Inspection Reports for
Edencrest at Green Meadows
6750 Corporate Dr, Johnston, IA 50131, United States, IA, 50131
Back to Facility Profile8 Reports
Inspection Report — Jun 29, 2026
Plan of Correction
Date: Jun 29, 2026
Visit Reason
Investigation of Incident #131894-C during a plan of correction survey.
Complaint Details
Investigation of Incident #131894-C
Findings
Two regulatory insufficiencies were cited related to documentation of tenant care and dementia-specific continuing education. The program failed to ensure accurate documentation of routine personal or health-related care for one tenant and failed to provide evidence that staff completed the required eight hours of dementia-specific education annually.
Violations (2)
481-69.25(1)q Tenant Document: The program failed to ensure accurate documentation of completion of routine personal or health-related care on task sheets for Tenant #C2, with multiple instances of denture care tasks charted as completed before the evening meal when dentures were needed.
481-69.30(3)b Dementia-Specific Continuing Education: The program failed to provide documentation that staff completed the required eight hours of dementia-specific continuing education annually, affecting 4 of 4 staff reviewed and potentially all program staff.
Inspection Report — Dec 15, 2025
Renewal
Date: Dec 15, 2025
Visit Reason
Recertification visit to determine compliance with certification of an Assisted Living Program for People with Dementia. The visit also included investigations of Complaint #130440-C and Complaint #130346-C.
Complaint Details
Complaint #130440-C was investigated with no insufficiencies cited. Complaint #130346-C was investigated and insufficiencies were cited.
Findings
No regulatory insufficiencies were cited during the investigation of Complaint #130440-C. Regulatory insufficiencies were cited during the investigation of Complaint #130346-C and/or the recertification visit.
Violations (2)
481-67.5(2)f(4) Medications: The program failed to administer medications as prescribed by the tenant's physician for 3 of 3 tenants reviewed. Tenant #1 did not receive a prescribed Lidocaine patch without explanation. Tenant #3's medications were administered contrary to an incident report instruction to hold them. Tenant #C3 was given morphine instead of lorazepam on one occasion.
481-69.26(4)a Service Plans: The program failed to ensure the service plan was individualized and did not address identified needs for 1 of 9 tenants reviewed. Tenant #2's service plan did not mention the use of bedrails, although bedrails were observed in place.
Inspection Report — Mar 6, 2025
Complaint Investigation
Date: Mar 6, 2025
Visit Reason
Investigation of Complaints #123396-C and #123400-C at an assisted living program for people with dementia.
Complaint Details
Investigation of Complaints #123396-C and #123400-C found no regulatory insufficiencies.
Findings
No regulatory insufficiencies were cited during the investigation of the complaints.
Report Facts
Number of tenants without cognitive disorder: 34
Number of tenants with cognitive disorder: 17
Inspection Report — Jul 11, 2024
Complaint Investigation
Date: Jul 11, 2024
Visit Reason
The inspection was conducted to investigate complaints numbered 119874-C, 119895-C, and 119934-C, as well as Incident 119887-I at the assisted living facility.
Complaint Details
Investigation of Incident 119887-I and Complaints 119874-C, 119895-C, and 119934-C found no regulatory insufficiencies.
Findings
No regulatory insufficiencies were cited during the investigation of the incident and complaints.
Report Facts
Number of tenants without cognitive impairment: 33
Number of tenants with cognitive impairment: 23
Inspection Report — Jan 25, 2024
Renewal
Date: Jan 25, 2024
Visit Reason
The inspection was conducted as a recertification visit to determine compliance with certification rules for an Assisted Living Program.
Findings
No regulatory insufficiencies were cited during the recertification visit or during the investigation of Incident #114836-I.
Report Facts
Number of tenants without cognitive impairment: 38
Number of tenants with cognitive impairment: 19
Inspection Report — Dec 1, 2022
Complaint Investigation
Date: Dec 1, 2022
Visit Reason
The inspection was conducted as a result of investigation of Incident #109237-I and Complaint #109191-C related to transportation safety concerns at the assisted living program.
Complaint Details
The investigation pertained to Incident #109237-I and Complaint #109191-C. No regulatory insufficiencies were cited for Complaints #107724-C and #106357-C. The tenant suffered a fractured neck and collarbone and ongoing pain after the incident. The tenant's daughter confirmed injuries and loss of strength due to being bedridden with Parkinson's disease.
Findings
The program failed to properly secure a wheelchair during transport of a tenant, resulting in the tenant's transport chair tipping over and causing injury. The Director was observed attaching the wheelchair hooks incorrectly, and the tenant suffered a fractured neck and collarbone.
Violations (1)
Failed to properly secure a wheelchair during transport of a tenant, resulting in injury.
Report Facts
Number of tenants without cognitive disorder in General Population Program: 38
Number of tenants with cognitive disorder in General Population Program: 1
Number of tenants without cognitive disorder in Memory Care Unit: 0
Number of tenants with cognitive disorder in Memory Care Unit: 22
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Alex McGregor | Community Director | Signed the plan of correction and mentioned as Director involved in the incident |
Inspection Report — Nov 30, 2022
Enforcement
Date: Nov 30, 2022
Visit Reason
This citation was issued following investigations of incidents and complaints identified as 109237-I, 109191-C, 107724-C, and 106357-C. The citation addresses failure to properly secure a wheelchair during tenant transport.
Complaint Details
Investigations 109237-I, 109191-C, 107724-C, and 106357-C
Findings
The program failed to properly secure a wheelchair during transport of Tenant #1, resulting in the wheelchair tipping over and causing the tenant to suffer a fractured neck and collarbone. The Director demonstrated improper securing of the wheelchair, and the tenant required hospital treatment and skilled nursing care.
Violations (1)
481-69.33(231C) Transportation: The program failed to properly secure a wheelchair during transport, causing Tenant #1's transport chair to tip over and resulting in serious injury. The Director was unable to determine how the wheelchair tipped over despite securing it with hooks and a seatbelt.
Report Facts
Fine amount: 3000
Inspection Report — Dec 19, 2019
Complaint Investigation
Date: Dec 19, 2019
Visit Reason
Investigation of Incident #87245-C at an Assisted Living Program for People with Dementia.
Complaint Details
Investigation of Incident #87245-C; no deficiencies found.
Findings
No regulatory insufficiencies were cited during the investigation.
Report Facts
Number of tenants without cognitive disorder in General Population: 41
Number of tenants with cognitive disorder in General Population: 7
Number of tenants without cognitive disorder in Memory Care Unit: 6
Number of tenants with cognitive disorder in Memory Care Unit: 16
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