resident assessments and Medicare claims.
Money and staffing.
Elm Crest Senior Living Community’s finances from its CMS cost report for the fiscal year ending August 2025, compared with 227 Iowa nursing homes that filed a recent report. Includes all financial data for this property, which could include management/ownership changes.
Is it financially stable?
Losing money on care, but less than last year
−7.1% operating margin
+10.1 pts vs prior year
An operating loss in 8 of the last 8 reported years. Other income ($0.1M) trims the net loss to −$0.5M. Watch for cost-cutting that reaches staffing.
Does it invest in staff?
Spends less on payroll than most Iowa homes
53.6% payroll share of revenue
IA average 61.0%Rank #181 / 227Payroll % of net patient revenue — State benchmarked This nursing home is ranked 181st out of 227 nursing homes we track in Iowa for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Iowa average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric.
Payroll rose $0.3M while revenue rose $0.6M. A low share can mean leaner staffing; check hours per resident in the staffing section.
FY 2025 scorecard
Each row shows the FY 2025 figure, the change since the prior report, the trend, and how it compares with Iowa homes.
Revenue & profit
Losing money on care
| Metric | FY 2025 | vs prior year | Trend 2018 → 2025Trend | IA median | Compared with IA homesRank in IA | In short |
|---|---|---|---|---|---|---|
| Net patient revenue What the home earns from resident care, after discounts and bad debt. | $7.6M | +$0.6M | Trend 20182025 | IA median $6.1M | Rank in IA Rank #79 / 227Net patient revenue — State benchmarked This nursing home is ranked 79th out of 227 nursing homes we track in Iowa for net patient revenue. Shows this facility's net patient revenue compared to the Iowa average, among facilities reporting a recent fiscal year. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 65% of homes | Above IA median Higher net patient revenue than 65% of IA homes that filed a recent report. Revenue mostly follows how big a home is. |
| Operating expenses Everything it costs to run the home: staff, supplies, rent, admin. | $8.2M | −$0.1M | Trend 20182025 | IA median $6.3M | Rank in IA Rank #76 / 227Operating expenses — State benchmarked This nursing home is ranked 76th out of 227 nursing homes we track in Iowa for operating expenses. Shows everything it cost to run the home — staff, supplies, rent, admin — compared with other Iowa homes reporting a recent fiscal year. Expenses in dollars mostly follow how big a home is, so this compares size, not efficiency; read it next to operating margin. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 67% of homes | Exceeds revenue Operating expenses are higher than net patient revenue, so resident care runs at a loss. |
| Net patient income Revenue minus operating expenses. Negative means care loses money. | −$0.5M | +$0.7M | Trend 20182025 | IA median −$0.0M | Rank in IA Rank #170 / 227Net patient income — State benchmarked This nursing home is ranked 170th out of 227 nursing homes we track in Iowa for net patient income. Shows net patient revenue minus operating expenses, compared with other Iowa homes reporting a recent fiscal year. Homes that lost money on care are in the pool too, so a rank in the bottom half usually means a loss. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 25% of homes | Loss, narrowing Resident care lost money this year, less than in the prior report. |
| Operating margin Net patient income as a share of revenue. The clearest health signal. | −7.1% | +10.1 pts | Trend 20182025 | IA median −0.5% | Rank in IA Rank #159 / 227Operating margin — State benchmarked This nursing home is ranked 159th out of 227 nursing homes we track in Iowa for operating margin. Shows net patient income as a share of net patient revenue, compared with other Iowa homes reporting a recent fiscal year. Unlike the dollar figures it does not follow size, so it is the fairest comparison of financial health between a small home and a large one. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 30% of homes | Loss A negative margin means resident care costs more than it earns. |
| Other income Money not from resident care: investments, grants, services. | $0.1M | — | Trend — | IA median $0.0M | Rank in IA Rank #99 / 207Other income — State benchmarked This nursing home is ranked 99th out of 207 nursing homes we track in Iowa for other income. Shows income from outside resident care — investments, grants, rentals, services — compared with other Iowa homes reporting a recent fiscal year. It is not part of net patient revenue; a high rank here can offset a loss on care. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 52% of homes | Offsets part of the loss Income from outside resident care covers part of the loss on care. |
| Net income The bottom line after other income. | −$0.5M | +$1.1M | Trend — | IA median $0.0M | Rank in IA Rank #184 / 227Net income — State benchmarked This nursing home is ranked 184th out of 227 nursing homes we track in Iowa for net income. Shows the bottom line after other income, compared with other Iowa homes reporting a recent fiscal year. Homes with a net loss are in the pool too, so a rank in the bottom half usually means a loss. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 19% of homes | Loss The bottom line is below zero even after other income. |
Staffing spend
Spends less of revenue on staff than most Iowa homes
| Metric | FY 2025 | vs prior year | Trend 2018 → 2025Trend | IA median | Compared with IA homesRank in IA | In short |
|---|---|---|---|---|---|---|
| Payroll costs Salaries and wage-related benefits, not counting contract labor. | $4.1M | +$0.3M | Trend 20182025 | IA median $3.7M | Rank in IA Rank #94 / 227Payroll costs — State benchmarked This nursing home is ranked 94th out of 227 nursing homes we track in Iowa for payroll costs. Shows total staff payroll — salaries plus wage-related benefits — benchmarked to the Iowa average, among facilities reporting a recent fiscal year. Higher payroll relative to peers often signals better staffing and less reliance on contract labor. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 59% of homes | Above IA median Higher payroll than 59% of IA homes. Payroll in dollars mostly follows how big a home is, so this compares size, not staffing levels. |
| Payroll share of revenue Payroll divided by revenue. Higher usually means more staff per resident. | 53.6% | +0.4 pts | Trend 20182025 | IA median 59.1% | Rank in IA Rank #181 / 227Payroll % of net patient revenue — State benchmarked This nursing home is ranked 181st out of 227 nursing homes we track in Iowa for payroll % of net patient revenue. Shows payroll as a percentage of net patient revenue versus the Iowa average, among facilities reporting a recent fiscal year. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings. Communities with the same value for a metric share the same rank. Rankings compare like with like: every nursing home we track in Iowa that reports data for that category. Nursing homes without available data are excluded, so the pool size varies from metric to metric. Higher than 20% of homes | 7.4 pts under IA average The IA average is 61.0% of revenue. Within 3 points of it reads as near the average. |
Charts, 2018–2025 2 charts · IA benchmark drawn as a dashed line
Revenue, expenses and income
What the home earned from resident care (net patient revenue), what it cost to run (operating expenses) and the difference between the two (net patient income), for each fiscal year it filed a CMS cost report.
USD, millions
Net patient revenue Operating expenses Net patient income
Where revenue goes
Both lines are a share of net patient revenue. Payroll share is what goes to salaries and wage-related benefits; operating margin is what is left after every operating cost (below 0%, resident care lost money). The dashed line is the Iowa payroll average.
% of net patient revenue
Payroll share Operating margin IA payroll average
Year-by-year data, 2018–2025 every reported year · latest first, scroll sideways
| Metric | 2018 | 2019 | 2020 | 2021 | 2022 | 2023 | 2024 | 2025 |
|---|---|---|---|---|---|---|---|---|
| Net patient revenue | $7.0M | $6.5M | $6.9M | $6.0M | $5.8M | $5.7M | $7.1M | $7.6M |
| Operating expenses | $7.8M | $7.4M | $7.7M | $7.9M | $7.6M | $7.7M | $8.3M | $8.2M |
| Net patient income | −$0.8M | −$0.9M | −$0.8M | −$1.8M | −$1.8M | −$2.0M | −$1.2M | −$0.5M |
| Operating margin | −10.9% | −13.0% | −11.7% | −30.1% | −31.4% | −36.1% | −17.2% | −7.1% |
| Net income | −$0.7M | −$0.8M | −$0.7M | −$1.1M | −$1.7M | −$1.8M | −$1.6M | −$0.5M |
| Payroll costs | $4.5M | $4.4M | $4.7M | $4.1M | $3.9M | $3.8M | $3.8M | $4.1M |
| Payroll share of revenue | 64.9% | 66.8% | 69.0% | 67.3% | 68.0% | 66.0% | 53.2% | 53.6% |
| Beds | 71 | 71 | 71 | 71 | 71 | 71 | 71 | 50 |
| Gross revenue | $7.5M | $7.2M | $7.1M | $6.1M | $6.1M | $6.1M | $7.5M | $8.0M |
| Salaries | $3.7M | $3.6M | $3.8M | $3.4M | $3.3M | $3.2M | $3.2M | $3.6M |
| Wage-related costs | $0.9M | $0.8M | $0.9M | $0.6M | $0.7M | $0.6M | $0.6M | $0.5M |
| Contract labor | $0.6M | $0.7M | $0.6M | $1.2M | $1.4M | $1.7M | $1.8M | $1.1M |
| Other operating costs | $3.2M | $3.0M | $2.9M | $3.8M | $3.7M | $4.0M | $4.5M | $4.1M |
| Net patient revenue per day | $311 | $319 | $348 | $387 | $376 | $400 | $454 | $494 |
| Cost per day | $344 | $361 | $389 | $503 | $494 | $545 | $533 | $529 |
| Average length of stay | 216.9 days | 160.3 days | 216.5 days | 93.0 days | 175.6 days | 156.1 days | 317.8 days | 221.0 days |
Showing 2025–2023 · scroll sideways for 5 earlier years
Earlier and partial years are in the download. Download CSV
Who this home usually serves
Residents split by who pays for their care: Medicare, Medicaid, or private pay and other sources.Mostly short-term rehab stays
Most residents typically stay for a few weeks or months before returning home or moving on.
Living Spaces & Floor Plans for Elm Crest Senior Living Community
Places of interest near Elm Crest Senior Living Community
0.4 miles from city center
Estimated distance in miles from Harlan's city center to Elm Crest Senior Living Community's address, calculated via Google Maps.
Calculate Travel Distance to Elm Crest Senior Living Community
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Programs that may help with care and living costs in Iowa
Elm Crest Senior Living Community is in Harlan, Iowa. These programs may support different care settings or living expenses. A listing does not confirm this community participates; our concierge team can help confirm.
VA Aid and Attendance (A&A) and Housebound Benefits
VA Pension Aid and Attendance and Housebound Benefits (Federal)
- Who it is for
- Veterans or survivors with VA pension eligibility and an Aid and Attendance or Housebound medical need
- Income limit
- No single monthly income cutoff. VA compares countable annual income, after permitted deductions, with the applicable Maximum Annual Pension Rate for the household and benefit category.
- Asset limit
- Net-worth limit is $163,699 from December 1, 2025 through November 30, 2026. Net worth includes countable assets plus annual income; exclusions and transfer rules apply.
Eligibility
- General
- Veterans or eligible survivors who qualify for VA Pension or Survivors Pension and meet the additional Aid and Attendance or Housebound criteria. Service, discharge, family status and pension eligibility rules also apply.
- IA specifics
- A federal VA pension benefit; Aid and Attendance and Housebound enhancements cannot be received together.
What it provides
- A higher pension ceiling for eligible Aid and Attendance or Housebound recipients. Actual pension equals the applicable annual maximum minus countable income; the two enhancements cannot be paid together.
State Supplementary Assistance (SSA)
Iowa State Supplementary Assistance (SSA)
- Income limit
- Below the income limit for the relevant SSA group.
- Asset limit
- Resources at or below $2,000 for a single person or $3,000 for a married couple living together.
Eligibility
- General
- Iowa residents who are aged, blind or disabled under Social Security standards, receive SSI or would receive it except for excess income, and meet the relevant assistance-category limits.
What it provides
- State-funded supplements for qualifying special needs; including family life homes; in-home health-related care and residential care facilities.
Elderly Waiver
Iowa Medicaid Elderly Waiver
Eligibility
- General
- Iowa residents age 65 or older who meet Medicaid and nursing-facility-level-of-care requirements.
What it provides
- Authorized waiver services can include case management; adult day care; homemaker; respite; home health; meals; assistive devices; modifications and transportation.
Family Caregiver Support Program
Family Caregiver Support Program (Iowa)
- Who it is for
- Family or informal caregivers of an adult 60+ or of someone of any age with dementia
Eligibility
- General
- Adult family or informal caregivers of adults age 60 or older or people of any age with Alzheimer's disease or a related disorder. The federal program also supports specified older-relative caregiver categories.
What it provides
- Caregiver information and access assistance; counseling and training; support groups; respite and limited supplemental services under the federal caregiver-support framework.
Money Follows the Person (Intellectual Disability or Brain Injury)
Iowa Money Follows the Person (Intellectual Disability or Brain Injury)
Eligibility
- General
- People in Iowa with an intellectual-disability or brain-injury diagnosis who have lived in a qualifying facility at least 60 consecutive days and want to move into the community. Iowa Medicaid must complete eligibility determination before discharge.
What it provides
- Transition services and enhanced supports for the first year after an approved move into the community.
Medicare Savings Program (MSP)
Iowa Medicare Savings Program
- Who it is for
- Medicare beneficiaries with limited income who need help with premiums or cost sharing
Eligibility
- General
- Medicare beneficiaries meeting the applicable state Medicare Savings Program eligibility rules.
- IA specifics
- Applications are administered by the state Medicaid program.
What it provides
- Assistance with Medicare premiums and; for qualified QMB beneficiaries; Medicare-covered deductibles and coinsurance. The qualifying category determines which costs are paid.




