1/5
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.
1/5
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.
At its 64-bed skilled nursing property located at 2121 Avenue L, Hillcrest Health Care Center manages regional patient accounts through a mix of private payments, Medicare credits, and state Medicaid options. The facility emphasizes sustained, continuity-based setups rather than temporary recoveries, with residential admissions averaging near a full calendar year. These longer operational timelines establish a stable daily baseline for seniors requiring ongoing clinical monitoring in the Hawarden area.
Round-the-clock shift support relies on an internal clinical team comprised of registered nurses, licensed practical nurses, and certified nurse aides who distribute floor hours to implement medical treatment logs and assist with daily physical tasks. This group works directly with incoming individuals to construct personal recovery profiles, which are paired with an internal social engagement program to manage therapeutic communication.
For neighborhood accessibility, the local surroundings register a walkability score of 49 out of 100, indicating that visiting family members or staff will typically require a personal car for basic community travel and appointments.
Prospective families can contact the business manager to check on active bed availability, ask about the schedule of in-house therapy sessions, or coordinate a time to view the property. The administrative department is also set up to review individual insurance parameters and outline how public aid networks or personal assets apply to monthly billing statements.
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.
Staffing hours
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.
Hours per resident per day vs Iowa averages
Total nursing care
This home is ranked 173rd out of 235 homes 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.
3h 50m
11% below state avg
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.
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.
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.
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.
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.
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.
4 of 6 metrics below state avg
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.
Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.
21% more staff per resident than Iowa average
8% better than Iowa average
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Manages medical care and health needs.
16 total: 5 full-time employees and 11 contractors.
16
Average shift length. Calculated as total hours divided by days worked and average staff per day.
10.3 hoursAssists with medical care and medications.
21 total: 5 full-time employees and 16 contractors.
21
Average shift length. Calculated as total hours divided by days worked and average staff per day.
9.7 hoursHelps with daily care and mobility.
62 total: 22 full-time employees and 40 contractors.
62
Average shift length. Calculated as total hours divided by days worked and average staff per day.
7.8 hours
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Total hours from contractors
3,811 contractor hours this quarter
This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
| Certified Nursing Assistant | 22 | 40 | 62 | 6,147 | 92 | 100% | 7.8 |
| Licensed Practical Nurse | 5 | 16 | 21 | 2,525 | 92 | 100% | 9.7 |
| Registered Nurse | 5 | 11 | 16 | 1,845 | 86 | 93% | 10.3 |
| Clinical Nurse Specialist | 3 | 0 | 3 | 607 | 61 | 66% | 7.2 |
| Nurse Practitioner | 1 | 0 | 1 | 567 | 63 | 68% | 9 |
| Medication Aide/Technician | 3 | 0 | 3 | 543 | 66 | 72% | 7.8 |
| Dietitian | 1 | 0 | 1 | 536 | 68 | 74% | 7.9 |
| Dental Services Staff | 1 | 0 | 1 | 528 | 66 | 72% | 8 |
| Physical Therapy Assistant | 5 | 0 | 5 | 445 | 63 | 68% | 6 |
| Speech Language Pathologist | 2 | 0 | 2 | 408 | 61 | 66% | 5.4 |
| Respiratory Therapy Technician | 3 | 0 | 3 | 354 | 47 | 51% | 7.5 |
| Qualified Social Worker | 2 | 0 | 2 | 186 | 41 | 45% | 4.2 |
| Other Dietary Services Staff | 1 | 0 | 1 | 19 | 7 | 8% | 2.8 |
| Physical Therapy Aide | 1 | 0 | 1 | 12 | 4 | 4% | 3 |
| Therapeutic Recreation Specialist | 1 | 0 | 1 | 4 | 2 | 2% | 2.2 |
| Administrator | 1 | 0 | 1 | 1 | 1 | 1% | 1 |
Includes penalties issued in 2024
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)
47% lower than Iowa averageIowa average: $48K
18% more fines than Iowa averageIowa average: 1.7
Serious action where Medicare and/or Medicaid temporarily stops payments for new residents until issues are fixed.
0
100% fewer payment denials than Iowa averageIowa average: 0.5
Penalties are imposed by CMS for violations of federal nursing home regulations.
2 penalties in the past 3 years
Multiple penalties were reported in the last 3 years.
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jul 28, 2024
Fines imposed for noncompliance, which can be assessed per day or per instance of violation.
Jan 31, 2024Last updated: Jan 2026
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.
14.9
45% worse than Iowa averageIowa average: 10.2
A composite score based on activities of daily living decline, walking ability decline, and incontinence.
27.7
28% 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
30.9%
64% worse than Iowa averageIowa average: 18.8%
Percent of long-stay residents whose ability to move independently worsened
22.2%
13% worse than Iowa averageIowa average: 19.7%
Percent of low risk long-stay residents who lose control of their bowels or bladder
30.0%
14% worse than Iowa averageIowa average: 26.2%
Percent of long-stay residents experiencing one or more falls with major injury
9.6%
167% worse than Iowa averageIowa average: 3.6%
Percent of long-stay high risk residents with pressure ulcers
3.3%
24% better than Iowa averageIowa average: 4.4%
Percent of long-stay residents with a urinary tract infection
0.0%
100% better than Iowa averageIowa average: 2.5%
Percent of long-stay residents who lose too much weight
8.3%
67% worse than Iowa averageIowa average: 5.0%
Percent of long-stay residents who have depressive symptoms
29.0%
647% worse than Iowa averageIowa average: 3.9%
Percent of long-stay residents who received an antipsychotic medication
15.3%
19% better than Iowa averageIowa average: 19.0%
Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine
85.5%
9% worse than Iowa averageIowa average: 94.4%
Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine
95.9%
In line with Iowa averageIowa average: 95.3%
Number of hospitalizations per 1,000 long-stay resident days.
0.60
59% better than Iowa averageIowa average: 1.48
Number of outpatient emergency department visits per 1,000 long-stay resident days.
2.03
In line with 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
55.3%
35% worse than Iowa averageIowa average: 85.1%
Percent of short-stay residents who newly received an antipsychotic medication
0.0%
100% better than Iowa averageIowa average: 1.8%
Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine
43.5%
41% worse than Iowa averageIowa average: 73.3%
Percentage of SNF residents who experience falls with major injury during their stay.
0.0%
100% better than Iowa averageIowa average: 0.8%
Percentage of residents at or above expected ability to care for themselves at discharge.
30.0%
44% worse than Iowa averageIowa average: 53.7%
Quality measures are calculated from Minimum Data Set (MDS) assessments. For most measures, lower percentages indicate better care quality.
31% of new residents, usually for short-term rehab.
67% of new residents, often for short stays.
3% of new residents, often for long-term daily care.
Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)
Total residents
50Residents meet regularly to discuss policies, care quality, and activities
State-approved Nurse Aide Training and Competency Evaluation Program on-site
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 Hillcrest Health Care Center from 2012–2023, based on CMS SNF Cost Reports.
Key figures below are for fiscal year ending in 12/2023.
Based on CMS SNF Cost Report for fiscal year ending in 12/2023.
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 #140 / 239Payroll — State benchmarkedThis home is ranked 140th out of 239 homes in Iowa for payroll. 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.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Iowa that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
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 #48 / 239Payroll % — State benchmarkedThis home is ranked 48th out of 239 homes in Iowa for payroll %. Shows payroll as a percentage of revenue versus the Iowa average. Well-run Iowa facilities typically land around 61–69% — the top third Statewide. Below 25% may signal understaffing or heavy agency use — read with Staffing ratings.Facilities with the same value for a metric share the same rank. Rankings are based only on facilities in Iowa that report data for that category. Facilities without available data are excluded from the ranking.Click the rank badge to see the full State ranking.Click here to see the full State ranking.
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).
Residents typically stay for brief periods, with frequent admissions and discharges throughout the year.
Most new residents arrive under private pay (67% of admissions), and a typical private pay stay runs around 1 - 2 years.
Coverage residents most often arrive under.
Coverage residents most often leave under.
0.0 miles from city center
Estimated distance in miles from Hawarden's city center to Hillcrest Health Care Center's address, calculated via Google Maps.
Add your location
Info below is compiled from CMS reports & the IA Dept. of Inspections, Appeals & Licensing (DIAL), senior community websites & trusted data sources such as Walk Score & BBB.
Communities are listed from highest to lowest based on our ranking methodology.
| Bethany Home Retirement Center | NH IL MC SNF | Dubuque (Eagle Point District) | 66
Facility
66
IA AVG
71
Rank
#181 / 406 | - | - | 4.19
Facility
4.19
IA AVG
4.30
Rank
#112 / 235 | 0% | -2% | $0
Facility
$0
IA AVG
$53.4k
Rank
#1 / 241 | 2
Facility
2
IA AVG
21.7
Rank
#6 / 234 | 2.0
Facility
2.0
IA AVG
4.1
Rank
#19 / 234 | - | 67 | - |
69
Facility
69
IA AVG
45
Rank
#103 / 528 | Mike Brannon | $9.2MFiscal year ending 12/2023
Facility
$9.2MFiscal year ending 12/2023
IA AVG
$7.0M
Rank
#67 / 239 | $6.2MFiscal year ending 12/2023
Facility
$6.2MFiscal year ending 12/2023
IA AVG
$3.1M
Rank
#37 / 239 | 68%Fiscal year ending 12/2023
Facility
68%Fiscal year ending 12/2023
IA AVG
46.3%
Rank
#43 / 239 | 165584 | ||||
| St Francis Manor | NH AL HOS SNF | Grinnell | 78
Facility
78
IA AVG
71
Rank
#119 / 406 |
69.2%
Facility
69.2%
IA AVG
64.7
Rank
#193 / 379 | +7% | 5.32
Facility
5.32
IA AVG
4.30
Rank
#23 / 235 | +34% | +24% | $0
Facility
$0
IA AVG
$53.4k
Rank
#1 / 241 | 1
Facility
1
IA AVG
21.7
Rank
#1 / 234 | 1.0
Facility
1.0
IA AVG
4.1
Rank
#1 / 234 | - | 54 | - |
82
Facility
82
IA AVG
45
Rank
#39 / 528 | St Francis Manor Inc | $7.3MFiscal year ending 12/2023
Facility
$7.3MFiscal year ending 12/2023
IA AVG
$7.0M
Rank
#72 / 239 | $5.0MFiscal year ending 12/2023
Facility
$5.0MFiscal year ending 12/2023
IA AVG
$3.1M
Rank
#40 / 239 | 69.4%Fiscal year ending 12/2023
Facility
69.4%Fiscal year ending 12/2023
IA AVG
46.3%
Rank
#59 / 239 | 165480 | ||||
| Friendship Village | NH AL IL MC SNF | Waterloo | 72
Facility
72
IA AVG
71
Rank
#143 / 406 |
91.7%
Facility
91.7%
IA AVG
64.7
Rank
#41 / 379 | +42% | 6.17
Facility
6.17
IA AVG
4.30
Rank
#3 / 235 | +5% | +44% | $0
Facility
$0
IA AVG
$53.4k
Rank
#1 / 241 | 8
Facility
8
IA AVG
21.7
Rank
#45 / 234 | 2.0
Facility
2.0
IA AVG
4.1
Rank
#19 / 234 | 1 | 66 | - |
52
Facility
52
IA AVG
45
Rank
#202 / 528 | Friends Of Faith Retirement Homes, Inc | $14.2MFiscal year ending 03/2024
Facility
$14.2MFiscal year ending 03/2024
IA AVG
$7.0M
Rank
#11 / 239 | $11.6MFiscal year ending 03/2024
Facility
$11.6MFiscal year ending 03/2024
IA AVG
$3.1M
Rank
#7 / 239 | 81.4%Fiscal year ending 03/2024
Facility
81.4%Fiscal year ending 03/2024
IA AVG
46.3%
Rank
#113 / 239 | 165081 | ||||
| Prairie Vista Village | NH AL IL SNF | South Altoona | 68
Facility
68
IA AVG
71
Rank
#170 / 406 |
50.0%
Facility
50.0%
IA AVG
64.7
Rank
#255 / 379 | -23% | 4.71
Facility
4.71
IA AVG
4.30
Rank
#58 / 235 | -20% | +10% | $0
Facility
$0
IA AVG
$53.4k
Rank
#1 / 241 | 5
Facility
5
IA AVG
21.7
Rank
#18 / 234 | 1.3
Facility
1.3
IA AVG
4.1
Rank
#8 / 234 | - | 34 | A |
29
Facility
29
IA AVG
45
Rank
#372 / 528 | John Freeman | $9.1MFiscal year ending 12/2023
Facility
$9.1MFiscal year ending 12/2023
IA AVG
$7.0M
Rank
#60 / 239 | $3.7MFiscal year ending 12/2023
Facility
$3.7MFiscal year ending 12/2023
IA AVG
$3.1M
Rank
#69 / 239 | 40.8%Fiscal year ending 12/2023
Facility
40.8%Fiscal year ending 12/2023
IA AVG
46.3%
Rank
#169 / 239 | 165610 | ||||
| Hillcrest Health Care Center | NH AL MC SNF | Hawarden | 64
Facility
64
IA AVG
71
Rank
#190 / 406 |
70.2%
Facility
70.2%
IA AVG
64.7
Rank
#187 / 379 | +9% | 3.83
Facility
3.83
IA AVG
4.30
Rank
#173 / 235 | +11% | -11% | $25.5k
Facility
$25.5k
IA AVG
$53.4k
Rank
#179 / 241 | 55
Facility
55
IA AVG
21.7
Rank
#212 / 234 | 9.2
Facility
9.2
IA AVG
4.1
Rank
#224 / 234 | 2 | 45 | - |
49
Facility
49
IA AVG
45
Rank
#233 / 528 | Melodee Wilkins | $5.1MFiscal year ending 12/2023
Facility
$5.1MFiscal year ending 12/2023
IA AVG
$7.0M
Rank
#163 / 239 | $2.7MFiscal year ending 12/2023
Facility
$2.7MFiscal year ending 12/2023
IA AVG
$3.1M
Rank
#140 / 239 | 53.2%Fiscal year ending 12/2023
Facility
53.2%Fiscal year ending 12/2023
IA AVG
46.3%
Rank
#48 / 239 | 165245 |
Hillcrest Health Care Center has a walk score of 49. Somewhat walkable. A few nearby services may be reachable on foot, but most trips require transportation.
Hillcrest Health Care Center's occupancy is 44.3%.
No, Hillcrest Health Care Center has a no-pet policy.
Hillcrest Health Care Center is registered as a for-profit.
Yes — there are 2 photos of Hillcrest Health Care Center in the photo gallery on this page.
Hillcrest Health Care Center is located at 2121 Avenue L, Hawarden, Ia 510231333.
(712) 551-1074 will put you in contact with the team at Hillcrest Health Care Center.
Care Cost Calculator: See Prices in Your Area
Nursing Home Data Explorer
Don’t Wait Too Long: 7 Red Flag Signs Your Parent Needs Assisted Living Now
The True Cost of Assisted Living in 2025 – And How Families Are Paying For It
Understanding Senior Living Costs: Pricing Models, Discounts & Financial Assistance
