Inspection Reports for Maple Grove Senior Living
1917 South 18th Street, Centerville, IA, 525443136
Back to Facility ProfileInspection Report Summary
The most recent inspection on November 14, 2023, found no deficiencies during the recertification visit for the Assisted Living Program. Earlier inspections showed a generally compliant record with occasional deficiencies related mainly to service plan development and staff adherence to medication sanitation procedures. Complaint investigations included a substantiated case in 2011 involving failure to assess a tenant’s mental health and notify authorities about a stolen item, but most complaints were unsubstantiated or did not result in citations. No fines, immediate jeopardy findings, or license actions were listed in the available reports. The inspection history suggests improvement over time, with recent visits showing no regulatory insufficiencies.
Deficiencies (last 11 years)
Deficiencies (over 11 years)
0.7 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
84% better than Iowa average
Iowa average: 4.4 deficiencies/yearDeficiencies per year
4
3
2
1
0
Census
Latest occupancy rate
5 residents
Based on a November 2023 inspection.
This facility has shown a decline in demand based on occupancy rates.
Census over time
Inspection Report
Renewal
Census: 5
Deficiencies: 0
Date: Nov 14, 2023
Visit Reason
Recertification visit conducted to determine compliance with certification rules for an Assisted Living Program.
Findings
No regulatory insufficiencies were cited during the recertification visit for the Assisted Living Program.
Inspection Report
Renewal
Census: 9
Deficiencies: 1
Date: May 6, 2021
Visit Reason
The inspection was conducted as a recertification visit to determine compliance with certification for an Assisted Living Program and to investigate Complaint 93826-C and perform an onsite infection control survey.
Complaint Details
No regulatory insufficiencies were cited regarding the investigation of Complaint 93826-C.
Findings
No regulatory insufficiencies were cited regarding the complaint investigation or infection control survey. However, a deficiency was cited for failure to consistently develop service plans based on evaluations for one tenant.
Deficiencies (1)
Failure to consistently develop service plans based on evaluations for Tenant #1.
Report Facts
Number of tenants without cognitive disorder: 7
Number of tenants with cognitive disorder: 2
Total census of program: 9
Evaluation dates for Tenant #1: Evaluations completed on 2020-08-25 and 2020-09-19 but no service plan developed.
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Becky Opdahl | RN, BSN, Administrator & AL Manager | Named in relation to the deficiency regarding service plans. |
Inspection Report
Renewal
Census: 16
Deficiencies: 0
Date: May 8, 2019
Visit Reason
Recertification visit to determine compliance with licensing rules for an Assisted Living Program (ALP).
Findings
No regulatory sufficiencies were cited during the recertification visit, indicating compliance with licensing rules for the Assisted Living Program.
Inspection Report
Renewal
Census: 17
Deficiencies: 0
Date: May 3, 2017
Visit Reason
The recertification visit was conducted to determine compliance with rules for an Assisted Living Program (ALP).
Findings
No regulatory insufficiencies were cited during the recertification visit for the Assisted Living Program.
Inspection Report
Monitoring
Census: 15
Deficiencies: 1
Date: Jan 14, 2015
Visit Reason
The visit was a Final Recertification Monitoring Evaluation conducted by the Department of Inspections and Appeals (DIA) to assess compliance with certification requirements for an Assisted Living Program.
Findings
The report identified a regulatory insufficiency related to staffing, specifically nurse delegation procedures and proper sanitation during medication administration. The facility failed to ensure staff followed proper hand hygiene and sanitation protocols during medication passes.
Deficiencies (1)
Staff failed to provide services in accordance with training, including improper sanitation during medication administration and eye drop administration.
Report Facts
Number of tenants without cognitive disorder: 15
Number of tenants with cognitive disorder: 0
Total population of program at time of on-site: 15
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Cheryle Campbell | RN Manager | Named as RN Manager interviewed regarding medication administration and sanitation expectations |
| Staff A | Staff member observed during medication pass with improper sanitation and hand hygiene |
Inspection Report
Monitoring
Census: 11
Deficiencies: 0
Date: May 15, 2012
Visit Reason
The visit was a final recertification monitoring evaluation conducted to review recertification documents and ensure compliance with Iowa Administrative Code chapters 481-67 and 481-69 for Maple Grove Assisted Living.
Findings
No regulatory insufficiencies were found during this evaluation. The program was found to be in compliance with all applicable rules, and tenant satisfaction was generally positive.
Report Facts
Number of tenants without cognitive disorder: 11
Number of tenants with cognitive disorder: 0
Total census of Assisted Living Program: 11
Number of tenants attending community meeting: 10
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor conducting the evaluation |
Inspection Report
Complaint Investigation
Census: 10
Deficiencies: 2
Date: Mar 9, 2011
Visit Reason
The inspection was conducted as a final incident investigation following reports of possible thefts of money and personal items from a tenant residing at Maple Grove Senior Living.
Complaint Details
The complaint involved allegations of theft of money and personal items from a tenant. The tenant reported multiple thefts totaling $210, $40, $170, and a diamond bracelet valued at $1600. The tenant was interviewed and police reports were filed. The program did not notify the department of the stolen bracelet. The complaint was substantiated as a regulatory insufficiency.
Findings
The investigation found multiple reports of missing money and personal items from a tenant, with inconsistent amounts reported stolen. The program failed to assess the tenant's mental health status appropriately and did not notify the department of an alleged stolen bracelet. The Department of Inspections and Appeals accepted the submitted Plan of Correction.
Deficiencies (2)
Failure to assess the tenant's mental health status and make appropriate referrals related to the tenant's mental health status during the period when personal items were reported missing.
Failure to notify the department of the alleged stolen bracelet reported by the tenant.
Report Facts
Current number of tenants without cognitive disorder: 10
Current number of tenants with cognitive disorder: 0
Total Population: 10
Reported stolen amounts: 210
Reported stolen amounts: 40
Reported stolen amounts: 170
Reported stolen amounts: 1600
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor of the incident investigation |
Inspection Report
Complaint Investigation
Census: 11
Deficiencies: 0
Date: Mar 24, 2009
Visit Reason
A complaint investigation was conducted at Maple Grove Senior Living due to allegations including tenant soiling and incontinence, unsafe food preparation, tenant confusion and hallucinations, a fall with injury, need for higher level of care, and failure to notify authorities of a serious injury.
Complaint Details
Complaint #22409-C alleged tenant soiling and incontinence, unsafe food preparation, tenant confusion and hallucinations, a fall with injury, need for higher level of care, and failure to notify the Department of Inspections and Appeals of a serious injury. The complaint investigator found no regulatory insufficiencies in any of these areas.
Findings
The investigation found no regulatory insufficiencies related to the complaints. Observations and record reviews indicated tenant independence except for medication administration, no serious injury from the fall, and appropriate program responses. No substantiated regulatory violations were identified.
Report Facts
Current number of tenants without cognitive disorder: 11
Current number of tenants with cognitive disorder: 0
Total Population: 11
Tenant age: 93
Date of tenant admission: Aug 28, 2006
Date of tenant functional assessment: Dec 3, 2008
Date of tenant incident: Mar 5, 2009
Date of tenant injury complaint: Mar 7, 2009
Date of tenant discharge to nursing area: Mar 23, 2009
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Michael Streepy | RN | Complaint investigator |
Inspection Report
Monitoring
Census: 12
Deficiencies: 0
Date: Jun 17, 2008
Visit Reason
An on-site monitoring evaluation was conducted at Maple Grove Senior Living to assess compliance with assisted living program regulations during the recertification period.
Findings
No regulatory insufficiencies were noted during the monitoring visit. Tenant feedback was positive regarding cleanliness, staff, food, activities, and safety.
Report Facts
Current number of tenants without cognitive disorder: 12
Current number of tenants with cognitive disorder: 0
Total Population: 12
Inspection Report
Complaint Investigation
Census: 16
Deficiencies: 0
Date: Mar 31, 2006
Visit Reason
A complaint investigation was conducted at Maple Grove Assisted Living to address allegations regarding tenant care needs and staffing adequacy.
Complaint Details
The complaint alleged the program was retaining a tenant requiring two-person assistance for falls and that staffing was inadequate. Both allegations were found unsubstantiated with no regulatory insufficiencies noted.
Findings
The investigation found no regulatory insufficiencies related to tenant care or staffing. Tenants who had fallen were assisted promptly without injury, and staffing levels were sufficient to meet tenant needs.
Report Facts
Current number of tenants without cognitive disorder: 15
Current number of tenants with cognitive disorder: 1
Total Population: 16
Number of falls for Tenant #2: 4
Staffing levels: 2
Staffing levels: 1
Inspection Report
Monitoring
Census: 33
Deficiencies: 3
Date: Mar 2, 2006
Visit Reason
An on-site monitoring evaluation was conducted at Madison Square Assisted Living to assess compliance with assisted living program regulations and tenant care standards.
Complaint Details
There were no substantiated complaints during this certification period.
Findings
The program was found to have regulatory insufficiencies related to inconsistent completion of functional, health, and cognitive evaluations after changes in tenant status, improper application of managed risk agreements, and failure to encourage tenant participation in decisions emphasizing choice, dignity, privacy, and independence.
Deficiencies (3)
The program does not evaluate tenants’ functional, health and cognitive abilities as needed with a change in condition.
The program does not apply the managed risk agreement correctly between the program and the tenant, when an action or behavior puts the tenant at risk and the tenant is unwilling to modify the risk.
The program does not encourage tenant participation in decisions that emphasize choice, dignity, privacy and independence.
Report Facts
Current number of tenants without cognitive disorder: 29
Current number of tenants with cognitive disorder: 4
Total Population: 33
Tenants attending community meeting: 18
Inspection Report
Complaint Investigation
Census: 14
Deficiencies: 1
Date: Nov 30, 2004
Visit Reason
A complaint investigation was conducted at Maple Grove Senior Living due to allegations regarding the presence of two dogs that leave feces and urine in the halls and dining areas, and that the dogs put their heads on tables while clients are eating.
Complaint Details
The complaint was related to two dogs leaving feces and urine in the halls and dining room, and putting their heads on tables during meals. The complaint was substantiated by private interviews with staff and tenants.
Findings
The investigation confirmed that the two dogs regularly defecated and urinated in the dining room and hallway, causing dissatisfaction among tenants despite their enjoyment of the dogs. The program was found to have failed to maintain a clean, safe, and sanitary building.
Deficiencies (1)
The program did not maintain a clean, safe and sanitary building as required by 321 IAC 25.40 (1).
Report Facts
Current number of tenants without cognitive disorder: 13
Current number of tenants with cognitive disorder: 1
Total Population: 14
Employees mentioned
| Name | Title | Context |
|---|---|---|
| David Armington | Administrator | Named in report header |
| Valerie Armington | Director | Named in report header |
| Hal L. Chase | RN BSN MPH | Monitor conducting the investigation |
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