Inspection Reports for
Independence Village of Ankeny
1275 SW State St, Ankeny, IA 50023, United States, IA, 50023
Back to Facility Profile9 Reports
Inspection Report — Dec 18, 2025
Plan of Correction
Date: Dec 18, 2025
Visit Reason
Investigation of Incidents #130367-I, #131026-I, and Complaint #131025-C.
Complaint Details
Incidents #130367-I, #131026-I, and Complaint #131025-C were investigated.
Findings
No regulatory insufficiencies were cited during the investigation of the incidents and complaint.
Inspection Report — Apr 24, 2025
Complaint Investigation
Date: Apr 24, 2025
Visit Reason
The inspection was conducted to investigate Complaint #124565-C regarding regulatory compliance related to tenant documentation.
Complaint Details
Investigation of Complaint #124565-C found the program did not have a copy of the power of attorney document for Tenant C1 in the tenant's record.
Findings
The program failed to ensure tenant records included copies of durable power of attorney documentation for tenants, specifically for one former tenant (Tenant C1). This deficiency was confirmed during the exit interview with the Director and delegating nurse.
Violations (1)
Failure to ensure tenant records included copies of durable power of attorney documentation.
Report Facts
Number of tenants with cognitive impairment: 14
Number of tenants without cognitive impairment: 0
Number of former tenants reviewed: 1
Global Deterioration Scale (GDS) score: 4
Inspection Report — May 1, 2024
Complaint Investigation
Date: May 1, 2024
Visit Reason
The inspection was conducted as a complaint investigation (#116472-C) and recertification visit to determine compliance with certification rules for an Assisted Living Program for People with Dementia.
Complaint Details
Complaint #116472-C triggered the investigation. The complaint involved concerns about occupancy agreements, tenant care, and service plan updates.
Findings
The program failed to ensure one tenant signed the occupancy agreement prior to move-in, failed to provide appropriate care including timely nursing assessments and documentation of vital signs for tenants, and failed to update and obtain signatures on service plans for tenants who experienced significant changes.
Violations (3)
Failure to ensure Tenant #4 signed the occupancy agreement prior to moving into the apartment.
Failure to provide appropriate care to Tenant #3 and Tenant #4, including lack of timely nursing assessments and failure to document vital signs.
Failure to update service plans within 30 days of significant changes and failure to obtain signatures on service plans for Tenant #2, Tenant #3, and Tenant #4.
Report Facts
Tenants reviewed: 4
Date of tenant #4 move-in: Dec 14, 2023
Date of tenant #4 occupancy agreement signature: Dec 19, 2023
Date of tenant #3 fall incident: Mar 2, 2024
Date of tenant #2 fall incident: Mar 15, 2024
Date of tenant #3 service plan: Apr 29, 2024
Date of tenant #4 service plan revision: Jan 29, 2024
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Consultant Registered Nurse | Consultant RN | Confirmed lack of timely nursing assessments and follow-up for Tenant #3's fall and verified failure to document vital signs for Tenant #4. |
| Executive Director | Confirmed deficiencies related to nursing assessments, service plan signatures, and occupancy agreement timing. | |
| Licensed Practical Nurse | LPN | Contacted Tenant #2's guardian and PCP regarding fall and received orders for x-rays and therapies. |
Inspection Report — Jul 25, 2023
Complaint Investigation
Date: Jul 25, 2023
Visit Reason
The inspection was conducted as part of an investigation of Complaint #114056-C regarding regulatory insufficiencies at the assisted living program.
Complaint Details
The inspection was triggered by Complaint #114056-C. The complaint involved concerns about incident reporting, tenant care, medication security, staff training, and other regulatory compliance issues.
Findings
The Program failed to consistently follow established policies and procedures including incident reporting, ensuring adequate and appropriate care, medication security, staff training, tenant evaluations, nurse reviews, emergency procedures, and dementia-specific education. Multiple deficiencies were cited across these areas.
Violations (12)
Failed to consistently follow established policy/procedure for incident reports, including lack of notification to responsible parties and lack of follow-up from Wellness Director or Executive Director.
Failed to ensure tenants received adequate and appropriate care, including medication availability and housekeeping services.
Medications were not consistently kept locked and accessible only to authorized personnel; medication cart lock was broken for 1-2 weeks.
Delegating nurse failed to ensure staff were sufficiently trained and competent within required timeframes.
Failed to ensure staff received dependent adult abuse training within required timeframes.
Failed to utilize the Global Deterioration Scale for tenants with moderate cognitive decline as required.
Failed to complete evaluations within 30 days of occupancy for some tenants.
Failed to complete evaluations annually and with significant change for some tenants.
Failed to complete 90-day nurse reviews for multiple tenants as required.
Failed to implement/document staff procedures addressing emergency needs of tenants with cognitive disorders or dementia.
Failed to ensure all personnel, including agency/contract staff, received appropriate training to meet tenant needs.
Failed to ensure staff received eight hours of dementia-specific education and training within 30 days of employment or contract start.
Report Facts
Tenants without cognitive impairment: 7
Tenants with cognitive impairment: 8
Incident reports reviewed: 6
Staff reviewed for training: 4
Agency staff reviewed: 2
Tenants reviewed for evaluations: 6
Tenants reviewed for nurse reviews: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Named in findings related to nurse delegation, dependent adult abuse training, dementia-specific training, and staff training deficiencies. | |
| Staff D | Named in findings related to nurse delegation and dependent adult abuse training deficiencies. | |
| Staff B | Named in findings related to dementia-specific training deficiencies. | |
| Staff C | Named in findings related to dementia-specific training deficiencies. | |
| Agency Staff E | Named in findings related to dementia-specific training and staff training deficiencies. | |
| Agency Staff F | Named in findings related to dementia-specific training deficiencies. | |
| Regional Wellness Director | Acknowledged multiple deficiencies including broken medication cart lock, failure to follow incident report policy, and training documentation. | |
| Clinical Operations Nurse | Confirmed use of emergency procedures policy and acknowledged training deficiencies. |
Inspection Report — Aug 24, 2022
Complaint Investigation
Date: Aug 24, 2022
Visit Reason
The inspection was conducted to investigate Complaint #100886-C at the Assisted Living Program.
Complaint Details
Complaint #100886-C was investigated and found to have no regulatory insufficiencies.
Findings
No regulatory insufficiencies were cited during the investigation of the complaint.
Inspection Report — Sep 9, 2021
Complaint Investigation
Date: Sep 9, 2021
Visit Reason
Investigation of complaint #96841 regarding the Assisted Living Program for people with Dementia.
Complaint Details
Complaint #96841 was investigated and found to have no regulatory insufficiencies.
Findings
No regulatory insufficiencies were cited during the investigation of complaint #96841.
Report Facts
Number of tenants with cognitive disorders: 17
Number of tenants without cognitive disorders: 0
Inspection Report — Mar 22, 2021
Renewal
Date: Mar 22, 2021
Visit Reason
The visit was a recertification inspection to determine compliance with certification of an Assisted Living Program for People with Dementia, including an onsite infection control visit and investigation of a complaint.
Complaint Details
Investigation of Incident #93417-I and Complaint #93426-C resulted in no regulatory insufficiencies.
Findings
No regulatory insufficiencies were cited during the recertification visit, infection control visit, or the complaint investigation.
Report Facts
Number of tenants with cognitive disorder: 15
Number of tenants without cognitive disorder: 0
Inspection Report — Aug 20, 2020
Complaint Investigation
Date: Aug 20, 2020
Visit Reason
The inspection was conducted as an onsite infection control survey and investigation of multiple complaints related to the Assisted Living Program for People with Dementia at Vintage Hills at Prairie Trail Memory Care.
Complaint Details
The investigation was triggered by complaints #88833-C, 90669-C, 91508-C, and 92296-C related to infection control and tenant care.
Findings
The program failed to follow standard operating procedures for preventing respiratory outbreaks, including improper staff mask use and movement restrictions. Additionally, the program failed to complete required tenant evaluations, service plans, and updates within required timeframes for recently admitted tenants.
Violations (5)
Failed to follow Standard Operating Procedure for preventing respiratory outbreak.
Failed to complete evaluations prior to occupancy for 1 of 2 recently admitted tenants.
Failed to complete evaluations within 30 days of occupancy for 2 of 2 recently admitted tenants.
Failed to develop preliminary service plans for 2 of 2 recently admitted tenants.
Failed to update service plans within 30 days of occupancy for 2 of 2 recently admitted tenants.
Report Facts
Number of tenants with cognitive disorder: 16
Number of tenants without cognitive disorder: 0
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jim Clindaniel | Executive Director | Named in Plan of Correction response and responsible for corrective actions |
Inspection Report — Dec 2, 2019
Complaint Investigation
Date: Dec 2, 2019
Visit Reason
The inspection was conducted as a complaint investigation related to regulatory insufficiencies cited during the investigation of Complaint #86552-C at Vintage Hills at Prairie Trail ALP/D.
Complaint Details
The investigation was triggered by Complaint #86552-C. The findings included failure to follow incident reporting policies and failure to provide adequate care and treatment. The complaint was substantiated as evidenced by the cited deficiencies.
Findings
The program failed to consistently follow the Fall Reduction Program and Incident Reporting Policies for 2 of 6 tenants reviewed, including inadequate documentation of vital signs after incidents. Tenant #1 had two unwitnessed falls with a severe cognitive decline and was not sent out for evaluation per policy. Tenant #2 lost balance and hit her head, with delayed notification to the primary care provider. The program also failed to consistently provide adequate care, treatment, and services to Tenant #1.
Violations (2)
Program failed to ensure consistent follow of Fall Reduction Program and Incident Reporting Policies for tenants.
Failure to provide adequate care, treatment, and services to Tenant #1 as required by tenant rights.
Report Facts
Number of tenants with cognitive disorder: 10
Number of tenants without cognitive disorder: 0
Tenants reviewed for Fall Reduction Program and Incident Reporting Policies: 6
Unwitnessed falls for Tenant #1: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Jim Clindaniel | Executive Director | Named in Plan of Correction as responsible for corrective actions |
| Staff A | Assisted Tenant #1 after fall and confirmed incident details | |
| Director of Nursing | Director of Nursing (DON) | Assisted Tenant #1 after fall and confirmed incident details |
| Registered Nurse | Registered Nurse (RN) | Confirmed Tenant #1 had two unwitnessed falls and severe cognitive decline |
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