Inspection Reports for The Heritage At Northern Hills

The inspection was conducted as a recertification visit to determine compliance with certification of an Assisted Living Program for People with Dementia.

The program failed to complete required cognitive evaluations prior to occupancy and annually with significant change, and failed to develop service plans based on all evaluations as required.

The inspection was conducted as part of an investigation of Complaints #111295-C and #111751-C regarding regulatory insufficiencies at the assisted living program.

The program failed to evaluate a tenant's functional, cognitive, and health status as required annually and with significant change, as evidenced by incomplete documentation and lack of updated service plans for Tenant C-1. The Administrator confirmed these findings.

The investigation was triggered by Complaints #111295-C and #111751-C. The findings were substantiated as the program did not meet evaluation requirements for Tenant C-1.

The visit was conducted to investigate complaint 106447-C at the assisted living program for people with dementia.

No regulatory insufficiencies were cited during the investigation of the complaint.

Complaint 106447-C was investigated and found to have no regulatory insufficiencies.

The inspection was conducted as a recertification visit to determine compliance with certification of an Assisted Living Program, including investigation of multiple complaints and a review of infection control.

The inspection found regulatory insufficiencies related to medication administration, tenant evaluations, service plans, nurse reviews, admission/retention criteria, and dementia-specific education for personnel. No deficiencies were cited during the infection control visit.

The inspection included investigation of complaints #95310-C, #96672-C, #97579-C, #100079-C, and #100159-C.

The inspection was conducted as an onsite infection control survey for an Assisted Living Program for People with Dementia.

No regulatory insufficiencies were cited during the onsite infection control survey completed on 09/01/2020.

The recertification visit was conducted to determine compliance with certification of an Assisted Living Program for People with Dementia.

The program failed to ensure that staff received required dementia-specific education and training within specified timeframes, including initial training within 30 days of employment, annual continuing education, and hands-on dementia training. Several staff members lacked documentation of required training.

Investigation of Complaint #85123-C at the assisted living program for people with dementia.

No regulatory insufficiencies were cited during the complaint investigation.

Investigation of Complaint #85123-C found no regulatory insufficiencies.

The inspection was conducted as an investigation of Complaint #74593-C regarding tenant rights violations at the assisted living program.

The program failed to consistently ensure the privacy of tenants, specifically by staff sending private medical information via personal cell phone text messages, potentially exposing tenant information to unauthorized persons.

Investigation of Complaint #74593-C found that staff sent tenant medical information via text messages using personal cell phones, risking unauthorized access to private information.

The inspection was conducted as an investigation of Complaint #73376-C at the assisted living facility.

No regulatory insufficiencies were cited during the complaint investigation.

Investigation of Complaint #73376-C found no regulatory insufficiencies.

The inspection was conducted as a recertification visit to determine compliance with certification for an Assisted Living Program.

The inspection identified regulatory insufficiencies including failure to complete required criminal background evaluations for staff, failure to discharge a tenant who exceeded admission criteria due to unmanageable incontinence, and failure to ensure all staff received required dementia-specific education annually.

The inspection was conducted as an investigation of Incident #67981-C at Heritage at Northern Hills, an assisted living program, to evaluate compliance with regulatory requirements related to tenant evaluations and nurse reviews.

The program failed to ensure evaluations of tenants with possible changes in condition were completed by the Registered Nurse (RN), affecting 3 of 8 tenants reviewed. Additionally, the RN failed to conduct nurse reviews with changes in condition for 3 of 7 tenants. Documentation and assessments by the RN were missing despite Licensed Practical Nurse (LPN) notes and hospice involvement.

Investigation of Incident #67981-C revealed regulatory insufficiencies related to tenant evaluation and nurse review processes. The complaint was substantiated based on record review and interviews.

The inspection was conducted as a final complaint/incident investigation following a complaint intake regarding service plans at Heritage at Northern Hills.

The investigation found that the program had assessed the tenant and developed a service plan to meet her needs, with no history of wandering or elopement prior to the incident. The tenant was diagnosed with a urinary tract infection after the incident. The program implemented a new service plan including hourly checks. The finding was unsubstantiated and no regulatory insufficiencies were identified.

Allegation regarding service plans was investigated and found unsubstantiated.

The inspection was conducted as a final complaint/incident investigation following an investigation by the Department of Inspections and Appeals from November 30 to December 7, 2015, regarding service plans and policies at Heritage at Northern Hills.

The investigation found the allegation regarding service plans to be unsubstantiated but identified a regulatory insufficiency related to program policies and procedures, specifically failure to follow policies regarding incident reports.

The complaint allegation was related to service plans. The findings were unsubstantiated. The report noted a regulatory insufficiency in policies and procedures related to incident reporting.

A recertification visit and incident investigation were conducted to determine compliance with certification for an Assisted Living Program and to investigate incident #53934-I.

The incident investigation was unsubstantiated. A regulatory insufficiency was cited in the area of Food Service due to failure to ensure consistent food safety training for staff preparing and serving meals.

The incident investigated was unsubstantiated. The tenant sustained an abrasion after a fall and was transported to the emergency room. No regulatory insufficiencies were found related to the incident.

The inspection was conducted as a complaint/incident investigation related to tenant injury, nurse review, evaluations prior to admission, service plans, and alleged bed bugs at Northern Hills, Sioux City, Iowa.

The investigation found that tenant rights violations and complaints about nurse reviews and evaluations were not substantiated. However, regulatory insufficiencies were identified in the areas of tenant evaluation, service plans, and nurse review, including incomplete or unsigned evaluations, lack of documentation of functional evaluations, incomplete service plans, and failure to complete nurse reviews with changes in condition.

Complaint #48205-C and Incident #48206-I alleged tenant rights issues related to a tenant injury; these were not substantiated. Complaint #48413-C alleged nurse review was not completed to determine if tenants exceeded admission criteria, evaluations were incomplete, service plans were not completed upon admission, and alleged bed bugs presence; the complaint was not substantiated.

The visit was a Final Recertification Monitoring Evaluation conducted to review the assisted living program's compliance with Iowa Administrative Code and to evaluate the program's recertification status.

No regulatory insufficiencies were found during the evaluation. The program was accepted, and the State Fire Marshal's inspection and Facility Engineer's approval of evacuation plans were also received.

The inspection was conducted as a complaint/incident investigation regarding allegations related to tenant rights and medication administration at Northern Hills Assisted Living.

The investigation found no regulatory insufficiencies related to tenant rights and incontinence supplies. However, medication administration practices did not follow accepted professional standards, including failure to cleanse hands between tenants and carrying unlabeled inhaled medication containers.

The complaint alleged the program did not have incontinence briefs available for a tenant and that a Licensed Practical Nurse passed medications without knowing the medications or reasons for administration. The complaint was investigated with monitoring observations and interviews with staff and tenants.

An on-site monitoring evaluation was conducted at Northern Hills Assisted Living to review the Plan of Correction in response to a Preliminary Recertification Monitoring Evaluation Report and to assess compliance with regulatory requirements.

The report found a regulatory insufficiency related to nursing services, specifically a lack of documented registered nurse observation of staff competency in colostomy care. Tenant and family satisfaction was positive, and no regulatory insufficiencies were found during the certification period prior to this visit.

The visit was an on-site monitoring investigation conducted in response to an incident intake regarding a tenant elopement at Northern Hills Assisted Living.

The investigation found no regulatory insufficiencies related to the incident. The tenant eloped but was safely returned by family, and staff reported no injuries or harm. The incident was reported to the department within 24 hours and the tenant was transferred to a higher level of care.

The complaint involved an allegation that Tenant #1 eloped from the program. The investigation included interviews with multiple staff members and review of documentation. The complaint was not substantiated as no regulatory insufficiencies were identified.

A complaint investigation revisit was conducted at Northern Hills assisted living program to evaluate regulatory insufficiencies related to Evaluation of Tenant, Service Plan, Medications, Nurse Review, and other areas.

The investigation found substantiated complaints in multiple areas including tenant evaluations, service plans, medication administration, nurse reviews, and record checks. The program received regulatory insufficiencies for inconsistent evaluations, incomplete service plans, medication errors, lack of nurse reviews, and incomplete implementation of the Plan of Correction.

The complaint investigation was substantiated with findings in Evaluation of Tenant, Service Plan, Medications, Nurse Review, and Record Checks. The program was assessed a $3,000 civil penalty.

A complaint investigation on-site visit was conducted at Northern Hills Assisted Living to investigate allegations related to inaccurate tenant documentation, medication administration failures, and insufficient staffing to meet tenant needs.

The investigation found regulatory insufficiencies including inaccurate documentation of an incident involving Tenant #1, failure to administer medications as per the tenant's service plan, and insufficient staffing to meet tenants' identified needs. Specific failures included incomplete meal reminders and medication cueing, leading to staff disciplinary actions.

There were substantiated complaints in the areas of assessment, occupancy and transfer, services, staffing, and record checks. The complaint investigation focused on inaccurate tenant documentation, medication administration failures, and insufficient staffing.

A complaint investigation on-site visit was conducted at Northern Hills Assisted Living to investigate allegations related to tenant evaluations, exclusion criteria, nurse reviews, service plans, staffing, and employee record checks.

The investigation found multiple regulatory insufficiencies including failure to evaluate tenants' functional and cognitive abilities, retaining tenants requiring higher levels of care, incomplete 90-day nurse reviews, outdated individualized service plans, inadequate staffing and training, and failure to complete employee criminal background checks prior to hire.

There were substantiated complaints in the area of services during this certification period. The complaint investigation found multiple regulatory insufficiencies as detailed in the findings.