2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
2/5
CMS (the Centers for Medicare & Medicaid Services) is the federal agency that rates nursing home quality. Its Overall Rating runs from 1 to 5 stars, combining health inspections, staffing, and quality measures, with inspections weighted most heavily.
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 13m 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.
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.
Data period: Q4 2025 (October 1 – December 31, 2025).
This nursing home is ranked 118th out of 228 nursing homes we track in Iowa for nurse hours. Total adjusted nursing hours per resident per day, combining RN, LPN, and aide time. CMS adjusts this for case-mix so facilities can be fairly compared.
4h 13mStandout metric: Certified nursing assistant is +12% above Iowa average
2 of 6 metrics below Iowa average
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. 8 total: 7 of the facility's own employees and 1 agency contractor.
8 staff · 8.9-hour shifts
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. 8 total: 4 of the facility's own employees and 4 agency contractors.
8 staff · 8.3-hour shifts
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. 70 total: 33 of the facility's own employees and 37 agency contractors.
70 staff · 7.7-hour shifts
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.
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.
RN + LPN + aide · Sat–Sun
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.
Sat–Sun
Every person who worked here at any point in the quarter, employees and contractors. It is not how many are on site at once: that is the "on an average day" figure.
108
54 employees · 54 contractors · 28 on an average day
108 total staff / 47 residents. Residents: CMS Long-Term Care Facility Characteristics (data as of Jun 2026); staff: CMS Payroll-Based Journal (Q4 2025).Residents and staff come from two different CMS releases, so the two counts can be a few months apart.
2.30 : 1
↑ 14% · IA 2.02This facility: 2.30 staff per resident, 14% above the Iowa average of 2.02 (among Iowa facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
108 staff ÷ 47 residents
See full Iowa ranking →
Average hours one staff member works on a day they are on shift, across every role.
7.9 h
↑ 5% · IA 7.5 hThis facility: 7.9 h, 5% above the Iowa average of 7.5 h (among Iowa facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
20,282 staff hours this quarter
See full Iowa ranking →60% of staff hours were worked by the facility's own employees
Iowa average: 92.3% · Contractors this quarter: Certified Nursing Assistant (37), Licensed Practical Nurse (4), Physical Therapy Assistant (3), Speech Language Pathologist (2), Qualified Social Worker (2), Registered Nurse (1), Administrator (1), Respiratory Therapy Technician (1), Occupational Therapy Aide (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.
A smaller, more intimate setting that may offer a quieter environment and closer staff-resident interactions.
50
Rank #143 / 237Bed count — State benchmarked This nursing home is ranked 143rd out of 237 nursing homes we track in Iowa for bed count. Shows this facility's certified or reported bed count compared to other Iowa facilities. Larger communities may offer more amenities, programs, and on-site services for residents and families. 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.Smaller home · May offer a more intimate, personalized care environment.
Somewhat walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
Rank #124 / 253Walk Score — State benchmarked This nursing home is ranked 124th out of 253 nursing homes we track in Iowa for walk score. Shows how walkable this facility's neighborhood is compared to the average walk score across Iowa facilities. Higher scores benefit residents, families, and staff. 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.
Occupancy between 85% and 95% suggests balanced demand.
Rank #28 / 227Occupancy rate — State benchmarked This nursing home is ranked 28th out of 227 nursing homes we track in Iowa for occupancy. Shows this facility's occupancy rate versus the Iowa average, with its Statewide rank out of 227. Higher occupancy signals strong local demand and financial stability. 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.Based on 47 residents and 50 beds. Source: state inspection report (Jan 2026)
Higher than the Iowa average: 78.8%
Average number of days residents stay at this facility, based on CMS cost report data. Shorter stays often reflect post-acute or rehab care; longer stays reflect long-term care.
Elm Crest Senior Living Community is administered by Leah Mulbauer.
This profile shows two inspection records, and their totals often differ. Inspection History and the Inspection Scorecard below are state data — the figures the state publishes and the state inspection reports we hold on file — covering the entire facility. CMS Health Inspection History covers only this home's Medicare and Medicaid-certified nursing beds, from federal certification surveys.
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, 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
| This Facility | IA Average | vs. IA Avg |
|---|---|---|---|
|
Violations
Total violations cited across all inspections on record. Iowa reports these as a federal and a state component, shown below; the two add up to this total.
| 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
Part of the Violations total above — the share cited under federal nursing-home requirements, which apply to Medicare/Medicaid-certified facilities. Federal + state add up to the total.
| 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
Part of the Violations total above — the share cited under Iowa state licensing requirements. Federal + state add up to the total.
| 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
Average 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
Combined count of all inspections conducted at this facility.
| 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 |
Federal inspection data published by CMS, covering this home's Medicare and/or Medicaid-certified skilled-nursing/nursing beds only.
94% corrected
18 of 19 citations corrected · 1 still open Latest inspection: Jun 10, 2026 · 1 citation (Quality of Care, serious), not yet corrected
Most cited category: Quality of Life & Care, 7 of 19 citations · 6 categories in total
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Corrected
Health citations are formal notices following inspections when they fail to comply with safety and care standards.
13 of 19 citations resulted from standard inspections; 4 of 19 resulted from complaint investigations; and 2 of 19 came from combined inspections (standard and complaint).
Includes all CMS health inspection records for this property, which could include management/ownership changes.
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.
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 Aug 2026)
100% lower than Iowa averageIowa average: $48K
100% fewer fines than Iowa averageIowa average: 1.4
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
1 
115% more payment denials than Iowa averageIowa average: 0.5
Penalties imposed by CMS in the past 3 years.
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: Aug 2026
How residents at this home fare on health outcomes and preventive care, compared with the Iowa average.
CMS star rating for the care of long-stay residents, who live at the home for 100 days or more. It is built from the long-stay quality measures below. 5 stars is the best.
3
/ 5
Average
↓ 8% · IA 3.3This facility: 3.0, 8% below the IA average of 3.3 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
CMS star rating for the care of short-stay residents, mostly people recovering after a hospital stay for under 100 days. It is built from the short-stay quality measures below. 5 stars is the best.
4
/ 5
Above average
↑ 56% · IA 2.6This facility: 4.0, 56% above the IA average of 2.6 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Average of five long-stay measures: pressure ulcers, falls with major injury, unplanned weight loss, worsening ability to walk, and needing more help with daily activities. Each is the % of residents affected, so lower is better.
14.5
Score · lower is better
↑ 57% · IA 9.2This facility: 14.5, 57% above the IA average of 9.2 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Average of three long-stay measures: needing more help with daily activities, worsening ability to walk, and loss of bowel or bladder control. Each is the % of residents affected, so lower is better.
31.6
Score · lower is better
↑ 60% · IA 19.8This facility: 31.6, 60% above the IA average of 19.8 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.13 long-stay measures: 6 better, 6 worse, 1 near IA average
8 short-stay measures: 4 better, 1 worse, 3 compared with US only
People who live at the home · 13 measures
Percent of long-stay residents whose need for help with daily activities has increased
32.8%
↑ 92% · IA 17.1This facility: 32.8, 92% above the IA average of 17.1 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents whose ability to move independently worsened
32.3%
↑ 94% · IA 16.6This facility: 32.3, 94% above the IA average of 16.6 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of low risk long-stay residents who lose control of their bowels or bladder
29.6%
↑ 16% · IA 25.6This facility: 29.6, 16% above the IA average of 25.6 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents with a urinary tract infection
4.0%
↑ 67% · IA 2.4This facility: 4.0, 67% above the IA average of 2.4 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents experiencing one or more falls with major injury
1.9%
↓ 49% · IA 3.8This facility: 1.9, 49% below the IA average of 3.8 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay high risk residents with pressure ulcers
3.7%
↓ 11% · IA 4.2This facility: 3.7, 11% below the IA average of 4.2 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who lose too much weight
1.6%
↓ 65% · IA 4.6This facility: 1.6, 65% below the IA average of 4.6 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who have depressive symptoms
2.2%
↓ 48% · IA 4.2This facility: 2.2, 48% below the IA average of 4.2 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents who received an antipsychotic medication
13.5%
↓ 31% · IA 19.5This facility: 13.5, 31% below the IA average of 19.5 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
97.4%
↑ 4% · IA 94.0This facility: 97.4, 4% above the IA average of 94.0 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
90.0%
↓ 6% · IA 95.3This facility: 90.0, 6% below the IA average of 95.3 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Number of hospitalizations per 1,000 long-stay resident days.
1.32
↓ 11% · IA 1.48This facility: 1.32, 11% below the IA average of 1.48 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Number of outpatient emergency department visits per 1,000 long-stay resident days.
2.43
↑ 16% · IA 2.09This facility: 2.43, 16% above the IA average of 2.09 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.Rehab and recovery after a hospital stay · 8 measures
Percentage of residents at or above expected ability to care for themselves at discharge.
68.9%
↑ 28% · US 53.7This facility: 68.9, 28% above the US average of 53.7 (among US facilities reporting a recent figure).
Rate of successful return to home or community from a skilled nursing facility.
49.9%
↓ 1% · US 50.6This facility: 49.9, 1% below the US average of 50.6 (among US facilities reporting a recent figure).
Percentage of SNF residents who experience falls with major injury during their stay.
2.0%
↑ 160% · US 0.8This facility: 2.0, 160% above the US average of 0.8 (among US facilities reporting a recent figure).
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
↓ 100% · IA 2.1This facility: 0.0, 100% below the IA average of 2.1 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine
89.6%
↑ 7% · IA 84.0This facility: 89.6, 7% above the IA average of 84.0 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
81.1%
↑ 11% · IA 73.3This facility: 81.1, 11% above the IA average of 73.3 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percentage of short-stay residents who were re-hospitalized after their nursing home admission.
4.4%
↓ 79% · IA 21.4This facility: 4.4, 79% below the IA average of 21.4 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.
Percentage of short-stay residents who had an outpatient emergency department visit.
19.2%
↑ 47% · IA 13.1This facility: 19.2, 47% above the IA average of 13.1 (among IA facilities reporting a recent figure).Green: 5% or more better than the state average. Yellow: within 5%. Red: 5% or more worse.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.
74% of new residents, usually for short-term rehab.
19% of new residents, often for short stays.
7% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jun 2026)
Total residents
47Residents 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.
Historical financial and operational data for Elm Crest Senior Living Community from 2012–2025, based on CMS SNF Cost Reports. Includes all financial data for this property, which could include management/ownership changes.
Key figures below are for fiscal year ending in 08/2025.
Based on CMS SNF Cost Report for fiscal year ending in 08/2025.
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Net patient revenue — what the home actually collects for resident care, after contractual allowances, bad debt and discounts are subtracted from its gross charges (CMS cost report, Worksheet G-3). It covers resident care only; money the home earns from other sources is shown separately as "Other income."
Net patient income: net patient revenue minus the home's total operating expenses. A positive figure means it earns more from resident care than it spends to deliver it; a negative figure means the opposite. It excludes non-operating "other income."
Money the home earns outside of resident care — such as investments, grants, rentals and other non-operating sources (CMS cost report, Worksheet G-3). It is tracked separately from net patient revenue: it is not part of that figure, and it is not included in net patient income.
Staff salaries plus wage-related costs — benefits such as payroll taxes, health insurance and retirement — from the home's own accounting records (CMS cost report, Worksheet A). Contract or agency labor is counted separately, under other operating costs.
Rank #95 / 220Payroll costs — State benchmarked This nursing home is ranked 95th out of 220 nursing homes we track in Iowa. 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.
Payroll as a share of revenue: staff salaries and wage-related benefits divided by net patient revenue. A higher figure means more of each revenue dollar goes to staff pay.
Rank #158 / 220Payroll % of net patient revenue — State benchmarked This nursing home is ranked 158th out of 220 nursing homes we track in Iowa. 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.
Everything it costs to run the home apart from payroll — food, utilities, supplies, maintenance, contract labor and administration. Calculated as total operating expense minus payroll (staff salaries and wage-related benefits).
The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
Most residents typically stay for a few weeks or months before returning home or moving on.
Most new residents arrive under Medicare (74% of admissions), and a typical Medicare stay runs around 1 - 2 months.
Coverage residents most often arrive under.
Coverage residents most often leave under.
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.
Add your location
Elm Crest Senior Living Community is located in Harlan, Iowa.
Here are the financial assistance programs available to residents in Iowa.
Elm Crest Senior Living Community has a walk score of 50. Somewhat walkable. Some errands can be accomplished on foot, with a mix of nearby amenities.
According to IA state health department records, Elm Crest Senior Living Community's license number is 830051.
Elm Crest Senior Living Community's occupancy is 94%.
Yes — see the floorplan options available at Elm Crest Senior Living Community on this page.
No, Elm Crest Senior Living Community has a no-pet policy.
The team at Elm Crest Senior Living Community can be reached at LMuhlbauer@abhomes.org.
Elm Crest Senior Living Community is registered as a non-profit in IA.
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