Inspection Reports for Independence Village of Ankeny
1275 SW State St, Ankeny, IA 50023, United States, IA, 50023
Back to Facility ProfileInspection Report Summary
The most recent inspection on April 24, 2025, cited a deficiency for failing to include durable power of attorney documentation in a tenant’s record. Earlier inspections showed a pattern of deficiencies related mainly to tenant care, documentation, service plan updates, and staff training, with some issues also involving medication security and incident reporting. Complaint investigations were mostly unsubstantiated, though several substantiated complaints identified repeated regulatory insufficiencies, including failures in evaluations, nurse reviews, and adherence to policies, sometimes resulting in civil penalties. Enforcement actions included fines ranging from $750 to $1,500 in earlier years, but no license suspensions or immediate jeopardy findings were listed in the available reports. The facility’s record shows some improvement in recent years with fewer and less extensive deficiencies noted compared to earlier inspections.
Deficiencies (last 12 years)
Deficiencies are regulatory violations found during state inspections.
Deficiencies per year
Census
Based on a April 2025 inspection.
Census over time
| Description |
|---|
| Failure to ensure tenant records included copies of durable power of attorney documentation. |
| Description |
|---|
| 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. |
| 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. |
| Description |
|---|
| 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. |
| 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. |
| Description |
|---|
| 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. |
| Name | Title | Context |
|---|---|---|
| Jim Clindaniel | Executive Director | Named in Plan of Correction response and responsible for corrective actions |
| Description |
|---|
| 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. |
| 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 |
| Name | Title | Context |
|---|---|---|
| Rose Boccella | Program Coordinator | Signed letter regarding Final Recertification Monitoring Evaluation Report |
| Description |
|---|
| Failure to update nurse reviews, evaluations, and service plans as required. |
| Medication administration records not properly documented for certain tenants. |
| Food safety training not completed timely for staff. |
| Background checks not completed prior to hire for some staff. |
| Policies and procedures not followed regarding narcotics administration and documentation. |
| Tenant rights violated as evidenced by wandering tenant and property damage. |
| Name | Title | Context |
|---|---|---|
| Dawn Ethofer | Executive Director | Named as Executive Director of Vintage Hills at Prairie Trail Assisted Living. |
| Lori Miner | RN BSN | Monitor conducting the inspection. |
| Rose Boccella | Program Coordinator | Contact person for questions and informal conference. |
| Jim Friberg | Acting Bureau Chief, Adult Services Bureau | Author of the demand letter. |
| Description |
|---|
| Failure to perform evaluations, service plans, nurse review, and record checks as required. |
| Doctor ordered tasks were not included on the Medication Administration Record. |
| Two tenants were treated disrespectfully by a tenant whose service plan was not updated. |
| Policies and procedures were not followed in relation to narcotics. |
| Incomplete documentation of tenant evaluations and service plans. |
| Food safety training was not completed by three employees prior to working in food service. |
| Background checks for staff lacked response from Department of Human Services. |
| Name | Title | Context |
|---|---|---|
| Dawn Ethofer | Executive Director | Named as Executive Director of Vintage Hills at Prairie Trail Assisted Living. |
| Lori Miner | RN BSN | Monitor conducting the investigation. |
| Rose Boccella | Program Coordinator | Contact person for appeal and payment of civil penalty. |
| Jim Friberg | Acting Bureau Chief, Adult Services Bureau | Signed the demand letter. |
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor conducting the complaint/incident investigation revisit |
| Rose Boccella | Program Coordinator | Author of the cover letter and contact for the report |
| Description |
|---|
| Failure to complete evaluations and update service plans as required. |
| Missing nurse notes and incomplete incident reports related to sexual intimacy incidents between tenants. |
| Failure to investigate and report possible theft of medications. |
| Incomplete staff training on dementia-specific education and dependent adult abuse. |
| Failure to complete criminal background checks prior to employment. |
| Failure to follow Plan of Correction related to nurse delegated medication administration training. |
| Name | Title | Context |
|---|---|---|
| Dawn Ethofer | Administrator | Named as administrator of Vintage Hills at Prairie Trail Assisted Living. |
| Hal L. Chase | RN BSN MPH | Monitor involved in complaint/incident investigation. |
| Joyce Kix | RN | Monitor involved in complaint/incident investigation. |
| Rose Boccella | Program Coordinator | Contact person for the program regarding the report and penalty. |
| Ann Martin | Bureau Chief, Adult Services Bureau | Signed the demand letter regarding the civil penalty. |
| Description |
|---|
| Medication administration errors involving narcotics and improper transcription by non-nursing staff. |
| Insufficient number of trained staff to meet tenants' identified needs. |
| Medication policies did not describe or identify procedures for transcribing medication orders. |
| Program failed to use a scored, objective cognitive evaluation tool at admission and did not complete functional, cognitive, and health evaluations within 30 days. |
| Service plans were not supported by evaluations and were not updated within required timeframes. |
| Failure to assess a tenant's swollen ankles and toes despite staff reports. |
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor for the complaint/incident investigation |
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor conducting the complaint/incident investigation |
| Rose Boccella | Program Coordinator | Author of the cover letter and contact person for the report |
| Julie Waterman | Administrator | Administrator of Vintage Hills at Prairie Trail Assisted Living, recipient of the report |
| Name | Title | Context |
|---|---|---|
| Rose Boccella | Program Coordinator | Signed cover letter and contact for questions |
| Hal L. Chase | RN BSN MPH | Monitor conducting the complaint/incident investigation |
| Description |
|---|
| When medications are administered traditionally by the program, the administration of medications shall be provided by a registered nurse, licensed practical nurse or advanced registered nurse practitioner or by unlicensed assistive personnel in accordance with requirements governing nurse delegation. |
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor conducting the complaint/incident investigation |
| Julie Waterman | Administrator | Administrator interviewed during investigation |
| Staff #1 | Interviewed regarding staff behavior allegations | |
| Staff #2 | Observed administering medications and interviewed regarding staff behavior allegations | |
| Staff #3 | Interviewed regarding pest control and structural issues |
Loading inspection reports...



