Twilight Acres
A nursing home in Wall Lake, Iowa 51466
600 West 6th Street, Wall Lake, Iowa 51466. (712) 664-2488.
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The short answer
Record last released by CMS on Oct 28, 2026.
- 4of 5 CMS’s overall rating
- 7 health citations at the latest inspection cycle Iowa average: 6.6
- 4.04 nurse hours per resident per day Iowa average: 3.86
- 0 fines in the last three years
Each figure’s source sits beside it, in its section below.
What these words mean7
- Star ratings
- CMS rates some kinds of place from 1 to 5 stars, more stars meaning better on CMS’s own measures for that kind: for a nursing home, its health inspections, staffing and quality measures. A rating is CMS’s summary of those measures; it doesn’t promise good care. Source: CMS, Care Compare and the Five-Star Quality Rating System.
- Inspection (survey)
- A visit by state inspectors, often unannounced, who check a place against the rules it must meet. For nursing homes and other places Medicare pays, CMS calls these visits surveys: a standard survey of a nursing home comes at least every 15 months, and a complaint survey whenever a complaint calls for one. Source: CMS; 42 CFR 488.308.
- Deficiency, citation, violation
- What inspectors write up when a place didn’t meet a rule: the rule, what they saw, and when. CMS calls it a deficiency; states may say citation or violation. It is the inspectors’ finding, not a court’s, and the place is usually asked for a plan to correct it. Source: CMS, statement of deficiencies (Form CMS-2567); each state’s licensing agency.
- Scope and severity (A to L)
- CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7).
- Nurse staffing hours
- The hours registered nurses, licensed practical nurses and nurse aides worked, per resident per day, from the payroll records each home sends CMS. Source: CMS, Payroll-Based Journal.
- Fines and payment denials
- A fine (civil money penalty) is money CMS makes a nursing home pay when it falls short of federal rules. A payment denial means Medicare and Medicaid stop paying for new admissions until the home meets the rules again. Source: CMS; 42 CFR 488.430 and 488.417.
- Capacity
- The most people the licence or certification lets the place care for at once: residents, children, beds or apartments, as the state counts them. It isn’t how many are there now. Source: Each state’s licensing agency.
What did inspectors find?
7 health citations at the latest inspection cycle
The Iowa average is 6.6.
Last standard inspection Dec 18, 2025.
Most serious in three years: D: no actual harm, potential for more than minimal harm.
CMS, Provider Information, State and US Averages and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
When those citations happened
8 citations in 4 months of the last 36. Last cited Aug 2026. Most serious: no actual harm, potential for more than minimal harm (D). The last 3 years, to Nov 5, 2026.
| Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 2023 | Dec | |||||||||||
| 2024 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2025 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec |
| 2026 | Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov |
Hover or focus a month to read it.
Hearth Record drew this from the dates and levels in the source’s own records.
All 8 citations in the last three years
Grouped by inspection, newest first. Each carries CMS grades each nursing home deficiency with a letter. A to C: no actual harm, with potential for minimal harm. D to F: no actual harm, but potential for more. G to I: actual harm. J to L: immediate jeopardy. Within each band, the letter rises as more residents were affected or could be: one or a few, a pattern, or widespread. Source: CMS, nursing home scope and severity grid (State Operations Manual, chapter 7)., from A, the least serious, to L, the most. 4 came from complaint inspections.
CMS, Health Deficiencies. Released Oct 28, 2026. Updated monthly.
Aug 4, 2026: complaint inspection3 citations
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Immediately tell the resident, the resident’s doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
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Provide enough food/fluids to maintain a resident’s health.
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Provide or get specialized rehabilitative services as required for a resident.
Mar 5, 2026: complaint inspection1 citation
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Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Dec 18, 2025: standard inspection3 citations
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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.
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Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident’s ability to function.
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Develop and implement policies and procedures for flu and pneumonia vaccinations.
Dec 12, 2024: standard inspection1 citation
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Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Is it certified, and in good standing?
- Certified for Medicare and Medicaid since Sep 1, 2003.
- Not on CMS’s special focus list.
- No abuse icon from CMS.
- No change of ownership in the last 12 months.
- CMS lists its ownership as non profit, corporation.
- 39 certified beds.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
Has it been fined or penalized?
- No fines in the last three years.
- No Medicare payment denials in the last three years.
- 4 citations in the last three years came from complaint inspections.
CMS, Penalties and Health Deficiencies. Released Oct 28, 2026. Updated monthly.
Who does the caring?
4.04 nurse hours per resident per day
The Iowa average is 3.86.
CMS publishes staffing about four months after the fact.
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | This home | Iowa average |
|---|---|---|
| Nurse hours per resident per day | 4.04 | 3.86 |
| Of which registered nurses | 0.69 | 0.74 |
| At weekends | 3.77 | 3.38 |
| Nursing staff turnover | 40.6% | 44.1% |
| Registered nurse turnover | 57.1% | 42.1% |
| Administrators who left | 1 | Not given |
Who owns it?
- 49 owners or officers are people: Alison A Horsley (runs it (operational or managerial control), 90%); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Tony Harman (runs it (operational or managerial control)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Sandra Schmitz (corporate officer); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Jenna Steinkamp (runs it (operational or managerial control)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Alison A Horsley (additional disclosable party (controls, leases property to, or provides services to the home)); Ann Stoltenberg (corporate director); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Zoltan L Pek (runs it (operational or managerial control)); Zoltan L Pek (additional disclosable party (controls, leases property to, or provides services to the home)); Diane Schroeder (corporate officer); Nicole Geibe (runs it (operational or managerial control)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Ann Vilhauer (corporate director); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Marilyn Aschinger (corporate director); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); Melanie J Hundling (corporate officer); Cindy Helm (runs it (operational or managerial control)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)); A person CMS lists without a name (additional disclosable party (controls, leases property to, or provides services to the home)).
- No private-equity firm among the owners CMS lists.
- No real-estate investment trust among the owners CMS lists.
CMS, All Owners. Checked Nov 5, 2026. Updated monthly.
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Organisation | Role | Share | Since |
|---|---|---|---|
| Cattail Inc. | Additional disclosable party (controls, leases property to, or provides services to the home) | Oct 1, 2024 | |
| BCG Holdings Inc. | Additional disclosable party (controls, leases property to, or provides services to the home) | Oct 1, 2024 | |
| Iowa Health Care Association | Additional disclosable party (controls, leases property to, or provides services to the home) | Oct 1, 2024 | |
| Ecsi Inc. | Additional disclosable party (controls, leases property to, or provides services to the home) | Oct 1, 2024 | |
| Olsen, Muhlbauer & Co, LLP | Additional disclosable party (controls, leases property to, or provides services to the home) | Jun 1, 2007 | |
| Cattail Bcg LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Oct 1, 2024 | |
| Key Rehabilitation Inc. | Additional disclosable party (controls, leases property to, or provides services to the home) | Aug 1, 2023 | |
| Brighton Consulting Group LLC | Additional disclosable party (controls, leases property to, or provides services to the home) | Oct 1, 2024 |
How do residents fare?
- CMS rates its quality measures 5 of 5 (Iowa average 3.4).
CMS, Provider Information and State and US Averages. Released Oct 28, 2026. Updated monthly.
| Measure | Rating |
|---|---|
| Overall rating | 4 of 5 |
| Health inspections | 3 of 5 |
| Staffing | 4 of 5 |
| Quality measures | 5 of 5 |
How does it compare nearby?
- Among the 12 nearest homes, within 26.1 miles, this one had the 3rd most health citations at the latest inspection cycle (7; the middle value was 3.5).
CMS, Provider Information. Released Oct 28, 2026. Updated monthly.
| Place | Miles away | Citations, latest cycle |
|---|---|---|
| Twilight Acres This nursing home | 7 | |
| Odebolt Specialty Care | 7.9 | 3 |
| Park View Rehabilitation Center | 11.8 | 14 |
| Accura Healthcare of Carroll | 17.6 | 19 |
| Accura Healthcare of Lake City, LLC | 17.6 | 7 |
| St Anthony Senior Services | 19.4 | 5 |
| Regency Park Nursing & Rehab Center of Carroll | 19.4 | 0 |
| Denison Care Center | 20.9 | 4 |
| Gracewell, An Eventide Community | 22.1 | 0 |
| Fonda Specialty Care | 25.0 | 0 |
| Willow Dale Wellness Village | 25.8 | 2 |
| Methodist Manor Retirement Community | 26.1 | 3 |
What the record doesn’t say
- Complaints that didn’t lead to a citation aren’t published.
- Inspections reach CMS’s data about six weeks after they happen, and staffing about four months after.
- CMS publishes the inspectors’ full written findings in a separate monthly file, which isn’t loaded yet.
- Fines and Medicare payment denials are the only enforcement CMS publishes; state licence actions aren’t included.
Sources
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Centers for Medicare & Medicaid Services, Provider Information (4pq5-n9py).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Health Deficiencies (r5ix-sfxw).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, Penalties (g6vv-u9sr).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, All Owners (afe44b85-cc6d-40d7-b5df-00ae8910d1d2).
Checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
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Centers for Medicare & Medicaid Services, State and US Averages (xcdc-v8bm).
Released Oct 28, 2026 and checked Nov 5, 2026. Updated monthly. Public domain (U.S. Government work).
If you believe something here is wrong, a correction starts with the agency whose record this copies: CMS. CMS’s own record is on Care Compare. If Hearth Record copied something wrongly, it will fix it and log the correction publicly, with its date: how corrections work.
This copy of the record was made on Nov 5, 2026.
From the home
The public record above comes first. Anything the home adds will appear here, below it, and say who wrote it.
Replies
None. Replies aren’t open yet. When they open, the home will be able to answer any finding for free, and the reply will show beside that finding, unedited and dated.
Paid listing
None. Paid listings aren’t open yet. When they open, anything paid for will say “Paid by the home”, and paying will never change a finding, a rating or the order of results.