The Highlands
607 Highland Drive, Decorah, IA 52101 · Winneshiek County · (563) 382-3603
86 certified beds, about 75 residents a day · Non profit - Corporation · Medicare and Medicaid since 1993
Part of a continuing care retirement community Certified for Medicaid Certified for Medicare
Overall
2 of 5
Health inspections
2 of 5
Staffing
4 of 5
Quality measures
3 of 5
CMS Care Compare ratings, data as of September 1, 2026 · CCN 165178 · See it on Medicare.gov · Compare with other homes
The record in brief
At its most recent standard inspection, on July 22, 2026, inspectors cited 4 health deficiencies (the Iowa average is 6.5, the national average 9.2).
Of 26 health citations since February 2024, 3 were rated as actual harm or immediate jeopardy to residents (1 immediate jeopardy).
CMS lists 2 fines totaling $93,839 in the last three years; the largest was $50,211, and the latest is dated December 9, 2024.
Nurses and nurse aides worked 3.90 hours per resident per day, against 3.82 across Iowa and 3.86 nationally. Registered nurses accounted for 0.44 of those hours.
53.3% of nursing staff left within the year CMS measured (Iowa average 44.0%).
Health inspections
Federal rules call for a standard inspection at least every 15 months, plus a visit whenever a complaint is filed. Each mark below is one citation, colored by how serious inspectors rated it. How to read a citation.
Under each citation, the quoted text is the inspector's own summary from the federal statement of deficiencies (CMS form 2567), word for word apart from a privacy scrub; CMS removes residents' and staff names before it publishes the text. The full notes are on Medicare.gov.
602/24
707/24
209/24
112/24
306/25
209/25
106/26
407/26
Potential for minimal harm Potential for more than minimal harm Actual harm Immediate jeopardy Found on a complaint visit
Where its citations fall on CMS's grid
CMS rates every citation by how much harm it caused (rows) and how many residents it touched (columns). The count in each box is this home's, across all 26 health citations on file.
Severity
Isolated
Pattern
Widespread
Immediate jeopardy
1J
0K
0L
Actual harm
2G
0H
0I
Potential for more than minimal harm
15D
6E
0F
Potential for minimal harm
0A
1B
1C
July 22, 2026Standard inspection · 4 citations
- E Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation, United States (US) Food and Drug Administration (FDA) Food Code, document review, and staff interview, the facility failed ensure staff washed hands prior to applying gloves and between glove changes. The facility also failed to prevent dirty gloves from coming into contact with food served to residents. The facility reported a census of 74 residents.
- D Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive.
Inspectors wroteBased on clinical record review, document review, policy review, and staff interview the facility failed to ensure the Iowa Physician Orders for Scope of Treatment (IPOST) matched provider's orders on the electronic health record (EHR) for Do Not Resuscitate (DNR) for 1 of 2 residents sampled (Resident #6). The facility identified a census of 74 residents.
- D Assess the resident when there is a significant change in condition
Inspectors wroteBased on clinical record review, Center for Medicare and Medicaid (CMS) Long-Term Care (LTC) Resident Assessment Instrument (RAI) Manual review, and staff interview the facility failed to complete a Minimum Data Set (MDS) Significant Change in Status Assessment (SCSA) within 14 days of hospice election for 1 of 2 residents receiving hospice services (Resident #30). The facility identified a census of 74 residents.
- D Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Inspectors wroteBased on clinical record review, document review, and staff interview, the facility failed to perform a new Preadmission Screening and Resident Review (PASRR, a federal mandate requiring all states to screen individuals before they are admitted to a Medicaid-certified nursing facility, ensuring they are placed in the most appropriate setting and receive necessary care) as required for 1 of 2 residents sampled (Resident #60). The facility reported a census of 74 residents.
June 18, 2026Complaint inspection · 1 citation
- D Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on clinical record review, facility document review, and staff interview, the facility failed to provide adequate supervision for residents with wandering behaviors for 2 of 3 residents reviewed for supervision (Residents #1 and #2). The facility failed to ensure staff from the area of the facility where the Resident #1 resided responded to a door alarm, resulting in Resident #1 eloping from the facility on 3/7/26 via the front door of the facility. A staff member from assisted living responded and assisted Resident #1. The facility failed to prevent Resident #2, who had a history of entering other resident's rooms, from entering Resident #3's room without staff knowledge, resulting in a physical altercation between Resident #2 and Resident #3. The facility reported a census of 71 residents.
September 23, 2025Complaint inspection · 2 citations
- E Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Inspectors wroteBased on observation, clinical record review and staff interview, the facility failed to properly position resident clothing while positioned in bed for 5 of 5 residents reviewed (Resident #2, #3, #4, #5 and #6). The facility identified a census of 68 residents.
- E Have enough outside ventilation via a window or mechanical ventilation, or both.
Inspectors wroteBased on observation, clinical record review and staff interview the facility failed to properly monitor and intervene when an air conditioning unit became non-operational. The facility identified a census of 68 residents.
June 12, 2025Standard inspection · 3 citations
- D Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Inspectors wroteBased on record review and staff interviews the facility failed to provide 48 hour notice before the end of Skilled Nursing Care stays for 2 of 3 residents reviewed for Skilled Nursing Care (Residents #28 and #62). The forms the facility failed to provide timely were Notice of Medicare Non-Coverage (NOMNC) (Form CMS 10123-NOMNC) and Skilled Nursing Facility Advance Beneficiary Notice of Non-coverage (SNFABN) (Form CMS-10055). The facility reported a census of 64 residents.
- D Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Inspectors wroteBased on personnel file review, facility assessment review, facility policy review, and staff interview, the facility failed to provide dependent adult abuse training, within 6 months of hire for 4 of 5 employee personnel files reviewed (Staff A, Staff B, Staff C, and Staff D). The facility identified a census of 64 residents.
- B Ensure each resident receives an accurate assessment.
Inspectors wroteBased on record review and staff interviews the facility failed to complete a Discharge Minimum Data Set (MDS) and Reentry MDS for 1 of 1 residents reviewed for hospitalizations (Resident #41). The facility reported a census of 64 residents.
December 9, 2024Complaint inspection · 1 citation
- J Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on record review, staff and medical professional interviews the facility failed to promptly identify and intervene for an acute change in a resident's condition related to dehydration for 1 of 3 residents reviewed (Resident#2), resulting in Resident #2 being transported and admitted to the hospital via ambulance 10/22/24 with severe dehydration and sepsis. Resident #2 died on [DATE]. Resident #2's Electronic Health Record (EHR) documented he had acute changes in condition noted as follows with lack of follow up assessments and notification to the physician with the condition changes: 10/17/24 increased blood pressure 10/18/24 No assessment completed 10/19/24 slightly elevated pulse 10/20/24 increase in pulse, blood pressure and mental status change. 10/21/24 No assessment completed 10/22/24 prior to being seen by psych via telecare in the early afternoon no assessment completed. [...]
September 25, 2024Complaint inspection · 2 citations
- D Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Inspectors wroteBased on clinical record review, facility policy review, and staff interview the facility failed to notify the family and primary care provider (PCP) of bruising for 1 of 3 residents reviewed (Resident #2). The facility reported a census of 61 residents.
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on observation, clinical record review, facility policy review, and staff interview the facility failed to assess a bruise after identification for 1 of 3 residents reviewed (Resident #2). The facility reported a census of 61 residents.
July 25, 2024Standard inspection · 7 citations
- G Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on clinical record review, facility documents, and staff interviews the facility failed to prevent accidents and hazards for 1 of 3 residents reviewed (Resident #41). The facility reported a census of 62 residents.
- E Provide each resident with a nourishing, palatable, well-balanced diet that meets his or her daily nutritional and special dietary needs.
Inspectors wroteBased on observation, staff interview, and policy review the facility failed to ensure 10 of 10 residents received a well-balanced diet that met their nutritional needs. The facility reported a census of 62 residents.
- E Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Inspectors wroteBased on record review, staff interviews, and policy review the facility failed to have a qualified and educated dietary staff provide food service to residents. The facility reported a census of 62 residents.
- E Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Inspectors wroteBased on observation, staff interviews, and policy review the facility failed to ensure during meal service, ready to eat food was not touched by contaminated gloves for multiple residents that were served chicken sandwiches. The facility reported a census of 62 residents.
- D Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Inspectors wroteBased on observation, resident, family, and staff interviews the facility staff failed to submit a new Preadmission Screening and Resident Review (PASRR) for 2 of 2 residents sampled (Residents #29 and #56). The facility reported a census of 62 residents.
- D Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Inspectors wroteBased on observation, clinical record review, policy review and staff interview, the facility failed to properly secure medication and assess resident safety for medication administration for 1 of 1 residents sampled (Resident #53). The facility identified a census of 62 residents.
- C 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.
Inspectors wroteBased on record review, staff interviews, and job description review the facility failed to have a qualified professional serve as the Dietary Manager. The facility reported a census of 62 residents.
February 7, 2024Complaint inspection · 6 citations
- G Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Inspectors wroteBased on clinical record review, hospital record review, policy review, and former and current staff interviews the facility failed to use safe transfer techniques for 1 of 4 (Resident #3) residents reviewed for gait belt transfers, resulting in a hip fracture. The facility failed to provide adequate supervision for a resident with dementia (Resident #1) who accessed a potentially hazardous area through a locked door. The facility reported a census of 64 residents.
- D Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Inspectors wroteBased on observation, clinical record review, and staff interview the facility failed to maintain privacy during the provision of activities of daily living (ADL) care for 1 of 3 residents sampled (Resident #1). The facility identified a census of 64 residents.
- D 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.
Inspectors wroteBased on observation, resident and staff interview, the facility failed to provide a homelike environment by serving breakfast meals on plastic food serving trays. The facility identified a census of 64 residents.
- D Ensure each resident receives an accurate assessment.
Inspectors wroteBased on clinical record review, staff interviews, and Resident Assessment Instrument (RAI) Manual review the facility failed to complete the Minimum Data Set (MDS) Assessments within 14 days of starting Hospice services and going off hospice services for 2 of 3 residents reviewed (Resident #4, and #13). The facility reported a census of 64 Residents.
- D Ensure services provided by the nursing facility meet professional standards of quality.
Inspectors wroteBased on observation, policy review, and staff interview the facility failed to check the expiration date on medications prior to giving the medication for 1 of 2 residents sampled (Resident #14). The facility identified a census of 64 residents.
- D Provide care and assistance to perform activities of daily living for any resident who is unable.
Inspectors wroteBased on observations, policy review, and staff interviews, the facility failed to provide incontinence care appropriately to prevent cross contamination and infection for 2 of 3 residents observed for incontinence care (Resident #7 and #11). The facility reported a census of 64 residents.
Fire safety inspections
28 fire safety citations on file: 6 on July 22, 2026, 8 on June 12, 2025, 14 on July 25, 2024.
Every fire safety citation28 citations
- F Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- F Follow proper procedures when the fire alarm was out of service for more than 4 hours.
- F Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- F Have simulated fire drills held at unexpected times.
- F Have generator or other power source capable of supplying service within 10 seconds.
- E Provide a written emergency evacuation plan.
- F Develop a communication plan.
- F Conduct testing and exercise requirements.
- F Install emergency lighting that can last at least 1 1/2 hours.
- F Have approved installation, maintenance and testing program for fire alarm systems.
- F Inspect, test, and maintain automatic sprinkler systems.
- F Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- F Provide a written emergency evacuation plan.
- F Have simulated fire drills held at unexpected times.
- F Develop and maintain an Emergency Preparedness Program (EP).
- F Conduct risk assessment and an All-Hazards approach.
- F Establish roles under a Waiver declared by secretary.
- F List the names and contact information of those in the facility.
- F Conduct testing and exercise requirements.
- F Install emergency lighting that can last at least 1 1/2 hours.
- F Have approved installation, maintenance and testing program for fire alarm systems.
- F Properly provide smoke detection systems in areas open to corridors.
- F Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
- F Have simulated fire drills held at unexpected times.
- F Have generator or other power source capable of supplying service within 10 seconds.
- F Ensure that testing and maintenance of electrical equipment is performed.
- D Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.
- D To conduct inspection, testing and maintenance of fire doors by qualified individuals.
Fines and payment denials
| Date | Penalty | Amount or length |
|---|---|---|
| December 9, 2024 | Fine | $50,211 |
| July 25, 2024 | Fine | $43,628 |
| July 25, 2024 | Payment Denial | 10 days from August 21, 2024 |
A payment denial means Medicare and Medicaid stopped paying for new admissions for that period.
Staffing
Hours of care per resident per day, from the payroll records every home sends CMS. Higher means more staff time with each resident.
| Measure | This home | Iowa | United States |
|---|---|---|---|
| All nursing staff (RN, LPN and aides) | 3.90 | 3.82 | 3.86 |
| Registered nurses | 0.44 | 0.74 | 0.69 |
| All nursing staff on weekends | 3.59 | 3.37 | 3.42 |
| Nurse aides | 2.79 | ||
| Licensed practical nurses | 0.66 | ||
| Nursing staff turnover (share who left in a year) | 53.3% | 44.0% | 45.8% |
| Registered nurse turnover | 44.4% | 42.1% | 42.9% |
| Administrators who left | 1 |
CMS expects 3.11 hours a day for residents as sick as this home's (its case-mix figure). The staffing star compares the two.
Staffing by quarter, from daily payroll records
Every nursing home sends CMS its staff hours for each day (the Payroll Based Journal). Here they are added up by quarter. The latest quarter is the one behind the figures above. In January to March 2026, nursing staff hours per resident were 4.02 on weekdays and 3.59 on weekends, 11% lower on weekends (nationally, weekends ran 15% lower). Contract or agency staff worked 39.9% of nursing hours, against 5.3% nationally. Total nursing hours per resident went from 3.40 in April to June 2025 to 3.90 in January to March 2026.
| Quarter | All nursing staff | Registered nurses | Weekdays | Weekends | Contract staff share | Days with no RN hours | Residents a day |
|---|---|---|---|---|---|---|---|
| Jan to Mar 2026 | 3.90 | 0.44 | 4.02 | 3.59 | 39.9% | 0 of 90 | 75 |
| Oct to Dec 2025 | 3.57 | 0.54 | 3.74 | 3.14 | 33.5% | 0 of 92 | 70 |
| Jul to Sep 2025 | 3.31 | 0.53 | 3.51 | 2.78 | 29.0% | 0 of 92 | 67 |
| Apr to Jun 2025 | 3.40 | 0.51 | 3.57 | 2.95 | 39.6% | 0 of 91 | 61 |
| United States, Jan to Mar 2026 | 3.75 | 0.62 | 3.92 | 3.33 | 5.3% | 0.5% of days | |
| Iowa, Jan to Mar 2026 | 3.80 | 0.71 | 3.98 | 3.36 | 4.7% | 0.3% of days |
Hours per resident per day: staff hours in the quarter divided by resident days (the daily census CMS derives from resident assessments). Registered nurses include the director of nursing and RNs with administrative duties; aides include nurse aides in training and medication aides, as in CMS's own staffing measure. How these are calculated.
Staff pay reports
Staff pay at this home
No staff pay figure for this home has passed review yet. A figure appears only after at least 5 reports from at least 3 different people, sent over at least 60 days, have passed review.
Official wage estimates for Iowa
| Job | Median | Middle half | Employed |
|---|---|---|---|
| Iowa, all employers | |||
| CNAs (nursing assistants) | $18.92 | $17.96 to $21.95 | 22,670 |
| LPNs and LVNs | $30.11 | $27.12 to $34.06 | 5,510 |
| Registered nurses | $37.80 | $32.83 to $41.32 | 34,420 |
| United States, nursing care facilities | |||
| CNAs (nursing assistants) | $20.67 | $17.91 to $22.55 | 534,270 |
| LPNs and LVNs | $33.86 | $30.05 to $37.40 | 188,210 |
| Registered nurses | $41.11 | $37.85 to $47.68 | 142,270 |
Hourly wages; the middle half runs from the 25th to the 75th percentile. Source: U.S. Bureau of Labor Statistics, Occupational Employment and Wage Statistics, May 2025. BLS has no separate estimate for medication aides. These are survey estimates for whole occupations, not figures for any one home.
Quality measures
The measures CMS uses for the quality star. Lower is better for every one of them.
| Measure | This home | Iowa | US |
|---|---|---|---|
| Percentage of long-stay residents whose need for help with daily activities has increased Long Stay residents, 2025Q2-2026Q1 | 27.6 | 17.1 | 13.9 |
| Percentage of long-stay residents with a catheter inserted and left in their bladder Long Stay residents, 2025Q2-2026Q1 | 1.2 | 1.5 | 0.8 |
| Percentage of long-stay residents with a urinary tract infection Long Stay residents, 2025Q2-2026Q1 | 0.0 | 2.4 | 1.6 |
| Percentage of long-stay residents experiencing one or more falls with major injury Long Stay residents, 2025Q2-2026Q1 | 2.1 | 3.8 | 3.2 |
| Percentage of short-stay residents who newly received an antipsychotic medication Short Stay residents, 2025Q2-2026Q1 | 0.0 | 2.1 | 1.6 |
| Percentage of long-stay residents whose ability to walk independently worsened Long Stay residents, 2025Q2-2026Q1 | 24.0 | 16.6 | 14.1 |
| Percentage of long-stay residents with pressure ulcers Long Stay residents, 2025Q2-2026Q1 | 4.1 | 4.2 | 4.6 |
| Percentage of long-stay residents who received an antipsychotic medication Long Stay residents, 2025Q2-2026Q1 | 25.6 | 19.4 | 15.4 |
| Percentage of short-stay residents who were rehospitalized after a nursing home admission Short Stay residents, 20250101-20251231 | 18.9 | 20.9 | 23.8 |
| Percentage of short-stay residents who had an outpatient emergency department visit Short Stay residents, 20250101-20251231 | 9.9 | 13.2 | 12.0 |
| Number of hospitalizations per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 1.5 | 1.5 | 1.9 |
| Number of outpatient emergency department visits per 1000 long-stay resident days Long Stay residents, 20250101-20251231 | 2.2 | 2.1 | 1.8 |
Owners and operators
Legal business name: AASE HAUGEN HOMES, INC..
| Name | Role | Type | Share | Since |
|---|---|---|---|---|
| Bjelland, Susan | W-2 managing employee | Individual | 02/22/2010 | |
| Elsbernd, Nancy | W-2 managing employee | Individual | 02/22/2010 | |
| Schmidt, Jeffrey | Corporate director | Individual | 05/20/2013 | |
| Continuum Health Care Services LLC | Operational/managerial control | Organization | 01/17/2013 |
As listed in the CMS ownership file, which names owners with a 5% or greater stake and the people and companies with operational or managerial control.
Questions to ask on a visit
Chosen from this home's own inspection record.
- How do you prevent falls and pressure injuries, and how are families told when one happens?Inspectors cited 7 problems in this area, most recently on June 18, 2026: "Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents."
- How do residents and families raise a complaint or grievance, and how fast is it answered?Inspectors cited 6 problems in this area, most recently on July 22, 2026: "Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive."
- When is the care plan meeting, and can family attend it?Inspectors cited 6 problems in this area, most recently on July 22, 2026: "Assess the resident when there is a significant change in condition"
- Can we see a week of menus and the kitchen, and how are special diets handled?Inspectors cited 5 problems in this area, most recently on July 22, 2026: "Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards."
- How long has the current administrator been here?CMS counts 1 administrator who left in the period it measured.
Other nursing homes nearby
- Wellington Place Decorah, 2.9 mi · 4 of 5 stars · 3 citations
- Ossian Care Center Ossian, 12.3 mi · 2 of 5 stars · 19 citations
- Green Lea Senior Living Mabel, 13.3 mi · 1 of 5 stars · 38 citations
- Northgate Care Center Waukon, 15.8 mi · 1 of 5 stars · 20 citations
- Good Samaritan - Waukon Waukon, 16.3 mi · 2 of 5 stars · 16 citations
- Evans Senior Living Community Cresco, 16.8 mi · 5 of 5 stars · 1 citation
- Tweeten Lutheran Health Care Center Spring Grove, 18.2 mi · 1 of 5 stars · 37 citations
- Gundersen Harmony Care Center Harmony, 19 mi · 5 of 5 stars · 4 citations
Iowa contacts for a concern about a nursing home
These are the official offices in Iowa. NursingHomeClear cannot take or act on complaints.
- Inspections and complaints: Iowa Department of Inspections, Appeals, and Licensing, Health Facilities, the state agency that inspects nursing homes for CMS and takes complaints about care.
- Resident advocate: Iowa Office of the State Long-Term Care Ombudsman, 866-236-1430. The long-term care ombudsman is a free, confidential advocate for residents and families, set up under the federal Older Americans Act.
- State inspection reports: Iowa Health Facility Database, Entity Search, where Iowa publishes its own records on licensed homes.
Common questions
- What is The Highlands's Medicare star rating?
- CMS rates The Highlands 2 out of 5 stars overall, with 2 for health inspections, 4 for staffing and 3 for quality measures (CMS data as of September 1, 2026).
- How many deficiencies did The Highlands get at its last inspection?
- 4 health deficiencies at the standard inspection on July 22, 2026. The Iowa average is 6.5.
- Has The Highlands been fined?
- Yes. CMS lists 2 fines totaling $93,839 in the last three years.
- Does The Highlands accept Medicaid?
- It is certified to take Medicaid (CMS lists it as "Medicare and Medicaid"). Certification does not mean a Medicaid bed is open: ask the admissions office.
- Who owns The Highlands?
- CMS lists 4 owners and managers. Legal business name: AASE HAUGEN HOMES, INC..
Sources
- Ratings, staffing and fines: CMS Provider Information, released September 30, 2026, data as of September 1, 2026.
- Citations: CMS Health Deficiencies and Fire Safety Deficiencies.
- Owners: CMS Ownership. Penalties: CMS Penalties.
- Staffing by quarter: CMS Payroll Based Journal Daily Nurse Staffing, April 2025 to March 2026, summed by NursingHomeClear.
- Inspector summaries: CMS Full Statement of Deficiencies (CMS-2567 text), data as of September 1, 2026. Each quote is the part of the statement before the detailed findings.
- Inspection reports with the inspectors' full notes are on this home's Medicare.gov page.
- Something wrong on this page? Ask for a correction. We fix errors in our copy of the data; findings themselves can only be changed by CMS and the state.
- NursingHomeClear is independent and not affiliated with CMS, Medicare or any state agency. This page reports federal records; it does not rate, recommend or endorse any home, and it is not medical or legal advice.