The home failed to honor residents’ choices about treatment, research participation, and advance care instructions. Cited December 2025 — limited pattern, potential for harm.
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F-Tag 578 — 42 CFR §483.10 — S/S: E
Nursing home report
Twilight Acres
Wall Lake, IA · Medicare-certified · 39 beds
In good standing
Non-profit
5 of 5 overall
Twilight Acres in Wall Lake, IA has an overall 5-star rating, with strong staffing and quality scores and no fines in the last 24 months. Its reported nurse staffing is 4.23 hours per resident per day, slightly above the federal benchmark of 4.1, though recent inspection citations included advance directives, vaccination policies, and pressure ulcer care.
Facility ratings
Health inspections
Staffing
4.2307 hrs/resident/day
Quality measures
Last inspection: March 5, 2026Penalties, last 24 months: $0
Federal guidance recommends at least 4.1 nursing hours per resident each day. This facility reports 4.2307.
Staffing detail
- Registered nurses
- 0.98
- Licensed practical nurses
- 0.74
- Nurse aides
- 2.51
- Weekend nursing
- 3.80
Hours per resident per day.
Total staff turnover: 36%
Registered nurse turnover: 43%
Resident outcomes
How often residents experience these outcomes, with the direction over the past year.
Long-stay residents on antipsychotic medication
8.3%Steady
Residents with a fall causing major injury
10.3%Worsening
Residents with pressure ulcers (bedsores)
2%Steady
Residents with a urinary tract infection
1.3%Steady
Residents who lost too much weight
8.2%Steady
Residents who were physically restrained
0%Steady
Residents needing more help with daily activities
6.7%Steady
Residents whose ability to walk got worse
12.9%Steady
Show all measures
Long-stay residents on antianxiety or sleep medication
14.3%Steady
Short-stay residents newly given an antipsychotic
0%Steady
Residents with a long-term catheter
3.5%Steady
Residents with new or worsening incontinence
27.9%Steady
Residents with depressive symptoms
1.4%Steady
Long-stay residents given the seasonal flu vaccine
95.2%Steady
Long-stay residents given the pneumonia vaccine
85.9%Worsening
Short-stay residents given the pneumonia vaccine
76.9%Steady
What the inspectors found
The nursing home failed to develop and follow policies to make sure residents received flu and pneumonia vaccinations. Cited December 2025 — limited pattern, potential for harm.
View the original federal record
F-Tag 883 — 42 CFR §483.80 — S/S: E
The nursing home failed to provide proper pressure ulcer care and failed to prevent new pressure sores from developing. Cited March 2026 — isolated incident, potential for harm.
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F-Tag 686 — 42 CFR §483.25(b) — S/S: D
The home failed to prevent unnecessary mind-altering medications or ensure medicines did not limit a resident’s ability to function. Cited December 2025 — isolated incident, potential for harm.
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F-Tag 605 — 42 CFR §483.12 — S/S: D
The nursing home failed to provide appropriate treatment and care according to residents' orders, preferences, and goals. Cited December 2024 — isolated incident, potential for harm.
View the original federal record
F-Tag 684 — 42 CFR §483.25 — S/S: D
Recent history
- STAFFING
Reported nurse staffing met or exceeded the federal recommendation.
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
- INSPECTION
Health inspection found 3 health deficiencies.
See what inspectors found
- INSPECTION
Health inspection found 1 health deficiency.
See what inspectors found
Operator & ownership
- Ownership
- Non profit - Corporation
- Occupancy
- 24.7 residents on an average day (63% of 39 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.