Inspection Reports for Chautauqua Guest Home #3 (9th St.)
302 Ninth Street, Charles City, IA, 506163697
Back to Facility ProfileInspection Report Summary
The most recent inspection on July 30, 2025, found the facility to be in substantial compliance with health requirements based on an accepted plan of correction. Earlier inspections showed a pattern of deficiencies primarily related to resident rights, including issues with dignity and respect during care, as well as some infection control concerns and food safety practices. Complaint investigations were mostly unsubstantiated, except for a few substantiated cases involving resident rights violations and infection control from 2023 and 2020. No fines, immediate jeopardy findings, or license actions were listed in the available reports. The facility’s record shows some recurring issues but also evidence of corrective actions and improvement over time.
Deficiencies (last 6 years)
Deficiencies (over 6 years)
1.5 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
66% better than Iowa average
Iowa average: 4.4 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
42 residents
Based on a July 2025 inspection.
This facility has shown a decline in demand based on occupancy rates.
Census over time
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Jul 30, 2025
Visit Reason
The document is a statement of deficiencies and plan of correction related to the facility's compliance with health requirements, indicating acceptance of a credible allegation of substantial compliance and certification effective July 25, 2025.
Findings
The facility was found to be in substantial compliance based on the accepted plan of correction, resulting in certification in compliance with health requirements effective July 25, 2025.
Inspection Report
Annual Inspection
Census: 42
Deficiencies: 1
Date: Jul 2, 2025
Visit Reason
The inspection was conducted as part of the facility's annual recertification survey with an investigation of complaint #128237-C from July 1 to July 3, 2025.
Complaint Details
Investigation of Complaint #128237-C did not result in a deficiency.
Findings
The facility was found not in compliance with resident rights requirements, specifically failing to ensure residents were treated with dignity and respect, as evidenced by staff forcibly pulling a spoon from Resident #13's hand during a meal. The complaint investigation did not result in a deficiency.
Deficiencies (1)
Failure to ensure residents are treated with dignity and respect, including forcibly pulling a spoon from Resident #13's hand during a meal.
Report Facts
Total census: 42
Resident #13's Brief Interview for Mental Status (BIMS) score: 99
Resident #13's July 2025 Documentation Survey Report: 0.25
Staff A Dependent Adult Abuse Mandatory Reporter Training completion date: Mar 1, 2024
Staff B Dependent Adult Abuse Mandatory Reporter Training completion date: Jan 24, 2023
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Apr 14, 2025
Visit Reason
The document is a Plan of Correction submitted following acceptance of a credible allegation of substantial compliance for the facility.
Findings
The facility was found to be in substantial compliance with health requirements, leading to certification effective March 25, 2025. No specific deficiencies or severity levels are detailed in the report.
Inspection Report
Complaint Investigation
Census: 44
Deficiencies: 1
Date: Mar 7, 2025
Visit Reason
The inspection was conducted due to a complaint (#126743) investigation from March 7, 2025 through March 13, 2025. The complaint was not substantiated.
Complaint Details
Complaint #126743 was investigated and found not substantiated.
Findings
The facility was found not in compliance with 42 CFR Part 483 related to Resident Rights/Exercise of Rights. Staff failed to treat one resident with dignity and respect during personal care, specifically regarding appropriate clothing and positioning.
Deficiencies (1)
Failure to treat one resident with dignity and respect while providing personal cares, including inappropriate handling of clothing and positioning.
Report Facts
Total census: 44
Brief Interview for Mental Status (BIMS) score: 3
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Certified Nursing Assistant (CNA) | Observed providing personal care to Resident #3 |
| Staff B | Certified Nursing Assistant (CNA) | Observed providing personal care to Resident #3 |
| Staff C | Registered Nurse (RN) | Observed providing personal care to Resident #3 and confirmed dignity issue |
| Director of Nursing | Responsible for periodic audits of staff knowledge regarding Resident Rights | |
| CQI Nurse | Responsible for periodic audits of staff knowledge regarding Resident Rights |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Dec 10, 2024
Visit Reason
Investigation of complaints #125135 and #125183 conducted from December 9, 2024 to December 10, 2024.
Complaint Details
Complaints #125135 and #125183 were investigated and found not substantiated.
Findings
The Chautauqua Guest Home #3 Nursing Home was found to be in compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities. Complaints #125135 and #125183 were not substantiated.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Nov 14, 2024
Visit Reason
A complaint investigation for Complaint #123859-C was conducted on November 14, 2024.
Complaint Details
Complaint #123859-C was investigated and the facility was found to be in substantial compliance.
Findings
The facility was found to be in substantial compliance.
Inspection Report
Annual Inspection
Census: 43
Deficiencies: 0
Date: Aug 15, 2024
Visit Reason
The inspection was conducted as an annual health recertification survey for compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities.
Findings
The Chautauqua Guest Home #3 was found to be in compliance with the applicable federal requirements during the annual survey conducted from August 12 to August 15, 2024.
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Apr 18, 2024
Visit Reason
The inspection was conducted following an investigation for complaint #119457 from April 16, 2024 to April 18, 2024.
Complaint Details
Investigation was related to complaint #119457; the facility was found in substantial compliance.
Findings
The Chautauqua Guest House #3 Nursing Home was found to be in substantial compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Jan 31, 2024
Visit Reason
The document serves as a Plan of Correction following acceptance of the facility's credible allegation of substantial compliance.
Findings
The facility was certified in compliance effective January 31, 2024, based on the acceptance of the Plan of Correction and credible allegation of substantial compliance.
Inspection Report
Annual Inspection
Census: 39
Deficiencies: 2
Date: Jan 18, 2024
Visit Reason
The inspection was conducted as the facility's annual recertification survey from January 16, 2024 to January 18, 2024.
Findings
The facility was found to be in substantial compliance overall, but deficiencies were identified related to failure to complete significant change Minimum Data Set (MDS) assessments within 14 days for two residents receiving hospice care, and failure to follow proper food safety and hand hygiene practices during meal service and food delivery.
Deficiencies (2)
Failure to complete significant change MDS assessments within 14 days for 2 residents receiving hospice care.
Failure to practice proper hand hygiene and cover food during meal service and food delivery for 5 residents.
Report Facts
Census: 39
Deficiencies cited: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dietary Cook | Observed failing to follow proper hand hygiene and food safety practices during meal service | |
| Director of Nursing (DON) | Expressed expectation for timely completion of MDS assessments | |
| MDS Coordinator | Interviewed regarding MDS assessment completion and hospice admission procedures | |
| Dietary Manager | Interviewed regarding expectations for glove changes and infection control |
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Oct 12, 2023
Visit Reason
The document serves as a Plan of Correction following acceptance of a credible allegation of substantial compliance for the facility.
Findings
The facility was certified in compliance effective October 6, 2023, based on acceptance of the credible allegation of substantial compliance and the submitted Plan of Correction.
Inspection Report
Complaint Investigation
Census: 39
Deficiencies: 2
Date: Sep 21, 2023
Visit Reason
The inspection was a COVID-19 Focused Infection Control Survey combined with investigations of complaints #111814-C, #113546-C, and #113568-C conducted from September 18 to September 21, 2023.
Complaint Details
Complaints #111814-C, #113546-C, and #113568-C were substantiated based on observations, clinical record reviews, policy reviews, and staff/resident interviews indicating violations of resident rights and infection control standards.
Findings
The facility was found to be in substantial compliance overall, but deficiencies were identified related to resident rights violations including staff yelling at residents and failure to use clean commodes, as well as infection control issues such as failure to sanitize commodes and prevent cross contamination. Staff were reeducated and corrective actions were planned and implemented.
Deficiencies (2)
Staff failed to treat Resident #1 with respect and dignity by yelling at the resident and taking her to her room against her wishes; failure to use a clean commode for Resident #2; failure to repeat peri-care after Resident #10 was laid on a dirty mattress.
Failure to establish and maintain an infection prevention and control program including failure to sanitize commodes after each use and prevent cross contamination when Resident #6's Foley catheter bag contacted the floor.
Report Facts
Total Residents: 39
BIMS score: 14
BIMS score: 15
BIMS score: 15
Incident date: 52523
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff F | Licensed Practical Nurse (LPN) | Involved in incident with Resident #1 and documented statements regarding the incident |
| Staff G | Certified Nursing Assistant (CNA) | Involved in incident with Resident #1, yelled at resident, suspended pending investigation |
| Director of Nursing | Director of Nursing | Performed periodic observations and reeducation of staff regarding resident rights and infection control |
| Administrator | Administrator | Reported Staff G was disrespectful toward Resident #1 and expected staff to follow resident rights |
| Staff A | Certified Nursing Assistant (CNA) | Observed and reported on commode cleaning and resident care |
| Staff B | Certified Nursing Assistant (CNA) | Observed and reported on commode cleaning and resident care |
| Staff C | Certified Nursing Assistant (CNA) | Reported on commode cleaning and resident dignity |
| Staff D | Registered Nurse (RN)/Assistant Director of Nursing (ADON) | Reported expectations for commode disinfection and cleaning schedules |
| Staff H | Certified Nursing Assistant (CNA) | Observed verbal exchanges between Resident #1 and staff |
| Staff J | Certified Nursing Assistant (CNA) | Reported Resident #1's comments about Staff G |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Oct 25, 2022
Visit Reason
A complaint investigation was conducted for complaints #108397-C, #108463-C, and #108466-C on October 24 to October 25, 2022.
Complaint Details
Complaint investigation for complaints #108397-C, #108463-C, and #108466-C; facility found in substantial compliance.
Findings
The facility was found to be in substantial compliance following the complaint investigation.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Jul 29, 2022
Visit Reason
The document reflects acceptance of a credible allegation of compliance and plan of correction for the facility.
Findings
The facility will be certified in compliance effective July 29, 2022, based on acceptance of the credible allegation of compliance and plan of correction.
Inspection Report
Annual Inspection
Census: 39
Deficiencies: 1
Date: Jul 25, 2022
Visit Reason
The inspection visit was conducted as part of the facility's annual recertification survey and investigation of complaint #99665-C from July 25, 2022 to July 28, 2022.
Complaint Details
Complaint #99665-C was investigated and found to be not substantiated.
Findings
The facility was found to be in substantial compliance with all deficiencies as of July 29, 2022. One deficiency was cited for failure to properly dispose of garbage and refuse, specifically for uncovered trash cans that were heaping full during multiple observations.
Deficiencies (1)
Facility failed to cover garbage cans with tight fitting lids when not in use; trash cans were heaping full and uncovered during multiple observations.
Report Facts
Census: 39
Dates of inspection: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Dietary Manager | Interviewed regarding trash can policy and observations of uncovered trash cans |
Inspection Report
Renewal
Census: 42
Deficiencies: 0
Date: Mar 22, 2021
Visit Reason
The Iowa Department of Inspections and Appeals conducted a Medicare Recertification and State Licensure survey of the facility.
Findings
The facility was found to be in compliance with Medicare Conditions of Participation and Iowa Administrative Code requirements.
Inspection Report
Routine
Census: 46
Deficiencies: 0
Date: Nov 24, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspection and Appeals from November 22 - 24, 2020.
Findings
The facility was found to be in compliance with CMS and Centers for Disease Control and Prevention (CDC) recommended practices to prepare for COVID-19.
Inspection Report
Complaint Investigation
Census: 46
Deficiencies: 2
Date: Sep 28, 2020
Visit Reason
The inspection was conducted as an investigation of Complaints #87669-C and #92831-C, which ended on 09/28/2020. Both complaints were substantiated, and a COVID-19 Focused Infection Control Survey was conducted in conjunction with the complaint investigation.
Complaint Details
Complaint #87669-C was substantiated. Complaint #92831-C was substantiated.
Findings
The facility was found to be in non-compliance with CMS and CDC recommended practices for COVID-19 infection control. Deficiencies included failure to ensure resident environment was free of accident hazards, inadequate supervision and assistance devices to prevent accidents, improper use of a gait belt during resident transfer, and failure to follow proper infection prevention and control procedures including PPE use.
Deficiencies (2)
The facility failed to follow the plan of care for a resident who sustained a fall while in a Lumex lift, including inadequate supervision and assistance devices to prevent accidents.
The facility failed to use proper Personal Protective Equipment (PPE) for infection control to mitigate transmission of COVID-19 virus with one resident.
Report Facts
Total residents: 46
Deficiencies cited: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Certified Nursing Assistant (CNA) | Failed to apply gait belt properly and did transfer with one assist instead of two |
| Staff B | Certified Nursing Assistant (CNA) | Observed in resident room without mask covering mouth |
| Staff C | Certified Nursing Assistant (CNA) | Observed in resident room with face mask below nose |
| Staff D | Certified Nursing Assistant (CNA) | Observed in resident room with face mask below chin |
| Staff E | Certified Nursing Assistant (CNA) | Observed in resident room with no face mask or face covering |
| Administrator | Confirmed and verified staff are expected to follow facility protocol for wearing PPE | |
| Director of Nursing | Involved in infection control education and audits | |
| Assistant Administrator | Involved in infection control education and audits | |
| CEO/President | Involved in infection control education and audits |
Inspection Report
Routine
Census: 48
Deficiencies: 0
Date: Jun 16, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspection and Appeals from June 15-16, 2020 to assess compliance with CMS and CDC recommended practices for COVID-19 preparation.
Findings
The facility was found to be in compliance with CMS and CDC recommended practices to prepare for COVID-19.
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