The most recent inspection on December 18, 2025 found the facility to be in substantial compliance with no deficiencies cited. Earlier inspections showed a mixed record with some deficiencies related to staff training, background checks, medication administration, nutrition, and care planning. Prior issues included failure to complete required Dependent Adult Abuse training and background checks for some staff, as well as documentation and procedural gaps in psychotropic drug use and dietary services. Complaint investigations during this period were mostly unsubstantiated or found the facility in substantial compliance, with no enforcement actions or fines listed in the available reports. The facility’s inspection history suggests improvement over time, with recent surveys showing compliance following correction of earlier deficiencies.
Deficiencies (last 6 years)
Deficiencies (over 6 years)1.2 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
73% better than Iowa average
Iowa average: 4.4 deficiencies/year
Deficiencies per year
43210
2020
2021
2022
2023
2024
2025
Census
Latest occupancy rate29 residents
Based on a August 2023 inspection.
This facility has shown a decline in demand based on occupancy rates.
An onsite revisit was conducted on 11/18/24 regarding the investigation of complaints #124129-C and #124187-C conducted from October 17, 2024 to October 24, 2024.
Findings
All deficiencies identified in the prior complaint investigations have been corrected and the facility was found in substantial compliance with all regulations surveyed effective October 25, 2024.
Complaint Details
The visit was related to complaints #124129-C and #124187-C. The facility was found in substantial compliance and all deficiencies were corrected.
Report Facts
Complaint investigation dates: Complaints investigated from October 17, 2024 to October 24, 2024
Inspection Report Plan of CorrectionDeficiencies: 0Oct 3, 2023
Visit Reason
The document serves as a Plan of Correction following acceptance of a credible allegation of substantial compliance by the facility.
Findings
The facility was found to be in substantial compliance and will be certified in compliance effective September 30, 2023.
The inspection was conducted as the facility's annual recertification survey and investigation of a reported incident #112338-I from August 27 to August 30, 2023.
Findings
The facility was found not to have substantiated the reported incident. Deficiencies were identified related to failure to ensure staff completed required Dependent Adult Abuse training within six months of hire and failure to complete Single Contact Repository (SING) background checks prior to hiring for some staff members.
Complaint Details
The facility reported incident #112338-I was investigated and found not substantiated.
Severity Breakdown
Level D: 2
Deficiencies (2)
Description
Severity
Failure to ensure 1 of 5 staff members completed the two-hour Dependent Adult Abuse training within 6 months of hire date.
Level D
Failure to complete Single Contact Repository (SING) background checks prior to hire on 2 of 5 staff members.
Level D
Report Facts
Census: 29Staff members reviewed: 5
Employees Mentioned
Name
Title
Context
Amy Hickie
Administrator
Reported no record of dependent adult abuse mandatory reporter training for Staff A and verified background checks for Staff B and Staff C
Staff A
Certified Nursing Assistant (CNA)
Lacked documentation of Dependent Adult Abuse training
Staff B
Certified Nursing Assistant (CNA)
Had incomplete background checks prior to hire
Staff C
Certified Nursing Assistant (CNA)
Had incomplete background checks prior to hire
Inspection Report Plan of CorrectionDeficiencies: 0Jun 28, 2022
Visit Reason
The document serves as a statement of deficiencies and plan of correction for Elkader Care Center, certifying the facility in compliance effective June 28, 2022, based on acceptance of a credible allegation of compliance and plan of correction.
Findings
The facility was certified in compliance effective June 28, 2022, based on acceptance of the credible allegation of compliance and plan of correction. No specific deficiencies or severity levels are detailed in the report.
The inspection was conducted as the facility's annual recertification survey from June 13, 2022 to June 16, 2022.
Findings
The facility was found deficient in ensuring psychotropic drugs were administered only when necessary with proper documentation of non-pharmacological interventions prior to administration. Additionally, deficiencies were noted in menu preparation and nutritional adequacy, and in maintaining a quality assessment and assurance committee with required attendance.
Deficiencies (3)
Description
Failure to attempt and document non-pharmacological and behavioral interventions prior to administration of as needed anxiolytic medication for Resident #10.
Failure to provide correct serving amounts as planned on the menu for pureed diets.
Failure to maintain a quality assessment and assurance committee with required meeting frequency and member attendance.
Report Facts
Facility census: 37Dates of survey: 4Number of servings observed: 4Medication order start date: Jan 19, 2022
Employees Mentioned
Name
Title
Context
Director of Nursing
Director of Nursing
Completed education with nurses on PRN anxiolytic medication interventions and monitoring compliance
Dietary Supervisor
Dietary Supervisor
Provided education to cooks on measuring blended food items and proper serving size; involved in meal preparation observations
Administrator
Administrator
Monitors compliance with quality assessment and assurance committee meetings
Inspection Report Plan of CorrectionDeficiencies: 0Jul 12, 2021
Visit Reason
The document reflects acceptance of the facility's credible allegation of compliance and plan of correction for regulatory compliance.
Findings
The facility was certified in compliance effective 7/12/21 based on acceptance of the plan of correction; no specific deficiencies or severity levels are detailed in the report.
The Iowa Department of Inspections and Appeals conducted a Medicare Recertification Survey and investigation of a facility reported incident to determine compliance with Medicare Conditions of Participation.
Findings
The facility was found to be not in compliance due to failure to develop and implement a behavior-related care plan for one resident and failure to complete nursing assessments and monitoring after outpatient dialysis for one resident. The facility reported a census of 32 residents.
Complaint Details
Facility Reported Incident #98199-I was reviewed and found not substantiated.
Deficiencies (2)
Description
Failed to develop and implement a behavior related care plan for 1 of 3 residents reviewed (Resident #20).
Failed to complete nursing assessments and monitoring of residents after outpatient dialysis for 1 of 1 resident that received dialysis services (Resident #1).
Report Facts
Total residents: 32Residents reviewed for behavior care plan deficiency: 3Residents reviewed for dialysis deficiency: 1
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspection and Appeals on 6/16/20 to assess the facility's 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.
Report
Nov 7, 2024
File
ScannedReport_812_2024-11-07_065511.pdf
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