Occupancy rate
39%
In line with Iowa averageMostly short-term rehab stays
Most residents typically stay for a few weeks or months before returning home or moving on.
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Assisted Living in Harlan
CMS overall rating
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.
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.
Elm Crest Retirement Community
Assisted Living in Harlan
CMS overall rating
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.
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.
Elm Crest Retirement Community
Elm Crest Retirement Community is a senior living community in Harlan, Iowa. It offers a variety of living options including independent living, assisted living, skilled nursing, and rehabilitation therapy. The community is committed to providing quality care and a comfortable living environment for seniors.
Quality ratings
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.
Nursing care per resident
This shows how many total hours of nursing staff time are available per resident each day. Higher numbers usually mean more staff support.
Capacity and availability
Smaller home
May offer a more intimate, personalized care environment.
Total beds
64
This home usually has availability
Lower occupancy suggests more openings may be available.
Occupancy rate
39.1%
Residents per day
25
Occupancy rate
39.1%
Residents per day
25
Who this home usually serves
Show admissions and discharges
TYPE OF STAY
Might be optimal for
Short stays
Recovery
Medicare-covered care
Breakdown by payment type
Medicare
82% of new residents, usually for short-term rehab.
Typical stay
1 - 2 months
Private pay
14% of new residents, often for short stays.
Typical stay
3 years
Medicaid
4% of new residents, often for long-term daily care.
Typical stay
8 - 9 years
Finances and operations
Voluntary non-profit community
Operated by a church.
Home revenue
$7.1M
Operating deficit
-$1.6M
Voluntary non-profit community
Operated by a church.
Home revenue
$7,080,701.00
Operating deficit
$-1,590,026.00
Payroll costs
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
$3.2M
The portion of the home's budget spent on staff, including nurses, caregivers, and other employees who support care and operations.
Other operating costs
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
$5.5M
All remaining costs needed to run the home, such as food, utilities, building maintenance, supplies and administrative expenses.
Total costs
$8.7M
64-bed community
A moderately sized community that may balance personal attention with shared amenities and social activities.
32 years in operation
A longer operating history, which may indicate experience navigating regulations and delivering ongoing care.
About this community
Occupancy
In line with Iowa averageOccupied beds
25 / 64
Average residents
51 per day
Facility TypeAssisted Living Programs
StatusActive
IssuanceOctober 12, 1999
ExpirationJanuary 29, 2026
CountyShelby
License NumberS0059
CMS Certification Number165372
Elm Crest Retirement Community is administrated by Kathy Goede.
Owner NameNo Related Entities Found
Staffing
Key information about the people who lead and staff this community.
ContactTim Nausler
Rehabilitation Services
Nursing Services
Skilled Nursing
Licensed Nurses/CNAs
Rehabilitation Therapy
Email
[email protected]
Fax7127555654
Specific ProgramsIndependent Living, Assisted Living, Skilled Care/Health Center, Rehab Therapy
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.
16 visits/inspections
Iowa average: 17 visits/inspections
Iowa average: 0 inspections
Show Inspection Reports
Latest inspection
Date
April 4, 2024
38 deficiencies
Deficiencies indicate regulatory issues. A higher number implies the facility had several areas requiring improvement.
Iowa average: 27 deficiencies
Inspection Report Summary for Elm Crest Retirement Community
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.
Health Inspection History
Inspections
Total health inspections
5
Iowa average 4.9
Last Health inspection on Nov 2025
Total health citations
19
Iowa average 21.7
Citations per inspection
3.8
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).
Breakdown of citation severity (last 3 years)
Critical Health citations
0
0
100% better than Iowa averageIowa average: 0.6
Serious Health citations
1
1
11% worse than Iowa averageIowa average: 0.9
0 critical citations
1 serious citation
18 moderate citations
0 minor citations
Citations history (last 3 years)
Quality of Care moderate citation
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Nov 13, 2025
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Nov 13, 2025
Infection Control moderate citation
Issues related to preventing and controlling infections, including hygiene practices and safety protocols.
Nov 14, 2024
Issues related to preventing and controlling infections, including hygiene practices and safety protocols.
Nov 14, 2024
Corrected
Nutrition moderate citation
Issues related to food quality, meal service, and resident's nutritional needs.
Nov 14, 2024
Issues related to food quality, meal service, and resident's nutritional needs.
Nov 14, 2024
Corrected
Quality of Care moderate citation
Issues related to how well residents receive appropriate treatment and support for their medical and daily care needs.
Nov 14, 2024
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.
Compare Assisted Living around Harlan The information below is reported by the Iowa Department of Inspections, Appeals, and Licensing.
Filter by care type
Hansen House Harlan
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.
IL
Independent Living Lifestyle-focused communities for older adults offering dining, activities, and transportation with minimal personal care. Best for active, independent seniors who want community without medical support.
MC
Memory Care Secured, specialized care for people living with Alzheimer's or dementia. Staff trained in cognitive impairment, with higher staff-to-resident ratios and an environment designed to reduce confusion and wandering risk.
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).
Harlan
118
No
32
15
44.9%
3
1
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
71
No
-
32
39.1%
8
0
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
71
No
50
-
92.0%
1
4
Places of interest near Elm Crest Retirement Community
0.0 miles from city center
2108 12th Street, Harlan, IA 515372023
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Staffing Data (Q2 2025)
This data corresponds to Q2 2025 and is based on CMS Payroll-Based Journal.
Total staff
120
Employees
64
Contractors
56
Staff to resident ratio
2.79:1
40% better than Iowa averageIowa average ratio: 2.00:1
Avg staff/day
28
Average shift
7.6 hours
0% compared with Iowa averageIowa average: 7.4 hours
Total staff hours (quarter)
19,342
Nursing staff breakdown
Registered Nurse
Manages medical care and health needs.
Total count
14
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8.8 hours
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.
Licensed Practical Nurse
Assists with medical care and medications.
Total count
5
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8 hours
Average shift length. Calculated as total hours divided by days worked and average staff per day.
8 hoursThis role is partially covered by contractors.
Certified Nursing Assistant
Helps with daily care and mobility.
Total count
82
Average shift length
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.4 hours
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.
Contractor staffing
Total hours from contractors
32%
6,186 contractor hours this quarter
Certified Nursing Assistant: 38
Registered Nurse: 6
Licensed Practical Nurse: 3
Qualified Social Worker: 2
Nurse Practitioner: 1
Respiratory Therapy Technician: 1
Occupational Therapy Aide: 1
Physical Therapy Assistant: 1
Speech Language Pathologist: 1
Medical Director: 1
Occupational Therapy Assistant: 1
Staff by category
| 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 |
82 Certified Nursing Assistant
% of Days
100%
14 Registered Nurse
% of Days
100%
5 Licensed Practical Nurse
% of Days
88%
1 Physical Therapy Assistant
% of Days
76%
1 Speech Language Pathologist
% of Days
74%
1 Dietitian
% of Days
69%
1 Administrator
% of Days
66%
2 Other Dietary Services Staff
% of Days
43%
2 Nurse Practitioner
% of Days
47%
1 Dental Services Staff
% of Days
44%
1 Occupational Therapy Aide
% of Days
38%
2 Qualified Social Worker
% of Days
46%
1 RN Director of Nursing
% of Days
16%
1 Respiratory Therapy Technician
% of Days
31%
1 Mental Health Service Worker
% of Days
10%
2 Medication Aide/Technician
% of Days
5%
1 Occupational Therapy Assistant
% of Days
9%
1 Medical Director
% of Days
5%
Facility Characteristics
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total census
43 residents
Residents by payment source
Medicare
6 residents (14%)
Medicaid
18 residents (41.9%)
Private pay or other
19 residents (44.2%)
Programs & Services
Residents' Group
Residents meet regularly to discuss policies, care quality, and activities
CCRC
Part of a Continuing Care Retirement Community offering multiple care levels
Active Resident Council
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.
Quality of care over time
These measures show how residents usually do over time at this home, based on health outcomes and preventive care.
High-risk clinical events score
A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline.
13.4
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
Functional decline score
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
28.0
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
Long-stay resident measures
Need for Help with Daily Activities Increased
Percent of long-stay residents whose need for help with daily activities has increased
25.8%
Percent of long-stay residents whose need for help with daily activities has increased
25.8%
37% worse than Iowa averageIowa average: 18.8%
Walking Ability Worsened
Percent of long-stay residents whose ability to move independently worsened
30.1%
Percent of long-stay residents whose ability to move independently worsened
30.1%
53% worse than Iowa averageIowa average: 19.7%
Low Risk Residents with Bowel/Bladder Incontinence
Percent of low risk long-stay residents who lose control of their bowels or bladder
28.1%
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%
Falls with Major Injury
Percent of long-stay residents experiencing one or more falls with major injury
4.1%
Percent of long-stay residents experiencing one or more falls with major injury
4.1%
13% worse than Iowa averageIowa average: 3.6%
High Risk Residents with Pressure Ulcers
Percent of long-stay high risk residents with pressure ulcers
0.7%
Percent of long-stay high risk residents with pressure ulcers
0.7%
85% better than Iowa averageIowa average: 4.4%
Urinary Tract Infection
Percent of long-stay residents with a urinary tract infection
4.9%
Percent of long-stay residents with a urinary tract infection
4.9%
99% worse than Iowa averageIowa average: 2.5%
Lost Too Much Weight
Percent of long-stay residents who lose too much weight
6.3%
Percent of long-stay residents who lose too much weight
6.3%
25% worse than Iowa averageIowa average: 5.0%
Depressive Symptoms
Percent of long-stay residents who have depressive symptoms
0.8%
Percent of long-stay residents who have depressive symptoms
0.8%
80% better than Iowa averageIowa average: 3.9%
Antipsychotic Use
Percent of long-stay residents who received an antipsychotic medication
7.2%
Percent of long-stay residents who received an antipsychotic medication
7.2%
62% better than Iowa averageIowa average: 19.0%
Pneumococcal Vaccine
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
99.3%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
99.3%
5% better than Iowa averageIowa average: 94.4%
Influenza Vaccine
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
90.0%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
90.0%
6% worse than Iowa averageIowa average: 95.3%
Short-stay resident measures
Pneumococcal Vaccine
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
75.6%
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
75.6%
11% worse than Iowa averageIowa average: 85.1%
Antipsychotic medication increase
Percent of short-stay residents who newly received an antipsychotic medication
2.9%
Percent of short-stay residents who newly received an antipsychotic medication
2.9%
60% worse than Iowa averageIowa average: 1.8%
Influenza Vaccine
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
81.1%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
81.1%
11% better than Iowa averageIowa average: 73.3%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
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 Jan 2026)
Total fines amount
$0
100% lower than Iowa averageIowa average: $48K
Number of fines
0
100% fewer fines than Iowa averageIowa average: 1.7
Payment Denials
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
1
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
Fines amount comparison
Fines amount comparison
This facility
$0
Iowa average
$48K
Penalty History
Penalties are imposed by CMS for violations of federal nursing home regulations.
Payment Denial
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Nov 14, 2024
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
Nov 14, 2024
8 days
Last updated: Jan 2026
Financial Trends
Historical financial and operational data for Elm Crest Retirement Community based on CMS SNF Cost Reports.
Occupancy Rate
59.9%
↑ 5.1pp vs 2023
Net Income
-$1,590,026
↑ ~$254K vs 2023
Total Payroll
$5,554,312
↑ ~$150K vs 2023
Profit Margin
-21.3%
↑ 8.8pp vs 2023
Loading trend charts...
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