Inspection Reports for Perry Lutheran Homes Spring Valley Campus
501 12th Street, Perry, IA, 502201913
Back to Facility ProfileInspection Report Summary
The most recent inspection on December 24, 2024, found no deficiencies during the recertification visit for the Assisted Living Program. Earlier inspections showed a mixed record, with some reports citing deficiencies primarily related to tenant evaluations, service plans, and staff training, especially in 2019 and prior years. Complaint investigations generally found most allegations unsubstantiated, though some substantiated issues involved care planning and food service. Enforcement actions included a $500 civil penalty in 2009 for late accident reporting, but no fines or license actions were noted in recent reports. The facility’s inspection history shows improvement over time, with the last two inspections free of deficiencies.
Deficiencies (last 12 years)
Deficiencies (over 12 years)
2.1 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
52% better than Iowa average
Iowa average: 4.4 deficiencies/yearDeficiencies per year
8
6
4
2
0
Census
Latest occupancy rate
31 residents
Based on a December 2024 inspection.
This facility has shown a steady increase in demand based on occupancy rates.
Census over time
Inspection Report
Renewal
Census: 31
Deficiencies: 0
Date: Dec 24, 2024
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.
Inspection Report
Renewal
Census: 34
Deficiencies: 0
Date: Nov 23, 2021
Visit Reason
A recertification visit and onsite infection control survey were conducted to determine compliance with certification for an Assisted Living Program.
Findings
No regulatory insufficiencies were cited during the recertification and infection control survey.
Inspection Report
Renewal
Census: 38
Deficiencies: 5
Date: Oct 24, 2019
Visit Reason
The inspection was a recertification visit conducted to determine compliance with certification for an Assisted Living Program.
Findings
The inspection found multiple regulatory insufficiencies related to staffing, training, tenant evaluations, and service plans. Specifically, the program failed to ensure nurse delegation documentation, dependent adult abuse training, timely tenant evaluations, and completion of preliminary service plans prior to occupancy.
Deficiencies (5)
Program's registered nurse failed to ensure 2 of 2 direct care staff reviewed were sufficiently trained within 60 days of hire.
Program failed to ensure staff completed training related to identification and reporting of dependent adult abuse for 3 of 4 staff reviewed employed longer than 6 months.
Program failed to ensure evaluations were completed prior to occupancy for 8 of 8 tenants admitted from another program.
Program failed to ensure evaluations were completed within 30 days of occupancy for 8 of 8 tenants reviewed.
Program failed to ensure preliminary service plans were completed prior to occupancy for 8 of 8 tenants admitted from another program.
Report Facts
Number of tenants without cognitive disorder: 38
Number of tenants with cognitive disorder: 0
Total population of program at time of on-site: 38
Staff reviewed for dependent adult abuse training: 4
Tenants admitted from another program: 8
Tenants reviewed for evaluation completion: 8
Inspection Report
Renewal
Census: 38
Deficiencies: 0
Date: Sep 19, 2017
Visit Reason
The inspection was conducted as a recertification to determine compliance with certification for an Assisted Living Program.
Findings
No regulatory insufficiencies were cited during the recertification inspection for the Assisted Living Program.
Report Facts
Number of tenants without cognitive disorder: 24
Number of tenants with cognitive disorder: 10
Total Population of Program: 34
Number of tenants without cognitive disorder: 0
Number of tenants with cognitive disorder: 4
Total Population of Program: 4
TOTAL census of Assisted Living Program: 38
Inspection Report
Complaint Investigation
Census: 37
Deficiencies: 6
Date: Nov 17, 2015
Visit Reason
The inspection was conducted as a Final Complaint Investigation & Recertification Monitoring Evaluation Report following a complaint alleging the kitchen was unclean. The visit also included evaluation of tenant, service plans, food service, and structural requirements.
Complaint Details
Complaint #54790-C alleged the kitchen was unclean. The complaint was unsubstantiated as the kitchen was generally clean and staff were observed cleaning the kitchen following breakfast during the onsite visit.
Findings
The complaint alleging the kitchen was unclean was found to be unsubstantiated. However, regulatory insufficiencies were cited related to evaluation of tenants, service plans, food service, and structural requirements.
Deficiencies (6)
Evaluations were not completed prior to admission, and a scored, objective tool or Global Deterioration Scale (GDS) was not used for cognitive evaluation.
Evaluations were not completed within 30 days of admission and were not completed with a change of condition.
Service plans were not completed annually, were not based on evaluations, and did not meet specific tenant needs.
Service plans were not signed prior to admission and were not signed by the tenant.
Staff responsible for food service did not have orientation on sanitation and safe food handling or annual in-service training on food protection.
An apartment in the dementia unit occupied by a tenant was not a private dwelling space.
Report Facts
Number of tenants without cognitive disorder: 31
Number of tenants with cognitive disorder: 1
Total Population of General Population Program: 32
Number of tenants without cognitive disorder: 3
Number of tenants with cognitive disorder: 2
Total Population of Dementia-Specific Program: 5
TOTAL census of Assisted Living Program: 37
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rose Boccella | Program Coordinator, Adult Services Bureau | Author of complaint investigation and plan of correction acceptance letters |
Inspection Report
Complaint Investigation
Census: 40
Deficiencies: 0
Date: Jul 29, 2015
Visit Reason
The inspection was conducted as a complaint/incident investigation following a reported fall with major injury at Spring Valley Assisted Living in Perry, IA.
Complaint Details
The complaint involved a fall with major injury. The incident was substantiated as reported, but no regulatory insufficiencies were found during the investigation.
Findings
The investigation found that the incident was appropriately reported and documented, with no regulatory insufficiencies identified. Evaluations, service plans, and nurse reviews were completed appropriately, and the tenant received prompt care.
Report Facts
Number of tenants without cognitive disorder in General Population Program: 32
Number of tenants with cognitive disorder in General Population Program: 2
Total Population of General Population Program: 34
Number of tenants without cognitive disorder in Dementia-Specific Program: 3
Number of tenants with cognitive disorder in Dementia-Specific Program: 3
Total Population of Dementia-Specific Program: 6
Total census of Assisted Living Program: 40
Inspection Report
Complaint Investigation
Census: 40
Deficiencies: 0
Date: Jan 7, 2014
Visit Reason
The inspection was conducted as a complaint/incident investigation following a report that Tenant #1 was missing jewelry, a credit card, and money.
Complaint Details
The complaint involved missing personal items (jewelry, credit card, and money) reported by Tenant #1. The program reported the incident, conducted an internal investigation, and notified the local police department. Staff and the administrator provided statements, and no regulatory insufficiencies were identified.
Findings
The investigation found no regulatory insufficiencies. Tenant #1 reported missing items, and an internal investigation was conducted, including interviews with staff and the administrator. The local police department was notified, and the case was ongoing at the time of the report.
Report Facts
Number of tenants without cognitive disorder (General Population Program): 35
Number of tenants with cognitive disorder (General Population Program): 1
Total Population of General Population Program: 36
Number of tenants without cognitive disorder (Dementia-Specific Program): 3
Number of tenants with cognitive disorder (Dementia-Specific Program): 1
Total Population of Dementia-Specific Program: 4
TOTAL census of Assisted Living Program: 40
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Lori Miner | RN BSN | Monitor conducting the complaint/incident investigation |
Inspection Report
Monitoring
Census: 42
Deficiencies: 4
Date: Aug 1, 2013
Visit Reason
The visit was a Final Recertification Monitoring Evaluation conducted to review the Plan of Correction in response to previously identified regulatory insufficiencies and to evaluate compliance with Iowa Administrative Code chapters 481-67 and 481-69.
Findings
The program received regulatory insufficiencies in the areas of Evaluation, Service Plan, Nurse Review, and Criteria for Admission and Retention. Tenant files showed issues with evaluations, service plans not reflecting changes in condition, and nurse reviews not completed timely. Tenant #1 and Tenant #2 exhibited combative behaviors and incontinence issues, with staff reporting challenges in care provision. The program was found to have deficiencies related to evaluation and care planning.
Deficiencies (4)
Failure to evaluate each tenant’s functional, cognitive and health status within 30 days of occupancy and as needed thereafter.
Service plans were not developed or updated based on evaluations and did not reflect changes in tenant conditions or needs.
Nurse reviews were not completed timely or reflective of tenant health and behavioral status changes.
Admission and retention criteria were not met for Tenant #1 and Tenant #2 due to behavioral and care needs.
Report Facts
Total census: 42
General Population Program tenants: 38
Dementia-Specific Program tenants: 4
Tenant files reviewed: 5
Community meeting attendance: 35
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor conducting the evaluation |
Inspection Report
Complaint Investigation
Census: 23
Deficiencies: 0
Date: Jan 7, 2013
Visit Reason
The inspection was conducted as a complaint/incident investigation following allegations related to staff refusal to assist tenants with toileting and admitting tenants not meeting assisted living guidelines.
Complaint Details
The complaint alleged a staff member refused to assist tenants with toileting, leaving them in soiled undergarments and being verbally abusive, and that the program admitted tenants not meeting assisted living guidelines. The investigation found no substantiated regulatory insufficiencies.
Findings
No regulatory insufficiencies were identified during the investigation. Staff files showed required training and background checks were completed. Interviews with staff and tenants revealed no ongoing complaints or concerns about care or staff behavior.
Report Facts
General Population Program tenants without cognitive disorder: 20
General Population Program tenants with cognitive disorder: 0
General Population Program total population: 20
Dementia-Specific Program tenants without cognitive disorder: 1
Dementia-Specific Program tenants with cognitive disorder: 2
Dementia-Specific Program total population: 3
Total census of Assisted Living Program: 23
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor conducting the complaint/incident investigation |
| Derrick Johnson | Administrator | Administrator of Spring Valley Senior Assisted Living named in the report |
Inspection Report
Complaint Investigation
Census: 23
Deficiencies: 7
Date: Oct 25, 2012
Visit Reason
The inspection was conducted as a complaint/incident investigation at Spring Valley Senior Assisted Living in Perry, IA, triggered by allegations including regulatory insufficiencies in Nurse Review, Evaluation, Service Plans, and Food Service.
Complaint Details
The complaint investigation was substantiated with findings of regulatory insufficiencies in nurse review, evaluation, service plans, and food service. Allegations included tenants being charged for a higher level of care than required, lack of nurse on call, inappropriate tenant placement, inadequate diets, and facility cleanliness. Most allegations were found to have no regulatory insufficiencies except those related to care planning and food service.
Findings
The investigation found multiple regulatory insufficiencies related to nurse reviews, evaluations, service plans, and food service. Specific issues included failure to complete nurse reviews and evaluations, incomplete or outdated service plans, inadequate staff training on modified diets, and lack of licensed dietitian oversight. No deficiencies were noted in occupancy agreements, staffing availability, or structural cleanliness.
Deficiencies (7)
Failure to complete nurse review when Tenant #1 displayed changes in cognitive and functional capabilities.
Failure to complete cognitive, health, and functional evaluations for Tenant #1 and Tenant #2 coinciding with service plan changes.
Failure to update service plans with interventions to meet specific needs of tenants.
Failure to maintain a service plan with specific interventions based on evaluations to meet tenant needs.
Lack of staff training on modified diets and absence of approved menus signed by a dietitian.
Failure to have a licensed dietitian responsible for therapeutic menu planning and review.
Failure to ensure programs engaged in food preparation and service meet state and local health laws and are licensed.
Report Facts
Total census: 23
Number of tenants without cognitive disorder: 20
Number of tenants with cognitive disorder: 3
Civil penalty amount: 1000
Reduced civil penalty amount: 650
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Joyce Kix | RN | Monitor for the complaint/incident investigation |
| Rose Boccella | Program Coordinator | Contact person for questions regarding the letter and report |
| Ann Martin | Bureau Chief, Adult Services Bureau | Signed the demand letter |
Inspection Report
Monitoring
Census: 31
Deficiencies: 2
Date: Sep 20, 2011
Visit Reason
An on-site monitoring evaluation was conducted at Spring Valley Assisted Living on September 20, 2011, to review the facility's compliance with regulatory requirements and the Plan of Correction from a prior recertification monitoring evaluation.
Findings
The program did not receive any regulatory insufficiencies during this certification period. Observations included individualized service plans and nurse reviews, with some noted regulatory insufficiencies related to documentation of tenant needs and nurse review requirements.
Deficiencies (2)
The service plan shall be individualized and indicate the tenant's identified needs and preferences for assistance.
If a tenant does not receive personal or health-related care but an observed significant change occurs, a nurse review shall be conducted. The program must ensure prescription medication orders are current and administered consistent with orders.
Report Facts
Number of tenants without cognitive disorder: 27
Number of tenants with cognitive disorder: 4
Total census of Assisted Living Program: 31
Number of tenants attending satisfaction meeting: 8
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Derrick Johnson | Manager | Manager of Spring Valley Assisted Living named in report |
| Lori Miner | RN BSN | Monitor conducting the evaluation |
| Rose Boccella | Program Coordinator | Signed letter regarding certification |
Inspection Report
Monitoring
Census: 36
Deficiencies: 1
Date: Nov 30, 2009
Visit Reason
An on-site monitoring evaluation was conducted at Spring Valley Retirement Community to assess compliance with assisted living program regulations and to evaluate the Plan of Correction submitted for regulatory insufficiencies.
Findings
The report found a regulatory insufficiency related to failure to notify the Department of Inspections and Appeals within 24 hours of an accident causing substantial injury. The Plan of Correction was accepted and a $500 civil penalty was assessed. No substantiated regulatory insufficiencies were found during the recertification period.
Deficiencies (1)
The program did not notify the Department of Inspections and Appeals within twenty-four hours of an accident causing substantial injury or death.
Report Facts
Civil penalty amount: 500
Tenant census: 36
Tenants without cognitive disorder: 32
Tenants with cognitive disorder: 4
Tenant meeting attendance: 24
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN BSN MPH | Monitor conducting the on-site monitoring evaluation |
| Ann Martin | Bureau Chief, Adult Services Bureau | Signed demand letter regarding civil penalty and Plan of Correction |
Inspection Report
Monitoring
Census: 31
Deficiencies: 0
Date: Oct 16, 2007
Visit Reason
An on-site monitoring evaluation was conducted at Spring Valley Assisted Living to assess compliance with assisted living program regulations as part of the initial certification monitoring process.
Complaint Details
There were no substantiated complaints during this certification period.
Findings
The evaluation found no regulatory insufficiencies during the visit. Tenant satisfaction was generally positive, with tenants reporting feeling safe, well cared for, and satisfied with services and activities.
Report Facts
Tenants without cognitive disorder: 31
Tenants with cognitive disorder: 0
Tenants attending community meeting: 19
Inspection Report
Monitoring
Census: 35
Deficiencies: 0
Date: Sep 14, 2005
Visit Reason
An on-site monitoring evaluation was conducted at Spring Valley Retirement Community to assess compliance with assisted living program regulations as part of a re-certification process.
Complaint Details
There were no substantiated complaints during this certification period.
Findings
There were no regulatory insufficiencies noted during this on-site evaluation. Tenants and family members reported satisfaction with the program, feeling safe and well cared for, with positive comments about staff and living conditions.
Report Facts
Current number of tenants without cognitive disorder: 34
Current number of tenants with cognitive disorder: 1
Total Population: 35
Tenant meeting attendance: 27
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Hal L. Chase | RN | Monitor conducting the on-site evaluation |
| Connie S. Clark | Manager | Facility manager named in report header |
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