Nursing Care Index

Hillcrest Health Care Center

Hawarden, Sioux County, Iowa · CCN 165245 · For-profit (LLC) · part of The Ensign Group (342 facilities, chain average 3.2 stars)

CMS rates Hillcrest Health Care Center 1 of 5 overall as of August 2026. 64 certified beds, 54 residents a day on average. 73 citations on record from the current inspection cycles, 2 at immediate jeopardy; 3 fines totalling $130,305 and 1 payment denial.

On record

CMS’s ratings

The Five-Star Quality Rating System, as CMS publishes it. Where CMS gives no rating, the reason CMS gives is printed instead.

Overall★☆☆☆☆ 1 of 5
Health inspections★☆☆☆☆ 1 of 5
Staffing★★☆☆☆ 2 of 5
Quality measures★★★☆☆ 3 of 5
Quality: long-stay / short-stay3 / — of 5

Staffing

Total nurse staffing3.1055 hours per resident per day
Registered nurses0.61426 hours per resident per day
Weekend total2.55759 hours per resident per day
Nursing staff turnover75% (registered nurses 80%)

Citations from health inspections

Each is a finding by a state surveyor on the date shown, in CMS’s words. The severity is CMS’s scope-and-severity grid, spelled out: harm on the left, how widespread on the right.

SurveyFindingSeverityStatus
2026-05-06
complaint survey
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-05-14
2026-05-06
complaint survey
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Quality of Life and Care Deficiencies · tag F0686
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-05-14
2026-05-06
complaint survey
Provide safe and appropriate respiratory care for a resident when needed.
Quality of Life and Care Deficiencies · tag F0695
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-05-14
2026-03-26
complaint survey
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0600
G Actual harm that is not immediate jeopardy; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26
complaint survey
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights Deficiencies · tag F0584
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-04-08
2026-03-26 Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-04-08
2026-03-26 Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services Deficiencies · tag F0725
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-04-08
2026-03-26 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary Deficiencies · tag F0804
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-04-08
2026-03-26 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2026-04-08
2026-03-26
complaint survey
Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies · tag F0558
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Honor the resident's right to manage his or her financial affairs.
Resident Rights Deficiencies · tag F0567
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26
complaint survey
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Resident Rights Deficiencies · tag F0580
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · tag F0582
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0605
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26
complaint survey
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0609
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Resident Rights Deficiencies · tag F0628
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Assessment and Care Planning Deficiencies · tag F0644
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · tag F0657
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26
complaint survey
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Quality of Life and Care Deficiencies · tag F0690
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Ensure that feeding tubes are not used unless there is a medical reason and the resident agrees; and provide appropriate care for a resident with a feeding tube.
Quality of Life and Care Deficiencies · tag F0693
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Provide the appropriate treatment and services to a resident who displays or is diagnosed with dementia.
Quality of Life and Care Deficiencies · tag F0744
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · tag F0760
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Resident Assessment and Care Planning Deficiencies · tag F0842
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Have a plan that describes the process for conducting QAPI and QAA activities.
Administration Deficiencies · tag F0865
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2026-03-26 Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Administration Deficiencies · tag F0868
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2026-04-08
2025-10-08
complaint survey
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Resident Assessment and Care Planning Deficiencies · tag F0657
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-10-13
2025-03-11 Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Resident Rights Deficiencies · tag F0625
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-03-28
2025-03-11
complaint survey
Provide care and assistance to perform activities of daily living for any resident who is unable.
Quality of Life and Care Deficiencies · tag F0677
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-03-28
2025-03-11 Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Nutrition and Dietary Deficiencies · tag F0801
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2025-03-28
2025-03-11 Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Resident Rights Deficiencies · tag F0582
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-03-28
2025-03-11 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights Deficiencies · tag F0584
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-03-28
2025-03-11 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-03-28
2025-03-11
complaint survey
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Quality of Life and Care Deficiencies · tag F0684
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-03-28
2025-03-11
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-03-28
2025-03-11 Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Pharmacy Service Deficiencies · tag F0758
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-03-28
2025-03-11 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2025-03-28
2024-07-28
complaint survey
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Nutrition and Dietary Deficiencies · tag F0805
J Immediate jeopardy to resident health or safety; isolated Deficient, Provider has date of correction
2024-08-07
2024-07-28
complaint survey
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Nutrition and Dietary Deficiencies · tag F0803
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-08-13
2024-07-28
complaint survey
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary Deficiencies · tag F0804
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-08-13
2024-07-28
complaint survey
Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
Nutrition and Dietary Deficiencies · tag F0809
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-08-13
2024-07-28
complaint survey
Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-08-13
2024-07-28
complaint survey
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-08-13
2024-07-28
complaint survey
Reasonably accommodate the needs and preferences of each resident.
Resident Rights Deficiencies · tag F0558
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-08-13
2024-07-28
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-08-13
2024-07-28
complaint survey
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Quality of Life and Care Deficiencies · tag F0690
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-08-13
2024-07-28
complaint survey
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services Deficiencies · tag F0725
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-08-13
2024-07-28
complaint survey
Ensure each resident receives and the facility provides food that accommodates resident allergies, intolerances, and preferences, as well as appealing options.
Nutrition and Dietary Deficiencies · tag F0806
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-08-13
2024-01-31 Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Nutrition and Dietary Deficiencies · tag F0805
K Immediate jeopardy to resident health or safety; pattern Deficient, Provider has date of correction
2024-02-08
2024-01-31 Provide and implement an infection prevention and control program.
Infection Control Deficiencies · tag F0880
F No actual harm, with potential for more than minimal harm; widespread Deficient, Provider has date of correction
2024-02-14
2024-01-31 Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Resident Rights Deficiencies · tag F0550
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Resident Rights Deficiencies · tag F0585
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Freedom from Abuse, Neglect, and Exploitation Deficiencies · tag F0607
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Nursing and Physician Services Deficiencies · tag F0725
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Nursing and Physician Services Deficiencies · tag F0726
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Nutrition and Dietary Deficiencies · tag F0802
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Nutrition and Dietary Deficiencies · tag F0803
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Nutrition and Dietary Deficiencies · tag F0804
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Ensure meals and snacks are served at times in accordance with resident’s needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
Nutrition and Dietary Deficiencies · tag F0809
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Nutrition and Dietary Deficiencies · tag F0812
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Have a plan that describes the process for conducting QAPI and QAA activities.
Administration Deficiencies · tag F0865
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Have the Quality Assessment and Assurance group have the required members and meet at least quarterly
Administration Deficiencies · tag F0868
E No actual harm, with potential for more than minimal harm; pattern Deficient, Provider has date of correction
2024-02-14
2024-01-31 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Resident Rights Deficiencies · tag F0584
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-02-14
2024-01-31 Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Resident Rights Deficiencies · tag F0623
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-02-14
2024-01-31 Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Resident Rights Deficiencies · tag F0625
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-02-14
2024-01-31 Ensure each resident receives an accurate assessment.
Resident Assessment and Care Planning Deficiencies · tag F0641
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-02-14
2024-01-31 Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Resident Assessment and Care Planning Deficiencies · tag F0644
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-02-14
2024-01-31 Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Resident Assessment and Care Planning Deficiencies · tag F0656
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-02-14
2024-01-31
complaint survey
Ensure services provided by the nursing facility meet professional standards of quality.
Resident Assessment and Care Planning Deficiencies · tag F0658
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-02-14
2024-01-31
complaint survey
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Pharmacy Service Deficiencies · tag F0758
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-02-14
2024-01-31 Ensure that residents are free from significant medication errors.
Pharmacy Service Deficiencies · tag F0760
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-02-14
2024-01-31 Develop and implement policies and procedures for flu and pneumonia vaccinations.
Infection Control Deficiencies · tag F0883
D No actual harm, with potential for more than minimal harm; isolated Deficient, Provider has date of correction
2024-02-14
2023-08-17
complaint survey
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Quality of Life and Care Deficiencies · tag F0689
D No actual harm, with potential for more than minimal harm; isolated Past Non-Compliance
2023-06-14

Fines and payment denials

DatePenaltyAmount
2026-03-26Payment denial for 22 days from 2026-04-22
2026-03-26Fine$104,855
2024-07-28Fine$8,649
2024-01-31Fine$16,801

Who owns and runs it

Every owner, officer and manager CMS lists, as filed. These are the names in CMS’s ownership record; anyone named in the ownership record can ask about it on the about page.

NameRoleShareSince
Caretrust Gp LLC
Organization
adp of the snf2011-07-18
Caretrust Reit Inc.
Organization
adp of the snf2011-07-18
Ctr Partnership Lp
Organization
adp of the snf2011-07-18
Ensign Services Inc.
Organization
adp of the snf2011-06-01
The Ensign Group Inc.
Organization
adp of the snf2002-07-29
Aerofund Holdings Inc.
Organization
operational/managerial control2011-07-18
Blu Medstaff LLC
Organization
operational/managerial control2011-07-18
Heart Medical Solutions LLC
Organization
operational/managerial control2011-07-18
Helping Hands Nursing Solution Inc.
Organization
operational/managerial control2011-07-18
Onshift Inc.
Organization
operational/managerial control2011-07-18
Kamstra, Lee
Individual
adp of the snf2025-07-10
Wilkins, Melodee
Individual
adp of the snf2025-07-10
Jorgensen, David
Individual
corporate director2024-01-01
Port, Barry
Individual
corporate director2018-07-20
Burnam, Soon
Individual
corporate officer2024-09-09
Keetch, Chad
Individual
corporate officer2011-03-01
Koenig, Debra
Individual
corporate officer2020-01-01
Sato, Ami
Individual
corporate officer2024-09-09
Burnam, Soon
Individual
managing control - governing body2024-09-09
Kamstra, Lee
Individual
managing control - governing body2024-09-16
Wilkins, Melodee
Individual
managing control - governing body2011-07-18
Kamstra, Lee
Individual
operational/managerial control2024-09-16
Wilkins, Melodee
Individual
operational/managerial control2011-07-18

What changed

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Source: Centers for Medicare & Medicaid Services, Provider Data Catalog (public domain), files dated 2026-08-01. Ratings are CMS’s; citations are state surveyors’ findings; nothing here is estimated or a recommendation. Every nursing home in Sioux County.