The nursing home failed to keep the area free of hazards and provide enough supervision to prevent accidents. Cited February 2026 — isolated incident, actual harm.
View the original federal record
F-Tag 689 — 42 CFR §483.25(d) — S/S: G
Nursing home report
Luther Manor at Hillcrest
Dubuque, IA · Medicare-certified · 103 beds
Needs attention
For-profitChain member
Data as of July 1, 2026
1 of 5 overall
Luther Manor at Hillcrest has an overall rating of 1 out of 5 stars, with a 1-star health inspection rating and a recent federal penalty. Staffing is rated 4 stars and reported nurse staffing is 4.49 hours per resident per day, above the 4.1 federal benchmark, while fines in the last 24 months totaled $42,406.
Facility ratings
Health inspections
Staffing
4.4927 hrs/resident/day
Quality measures
Last inspection: February 12, 2026Penalties, last 24 months: $42,406recent federal penalty
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 4.4927.
Staffing detail
- Registered nurses
- 0.66
- Licensed practical nurses
- 0.38
- Nurse aides
- 3.45
- Weekend nursing
- 3.99
Hours per resident per day.
Total staff turnover: 54%
Registered nurse turnover: 58%
Resident outcomes
Each measure compares a year ago with the most recent quarter. Green means the facility moved the right way; red means the wrong way.
Negative outcomes
Lower is better — fewer affected residents. A decrease is good (green); an increase is concerning (red).
Long-stay residents on antipsychotic medication
34%33.3%Improving
Residents with a fall causing major injury
3.6%3.4%No change
Residents with pressure ulcers (bedsores)
4.3%1%Improving
Residents with a urinary tract infection
1.2%5.8%Worsening
Residents who lost too much weight
2.9%3.9%Worsening
Residents who were physically restrained
0%0%No change
Residents needing more help with daily activities
29.4%28%Improving
Residents whose ability to walk got worse
18.3%19.1%Worsening
Long-stay residents on antianxiety or sleep medication
19.2%21.8%Worsening
Short-stay residents newly given an antipsychotic
0%0%No change
Residents with a long-term catheter
3.6%0%Improving
Residents with new or worsening incontinence
29.1%36.4%Worsening
Residents with depressive symptoms
21.5%5.1%Improving
Positive outcomes
Higher is better — e.g. vaccinations. An increase is good (green); a decrease is concerning (red).
Long-stay residents given the seasonal flu vaccine
—68%—
Long-stay residents given the pneumonia vaccine
73.5%58.6%Worsening
Short-stay residents given the seasonal flu vaccine
—40.9%—
Short-stay residents given the pneumonia vaccine
62%40.4%Worsening
What the inspectors found
The nursing home failed to ensure residents were free from significant medication errors. Cited October 2025 — isolated incident, actual harm.
View the original federal record
F-Tag 760 — 42 CFR §483.45(f)(2) — S/S: G
The home failed to provide safe, appropriate pain management for a resident who needed it. Cited September 2025 — isolated incident, actual harm.
View the original federal record
F-Tag 697 — 42 CFR §483.25(k) — S/S: G
The home failed to make sure food was safely sourced, stored, prepared, and served according to professional standards. Cited February 2026 — widespread issue, potential for harm.
View the original federal record
F-Tag 812 — 42 CFR §483.60(i) — S/S: F
The home failed to have a plan for how it would carry out quality improvement and oversight activities. Cited February 2026 — widespread issue, potential for harm.
View the original federal record
F-Tag 865 — 42 CFR §483.75 — S/S: F
Recent history
- STAFFING
Reported nurse staffing met or exceeded the federal recommendation.
- PENALTY
A federal fine of $34,125 was recorded.
- INSPECTION
Health inspection found 12 health deficiencies.
See what inspectors found
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
- INSPECTION
Health inspection found 2 health deficiencies.
See what inspectors found
- PENALTY
A federal payment denial was recorded.
- PENALTY
A federal fine of $8,281 was recorded.
Penalties & enforcement
On record with Medicare: 2 fines · $42,406 in total fines · 1 payment denial.
- $34,125
Federal fine
Feb 12, 2026
- 34 days
Medicare/Medicaid payment denial
Jul 25, 2025
- $8,281
Federal fine
Jul 25, 2025
Operator & ownership
Recent ownership change · Nov 1, 2024
Now operated by Luther Manor at Hillcrest, previously Luther Manor Communities.
- Ownership
- For profit - Corporation
- Chain
- Part of SHLOMO HOFFMAN · 10 homes · 2.4 stars avg
- Occupancy
- 91.2 residents on an average day (89% of 103 beds)
- Resident voice
- Resident council
- Medicare history
- Certified for 22 years
Things at a nursing home change — inspections, staffing, ownership, news.
Source: Centers for Medicare & Medicaid Services — public records, updated monthly. GoodStanding presents official records with plain-language summaries. Always visit a facility in person.