Inspection Reports for Iowa Veterans Home
1301 Summit St, Marshalltown, IA 50158, United States, IA, 50158
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Inspection Report
Plan of Correction
Deficiencies: 0
Dec 16, 2025
Visit Reason
The document is a statement of deficiencies and plan of correction related to the facility's compliance with health requirements, certifying substantial compliance effective December 5, 2025.
Findings
The facility was found to be in substantial compliance based on the credible allegation and plan of correction submitted, resulting in certification of compliance with health requirements.
Report Facts
Certification effective date: Dec 5, 2025
Inspection Report
Complaint Investigation
Census: 353
Deficiencies: 1
Nov 17, 2025
Visit Reason
The inspection was conducted as a result of complaint #129295-C, which triggered an investigation from September 8, 2025, to November 17, 2025.
Findings
The facility failed to ensure safe wheelchair transportation for two residents, resulting in a deficiency related to free of accident hazards and supervision. Observations and interviews confirmed staff did not apply foot pedals on wheelchairs during transport, posing safety risks.
Complaint Details
Complaint #129295-C was substantiated, resulting in a deficiency related to accident hazards and supervision for wheelchair safety.
Severity Breakdown
D: 1
Deficiencies (1)
| Description | Severity |
|---|---|
| Failure to ensure safe wheelchair transportation for residents, including not applying foot pedals on wheelchairs during transport. | D |
Report Facts
Resident census: 353
Brief Interview for Mental Status (BIMS) score: 7
Dates of complaint investigation: September 8, 2025 to November 17, 2025
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff B | Registered Nurse (RN) | Observed and interviewed regarding wheelchair transportation practices |
| Nursing Services Director | Interviewed about expectations for staff to apply foot pedals on wheelchairs |
Inspection Report
Annual Inspection
Census: 352
Deficiencies: 0
Mar 27, 2025
Visit Reason
The inspection was conducted as an annual recertification survey with an investigation of facility reported incidents #127413-I, #127535-I, and #127527-I from March 24, 2025 to March 27, 2025.
Findings
The Iowa Veterans Home was found to be in compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities. The investigated incidents were not substantiated.
Inspection Report
Complaint Investigation
Deficiencies: 0
Nov 26, 2024
Visit Reason
A complaint investigation for complaint #124055-C was conducted from November 25, 2024 to November 26, 2024.
Findings
The facility was found to be in substantial compliance following the complaint investigation.
Complaint Details
Complaint #124055-C was investigated and the facility was found to be in substantial compliance.
Report Facts
Complaint number: 124055
Inspection Report
Complaint Investigation
Deficiencies: 0
Aug 8, 2024
Visit Reason
Investigation of complaint intakes #121475-C and #121586-I conducted from August 6, 2024 to August 8, 2024.
Findings
The Iowa Veterans Home was found to be in substantial compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities following the complaint investigation.
Complaint Details
Investigation of complaint intakes #121475-C and #121586-I.
Inspection Report
Plan of Correction
Deficiencies: 0
Jun 10, 2024
Visit Reason
The document is a statement of deficiencies and plan of correction related to the Iowa Veterans Home Nursing Home's compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities.
Findings
The Iowa Veterans Home Nursing Home is in substantial compliance based on acceptance of a credible allegation of substantial compliance and the submitted Plan of Correction. The facility will be certified in compliance effective May 31, 2024.
Inspection Report
Annual Inspection
Census: 339
Deficiencies: 1
May 2, 2024
Visit Reason
The inspection was conducted as the facility's annual recertification survey to assess compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities.
Findings
The Iowa Veterans Home was found not in compliance due to failure to provide documented rationale for psychotropic medication use beyond 14 days for Resident #87 and failure to perform periodic re-evaluation of the medication regimen. Complaint #119410-C was unsubstantiated.
Complaint Details
Complaint #119410-C was unsubstantiated.
Deficiencies (1)
| Description |
|---|
| Facility failed to provide a documented rationale on why Resident #87's PRN psychotropic medication needed continuation beyond 14 days and failed to perform periodic re-evaluation of the medication regimen. |
Report Facts
Total Census: 339
Complaint Number: 119410
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff B | RN Nursing Service Director | Spoke to Pharmacy Director regarding medication order duration for Resident #87 |
| Staff A | Registered Nurse | Documented telephone order for lorazepam on 4/30/24 |
Inspection Report
Complaint Investigation
Deficiencies: 0
Jun 20, 2023
Visit Reason
A complaint investigation was conducted for Complaint #113029-C on June 20-21, 2023.
Findings
The facility was found to be in substantial compliance with no deficiencies noted.
Complaint Details
Complaint #113029-C was investigated and the facility was found to be in substantial compliance.
Inspection Report
Annual Inspection
Deficiencies: 0
Mar 2, 2023
Visit Reason
An annual recertification survey and investigation of multiple complaints and a facility reported incident were conducted from February 27, 2023 to March 2, 2023.
Findings
The facility was found to be in substantial compliance at the time of the survey.
Complaint Details
The investigation included complaints #105237-C, #105837-C, #109466-C, #109533-C, #109682-C, #111307-C and facility reported incident #107533-I.
Inspection Report
Complaint Investigation
Deficiencies: 0
Jun 23, 2022
Visit Reason
A complaint investigation for Complaint #101469-C and a Facility-Self Reported Incident #103610-I was conducted from June 20, 2022 to June 23, 2022.
Findings
The facility was found to be in substantial compliance.
Complaint Details
Investigation was related to Complaint #101469-C and Facility-Self Reported Incident #103610-I; the facility was found to be in substantial compliance.
Inspection Report
Routine
Census: 351
Deficiencies: 0
Oct 18, 2021
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspection and Appeals from 10/13 to 10/18/2021 to assess compliance with CMS and CDC recommended practices for COVID-19.
Findings
The facility was found to be in compliance with CMS and CDC recommended practices for COVID-19. An investigation of a facility-reported incident #99601-I did not result in any deficiency.
Report Facts
Total Residents: 351
Inspection Report
Routine
Census: 350
Deficiencies: 0
Sep 9, 2021
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspections and Appeals from 09/07/2021 to 09/09/2021 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.
Report Facts
Total census: 350
Inspection Report
Complaint Investigation
Census: 351
Deficiencies: 0
Jul 19, 2021
Visit Reason
A COVID-19 Focused Infection Control Survey and an investigation of Complaint #97837 were conducted by the Department of Inspection and Appeals from 7/12/21 to 7/19/21.
Findings
The facility was found to be in compliance with CMS and CDC recommended practices to prepare for COVID-19. Complaint #97837 was not substantiated.
Complaint Details
Complaint #97837 was investigated and found not substantiated.
Inspection Report
Annual Inspection
Deficiencies: 0
May 20, 2021
Visit Reason
The inspection was conducted as a recertification survey and investigation of Facility Self-Reported Incidents #97364 and #97365 during 5/17-20/2021.
Findings
The facility was found in substantial compliance. Incident #97634 was not substantiated and incident #97365 was substantiated without a deficiency.
Inspection Report
Complaint Investigation
Census: 353
Deficiencies: 0
Feb 23, 2021
Visit Reason
A COVID-19 Focused Infection Control Survey and an investigation of Complaints #92393 and #95977 was conducted by the Department of Inspections and Appeals from 2/8/21 to 2/23/21.
Findings
The facility was found to be in compliance with CMS and CDC recommended practices to prepare for COVID-19. Both complaints were not substantiated.
Complaint Details
Complaints #92393 and #95977 were investigated and found not substantiated.
Inspection Report
Routine
Census: 363
Deficiencies: 0
Dec 23, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspections and Appeals from 12/21/2020 through 12/23/2020 to assess compliance with CMS and CDC recommended practices for COVID-19 preparation.
Findings
The facility was found in compliance with CMS and CDC recommended practices to prepare for COVID-19.
Inspection Report
Abbreviated Survey
Census: 394
Deficiencies: 0
Aug 6, 2020
Visit Reason
A COVID 19 Focused Infection Control Survey was conducted by the Department of Inspections and Appeals on 8/5/2020 through 8/6/2020 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.
Inspection Report
Abbreviated Survey
Census: 388
Deficiencies: 0
Jul 16, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspections and Appeals from 07/14/2020 through 07/16/2020 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.
Inspection Report
Routine
Census: 393
Deficiencies: 0
Jun 18, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspections and Appeals on 6/17/2020 through 6/18/2020 to assess compliance with CMS and CDC recommended practices.
Findings
The facility was found to be in compliance with CMS and CDC recommended practices to prepare for COVID-19.
Report Facts
Total residents: 393
Inspection Report
Complaint Investigation
Deficiencies: 0
Feb 27, 2020
Visit Reason
The inspection was conducted as a complaint investigation related to Incident #89597.
Findings
The complaint investigation found that Incident #89597 was not substantiated according to Code of Federal Regulations (42CFR) Part 483, Subpart B-C.
Complaint Details
Incident #89597 was investigated and found not substantiated.
Inspection Report
Complaint Investigation
Census: 428
Deficiencies: 2
Jan 22, 2020
Visit Reason
Investigation of Complaint #87671-C conducted December 31, 2019-January 22, 2020 resulted in the following deficiencies related to resident rights and smoking restrictions.
Findings
The facility failed to ensure residents' rights to a dignified existence, self-determination, and communication, specifically restricting residents' rights to smoke and moving residents due to smoking concerns. Resident #5 was moved and restricted from leaving the unit without supervision, and multiple smoking incidents and violations were documented. The facility had a census of 428 residents at the time of inspection.
Complaint Details
Complaint #87671-C investigated from December 31, 2019 to January 22, 2020. The complaint was substantiated with findings related to residents' rights and smoking restrictions.
Severity Breakdown
SS=G: 1
SS=D: 1
Deficiencies (2)
| Description | Severity |
|---|---|
| Facility failed to ensure residents' rights without interference, coercion, discrimination, or reprisal, specifically restricting residents' rights to smoke and moving Resident #5 to another unit with restrictions. | SS=G |
| Facility failed to develop and implement a comprehensive person-centered care plan for residents who smoke or use smokeless products, including Resident #1 and Resident #14. | SS=D |
Report Facts
Census: 428
Resident cigarettes per day: 6
Resident cigarettes per day: 3
Resident cigarettes per hour: 4
Resident cigarettes per day: 10
Resident cigarettes per day: 2
Resident cigarettes per day: 6
Resident cigarettes per day: 1
Resident cigarettes per day: 3
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 1
Resident cigarettes per day: 3
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Resident cigarettes per day: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff J | Registered Nurse (RN) | Documented smoking assessments and incidents related to Resident #5 and Resident #14. |
| Staff M | Social Worker | Met with Resident #5 to discuss smoking incidents and restrictions. |
| Staff O | Registered Nurse (RN) | Documented calls and observations related to Resident #5 smoking incidents. |
| Staff F | Security | Observed and reported smoking incidents and searched Resident #5's belongings. |
| Staff G | Nursing Supervisor | Confirmed smoking privileges revocation and communicated with Resident #7. |
| Staff K | Certified Medication Aide (CMA) | Monitored Resident #14's smoking and medication compliance. |
| Staff L | Nurse Clinical | Worked with Resident #14 and monitored smoking room. |
| Staff S | Registered Nurse (RN) | Documented smoking incidents and interactions with Resident #7. |
| Staff E | Licensed Practical Nurse (LPN) | Educated Resident #7 about smoking safety and monitored smoking room. |
| Staff B | Nursing Supervisor | Documented removal of smoking privileges for Resident #7. |
| Staff A | Director of Nursing (DON) | Provided resident education regarding smoking incidents. |
| Staff F | Registered Nurse (RN) | Reported smoking incidents and searched Resident #7's room. |
| Staff H | Licensed Practical Nurse (LPN) | Educated Resident #7 about smoking safety. |
| Staff C | Residential Treatment Worker (RTW) | Observed smoking room and monitored residents. |
| Staff D | Registered Nurse (RN) | Observed Resident #1 smoking and documented assessments. |
| Staff N | Nursing Services Director (NSD) | Communicated with Resident #7 about smoking privileges. |
| Staff F | Nursing Supervisor | Contacted and discussed smoking restrictions with Resident #5. |
| Staff L | Nurse Clinical | Called supervisor regarding Resident #14 smoking incident. |
| Staff J | Registered Nurse (RN) | Monitored Resident #14 and documented smoking incidents. |
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