Norwalk Nursing and Rehabilitation Center
Nursing Home & Assisted Living · Norwalk, IA
CMS overall rating Info 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.

Norwalk Nursing and Rehabilitation Center

Nursing Home & Assisted Living · Norwalk, IA
CMS overall rating Info 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.
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Norwalk Nursing and Rehabilitation Center accepts Medicare, Medicaid, and private pay.

Overview of Norwalk Nursing and Rehabilitation Center

Providing short-term rehabilitation and longer-term skilled care, Norwalk Nursing and Rehabilitation Center is a nursing home with 45 beds. It is owned by Karah Appleget and accepts Medicare, Medicaid, and private pay, so families have several options for covering both post-acute recovery and ongoing nursing care. The facility has an occupancy rate of 93%. Residents stay an average of 137 days, which includes rehabilitation admissions and longer-term care residents.

Clinical support is a central part of daily operations. Licensed nurses are available 24 hours a day, and physicians make regular visits to oversee medical care. The facility offers restorative rehabilitation, dietary and nutritional counseling, and disease management programs to reduce preventable hospital readmissions.

Vision and dental services are available on-site. Staff also develop individualized care plans based on each resident’s needs.

The facility has a Walk Score of 70. Visiting family members can easily navigate the neighborhood on foot and access nearby services. It’s a walkable community where many errands can be completed without a car, which is less common in many rural care settings.

Families considering Norwalk Nursing and Rehabilitation Center should take a tour of the facility to see the environment, meet staff members, and learn more about the home’s rehabilitation services and care programs.

Quality ratings

Measured by Centers for Medicare & Medicaid Services (CMS)

Overall rating Info 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.
Health Inspection Info 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.
Staffing Info 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.
Quality Measures Info 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.

Capacity and availability

Avg. Length of Stay Info 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.
137 days
Bed community size
45-bed community Rank #305 / 407Bed count — State benchmarkedThis home is ranked 305th out of 407 homes in Iowa. 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.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.
A moderately sized community that may balance personal attention with shared amenities and social activities.
Walk Score
Walk Score: 70 / 100 Rank #98 / 528Walk Score — State benchmarkedThis home is ranked 98th out of 528 homes in Iowa. Shows how walkable this facility's neighborhood is compared to the average Walk Score across Iowa facilities. Higher scores benefit residents, families, and staff.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.
Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

About this community

Occupancy

Occupancy rate
93%
Rank #39 / 407Occupancy rate — State benchmarkedThis home is ranked 39th out of 407 homes in Iowa. Shows this facility's occupancy rate versus the Iowa average, with its Statewide rank out of 407. Higher occupancy signals strong local demand and financial stability.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.
Higher than the Iowa average: 75.4%
Occupied beds
42 / 45
Average occupied beds in Iowa homes 51 beds

License Details

Facility TypeFree Standing Nursing Facility / Skilled Nursing Facility
StatusActive
ExpirationMarch 1, 2027
CountyWarren
License Number910532
CMS Certification Number165179
Certification TypeFALSE

Ownership & Operating Entity

Norwalk Nursing and Rehabilitation Center is administered by Danielle Hage.

Therapy & Rehabilitation

1 service
Rehabilitation Services

Staffing & Medical

2 services
Doctor on Staff
24-Hour Staffing

Contact Information

Fax5159819215

Amenities & Lifestyle

Specific ProgramsLicensed nurses on-site 24/7, Physician visits, Dietary and nutritional counseling, Restorative rehabilitation, Vision and dental care, Disease management and early intervention, Hospital readmission reduction program, Individualized resident care plans, Assistance with activities of daily living, Housekeeping and laundry services
Operating Hours24/7

Contact Norwalk Nursing and Rehabilitation Center

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.

Since 2020 · 6 years of data 27 deficiencies 19 inspections

Inspection Scorecard Info This scorecard compares key inspection, deficiency, 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.

Since 2020 vs. Iowa state average
Overall vs. IA average 1 Worse Metrics worse than Iowa average:
• Total inspections (27% above)
2 At Avg Metrics at Iowa average:
• Total deficiencies (at IA avg)
• Deficiencies per year (at IA avg)
1 Better Metrics better than Iowa average:
• Deficiencies per inspection (22% below)
Latest Inspection December 31, 2025

Deficiencies Info Deficiencies are formal regulatory issues recorded during state inspections.

This Facility IA Average vs. IA Avg
Total deficiencies Info Formal regulatory issues recorded by inspectors across all inspection types. 27 27 This facility has total deficiencies in line with the Iowa average (27 vs. IA avg 27).— At avg
Deficiencies per year Info Average deficiencies per year since 2020. 4.5 4.5 This facility has deficiencies per year in line with the Iowa average (4.5 vs. IA avg 4.5).— At avg
Deficiencies per inspection Info Average deficiencies per inspection. 1.4 1.8 This facility has 22% fewer deficiencies per inspection than a typical Iowa assisted living residence (1.4 vs. IA avg 1.8).↓ 22% better

Inspections Info State inspections evaluate whether the facility meets health and safety standards.

This Facility IA Average vs. IA Avg
Total inspections Info Combined count of all routine and focused inspections. Excludes complaint investigations. 19 15 This facility has 27% more total inspections than a typical Iowa assisted living residence (19 vs. IA avg 15).↑ 27% worse

Inspection Reports Summary Info An editor-reviewed summary of the themes and findings across this facility's recent inspection reports.

  • The December 31, 2025 inspection found one deficiency for failing to transcribe, verify, and administer insulin orders for Resident #5, with no deficiencies cited from the complaint investigation.
  • The December 5, 2024 annual inspection cited five deficiencies including failure to provide dignified eating assistance, incomplete background checks, inaccurate advance directives, delayed care plan updates, and poor infection control during incontinence care.
  • The April 16, 2025 complaint investigation substantiated failure to safely transfer residents in wheelchairs without foot pedals and lack of a policy for wheelchair transport.

Health Inspection History

Inspections since 2022
Total health inspections 3

State average N/A


Last Health inspection on Apr 2025

Total health citations
11 Rank #78 / 250Health citations — State benchmarkedThis home is ranked 78th out of 250 homes in Iowa. Shows this facility's total health deficiency citations benchmarked to the Iowa State average, with a ranking across all 250 IA facilities. Lower citation counts earn a better 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.

State average N/A

Citations per inspection
3.67 Rank #119 / 250Citations per inspection — State benchmarkedThis home is ranked 119th out of 250 homes in Iowa. Shows average deficiency citations per CMS inspection for this facility versus the Iowa mean across 250 facilities with citation data. Lower is better.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.

State average N/A


Health citations are formal notices following inspections when they fail to comply with safety and care standards.

9 of 11 citations resulted from standard inspections; 1 of 11 resulted from complaint investigations; and 1 of 11 came from combined inspections (standard and complaint).

Breakdown of citation severity (last 4 years)
Critical health citations
0
In line with State average

State average: N/A


Serious health citations
0
In line with State average

State average: N/A

0 critical citations State average: N/A

0 serious citations State average: N/A

11 moderate citations State average: N/A

0 minor citations State average: N/A
Citations history (last 4 years)
Quality of Care moderate citation Apr 16, 2025
Corrected

Abuse/Neglect moderate citation Dec 05, 2024
Corrected

Quality of Care moderate citation Dec 05, 2024
Corrected

Care Planning moderate citation Dec 05, 2024
Corrected

Staffing Data

Reporting period: October 1 – December 31, 2025 (Q4 2025). Source: CMS Payroll-Based Journal report.

Total staff 95
Employees 79
Contractors 16
Staff to resident ratio 2.26 : 1
0% compared with State average

State average ratio: 0 : 0

Avg staff/day 20
Average shift 8.8 hours
0% compared with State average

State average: 0 hours

Total staff hours (quarter) 16,242

Nursing staff breakdown

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Registered Nurse

Manages medical care and health needs.

RN Staff Info All 9 RN Staff are full-time employees. No contractors work on this role. 9
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.2 hours
Licensed Practical Nurse

Assists with medical care and medications.

LPN Staff Info All 11 LPN Staff are full-time employees. No contractors work on this role. 11
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.5 hours
Certified Nursing Assistant

Helps with daily care and mobility.

CNA Staff Info All 40 CNA Staff are full-time employees. No contractors work on this role. 40
Average shift length Info Average shift length. Calculated as total hours divided by days worked and average staff per day. 9.5 hours

Contractor staffing

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.

Total hours from contractors

8%

1,297 contractor hours this quarter

Respiratory Therapy Technician: 4 Physical Therapy Assistant: 3 Speech Language Pathologist: 2 Physical Therapy Aide: 2 RN Director of Nursing: 1 Occupational Therapy Aide: 1 Qualified Social Worker: 1 Medical Director: 1 Occupational Therapy Assistant: 1

Staff by category

Q4 2025 · Oct 1 – Dec 31 More info This data comes from the CMS Payroll-Based Journal report covering October 1 – December 31, 2025.
Certified Nursing Assistant 40 0 40 7,507 92 100% 9.5
Licensed Practical Nurse 11 0 11 2,367 92 100% 9.5
Medication Aide/Technician 9 0 9 1,410 81 88% 9.4
Registered Nurse 9 0 9 1,162 87 95% 9.2
RN Director of Nursing 2 1 3 611 62 67% 9.1
Dietitian 3 0 3 543 69 75% 7.6
Administrator 2 0 2 536 64 70% 8
Speech Language Pathologist 0 2 2 522 62 67% 8.4
Physical Therapy Assistant 0 3 3 482 62 67% 7.6
Mental Health Service Worker 1 0 1 476 59 64% 8.1
Nurse Practitioner 1 0 1 368 46 50% 8
Respiratory Therapy Technician 0 4 4 126 25 27% 5
Occupational Therapy Aide 0 1 1 55 40 43% 1.4
Physical Therapy Aide 0 2 2 30 6 7% 5
Occupational Therapy Assistant 0 1 1 21 3 3% 6.8
Qualified Social Worker 0 1 1 18 12 13% 1.5
Clinical Nurse Specialist 1 0 1 8 1 1% 8
Medical Director 0 1 1 1 1 1% 1
40 Certified Nursing Assistant
% of Days 100%
11 Licensed Practical Nurse
% of Days 100%
9 Medication Aide/Technician
% of Days 88%
9 Registered Nurse
% of Days 95%
3 RN Director of Nursing
% of Days 67%
3 Dietitian
% of Days 75%
2 Administrator
% of Days 70%
2 Speech Language Pathologist
% of Days 67%
3 Physical Therapy Assistant
% of Days 67%
1 Mental Health Service Worker
% of Days 64%
1 Nurse Practitioner
% of Days 50%
4 Respiratory Therapy Technician
% of Days 27%
1 Occupational Therapy Aide
% of Days 43%
2 Physical Therapy Aide
% of Days 7%
1 Occupational Therapy Assistant
% of Days 3%
1 Qualified Social Worker
% of Days 13%
1 Clinical Nurse Specialist
% of Days 1%
1 Medical Director
% of Days 1%

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

No penalties in the past 3 years

No civil money penalties or payment denials were reported in the last 3 years.

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 Info A composite score based on pressure ulcers, falls with injury, weight loss, walking ability decline, and activities of daily living decline. 13.6
33% worse than State average

State average: 10.2

Functional decline score Info A composite score based on activities of daily living decline, walking ability decline, and incontinence. 28.1
30% worse than State average

State average: 21.6

Long-stay resident measures
Significantly below average State avg: 3.3 Info CMS star rating based on long-stay quality measure performance. 5 stars = significantly above average, 1 star = significantly below average.
Need for Help with Daily Activities Increased Info Percent of long-stay residents whose need for help with daily activities has increased 23.5%
25% worse than State average

State average: 18.8%

Walking Ability Worsened Info Percent of long-stay residents whose ability to move independently worsened 33.4%
70% worse than State average

State average: 19.7%

Low Risk Residents with Bowel/Bladder Incontinence Info Percent of low risk long-stay residents who lose control of their bowels or bladder 27.4%
5% worse than State average

State average: 26.2%

Falls with Major Injury Info Percent of long-stay residents experiencing one or more falls with major injury 4.8%
34% worse than State average

State average: 3.6%

High Risk Residents with Pressure Ulcers Info Percent of long-stay high risk residents with pressure ulcers 2.4%
45% better than State average

State average: 4.4%

Urinary Tract Infection Info Percent of long-stay residents with a urinary tract infection 5.6%
125% worse than State average

State average: 2.5%

Lost Too Much Weight Info Percent of long-stay residents who lose too much weight 4.0%
19% better than State average

State average: 5.0%

Depressive Symptoms Info Percent of long-stay residents who have depressive symptoms 0.0%
100% better than State average

State average: 3.9%

Antipsychotic Use Info Percent of long-stay residents who received an antipsychotic medication 3.1%
84% better than State average

State average: 19.0%

Pneumococcal Vaccine Info Percent of long-stay residents assessed and appropriately given the pneumococcal vaccine 98.6%
In line with State average

State average: 94.4%

Influenza Vaccine Info Percent of long-stay residents assessed and appropriately given the seasonal influenza vaccine 100.0%
5% better than State average

State average: 95.3%

Hospitalizations per 1,000 days Info Number of hospitalizations per 1,000 long-stay resident days. 3.44
132% worse than State average

State average: 1.48

ED visits per 1,000 days Info Number of outpatient emergency department visits per 1,000 long-stay resident days. 3.27
56% worse than State average

State average: 2.09

Short-stay resident measures
Significantly below average State avg: 2.6 Info CMS star rating based on short-stay quality measure performance. 5 stars = much above average, 1 star = much below average.
Pneumococcal Vaccine Info Percent of short-stay residents assessed and appropriately given the pneumococcal vaccine 91.6%
8% better than State average

State average: 85.1%

Antipsychotic medication increase Info Percent of short-stay residents who newly received an antipsychotic medication 3.5%
89% worse than State average

State average: 1.8%

Influenza Vaccine Info Percent of short-stay residents assessed and appropriately given the seasonal influenza vaccine 80.7%
10% better than State average

State average: 73.3%

Re-hospitalized after SNF stay Info Percentage of short-stay residents who were re-hospitalized after their nursing home admission. 22.2%
In line with State average

State average: 21.3%

Emergency department visits Info Percentage of short-stay residents who had an outpatient emergency department visit. 16.8%
28% worse than State average

State average: 13.1%

Falls with major injury Info Percentage of SNF residents who experience falls with major injury during their stay. 0.0%
100% better than State average

State average: 0.8%

Ability to care for self at discharge Info Percentage of residents at or above expected ability to care for themselves at discharge. 25.8%
52% worse than State average

State average: 53.7%

Successful return to home or community Info Rate of successful return to home or community from a skilled nursing facility. 49.1%
In line with State average

State average: 50.6%

Breakdown by payment type

Medicare

42% of new residents, usually for short-term rehab.

Typical stay 26 days

Private pay

42% of new residents, often for short stays.

Typical stay 3 - 4 months

Medicaid

15% of new residents, often for long-term daily care.

Typical stay 1 - 2 years

Facility Characteristics

Source: CMS Long-Term Care Facility Characteristics (Data as of Jan 2026)

Total residents 42
Medicare
4
9.5% of residents
Medicaid
23
54.8% of residents
Private pay or other
15
35.7% of residents
Programs & Services
Residents Group

Residents meet regularly to discuss policies, care quality, and activities

Active Resident Council

Organized group of residents that meets regularly to discuss facility policies, quality of life, and activities.

Finances and operations

Based on CMS SNF Cost Report for fiscal year ending in 12/2023.

For-profit
Corporation
Net patient revenue Info 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."
$4.3M
Net patient income Info 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."
-$225.9K
For-profit Corporation
Net patient revenue Info 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."
$4.3M Rank #152 / 251Revenue — State benchmarkedThis home is ranked 152nd out of 251 homes in Iowa. Shows this facility's annual revenue compared to the Iowa average. Higher revenue generally means more resources for staffing and capital — read alongside Payroll %.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.
Net patient income Info 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."
-$225.9K
Other income Info 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.
$7.4K
Payroll costs Info 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 #151 / 251Payroll — State benchmarkedThis home is ranked 151st out of 251 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.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.
$2.7M 64.1% of net patient revenue Info 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 #129 / 251Payroll % — State benchmarkedThis home is ranked 129th out of 251 homes in Iowa. 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.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.
Other operating costs Info 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).
$1.8M
Total costs Info The home's total operating expense for the year — all the costs of running it, salaries included (CMS cost report, Worksheet G-3).
$4.5M

Who this home usually serves

TYPE OF STAY

Mix of rehab and long-term care

This home supports both short-term rehab and long-term care, with residents staying for a wide range of durations.

New residents most often arrive under Medicare (42% of admissions), and a typical Medicare stay runs around 26 days.

Admissions
106 total

Coverage residents most often arrive under.

Medicare 42%
Private pay 42%
Medicaid 15%
Discharges
106 total

Coverage residents most often leave under.

Medicare 26%
Private pay 50%
Medicaid 24%

Places of interest near Norwalk Nursing and Rehabilitation Center

Address 0.0 miles from city center Info Estimated distance in miles from Norwalk's city center to Norwalk Nursing and Rehabilitation Center's address, calculated via Google Maps.

Calculate Travel Distance to Norwalk Nursing and Rehabilitation Center

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Address

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Frequently Asked Questions about Norwalk Nursing and Rehabilitation Center

Is Norwalk Nursing and Rehabilitation Center in a walkable area?

Norwalk Nursing and Rehabilitation Center has a walk score of 70. Very walkable. Most errands can be accomplished on foot, and many essentials are within a short walk.

What is the license number of Norwalk Nursing and Rehabilitation Center?

According to IA state health department records, Norwalk Nursing and Rehabilitation Center's license number is 910532.

When does Norwalk Nursing and Rehabilitation Center's license expire?

According to IA state health department records, Norwalk Nursing and Rehabilitation Center's license expires on March 1, 2027.

What is the occupancy rate at Norwalk Nursing and Rehabilitation Center?

Norwalk Nursing and Rehabilitation Center's occupancy is 93%.

What is the best email address for Norwalk Nursing and Rehabilitation Center?

The team at Norwalk Nursing and Rehabilitation Center can be reached at dhage@norwalknursingandrehab.com.

Does Norwalk Nursing and Rehabilitation Center operate as a for-profit or non-profit?

Norwalk Nursing and Rehabilitation Center is registered as a for-profit in IA.

Who is the administrator of Norwalk Nursing and Rehabilitation Center?

Danielle Hage is the administrator of Norwalk Nursing and Rehabilitation Center.

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