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The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating is scored from 1 to 5 stars and combines results from health inspections, staffing levels, and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
The Overall CMS Rating combines results from health inspections, staffing levels and quality measures. Health inspections carry the most weight. Staffing and quality scores can increase or decrease the final rating based on performance compared to state and national standards.
Based on the results of the facility's three most recent standard inspections and any complaint investigations. CMS reviews the number, scope, and severity of deficiencies, with more recent findings weighted more heavily.
Measures average nursing staff hours per resident per day, including Registered Nurses (RNs) and total nursing staff. Ratings are adjusted based on the level of care residents require and are compared to state and national benchmarks.
Based on clinical and physical health indicators reported to CMS, such as hospital readmissions, falls, pressure ulcers, and improvements in mobility. These measures reflect how well residents' health needs are being managed.
Daily nursing hours per resident by staff type, reported to CMS. Higher is generally better — compare this facility to state and national averages to see where staffing stands.
This home is ranked 160th out of 224 homes in Iowa.| Staff type | Hours / day | vs state avg |
|---|---|---|
|
Registered Nurse (RN)
RNs hold the highest nursing license and can assess residents, interpret test results, and direct care plans. More RN hours per day often signals stronger clinical oversight and faster response to health changes.
| 53m per day | ▲ 20% State avg: 44m per day · National avg: 41m per day |
|
LPN / LVN
Licensed Practical Nurses (LPNs) or Licensed Vocational Nurses (LVNs) deliver routine hands-on care — medication administration, wound dressing, and monitoring vital signs. They work under RN supervision and make up a large share of daily bedside care.
| 25m per day | ▼ 26% State avg: 34m per day · National avg: 52m per day |
|
Nurse Aide
Certified Nurse Aides (CNAs) provide the most direct day-to-day assistance: bathing, dressing, feeding, and mobility. Nurse aide hours are typically the largest staffing category and directly affect residents' quality of life.
| 2h 41m per day | ▲ 6% State avg: 2h 32m per day · National avg: 2h 20m per day |
|
Total Nursing (Weekend)
Combined nursing hours (RN + LPN + Nurse Aide) per resident per day on weekends. Staffing often drops on weekends — this figure reveals whether the facility maintains adequate coverage outside of weekday hours.
| 3h 32m per day | ▲ 6% State avg: 3h 21m per day · National avg: 3h 26m per day |
|
Physical Therapist
Hours per resident per day provided by licensed Physical Therapists (PTs) or PT Assistants. PT services help residents recover mobility after injury or illness and are especially important for post-acute (short-stay) rehabilitation.
| 1m per day | ▼ 50% State avg: 2m per day · National avg: 4m per day |
|
RN (Weekend)
Registered nurse hours specifically on weekends. Facilities sometimes reduce RN presence on Saturdays and Sundays — a low weekend RN figure compared to weekday hours can indicate reduced clinical oversight when most administrative staff are absent.
| 41m per day | ▲ 37% State avg: 30m per day · National avg: 28m per day |
Most residents typically stay for a few weeks or months before returning home or moving on.
82% of new residents, usually for short-term rehab.
14% of new residents, often for short stays.
4% of new residents, often for long-term daily care.
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Rank #104 / 226Payroll — state benchmarkedThis home is ranked 104th out of 226 homes in Iowa.Shows total annual staff payroll benchmarked to the Iowa average. Higher payroll investment relative to peers often signals better staffing and less reliance on cheaper contract labor.
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Lower than the Iowa average: 75.4%Elm Crest Retirement Community is administrated by Kathy Goede.
Key information about the people who lead and staff this community.
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.
This scorecard compares key inspection, citation, 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.
Deficiencies are formal regulatory issues recorded during state inspections.
| Metric | This Facility | IA Average | vs. IA Avg |
|---|---|---|---|
|
Total deficiencies
Formal regulatory issues recorded by inspectors across all inspection types.
| 38 | 27 | This facility has 41% more total deficiencies than a typical Iowa nursing home (38 vs. IA avg 27).↑ 41% worse |
|
Deficiencies per year
Average deficiencies per year since 2007.
| 2 | 1.4 | This facility has 43% more deficiencies per year than a typical Iowa nursing home (2 vs. IA avg 1.4).↑ 43% worse |
|
Deficiencies per inspection
Average deficiencies per inspection.
| 2.4 | 1.8 | This facility has 33% more deficiencies per inspection than a typical Iowa nursing home (2.4 vs. IA avg 1.8).↑ 33% worse |
State inspections evaluate whether the facility meets health and safety standards.
| Metric | This Facility | IA Average | vs. IA Avg |
|---|---|---|---|
|
Total inspections
Combined count of all routine and focused inspections. Excludes complaint investigations.
| 16 | 15 | This facility has 7% more total inspections than a typical Iowa nursing home (16 vs. IA avg 15).↑ 7% worse |
An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.
The most recent inspection on April 4, 2024, found no deficiencies during the recertification visit for the Assisted Living Program. Earlier inspections showed a pattern of deficiencies mainly related to tenant evaluations, individualized service plans, and nurse reviews following changes in tenant conditions. Complaint investigations over the years were mostly unsubstantiated, with one substantiated case in 2012 involving medication administration and storage issues. Enforcement actions included a $1,000 civil penalty in 2010 for staff training and fire drill deficiencies, but no license suspensions or revocations were listed in the available reports. The facility’s record shows improvement over time, with recent inspections free of cited deficiencies.
Read the full inspection reports for this facility, including detailed findings and corrective actions.
Show Inspection ReportsIowa average 4.9
Last Health inspection on Nov 2025
Iowa average 21.7
Iowa average 4.11
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
14 of 19 citations resulted from standard inspections; 3 of 19 resulted from complaint investigations; and 2 of 19 came from combined inspections (standard and complaint).
100% better than Iowa averageIowa average: 0.6
1
11% worse than Iowa averageIowa average: 0.9
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Nov 13, 2025
Issues related to preventing and controlling infections, including hygiene practices and safety protocols.
Nov 14, 2024
Corrected
Issues related to food quality, meal service, and resident's nutritional needs.
Nov 14, 2024
Corrected
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Nov 14, 2024
Corrected
Data sourced from CMS Health Deficiencies reports. 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.
Elm Crest Retirement Community is located in Harlan, Iowa.
Here are the financial assistance programs available to residents in Iowa.
0.0 miles from city center
Estimated distance in miles from Harlan's city center to Elm Crest Retirement Community's address, calculated via Google Maps.
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This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
40% better than Iowa averageIowa average ratio: 2.00:1
0% compared with Iowa averageIowa average: 7.4 hours
Manages medical care and health needs.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.8 hoursThis role is partially covered by contractors.
Assists with medical care and medications.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8 hoursThis role is partially covered by contractors.
Helps with daily care and mobility.
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.4 hoursThis role is partially covered by contractors.
Total hours from contractors
6,186 contractor hours this quarter
| Certified Nursing Assistant | 44 | 38 | 82 | 11,094 | 91 | 100% | 7.4 |
| Registered Nurse | 8 | 6 | 14 | 3,056 | 91 | 100% | 8.8 |
| Licensed Practical Nurse | 2 | 3 | 5 | 1,254 | 80 | 88% | 8 |
| Physical Therapy Assistant | 0 | 1 | 1 | 526 | 69 | 76% | 7.6 |
| Speech Language Pathologist | 0 | 1 | 1 | 506 | 67 | 74% | 7.5 |
| Dietitian | 1 | 0 | 1 | 504 | 63 | 69% | 8 |
| Administrator | 1 | 0 | 1 | 480 | 60 | 66% | 8 |
| Other Dietary Services Staff | 2 | 0 | 2 | 454 | 39 | 43% | 7.1 |
| Nurse Practitioner | 1 | 1 | 2 | 365 | 43 | 47% | 8.5 |
| Dental Services Staff | 1 | 0 | 1 | 343 | 40 | 44% | 8.6 |
| Occupational Therapy Aide | 0 | 1 | 1 | 233 | 35 | 38% | 6.7 |
| Qualified Social Worker | 0 | 2 | 2 | 156 | 42 | 46% | 3.7 |
| RN Director of Nursing | 1 | 0 | 1 | 129 | 15 | 16% | 8.6 |
| Respiratory Therapy Technician | 0 | 1 | 1 | 103 | 28 | 31% | 3.7 |
| Mental Health Service Worker | 1 | 0 | 1 | 68 | 9 | 10% | 7.6 |
| Medication Aide/Technician | 2 | 0 | 2 | 38 | 5 | 5% | 6.3 |
| Occupational Therapy Assistant | 0 | 1 | 1 | 32 | 8 | 9% | 3.9 |
| Medical Director | 0 | 1 | 1 | 4 | 5 | 5% | 0.7 |
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
43Residents meet regularly to discuss policies, care quality, and activities
Part of a Continuing Care Retirement Community offering multiple care levels
Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.
Data sourced from CMS Long-Term Care Facility Characteristics quarterly report. Payer mix reflects the current resident census by primary payment source.
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
13.4
31% worse than Iowa averageIowa average: 10.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
28.0
30% worse than Iowa averageIowa average: 21.6
CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Percent of long-stay residents whose need for help with daily activities has increased
25.8%
37% worse than Iowa averageIowa average: 18.8%
Percent of long-stay residents whose ability to move independently worsened
30.1%
53% worse than Iowa averageIowa average: 19.7%
Percent of low risk long-stay residents who lose control of their bowels or bladder
28.1%
7% worse than Iowa averageIowa average: 26.2%
Percent of long-stay residents experiencing one or more falls with major injury
4.1%
13% worse than Iowa averageIowa average: 3.6%
Percent of long-stay high risk residents with pressure ulcers
0.7%
85% better than Iowa averageIowa average: 4.4%
Percent of long-stay residents with a urinary tract infection
4.9%
99% worse than Iowa averageIowa average: 2.5%
Percent of long-stay residents who lose too much weight
6.3%
25% worse than Iowa averageIowa average: 5.0%
Percent of long-stay residents who have depressive symptoms
0.8%
80% better than Iowa averageIowa average: 3.9%
Percent of long-stay residents who received an antipsychotic medication
7.2%
62% better than Iowa averageIowa average: 19.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
99.3%
5% better than Iowa averageIowa average: 94.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
90.0%
6% worse than Iowa averageIowa average: 95.3%
Number of hospitalizations per 1,000 long-stay resident days.
1.32
11% better than Iowa averageIowa average: 1.48
Number of outpatient emergency department visits per 1,000 long-stay resident days.
2.43
16% worse than Iowa averageIowa average: 2.09
CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
75.6%
11% worse than Iowa averageIowa average: 85.1%
Percent of short-stay residents who newly received an antipsychotic medication
2.9%
60% worse than Iowa averageIowa average: 1.8%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
81.1%
11% better than Iowa averageIowa average: 73.3%
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
4.4%
79% better than Iowa averageIowa average: 21.3%
Percentage of short-stay residents who had an outpatient emergency department visit.
19.2%
47% worse than Iowa averageIowa average: 13.1%
Percentage of SNF residents who experience falls with major injury during their stay.
2.0%
160% worse than Iowa averageIowa average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
68.9%
28% better than Iowa averageIowa average: 53.7%
Rate of successful return to home or community from a skilled nursing facility.
49.9%
In line with Iowa averageIowa average: 50.6%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
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 Jan 2026)
100% lower than Iowa averageIowa average: $48K
100% fewer fines than Iowa averageIowa average: 1.7
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
1
88% more payment denials than Iowa averageIowa average: 0.5
Penalties are imposed by CMS for violations of federal nursing home regulations.
1 penalty in the past 3 years
Nov 14, 2024 · 8 days
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Nov 14, 2024Last updated: Jan 2026
The information below is reported by the Iowa Department of Inspections, Appeals, and Licensing.
| Elm Crest Retirement Community |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Harlan | 64 | 59.9% | -21% | 3.88 | +1% | -10% | 0 | 19 | 3.8 | 1 | 44 | 50 | American Baptist Homes Of The Midwest | $7.1M | $3.2M | 45.1% | 165372 | ||||
| Elm Crest Senior Living Community |
NH Nursing Home Licensed facility providing 24/7 skilled nursing care for residents with complex, ongoing medical needs. Staffed by RNs, LPNs, and CNAs. Inspected and star-rated annually by CMS. Accepts Medicare (short-term rehab) and Medicaid (long-term care).
AL Assisted Living A licensed, long-term care setting for seniors or individuals with disabilities who need help with daily activities — like bathing, dressing, and medication management — but not 24-hour skilled nursing. Offers housing, meals, and around-the-clock support while aiming to maximize resident independence. | Harlan (12Th Street) | 50 | 59.9% | -21% | 3.88 | +1% | -10% | 0 | 19 | 3.8 | 1 | 44 | 50 | American Baptist Homes Of The Midwest | $7.1M | $3.2M | 45.1% | 165372 |
Historical financial and operational data for Elm Crest Retirement Community based on CMS SNF Cost Reports.
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The legal owner and operator of Elm Crest Retirement Community is No Related Entities Found.
Elm Crest Retirement Community has a walk score of 50. Moderately walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
According to IA state health department records, Elm Crest Retirement Community's license number is S0059.
According to IA state health department records, Elm Crest Retirement Community's license expires on January 29, 2026.
Elm Crest Retirement Community's occupancy is 39%.
The team at Elm Crest Retirement Community can be reached at [email protected].
Kathy Goede is the administrator of Elm Crest Retirement Community.
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