Inspection Reports for Edencrest at The Tuscany

1600 8th St SE, Altoona, IA 50009, USA, IA, 50009

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Deficiencies (last 3 years)

Deficiencies (over 3 years) 3.7 deficiencies/year

Deficiencies are regulatory violations found during state inspections.

16% better than Iowa average
Iowa average: 4.4 deficiencies/year

Deficiencies per year

4 3 2 1 0
2022
2023
2024

Census

Latest occupancy rate 37 residents

Based on a September 2024 inspection.

This facility has shown a steady increase in demand based on occupancy rates.

Census over time

0 10 20 30 40 50 Mar 2022 Apr 2022 Jul 2022 Aug 2023 Dec 2023 Sep 2024

Inspection Report

Recertification
Census: 37 Deficiencies: 2 Date: Sep 19, 2024

Visit Reason
The inspection was conducted as a recertification visit to determine compliance with certification of an Assisted Living Program for People with Dementia and included investigation of Incident #118262-I.

Complaint Details
The visit included investigation of Incident #118262-I related to a tenant fall and lack of hourly visual checks.
Findings
The inspection found regulatory insufficiencies including failure to follow program policies for completing hourly visual checks on a discharged tenant who later suffered a fracture, and failure to complete required background checks prior to hire for one employee (Culinary Coordinator).

Deficiencies (2)
Program staff failed to follow procedures for completing visual checks on Tenant C1, missing hourly checks as required by the service plan.
The program failed to complete background checks prior to hire for 1 of 7 employees reviewed (Culinary Coordinator).
Report Facts
Number of tenants without cognitive impairment: 18 Number of tenants with cognitive impairment: 19 Total census: 37 Employees reviewed for background checks: 7 Employee with missing background check: 1

Employees mentioned
NameTitleContext
Emily MosesRNProvided on-site training regarding policy for pendant response times and visual checks
Staff AResponded to Tenant C1 after fall and failed to document hourly visual checks
Staff BResponded to Tenant C1 after fall and reported on rounds
Executive DirectorConfirmed findings regarding missing background check and tenant incident
Culinary CoordinatorEmployee hired without prior background check

Inspection Report

Complaint Investigation
Census: 43 Deficiencies: 3 Date: Dec 18, 2023

Visit Reason
The inspection was conducted as a result of the investigation of Incident #117321-I and Complaint #116335-C at Edencrest at the Tuscany MC.

Complaint Details
The visit was complaint-related, investigating Incident #117321-I and Complaint #116335-C. The complaint was substantiated as deficiencies were found related to tenant evaluations, incident reporting, and life safety alarm systems.
Findings
The inspection identified regulatory insufficiencies including failure to evaluate a tenant's functional, cognitive, and health status after significant change, failure to maintain incident reports for tenant incidents, and failure to ensure the alarm system connected to each exit door in the dementia-specific program operated properly.

Deficiencies (3)
Failure to evaluate a tenant's functional, cognitive and health status as needed with significant change to determine continued eligibility and service changes.
Failure to maintain incident reports involving tenants, including incidents related to medication errors, accidents, falls, and elopements.
Failure to ensure the alarm system connected to each exit door in the dementia-specific program operated properly.
Report Facts
Number of tenants without cognitive impairment: 20 Number of tenants with cognitive impairment: 23 Total census: 43 Date survey completed: Dec 18, 2023

Employees mentioned
NameTitleContext
DirectorConfirmed findings regarding missing evaluations and incident reports; confirmed alarm system failure.
Staff CReported the courtyard exit door alarm did not sound on 12/04/23.

Inspection Report

Complaint Investigation
Census: 38 Deficiencies: 3 Date: Aug 28, 2023

Visit Reason
The inspection was conducted as a result of investigations #110262-C and #114930-C to assess compliance with dependent adult abuse training and dementia-specific education requirements.

Complaint Details
The inspection was triggered by complaint investigations #110262-C and #114930-C. The findings pertain to failure in staff training compliance.
Findings
The program failed to consistently ensure staff received required dependent adult abuse training and dementia-specific education within mandated timeframes. Specific deficiencies were found related to training completion for several staff members.

Deficiencies (3)
Program failed to consistently ensure staff received Dependent Adult Abuse (DAA) training as required by Iowa Code section 235B.16.
Program failed to consistently ensure staff received eight hours of dementia-specific training within 30 days of employment.
Program failed to consistently ensure staff received eight hours of dementia-specific continuing education annually.
Report Facts
Total census: 38 Number of tenants without cognitive impairment: 38 Number of tenants with cognitive impairment: 0 Staff affected by DAA training deficiency: 1 Staff affected by dementia-specific training deficiency within 30 days: 3 Staff affected by annual dementia-specific continuing education deficiency: 1

Employees mentioned
NameTitleContext
Staff BNamed in deficiency for failure to complete Dependent Adult Abuse training and annual dementia-specific continuing education
Staff ANamed in deficiency for failure to complete dementia-specific training within 30 days of employment
Staff CNamed in deficiency for failure to complete dementia-specific training within 30 days of employment

Inspection Report

Complaint Investigation
Census: 37 Deficiencies: 2 Date: Jul 7, 2022

Visit Reason
The inspection was conducted as an investigation of complaints identified by case numbers 103639-C, 103638-C, and 105325-C regarding care and services at the assisted living program for people with dementia.

Complaint Details
The visit was complaint-related, investigating concerns about temporary staff neglecting tenant care, including tenants found soiled and unattended, and failure to provide personal cares. Family members and staff reported ongoing issues with agency staff not providing adequate care.
Findings
The investigation found failures to provide adequate and appropriate care to one tenant with cognitive impairment and potentially affected all 15 tenants in the memory care unit, including issues with temporary staff neglecting tenant care and soiling. Additionally, the program failed to have an operating alarm system on the exit door to the courtyard in the memory care unit.

Deficiencies (2)
Failed to provide adequate and appropriate care, treatment, and services to 1 of 3 tenants reviewed with cognitive impairment, with concerns about temporary staff neglecting tenant care and hygiene.
Failed to have an operating alarm system connected to the exit door to the courtyard in the memory care unit.
Report Facts
Number of tenants without cognitive disorder in General Population Program: 20 Number of tenants with cognitive disorder in General Population Program: 2 Number of tenants without cognitive disorder in Memory Care Unit: 0 Number of tenants with cognitive disorder in Memory Care Unit: 15 Total census of Assisted Living Program for People with Dementia: 37

Inspection Report

Complaint Investigation
Census: 14 Deficiencies: 1 Date: Apr 13, 2022

Visit Reason
The inspection was conducted as part of an investigation of complaint #103845 regarding the adequacy and appropriateness of care and services provided to tenants.

Complaint Details
The complaint investigation found that Tenant #1 fell out of bed on 4/6/22, suffered multiple head wounds requiring staples, and staff failed to promptly notify the nurse or administrator. The on-call nurse did not answer calls initially, and staff did not follow up appropriately. The Administrator confirmed no procedure was in place for staff to follow if unable to reach the on-call person.
Findings
The program failed to provide adequate and appropriate care and services to one tenant who sustained a head injury after a fall. Staff delayed notifying the nurse and administrator, and there was no procedure for staff to follow when unable to reach the on-call nurse.

Deficiencies (1)
Failure to provide adequate and appropriate care and services to Tenant #1 who fell and sustained head wounds requiring emergency treatment.
Report Facts
Number of tenants: 14 Number of tenants with cognitive disorders: 13 Number of tenants without cognitive disorders: 1 Staples needed: 10 Staples needed: 12 Number of calls to on-call RN: 12 Time of 911 call: 640

Inspection Report

Renewal
Census: 27 Deficiencies: 0 Date: Mar 14, 2022

Visit Reason
A recertification visit was conducted to determine compliance with certification for an Assisted Living Program. Complaints #101295-C, 101457-C and 102654-C were also completed.

Complaint Details
Complaints #101295-C, 101457-C and 102654-C were investigated and completed with no regulatory insufficiencies cited.
Findings
No regulatory insufficiencies were cited during the recertification visit and complaint investigations.

Report Facts
Number of tenants without cognitive disorder in General Population: 16 Number of tenants with cognitive disorder in General Population: 4 Number of tenants without cognitive disorder in Memory Care Unit: 0 Number of tenants with cognitive disorder in Memory Care Unit: 7 Total Census of Assisted Living Program for People with Dementia: 27

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