The home failed to honor residents’ choices about treatment, research participation, and advance care instructions. Cited December 2025 — limited pattern, potential for harm.
View the original federal record
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
Data as of July 1, 2026
5 of 5 overall
Twilight Acres in Wall Lake, IA has a 5-star overall rating, with 4-star health inspection and staffing ratings and 5-star quality measures. It reported 4.07 nurse staffing hours per resident day, just below the federal benchmark of 4.1, and had no fines in the last 24 months.
Facility ratings
Health inspections
Staffing
4.0743 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 4.0743.
Staffing detail
- Registered nurses
- 0.73
- Licensed practical nurses
- 0.91
- Nurse aides
- 2.44
- Weekend nursing
- 3.73
Hours per resident per day.
Total staff turnover: 35%
Registered nurse turnover: 29%
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
—9.4%—
Residents with a fall causing major injury
10%4.2%Improving
Residents with pressure ulcers (bedsores)
—0%—
Residents with a urinary tract infection
—4.2%—
Residents who lost too much weight
—7.9%—
Residents who were physically restrained
0%0%No change
Residents needing more help with daily activities
—4.8%—
Residents whose ability to walk got worse
—8.8%—
Long-stay residents on antianxiety or sleep medication
—15.6%—
Short-stay residents newly given an antipsychotic
—0%—
Residents with a long-term catheter
—0%—
Residents with new or worsening incontinence
—11.8%—
Residents with depressive symptoms
—1.4%—
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
—95.2%—
Long-stay residents given the pneumonia vaccine
65%91.7%Improving
Short-stay residents given the pneumonia vaccine
—82%—
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 was below the federal recommendation of 4.1 hours per resident per day.
- 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
- 27.7 residents on an average day (71% 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.