Inspection Reports for Pioneer Valley Living and Rehab
400 Sergeant Square Drive, IA, 51054
Back to Facility ProfileDeficiencies per Year
16
12
8
4
0
Severe
Moderate
Unclassified
Census Over Time
Inspection Report
Complaint Investigation
Deficiencies: 0
Oct 21, 2025
Visit Reason
A complaint investigation was conducted for complaints #2567740, #2567765 and facility reported incidents #2567723, #2633974 from October 21, 2025 to October 22, 2025.
Findings
The facility was found to be in substantial compliance.
Complaint Details
Investigation involved complaints #2567740, #2567765 and facility reported incidents #2567723, #2633974. The facility was found to be in substantial compliance.
Inspection Report
Re-Inspection
Deficiencies: 0
May 22, 2025
Visit Reason
A second revisit of the survey ending February 6, 2025 and investigation of complaints #128452-C and #128446-C was conducted from May 19, 2025 to May 22, 2025.
Findings
All deficiencies were corrected and the facility is in substantial compliance effective May 22, 2025. Complaints #128452-C and #128446-C did not result in a deficiency.
Complaint Details
Complaints #128452-C and #128446-C were investigated and did not result in any deficiencies.
Inspection Report
Complaint Investigation
Census: 45
Deficiencies: 9
Apr 3, 2025
Visit Reason
The onsite revisit of the survey ending February 6, 2025, and investigation of complaints #126963-C and #126598-C conducted from March 31, 2025 to April 4, 2025. Complaints #126963-C and #126598-C were substantiated.
Findings
The facility failed to provide dignity to 1 of 5 residents reviewed, failed to complete a Significant Change Minimum Data Set within 14 days for 1 resident, failed to submit comprehensive Minimum Data Set assessments timely for 2 of 15 residents, failed to update and provide resident-specific care plans for 3 of 13 residents, failed to follow physician orders for blood pressure and weights for 2 residents, failed to provide adequate care and services for activities of daily living, failed to adequately monitor skin issues and intervene with ordered treatments for 2 of 3 residents, failed to implement a comprehensive Quality Assessment and Performance Improvement (QAPI) program, and failed to ensure compliance with infection control standards.
Complaint Details
Complaints #126963-C and #126598-C were substantiated based on observations, interviews, and record reviews.
Severity Breakdown
Severity Level F: 3
Deficiencies (9)
| Description | Severity |
|---|---|
| Facility failed to provide dignity to resident waiting to return to room in soiled garments. | — |
| Failed to complete Significant Change Minimum Data Set within 14 days for resident admitted to hospice. | — |
| Failed to submit comprehensive Minimum Data Set assessments timely for residents #3 and #10. | — |
| Failed to update and provide resident-specific care plans for residents #4, #7, and #10. | — |
| Failed to follow physician orders for blood pressure parameters and daily weights for residents #2 and #3. | — |
| Failed to provide adequate care and services in activities of daily living including hygiene, mobility, elimination, and dining for dependent residents. | — |
| Failed to adequately monitor skin issues and intervene with ordered treatments for residents #4 and #10. | — |
| Failed to implement an effective Quality Assessment and Performance Improvement (QAPI) program. | Severity Level F |
| Failed to ensure compliance with infection prevention and control standards. | Severity Level F |
Report Facts
Census: 45
Residents reviewed: 15
Residents reviewed for care plans: 13
Residents reviewed for blood pressure and weights: 6
Residents reviewed for skin issues: 3
Residents reviewed for psychotropic medication use: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff J | Director of Nursing | Named in relation to failure to complete MDS documents and care plan updates |
| Staff GG | Certified Nursing Assistant / Certified Medication Aide | Named in relation to resident care and repositioning |
| Staff EE | Certified Nursing Assistant | Named in relation to resident care and repositioning |
| Staff U | Director of Nursing | Named in relation to failure to respond to MDS completion |
| Staff P | Licensed Practical Nurse | Named in relation to restorative program completion |
| Staff B | Director of Rehabilitation | Named in relation to restorative program training |
| Staff Q | Licensed Practical Nurse | Named in relation to resident wound care |
| Staff DD | Registered Nurse | Named in relation to wound care and dressing observations |
| Staff BB | Certified Nurse Aide | Named in relation to resident care and transfers |
Inspection Report
Complaint Investigation
Census: 47
Deficiencies: 12
Feb 6, 2025
Visit Reason
The inspection was conducted as a complaint investigation triggered by multiple substantiated complaints regarding resident care and facility practices.
Findings
The facility was found to have multiple deficiencies including failure to ensure resident rights, inadequate care planning and assessments, improper handling of residents leading to injuries, failure to complete required documentation, and medication management issues. Several residents experienced neglect and harm, including bruising and pressure ulcers, and the facility failed to provide adequate supervision and care.
Complaint Details
The investigation was based on multiple complaints (#123403-C, #123441-C, #125411-A, #125903-C, #126044-C, #126047-C) all substantiated. The complaints involved resident abuse, neglect, and failure to provide adequate care and supervision.
Deficiencies (12)
| Description |
|---|
| Failure to treat residents with dignity and respect, including inadequate care for residents with bruises and injuries. |
| Failure to complete and submit comprehensive Minimum Data Set (MDS) assessments timely and accurately. |
| Failure to develop and implement comprehensive care plans for residents. |
| Failure to ensure residents' rights related to bed hold policies and transfer notices. |
| Failure to provide adequate supervision and prevent accidents, including falls and pressure ulcers. |
| Failure to properly document and follow up on neurological assessments after resident falls. |
| Failure to ensure proper medication management, including monitoring of insulin and psychotropic medications. |
| Failure to maintain accurate and complete medical records and resident-identifiable information. |
| Failure to implement an effective Quality Assurance and Performance Improvement (QAPI) program. |
| Failure to establish and maintain an infection prevention and control program. |
| Failure to ensure safe use of mechanical lifts and transfers, resulting in resident injuries. |
| Failure to provide adequate skin care and prevent pressure ulcers. |
Report Facts
Resident census: 47
Number of substantiated complaints: 6
Residents reviewed for MDS assessments: 37
Residents reviewed for medication management: 6
Residents reviewed for care plans: 22
Residents reviewed for neurological assessments: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Stephanie Amble | Administrator | Signed the initial statement of deficiencies and plan of correction |
| Staff E | Certified Nursing Assistant (CNA) | Named in resident abuse and rough handling findings |
| Staff F | Certified Nursing Assistant (CNA) | Named in resident abuse and rough handling findings |
| Staff J | Director of Nursing (DON) | Interviewed regarding resident complaints and care plan deficiencies |
| Staff U | Licensed Practical Nurse (LPN) | Involved in resident care and medication administration findings |
| Staff C | Licensed Practical Nurse (LPN) | Named in resident transfer and rough handling findings |
| Staff D | Certified Nursing Assistant (CNA) | Named in resident transfer and rough handling findings |
| Staff G | Registered Nurse (RN) | Provided written statement regarding resident injury |
| Staff Q | Licensed Practical Nurse (LPN) | Involved in medication administration and resident monitoring |
| Staff V | Certified Medication Aide (CMA) | Involved in resident care and medication administration |
| Staff K | Certified Nursing Assistant (CNA) | Involved in resident care and transfer |
| Staff T | Certified Nursing Assistant (CNA) | Involved in resident care and transfer |
| Staff N | Certified Nursing Assistant (CNA) | Involved in resident care and transfer |
| Staff J | Physical Therapist Assistant (PTA) | Conducted resident therapy evaluations |
| Staff O | Licensed Practical Nurse (LPN) | Involved in medication administration and resident monitoring |
| Staff AA | Certified Nursing Assistant (CNA) | Involved in resident care and transfer |
| Staff F | Licensed Practical Nurse (LPN) | Involved in neurological assessments and resident care |
| Staff S | Certified Nursing Assistant (CNA) | Involved in resident care and transfer |
| Staff R | Registered Nurse (RN) | Provided written statement regarding resident injury |
| Staff X | Hospice Nurse | Involved in medication administration and resident care |
| Staff J | Director of Nursing (DON) | Interviewed regarding resident care and medication management |
| Staff Q | Licensed Practical Nurse (LPN) | Involved in medication administration and resident monitoring |
Inspection Report
Plan of Correction
Deficiencies: 0
Apr 3, 2024
Visit Reason
The document is a plan of correction submitted following a credible allegation of substantial compliance with 42 CFR Part 483 for the Pioneer Valley Living and Rehab Nursing Home.
Findings
The facility is in substantial compliance with federal requirements based on acceptance of the credible allegation and plan of correction. Certification in compliance is effective March 15, 2024.
Report Facts
Certification effective date: Mar 15, 2024
Inspection Report
Annual Inspection
Census: 47
Deficiencies: 15
Feb 15, 2024
Visit Reason
The inspection was conducted as the facility's annual recertification survey and investigation of complaint #116961-C.
Findings
The facility failed to complete comprehensive, significant change, quarterly, and Minimum Data Set (MDS) assessments timely as required by CMS guidelines. The facility also failed to implement care plans properly, administer medications as ordered, provide adequate nutrition and hydration, maintain sufficient dietary staffing, ensure food safety and infection control practices, properly review facility assessments, and maintain an effective QAPI and ethics program.
Complaint Details
Complaint #116961-C was substantiated.
Deficiencies (15)
| Description |
|---|
| Failed to complete comprehensive MDS assessments timely for 4 residents. |
| Failed to complete significant change MDS assessments timely for 2 residents on hospice. |
| Failed to complete quarterly MDS assessments timely for 4 residents. |
| Failed to transmit MDS resident assessment information timely for 4 residents. |
| Failed to implement offloading procedures to decrease pressure for 1 resident as directed by care plan. |
| Failed to ensure staff administered medications according to physician's orders for 2 residents. |
| Failed to provide accurate and timely assessment and interventions for 2 residents, including delayed blood glucose monitoring and failure to provide stoma treatments. |
| Failed to provide adequate fluids for 4 residents, including failure to fill water pitchers and administer feeding tube water. |
| Failed to provide sufficient dietary support personnel to safely and effectively carry out food and nutrition service functions. |
| Failed to prepare, serve, and distribute food in accordance with professional food service safety standards, including improper glove use. |
| Failed to properly review and update the facility assessment annually with required signatures. |
| Failed to establish and implement written policies and procedures for the QAPI program and failed to maintain performance improvement plans. |
| Failed to maintain effective systems for feedback, data collection, monitoring, and adverse event tracking in the QAPI program. |
| Failed to provide adequate infection prevention practices during medication administration and failed to review infection control policy annually. |
| Failed to ensure annual ethics training and annual review of ethics policy. |
Report Facts
Residents reviewed for MDS assessments: 4
Residents reviewed for significant change assessments: 2
Residents reviewed for quarterly assessments: 4
Residents reviewed for MDS transmission: 4
Residents reviewed for medication administration: 2
Residents reviewed for nutrition and hydration: 4
Facility census: 47
MDS assessments completed: 22
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff J | Chief Operating Officer/Minimum Data Set Coordinator/Care Plan Coordinator | Reported struggling to complete Care Plans and MDS assessments; involved in Performance Improvement Plan |
| Staff K | Registered Nurse | Worked weekend of 2/10/24 and 2/11/24; missed documenting insulin administration; history of medication errors |
| Staff Q | Registered Nurse | Failed to perform hand hygiene during medication administration for Resident #3 |
| Administrator | Facility Administrator | Reported lack of knowledge of annual ethics training requirements and infection control policy review |
| Staff G | Certified Dietary Manager | Educated staff on hand hygiene and food safety |
| Staff E | Certified Nurse Aide | Reported weekend dietary staffing shortages requiring CNA's to prepare meals |
Inspection Report
Re-Inspection
Deficiencies: 0
Sep 14, 2023
Visit Reason
The inspection visit was a re-inspection conducted following a prior survey ending on July 13, 2023, to verify compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities.
Findings
The Pioneer Valley Living and Rehab Nursing Home was found to be in substantial compliance effective August 18, 2023, following the onsite revisit conducted September 13-14, 2023. No discretionary denial of payment was effectuated.
Inspection Report
Annual Inspection
Census: 49
Deficiencies: 7
Jul 13, 2023
Visit Reason
Annual survey conducted from July 3 to July 13, 2023, to assess compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities.
Findings
The facility was found not in compliance with multiple federal regulations including failure to protect residents from abuse, misappropriation of medication, inadequate nursing care, improper medication storage and labeling, and infection control deficiencies. Immediate Jeopardy was identified related to resident safety and abuse.
Severity Breakdown
Immediate Jeopardy: 2
Severity D: 3
Severity E: 2
Deficiencies (7)
| Description | Severity |
|---|---|
| Failure to protect a vulnerable resident from inappropriate sexual contact by another resident, resulting in Immediate Jeopardy. | Immediate Jeopardy |
| Failure to accurately account for a resident's schedule IV medication (lorazepam), resulting in misappropriation of medication. | Severity D |
| Failure to follow professional nursing standards including providing nonexpired medication and ensuring proper observation of supplement intake. | Severity D |
| Failure to protect residents from accidents and injuries by not providing adequate education and supervision for residents going outside unsupervised, resulting in Immediate Jeopardy. | Immediate Jeopardy |
| Failure to keep accurate narcotic records and prevent misappropriation of medications, including failure to complete accurate narcotic counts. | Severity E |
| Failure to maintain separately locked, permanently affixed compartments for schedule IV medication with a distinct access system from non-scheduled medications. | Severity D |
| Failure to provide adequate infection prevention practices including failure to perform hand hygiene between residents and failure to wear gloves when administering eye drops and insulin. | Severity E |
Report Facts
Facility census: 49
Deficiency count: 36
Resident weight loss: 10
Resident #10 hematoma size: 1.5
Resident #10 hematoma size: 3.2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff C | Registered Nurse | Named in narcotic medication misappropriation and medication error findings |
| Staff I | Temporary Nurse Aide / Certified Nurse Aide | Named in resident fall and supervision deficiency |
| Staff E | Registered Nurse | Named in infection control and medication administration deficiencies |
| Staff H | Certified Nurse Aide | Named in resident fall incident |
| Staff Q | Licensed Practical Nurse | Named in narcotic medication misappropriation |
| Staff P | Registered Nurse | Named in narcotic medication misappropriation |
| Staff O | Certified Medication Assistant | Named in narcotic medication misappropriation |
| Staff U | Certified Medication Assistant | Named in resident supervision deficiency |
| Staff M | Certified Nurse Aide | Named in resident supervision deficiency |
| Staff V | Certified Nurse Aide | Named in resident supervision deficiency |
Inspection Report
Plan of Correction
Deficiencies: 0
Jan 18, 2023
Visit Reason
The document is a statement of deficiencies and plan of correction related to the facility's compliance with regulatory requirements, indicating acceptance of a credible allegation of compliance and plan of correction.
Findings
The facility was certified in compliance effective January 15, 2023, based on acceptance of the credible allegation of compliance and plan of correction. No specific deficiencies or severity levels are detailed in the report.
Inspection Report
Annual Inspection
Census: 48
Deficiencies: 5
Dec 15, 2022
Visit Reason
A recertification health survey and investigation of complaint #105182-C was completed from 12/12/22 to 12/15/22 to assess compliance with federal regulations and investigate complaint allegations.
Findings
The facility was found to have multiple deficiencies including failure to complete PASARR status changes, failure to provide timely assessments and interventions for residents with chronic conditions, failure to submit veteran admissions to the Iowa Department of Veteran Affairs, and inaccurate documentation of wound care treatments.
Complaint Details
Complaint #105182-C was substantiated based on findings related to PASARR coordination and assessments.
Severity Breakdown
SS=D: 2
SS=E: 1
Deficiencies (5)
| Description | Severity |
|---|---|
| Failure to complete PASARR status change for a resident with newly identified schizophrenia diagnosis. | — |
| Failure to provide timely assessments and interventions for two residents, including missed urology follow-up appointment and failure to implement diabetic foot treatment order. | SS=D |
| Failure to submit 4 of 8 resident admissions to the Iowa Department of Veteran Affairs within 30 days of admission. | — |
| Failure to accurately document completed wound care treatments; nurse documented treatments four hours earlier than completion. | SS=D |
| Failure to be licensed and comply with federal, state, and local laws and professional standards. | SS=E |
Report Facts
Resident census: 48
Residents reviewed: 12
Residents admissions reviewed: 8
Veteran residents not submitted: 4
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff C | Registered Nurse (RN) | Named in findings related to wound care treatment documentation and assessment of Resident #23 |
| Staff A | Certified Nursing Assistant (CNA) | Named in findings related to noticing blood in Resident #8's urinary catheter |
| Director of Nursing | Director of Nursing (DON) | Named in findings related to PASARR status change, missed appointment, and wound care documentation |
| Administrator | Administrator | Named in findings related to Veteran Affairs submission compliance |
Inspection Report
Complaint Investigation
Census: 32
Deficiencies: 4
Aug 5, 2021
Visit Reason
A recertification health survey and investigation of Complaints #94348 and #96985 was completed from 8/2 to 8/5/2021. Complaint #94348 was substantiated and Complaint #96985 was not substantiated.
Findings
The facility was found deficient in multiple areas including failure to ensure physician signatures on residents' code status paperwork, failure to remove expired medical supplies, improper food storage and handling, and failure to follow proper infection prevention and control practices including hand hygiene and glove use during resident care and medication administration.
Complaint Details
Complaint #94348 was substantiated; Complaint #96985 was not substantiated.
Severity Breakdown
SS=D: 4
Deficiencies (4)
| Description | Severity |
|---|---|
| Failure to ensure the physician signed a resident's code status paperwork for 2 out of 12 residents reviewed (Resident #12 and #82). | SS=D |
| Failure to meet professional standards by not removing expired medical supplies from stock to prevent unsafe medication administration. | SS=D |
| Failure to store food in a manner that prevented foodborne illness and to keep food in accordance with professional standards for food service safety. | SS=D |
| Failure to implement proper infection control standards when providing care for 1 of 12 residents observed and failure to follow proper hand hygiene protocol during medication administration. | SS=D |
Report Facts
Facility census: 32
Residents reviewed: 12
Expired Swab Caps: 24
Expired Insyte Needles 22 gauge: 5
Expired Insyte Needles 24 gauge: 2
Expired Insyte Needle 20 gauge: 1
Expired Grey Poupon jars: 5
Expired Crisco containers: 5
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Certified Nursing Assistant (CNA) | Named in infection control deficiency related to improper glove use and hand hygiene during resident care |
| Staff B | Certified Nursing Assistant (CNA) | Named in infection control deficiency related to improper glove use and hand hygiene during resident care |
| Staff C | Certified Medical Assistant (CMA) | Named in infection control deficiency related to failure to perform hand hygiene after medication administration |
| Staff D | Licensed Practical Nurse (LPN) | Provided information about IPOST form and physician signature requirements |
| Staff F | Licensed Practical Nurse (LPN) | Acknowledged expired medical supplies |
| Director of Nursing | Director of Nursing (DON) | Provided statements regarding deficiencies in infection control, expired supplies, and IPOST form signatures |
| Quality Assurance Nurse | Quality Assurance Nurse (QA Nurse) | Acknowledged responsibility for removing expired supplies |
| Dietary Manager | Dietary Manager (DM) | Acknowledged expired food items and lack of tracking process |
| Administrator | Administrator | Agreed staff did not follow proper hand hygiene practices |
| Resident Care Coordinator | Resident Care Coordinator | Stated facility did not have a glove usage policy |
Inspection Report
Complaint Investigation
Census: 32
Deficiencies: 4
Aug 5, 2021
Visit Reason
A recertification health survey and investigation of Complaints #94348 and #96985 was completed on 08/02/2021 through 08/05/2021. Complaint #94348 was substantiated and Complaint #96985 was not substantiated.
Findings
The facility failed to ensure physician signatures on residents' code status paperwork for 2 of 12 residents reviewed, failed to meet professional standards by not removing expired medical supplies, failed to store food properly to prevent foodborne illness, and failed to implement proper infection control standards including hand hygiene and glove use during medication administration and resident care.
Complaint Details
Complaint #94348 was substantiated; Complaint #96985 was not substantiated.
Severity Breakdown
Severity Level D: 4
Deficiencies (4)
| Description | Severity |
|---|---|
| Facility failed to ensure physician signed residents' Do Not Resuscitate (DNR) status and IPOST forms for 2 residents. | Severity Level D |
| Facility failed to meet professional standards by not removing expired medical supplies from stock. | Severity Level D |
| Facility failed to store food in a manner that prevented foodborne illness and to keep food in accordance with professional standards for food service safety. | Severity Level D |
| Facility failed to implement proper infection prevention and control standards including hand hygiene and glove use during medication administration and resident care for 1 of 12 residents observed. | Severity Level D |
Report Facts
Residents reviewed: 12
Residents observed: 12
Facility census: 32
Expired swab caps: 24
Expired insyte needles 22 gauge: 5
Expired insyte needles 24 gauge: 2
Expired insyte needle 20 gauge: 1
Expired food items: 5
Expired food items: 1
Inspection Report
Routine
Census: 41
Deficiencies: 0
Dec 17, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspections and Appeals to assess the facility's 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
Complaint Investigation
Census: 44
Deficiencies: 6
Aug 17, 2020
Visit Reason
A focused COVID-19 infection survey and investigation of Complaints #89160-C, #91051-C and #92336-C was conducted from 7/29/20 through 8/17/20.
Findings
The facility was found to be in compliance with CDC recommended practices to prepare for COVID-19. The facility failed to establish and implement accurate and appropriate care plan interventions for 3 of 9 residents (#4, #7 and #2). The facility failed to provide professional standards of care by accurately documenting and transcribing admission and transfer orders for Resident #4. The facility failed to thoroughly assess and initiate interventions for residents with pressure sores for 4 of 4 residents reviewed. The facility failed to ensure sufficient fluid intake and proper hydration for Resident #4. The facility failed to ensure respiratory and oral care consistent with professional standards for Resident #4. The facility failed to complete accurate resident records for 3 of 9 residents reviewed.
Complaint Details
Complaint #89160-C was substantiated. Complaint #91051-C was substantiated. Complaint #92336-C was not substantiated.
Deficiencies (6)
| Description |
|---|
| Failed to establish and implement accurate and appropriate care plan interventions for 3 of 9 residents (#4, #7 and #2). |
| Failed to provide professional standards of care by accurately documenting and transcribing admission and transfer orders for Resident #4. |
| Failed to thoroughly assess and initiate interventions for residents with pressure sores for 4 of 4 residents reviewed (Residents #5, #3, #7, #4). |
| Failed to ensure sufficient fluid intake to maintain proper hydration and health for Resident #4. |
| Failed to ensure respiratory and oral care consistent with professional standards of practice for Resident #4. |
| Failed to complete accurate resident records for 3 of 9 residents reviewed (Residents #8, #9, #1). |
Report Facts
Residents with pressure sores reviewed: 4
Residents with care plan deficiencies: 3
BIMS score: 8
BIMS score: 13
BUN level: 84
Creatinine level: 1.6
Sodium level: 153
Chloride level: 120
Albumin level: 2.2
Pressure ulcer measurements: 6.5
Pressure ulcer measurements: 3.2
Pressure ulcer measurements: 7.2
Pressure ulcer measurements: 3
Pressure ulcer measurements: 3.5
Pressure ulcer measurements: 3.5
Pressure ulcer measurements: 2.9
Pressure ulcer measurements: 1.9
Pressure ulcer measurements: 0.1
Pressure ulcer measurements: 3.7
Pressure ulcer measurements: 3
Pressure ulcer measurements: 0.2
Pressure ulcer measurements: 0.6
Pressure ulcer measurements: 0.3
Pressure ulcer measurements: 0.3
Pressure ulcer measurements: 1.2
Pressure ulcer measurements: 1.3
Pressure ulcer measurements: 0.8
Pressure ulcer measurements: 0.5
Pressure ulcer measurements: 0.4
Pressure ulcer measurements: 0.4
Pressure ulcer measurements: 0.3
Pressure ulcer measurements: 0.6
Pressure ulcer measurements: 0.3
Pressure ulcer measurements: 0.3
Pressure ulcer measurements: 0.2
Pressure ulcer measurements: 2
Pressure ulcer measurements: 3.6
Pressure ulcer measurements: 5
Pressure ulcer measurements: 3
Pressure ulcer measurements: 2
Pressure ulcer measurements: 2
Pressure ulcer measurements: 1.1
Pressure ulcer measurements: 1
Pressure ulcer measurements: 2
Pressure ulcer measurements: 1
Pressure ulcer measurements: 1.3
Pressure ulcer measurements: 2.5
Pressure ulcer measurements: 2.5
Pressure ulcer measurements: 2
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Staff D | Licensed Practical Nurse / Resident Care Coordinator | Named in wound care, skin assessments, and order entry deficiencies for Resident #4 and Resident #5 |
| Staff G | Registered Nurse | Named in respiratory and oral care for Resident #4 |
| Staff I | Registered Nurse | Observed providing wound care to Resident #7 |
| Staff O | Licensed Practical Nurse | Named in wound care and order entry deficiencies for Resident #5 |
| Staff L | Licensed Practical Nurse | Named in wound care and order entry deficiencies for Resident #5 |
| Staff H | Licensed Practical Nurse | Named in wound care and respiratory care for Resident #4 |
| Staff C | Registered Nurse | Named in respiratory care for Resident #4 |
| Staff F | Speech Therapist | Named in oral care for Resident #4 |
| Staff E | Occupational Therapist | Named in therapy care for Resident #4 |
| Staff R | Licensed Practical Nurse | Named in wound care for Resident #5 |
| Staff P | Certified Nurse Aide | Named in wound care for Resident #5 |
| Staff N | Certified Nurse Aide | Named in wound care for Resident #5 |
| Staff M | Certified Nurse Aide | Named in wound care for Resident #5 |
| Staff K | Licensed Practical Nurse | Named in wound care for Resident #5 |
| Staff Q | Licensed Practical Nurse | Named in hydration care for Resident #4 |
| Director of Nursing | Director of Nursing | Named in multiple findings including order entry, wound care, hydration, respiratory care, and record accuracy |
| Administrator | Administrator | Named in order entry and policy communication |
| Podiatrist | Podiatrist | Named in wound care and pressure sore assessment for Resident #5 |
| Primary Care Physician | Physician | Named in wound care and pressure sore assessment for Resident #5 |
| Clinic Representative | Clinic Nurse | Named in wound care communication for Resident #5 |
| Dietician | Dietician | Named in nutritional care for Resident #4 |
Inspection Report
Routine
Census: 46
Deficiencies: 0
Jun 15, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspection and Appeals on 6/15/20 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.
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