Inspection Reports for Martina Place
5815 Winwood Dr, Johnston, IA 50131, IA, 50131
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Inspection Report
Renewal
Census: 52
Deficiencies: 0
Jun 19, 2025
Visit Reason
The visit was a recertification inspection 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.
Report Facts
Number of tenants without cognitive impairment: 41
Number of tenants with cognitive impairment: 11
Total census: 52
Inspection Report
Plan of Correction
Census: 49
Deficiencies: 1
Dec 21, 2022
Visit Reason
The visit was conducted as a recertification survey to determine compliance with certification rules for an Assisted Living Program.
Findings
No regulatory insufficiencies were cited during the complaint investigation. However, a deficiency was cited for failure to complete required cognitive evaluations annually or with significant change for 3 of 5 tenants reviewed.
Complaint Details
No regulatory insufficiencies were cited during the investigation of Complaint #105050-C.
Deficiencies (1)
| Description |
|---|
| Failure to ensure cognitive evaluations were completed annually or with significant change for 3 of 5 tenants reviewed (Tenants #1-#3). |
Report Facts
Number of tenants without cognitive impairment: 42
Number of tenants with cognitive impairment: 7
Total census: 49
Tenants reviewed for cognitive evaluations: 5
Tenants with deficient cognitive evaluations: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Executive Director | Signed the report and acknowledged the findings during the exit interview. | |
| Program Director | Conducted review and created checklist for nursing staff; acknowledged deficiencies. | |
| Nurse Coordinator | Completed cognitive evaluations on 2/20/2023 for tenants #2 and #3. |
Inspection Report
Renewal
Census: 60
Deficiencies: 0
Sep 10, 2019
Visit Reason
Recertification visit conducted to determine compliance with certification for an Assisted Living Program.
Findings
No regulatory insufficiencies were cited during the recertification visit for the Assisted Living Program.
Report Facts
Number of tenants without cognitive disorder: 55
Number of tenants with cognitive disorder: 5
Total census: 60
Inspection Report
Complaint Investigation
Census: 58
Deficiencies: 2
Jul 17, 2019
Visit Reason
Investigation of Complaint #83725-C regarding regulatory insufficiencies at Martina Place Assisted Living Program.
Findings
The program failed to follow policies and procedures for medication administration and documentation of narcotics for multiple tenants, and failed to provide appropriate treatment and services for a tenant. Specific issues included inaccurate narcotic counts, failure to administer prescribed medications consistently, and failure to apply a Lidocaine patch as ordered.
Complaint Details
Complaint #83725-C was investigated and regulatory insufficiencies were cited related to medication administration and tenant rights.
Deficiencies (2)
| Description |
|---|
| Program failed to follow policies and procedures for medication administration and documentation of narcotics for 2 of 3 tenants reviewed. |
| Program failed to provide appropriate treatment and services for 1 of 3 tenants reviewed, including failure to apply Lidocaine patch as ordered. |
Report Facts
Number of tenants without cognitive disorder: 54
Number of tenants with cognitive disorder: 4
Total population of program: 58
Medication dosage: 20
Number of tenants reviewed for medication administration: 3
Completion date for plan of correction: Aug 23, 2019
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Heather McClure | Executive Director | Signed the report and responsible for oversight |
| Unnamed Director of Nursing | Director of Nursing | Confirmed findings and educated staff on medication administration policy |
Inspection Report
Renewal
Census: 42
Deficiencies: 1
Sep 13, 2017
Visit Reason
The inspection was conducted as a recertification visit to determine compliance with certification requirements for an Assisted Living Program.
Findings
The program failed to provide the required eight hours of dementia-specific education and training within 30 days of employment for 2 out of 4 staff reviewed. This deficiency was cited during the recertification visit.
Deficiencies (1)
| Description |
|---|
| Program failed to provide 8 hours of dementia training within 30 days of employment for 2 out of 4 staff reviewed. |
Report Facts
Number of tenants without cognitive disorder: 35
Number of tenants with cognitive disorder: 7
Total population of program at time of on-site: 42
Staff reviewed for dementia training: 4
Hours of dementia training completed by Staff A: 0.5
Hours of dementia training completed by Staff B: 0.5
Inspection Report
Complaint Investigation
Census: 50
Deficiencies: 1
Sep 2, 2015
Visit Reason
The inspection was conducted following a report of a tenant fall and fractured ribs due to water on the floor from a leaking air conditioner, and also included a recertification monitoring evaluation. Additionally, a tenant was found to have eloped, triggering a complaint investigation.
Findings
No regulatory insufficiencies were found during the recertification visit. However, a regulatory insufficiency was cited for failure to notify the department within 24 hours when a tenant eloped from the program.
Complaint Details
The complaint investigation was triggered by a tenant fall and fractured ribs reported on 7-1-15 and a tenant elopement incident on 8-24-15. The allegation related to the fall was not substantiated. The elopement was confirmed and the program failed to notify the department timely.
Deficiencies (1)
| Description |
|---|
| Program failed to notify the Department when a tenant eloped, violating 481-67.4(4) Program Notification to Department. |
Report Facts
Census: 50
Tenants without cognitive disorder: 38
Tenants with cognitive disorder: 12
Incident report time: 5.15
Correction timeframe: 30
Plan of Correction submission timeframe: 10
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Cole Taggart | Manager | Named in relation to the tenant elopement incident and Plan of Correction |
| Rose Boccella | Program Coordinator | Author of the report and contact person for questions |
Inspection Report
Monitoring
Census: 53
Deficiencies: 4
Apr 23, 2013
Visit Reason
The visit was a Final Recertification Monitoring Evaluation conducted to review the Plan of Correction and ensure compliance with regulatory requirements for Martina Place Assisted Living.
Findings
The program had no regulatory insufficiencies during this certification period. The monitoring evaluation included observations on service plans and dementia-specific education for personnel, identifying some regulatory insufficiencies related to individualized service plans and dementia education documentation.
Deficiencies (4)
| Description |
|---|
| The service plan lacked mention of home health agency services and identification of what needs the physical therapist met for certain tenants. |
| The service plan shall be individualized and indicate the service providers if other than the program, including hospice care, home health care, occupational therapy, and physical therapy. |
| Staff files lacked documentation of dementia-specific education during 2012 and 2013 for several staff members. |
| All personnel employed by or contracting with the dementia-specific program must receive a minimum of eight hours of dementia-specific education and training within 30 days of employment or contract start date. |
Report Facts
Number of tenants without cognitive disorder: 47
Number of tenants with cognitive disorder: 6
Total Population of Program at time of on-site: 53
Tenants attending community meeting: 17
Hours of dementia training required for new employees: 8
Hours of dementia training required annually for direct care staff: 2
Inspection Report
Complaint Investigation
Census: 58
Deficiencies: 3
Apr 25, 2012
Visit Reason
The inspection was conducted as a complaint/incident investigation following a report that Tenant #1 had eloped from the program on 4-19-12.
Findings
The investigation found that Tenant #1, a 75-year-old with multiple diagnoses including dementia, had several episodes of confusion and elopement attempts. The program had established a managed risk agreement and used a wander-guard pendant, but the tenant eloped multiple times. Regulatory insufficiencies were identified related to evaluation and service plans not meeting required timelines and content.
Complaint Details
The complaint investigation was substantiated based on observations of Tenant #1’s elopement incidents on 4-5-12 and 4-19-12, confusion episodes, and inadequate service plan updates. The program was directed to increase monitoring and implement safety measures including locked doors and frequent checks.
Deficiencies (3)
| Description |
|---|
| A program shall evaluate each tenant’s functional, cognitive and health status within 30 days of occupancy and as needed with significant change, but not less than annually. |
| A service plan shall be developed for each tenant based on evaluations and updated at least annually and whenever changes are needed. |
| When a tenant needs personal care or health-related care, the service plan shall be updated within 30 days of the tenant’s occupancy and as needed with significant change, but not less than annually. |
Report Facts
Number of tenants without cognitive disorder: 54
Number of tenants with cognitive disorder: 4
Total census: 58
Tenant age: 75
Cognitive evaluation score: 28
Incident time: 16
Incident time: 18
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor for the complaint/incident investigation |
Inspection Report
Monitoring
Census: 56
Deficiencies: 0
May 11, 2011
Visit Reason
The visit was a Final Recertification Monitoring Evaluation conducted to review recertification documents and evaluate compliance with Iowa Administrative Code chapters governing assisted living programs.
Findings
No regulatory insufficiencies were found during the evaluation. The program did not receive any regulatory insufficiencies during the certification period, and the onsite monitoring evaluation found no deficiencies.
Report Facts
Current number of tenants without cognitive disorder: 53
Current number of tenants with cognitive disorder: 3
Total Population: 56
Tenant meeting attendance: 32
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Christine Brown | Administrator | Administrator of Martina Place Assisted Living |
| Hal L. Chase | RN BSN MPH | Monitor conducting the evaluation |
| Rose Boccella | Program Coordinator | Signed the report letter |
Inspection Report
Complaint Investigation
Census: 57
Deficiencies: 6
Nov 2, 2010
Visit Reason
A complaint investigation on-site visit was conducted at Martina Place Assisted Living on November 2, 2010, to investigate allegations related to tenant care and involuntary transfers.
Findings
The investigation found multiple regulatory insufficiencies including failure to complete required functional, cognitive, and health evaluations; failure to notify tenants or legal representatives about involuntary transfers; and failure to update service plans to reflect interventions related to falls, ambulation assistance, and hallucinations. Several tenants were found to have been transferred to skilled nursing without proper notification or documentation.
Complaint Details
Complaint Intake #: 31016-C. The complaint alleged that a tenant was involuntarily transferred from the assisted living program to a skilled nursing facility following hospitalization without proper notification or procedures being followed. The investigation reviewed six tenant files and found multiple regulatory insufficiencies related to tenant care, evaluations, transfers, and notification processes.
Deficiencies (6)
| Description |
|---|
| Occupancy agreement did not include the internal appeals process or required grievance and discharge notification procedures. |
| Failure to complete functional, cognitive, and health evaluations when there was a significant change in tenant status. |
| Failure to notify tenant or tenant's legal representative about involuntary transfer and failure to provide contact information for tenant advocate. |
| Failure to update tenant service plans to reflect interventions related to increased risk for falls, assistance with ambulation, and visual hallucinations. |
| Failure to treat tenants with consideration and autonomy regarding return to the program after transfer. |
| Failure to assess and document health status and monitor progress at least every 90 days or when changes occur. |
Report Facts
Current number of tenants without cognitive disorder: 53
Current number of tenants with cognitive disorder: 4
Total Population: 57
Number of tenant files reviewed: 6
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor for the complaint investigation |
| Lori Miner | RN BSN | Monitor for the complaint investigation |
| Rose Boccella | Program Coordinator, Adult Services Bureau | Signed cover letter transmitting the Final Complaint Investigation Report |
Inspection Report
Complaint Investigation
Census: 60
Deficiencies: 0
May 27, 2009
Visit Reason
The visit was conducted as a complaint investigation and recertification monitoring evaluation at Martina Place Assisted Living, triggered by complaint #23341-C regarding tenant odors and care concerns.
Findings
No regulatory insufficiencies were identified during the complaint investigation and recertification monitoring evaluation. Tenant and staff interviews indicated occasional body odors in some tenants but no malodors in the facility. The program was found to be in compliance with regulatory requirements.
Complaint Details
Complaint Allegation: Several tenants had body odor; Tenant #1 had a very strong urine odor; a strong urine odor was present on the second floor hallway. Monitoring observations found occasional body odor and incontinence in some tenants, but no regulatory insufficiencies were noted.
Report Facts
Tenants with dementia or cognitive disorder: 6
Tenants without cognitive disorder: 54
Total population: 60
Tenant meeting attendance: 23
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor conducting the complaint investigation and monitoring evaluation |
Inspection Report
Monitoring
Census: 61
Deficiencies: 0
May 11, 2005
Visit Reason
An on-site monitoring evaluation was conducted at Martina Place Assisted Living on May 11, 2005, as part of the re-certification monitoring evaluation process.
Findings
The evaluation found no regulatory insufficiencies during the on-site visit. Tenant and family satisfaction was positive, with tenants reporting attentive staff, respect for privacy, and good quality food. There were no substantiated complaints during the certification period.
Complaint Details
There were no substantiated complaints during this certification period.
Report Facts
Current number of tenants in Dementia Specific Program: 11
Current number of tenants without cognitive disorder: 50
Total Population: 61
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Matt Garcia | Administrator | Administrator of Martina Place Assisted Living |
| Hal L. Chase | RN BSN MPH | Monitor conducting the evaluation |
| Ms. Brown | Leadership staff mentioned in tenant satisfaction | |
| Ms. Ballard | Program nurse | Program nurse mentioned in tenant satisfaction |
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