Inspection Reports for Mill Pond
1201 SE Mill Pond Ct, Ankeny, IA 50021, United States, IA, 50021
Back to Facility Profile
Inspection Report
Complaint Investigation
Deficiencies: 0
Nov 12, 2025
Visit Reason
A complaint investigation for complaint #1778464-C and facility reported incident #2666895-I was conducted from November 12, 2025 to November 13, 2025.
Findings
The facility was found to be in substantial compliance.
Complaint Details
Complaint #1778464-C and facility reported incident #2666895-I were investigated and found to be in substantial compliance.
Inspection Report
Complaint Investigation
Deficiencies: 0
Oct 23, 2025
Visit Reason
A complaint investigation for complaint #2640934-C was conducted from 10/22/2025 to 10/23/2025.
Findings
The facility was found to be in substantial compliance.
Complaint Details
Complaint #2640934-C was investigated and the facility was found to be in substantial compliance.
Inspection Report
Plan of Correction
Deficiencies: 0
Apr 2, 2025
Visit Reason
The document is a Plan of Correction submitted following a survey, indicating acceptance of the facility's credible allegation of substantial compliance.
Findings
The facility will be certified in compliance effective March 26, 2025, based on acceptance of the Plan of Correction and credible allegation of substantial compliance.
Inspection Report
Annual Inspection
Census: 59
Deficiencies: 2
Mar 6, 2025
Visit Reason
The inspection was conducted as the facility's annual recertification survey from March 3, 2025 to March 6, 2025.
Findings
The facility failed to meet food safety requirements by not obtaining final cooking temperatures on alternative menu items and failed to ensure proper documentation of insulin administration for a resident. Deficiencies were noted in food safety compliance and resident medication records.
Deficiencies (2)
| Description |
|---|
| Facility failed to obtain final cooking food temperatures on alternative menu items prepared in the satellite kitchen. |
| Facility failed to ensure documentation of insulin administration for one resident reviewed for medication regimen. |
Report Facts
Census: 59
Medication administration documentation errors: 5
Inspection Report
Complaint Investigation
Deficiencies: 0
Nov 13, 2024
Visit Reason
A complaint investigation was conducted for Complaint #124181-C and Facility Reported Incident #123158-I from November 13, 2024 to November 14, 2024.
Findings
The facility was found to be in substantial compliance.
Complaint Details
Investigation related to Complaint #124181-C and Facility Reported Incident #123158-I; facility found in substantial compliance.
Inspection Report
Plan of Correction
Deficiencies: 0
May 1, 2024
Visit Reason
The document serves as a plan of correction following a prior inspection, with certification of compliance effective May 1, 2024.
Findings
The facility was found to be in substantial compliance based on the credible allegation and plan of correction accepted by the surveyors.
Inspection Report
Annual Inspection
Census: 57
Deficiencies: 5
Apr 15, 2024
Visit Reason
The inspection was conducted as part of the facility's Annual Recertification Survey and investigation of complaints and facility reported incidents.
Findings
The facility was found deficient in multiple areas including failure to treat residents with dignity and respect, failure to report and investigate allegations of abuse timely, failure to provide adequate ADL care including oral and incontinent care, and failure to notify the provider of changes in pressure ulcer condition.
Complaint Details
Complaint #118336-C was substantiated. Facility reported incident #118531-I was substantiated.
Severity Breakdown
SS=D: 5
Deficiencies (5)
| Description | Severity |
|---|---|
| Failure to ensure staff treated residents with dignity and respect for 1 of 1 residents reviewed for dignity (Resident #45). | SS=D |
| Failure to report an allegation of abuse in a timely manner to the State Agency for 1 of 2 residents reviewed for abuse (Resident #45). | SS=D |
| Failure to initiate an abuse investigation and separate residents from alleged perpetrators in a timely manner for 1 of 2 residents reviewed for abuse (Resident #45). | SS=D |
| Failure to provide oral care after meals as directed and incontinent care for 1 of 3 residents reviewed for Activities of Daily Living (Resident #51). | SS=D |
| Failure to notify the provider after a change in condition in a pressure ulcer for 1 of 3 residents reviewed for pressure ulcers (Resident #37). | SS=D |
Report Facts
Census: 57
Deficiencies cited: 5
BIMS score: 15
BIMS score: 99
Pressure ulcer measurement: 0.3
Pressure ulcer measurement: 0.8
Pressure ulcer measurement: 0.5
Pressure ulcer measurement: 3.2
Pressure ulcer measurement: 2.8
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff J | Certified Nursing Assistant | Named in resident mistreatment and abuse allegation involving Resident #45 |
| Staff I | Certified Nursing Assistant | Named in resident mistreatment and abuse allegation involving Resident #45 |
| Staff K | Certified Nursing Assistant | Named in resident mistreatment and abuse allegation involving Resident #45 |
| Staff B | Licensed Practical Nurse | Named in verbal altercation and abuse allegation involving Resident #45 |
| Staff H | Certified Nursing Assistant | Received resident complaint about mistreatment for Resident #45 |
| Staff F | Certified Nursing Assistant | Provided incontinent care to Resident #51 without oral care |
| Staff E | Certified Nursing Assistant | Provided incontinent care to Resident #51 without oral care |
| Staff D | Certified Nursing Assistant | Provided care to Resident #51 but failed to provide oral care after meals |
| Staff G | Licensed Practical Nurse | Applied ointment to Resident #51's buttocks |
| Staff M | Certified Nursing Assistant | Provided incontinence care to Resident #51 without oral care |
| Staff L | Certified Nursing Assistant | Provided incontinence care to Resident #51 without oral care |
| Staff C | Clinical Administrator | Oversaw investigation and reporting of abuse and pressure ulcer care |
| Staff A | Hospice Nurse | Measured Resident #37's pressure ulcer on 4/10/24 |
Inspection Report
Complaint Investigation
Deficiencies: 0
Dec 12, 2023
Visit Reason
A complaint investigation for complaint #113365-C was conducted on December 12, 2023.
Findings
The facility was found to be in substantial compliance.
Complaint Details
Complaint #113365-C was investigated and the facility was found to be in substantial compliance.
Inspection Report
Plan of Correction
Deficiencies: 0
Mar 20, 2023
Visit Reason
The document is a plan of correction submitted following a survey to address deficiencies and certify compliance.
Findings
The facility was found to be in compliance based on acceptance of the credible allegation of compliance and plan of correction effective March 20, 2023.
Inspection Report
Annual Inspection
Census: 52
Deficiencies: 2
Feb 23, 2023
Visit Reason
The inspection was conducted as part of the facility's Annual Recertification survey and investigation of complaint #109836-C from February 20, 2023 to February 23, 2023.
Findings
The facility was found deficient in maintaining acceptable nutritional status for one resident who experienced significant weight loss without proper physician notification. Additionally, the facility failed to answer call lights promptly for three residents, with wait times up to 34 minutes, despite administrative expectations for response within 15 minutes.
Complaint Details
The inspection included an investigation of complaint #109836-C.
Severity Breakdown
SS=D: 2
Deficiencies (2)
| Description | Severity |
|---|---|
| Failure to maintain acceptable parameters of nutritional status for Resident #2, including lack of timely weight documentation and physician notification of significant weight loss. | SS=D |
| Failure to provide sufficient nursing staff response to call lights within 15 minutes for 3 residents (Residents #255, #254, and #10). | SS=D |
Report Facts
Resident weight loss: 15
Facility census: 52
Call light wait time: 34
Call light wait time: 30
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Registered Nurse (RN) | Interviewed regarding Resident #2's weight monitoring and documentation. |
| Staff B | Certified Nursing Aid (CNA) | Interviewed regarding weight documentation and reweighing Resident #2. |
| Staff C | Licensed Practical Nurse (LPN) | Interviewed regarding weight reporting and physician notification procedures. |
| Director of Nursing | Director of Nursing (DON) | Interviewed regarding staff responsibilities for weight monitoring and physician notification. |
| Administrator | Administrator | Interviewed regarding expectations for call light response times. |
Inspection Report
Complaint Investigation
Deficiencies: 0
Nov 15, 2022
Visit Reason
The complaint investigation was conducted for complaints #106701-C and facility reported incidents #106465-I and #106461-I from November 14 to November 15, 2022.
Findings
Complaint #106791 was substantiated without a deficiency. No other deficiencies or findings are explicitly stated in the report.
Complaint Details
Complaint #106791 was substantiated without a deficiency.
Inspection Report
Renewal
Census: 53
Deficiencies: 1
Sep 28, 2021
Visit Reason
The inspection was conducted as part of a recertification survey and investigation of incident #92307 completed September 20-28, 2021.
Findings
The facility failed to provide a safe method of transfer for one resident, resulting in fractures due to improper use of a mechanical lift. The incident was substantiated, and the facility implemented staff retraining and corrective actions to ensure compliance with care plans and safety protocols.
Deficiencies (1)
| Description |
|---|
| Facility failed to provide a safe method of transfer for one resident, resulting in fractures of the left shoulder and right hip when staff failed to use a full mechanical lift. |
Report Facts
Total residents: 53
Incident investigation dates: 8
Inspection Report
Abbreviated Survey
Census: 45
Deficiencies: 0
Jun 10, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspection and Appeals on 6/10/20 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 Facts
Total residents: 45
Inspection Report
Annual Inspection
Census: 54
Deficiencies: 1
Jan 15, 2020
Visit Reason
The inspection was conducted as part of the facility's annual health survey to assess compliance with federal regulations, specifically regarding therapeutic diet prescriptions.
Findings
The facility failed to provide the correct pureed diet to one of two residents on a pureed diet, resulting in a resident receiving ground steak instead of pureed steak. The facility implemented corrective actions including staff coaching, education, and ongoing audits to ensure compliance with therapeutic diet orders.
Deficiencies (1)
| Description |
|---|
| Failed to provide the correct diet for one of two residents on a pureed diet, serving ground steak instead of pureed steak. |
Report Facts
Facility census: 54
Date of compliance: Jan 24, 2020
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Cook | Named in the finding for serving incorrect diet and received coaching and education |
| Staff B | Certified Nurse Aide | Reported on diet menu slips and diet verification process |
| Staff C | Certified Nurse Aide | Reported on pocket care plan and diet verification |
| Dietary Manager | Reported on diet preferences and staff training | |
| Medical Director | Clarified diet order for Resident #24 |
Loading inspection reports...
