Hawarden, IA (Iowa Capital Dispatch) — State inspectors cited a Hawarden nursing home for 24 regulatory violations, including a case involving sexual abuse of a resident, following an investigation earlier this year.
Inspectors with the Iowa Department of Inspections, Appeals, and Licensing visited Hillcrest Health Care Center in March 2026 after receiving six complaints. According to state reports, all six complaints were verified.
The facility was cited for a wide range of violations, including resident abuse, failure to protect resident funds, failure to notify emergency contacts, inadequate infection control, insufficient staffing, and failure to provide appropriate care for residents with dementia.
Resident Abuse Allegations
According to inspectors, a staff member reported on March 8 that a male resident had entered a female resident’s room and attempted to get into bed with her.
A registered nurse responded immediately. The female resident, who had no cognitive impairment, told staff:
“I was in bed, my door was halfway closed, when this man came in and just kept coming towards me… He touched my leg, and I told him to stop immediately… I pushed my call light and screamed twice.”
Minutes later, staff found the same male resident in another woman’s room. According to the report, the resident’s clothing had been partially removed, and the man was on the bed with his hand on her.
Staff separated the individuals and notified the facility’s director of nursing.
Reporting and Safety Concerns
Inspectors say staff were initially advised not to document the incidents because it was unclear what had occurred. One nurse reportedly threatened to refuse her assignment unless the situation was reported.
State reports indicate the facility did not immediately report the incident as required.
The administrator, Amanda Birch, acknowledged a delay in reporting but said she acted once she became aware. The director of nursing told inspectors she was not fully informed when staff first contacted her.
The female resident involved in the first incident later told inspectors she was trying to leave the facility because the alleged perpetrator remained there. She also reported difficulty sleeping and ongoing fear.
Staffing Complaints
Inspectors documented repeated complaints from both staff and residents about staffing shortages.
Residents reported long waits for assistance, including:
•Waiting more than 30 minutes for help after using call lights
•Being left unattended in the bathroom
•Not receiving help during overnight hours
Staff echoed those concerns. Records show only one certified nursing assistant was working from 6 p.m. to midnight on March 8, responsible for more than 50 residents.
A licensed practical nurse told inspectors staffing levels “put the residents and the staff’s licenses at risk,” and said management did not respond until she threatened to leave her shift.
State records show the facility was also cited for insufficient staffing in January and July of 2024.
Ownership and Rating
Hillcrest Health Care Center is owned by The Ensign Group, a for-profit company that operates more than 300 care facilities across multiple states.
The Hawarden facility currently holds a one-star overall rating from the Centers for Medicare and Medicaid Services’ five-star rating system.
Penalty
Despite the number of violations, the state issued a single $500 fine tied to the abuse-related violation under state regulations. No federal penalties have been reported for the additional violations.
An administrator filling in at the facility declined to comment when contacted.
This story is courtesy of the Iowa Capital Dispatch, and this article was written by Clark Kauffman
