Inspection Reports for
Westview Acres Care Center
203 SW Lorraine, Leon, IA, 501440140
Back to Facility ProfileDeficiencies (last 6 years)
Deficiencies (over 6 years)
5.8 deficiencies/year
Deficiencies are regulatory violations found during state inspections.
32% worse than Iowa average
Iowa average: 4.4 deficiencies/yearDeficiencies per year
16
12
8
4
0
Census
Latest occupancy rate
35 residents
Based on a June 2025 inspection.
This facility has shown a decline in demand based on occupancy rates.
Occupancy over time
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Oct 7, 2025
Visit Reason
A complaint investigation for facility reported incident #129660-I was conducted.
Complaint Details
Complaint investigation for incident #129660-I; facility found in substantial compliance.
Findings
The facility was found to be in substantial compliance.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Jun 25, 2025
Visit Reason
The document is a Plan of Correction related to a prior inspection, indicating acceptance of the facility's credible allegation of substantial compliance and plan of correction.
Findings
The facility was certified in compliance effective June 23, 2025, based on acceptance of the credible allegation of substantial compliance and the Plan of Correction.
Inspection Report
Annual Inspection
Census: 35
Deficiencies: 1
Date: Jun 5, 2025
Visit Reason
The inspection was conducted to assess compliance with regulatory requirements, specifically focusing on the facility's completion and submission of comprehensive assessments related to significant changes in resident conditions.
Findings
The facility failed to complete and submit a comprehensive assessment (MDS) related to a significant change in condition for 1 of 5 residents reviewed (Resident #5). The Director of Nursing and MDS Coordinator confirmed the omission and the need for a late submission of the MDS Significant Change update.
Deficiencies (1)
Failed to complete and submit a comprehensive assessment related to a significant change for Resident #5.
Report Facts
Residents Affected: 1
Census: 35
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing | Director of Nursing | Interviewed regarding significant change in Resident #5's condition and MDS submission |
| MDS Coordinator | MDS Coordinator | Interviewed and confirmed missed submission of MDS changes for Resident #5 |
Inspection Report
Annual Inspection
Census: 35
Deficiencies: 1
Date: Jun 5, 2025
Visit Reason
The inspection was conducted as the facility's annual recertification survey combined with an investigation of complaint #127602-C from June 2 to June 5, 2025.
Complaint Details
The complaint #127602-C was investigated during the survey, and no deficiency was cited related to the complaint.
Findings
No deficiencies were cited related to the complaint. However, a deficiency was found related to the facility's failure to complete and submit a comprehensive assessment after a significant change in condition for one of five residents reviewed (Resident #5).
Deficiencies (1)
Failure to complete and submit a comprehensive assessment related to a significant change in condition for Resident #5 within 14 days.
Report Facts
Residents reviewed: 5
Census: 35
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Director of Nursing (DON) | Interviewed on 6/05/25 regarding Resident #5's health status and MDS entry | |
| MDS Coordinator | Interviewed on 6/05/25 regarding updating the Care Plan and MDS submission for Resident #5 |
Inspection Report
Complaint Investigation
Deficiencies: 0
Date: Dec 30, 2024
Visit Reason
A complaint investigation for complaint #123655-C was conducted from December 24, 2024 to December 30, 2024.
Complaint Details
Complaint #123655-C was investigated and the facility was found to be in substantial compliance.
Findings
The facility was found to be in substantial compliance.
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Aug 16, 2024
Visit Reason
The visit was conducted to assess compliance with 42 CFR Part 483 Requirements for Long Term Care Facilities and to review the provider's credible allegation of compliance and plan of correction.
Findings
The facility, Westview Acres, was found to be in substantial compliance effective August 16, 2024, based on the department's acceptance of the credible allegation of compliance and plan of correction.
Inspection Report
Routine
Census: 40
Deficiencies: 6
Date: Jul 25, 2024
Visit Reason
The inspection was conducted to assess compliance with regulatory requirements related to resident rights, staff training, care planning, staffing adequacy, medication management, infection control, and safety protocols at Westview Acres Care Center.
Findings
The facility was found deficient in multiple areas including failure to obtain physician signature on advance directives, incomplete staff abuse training, failure to revise care plans timely, inadequate response to resident call lights, failure to implement gradual dose reductions for psychotropic medications, and deficiencies in infection prevention practices including lack of a water management program and improper hand hygiene during resident care.
Deficiencies (6)
Failed to have the Doctor signature on the Iowa Physician Orders for Scope of Treatment (IPOST) for 1 of 16 residents reviewed for Advance Directives (Resident #17).
Failed to ensure 1 of 5 staff members reviewed completed the two hour Dependent Adult Abuse training within 6 months of their hire date.
Failed to revise the care plan for 1 of 16 residents reviewed for revision of care plan (Resident #23).
Failed to respond to resident call lights in a timely manner for 5 of 5 residents reviewed (#1, #7, #13, #30, & #32).
Failed to ensure a psychotropic medication gradual dose reduction (GDR) was appropriately attempted for 1 of 1 resident (#13) reviewed.
Failed to implement a comprehensive water management program and identify areas or devices in the building to reduce the risk and prevent the growth of Legionella or other waterborne pathogens. Also failed to implement appropriate hand hygiene practices during resident care.
Report Facts
Residents census: 40
Staff members reviewed: 5
Residents reviewed: 16
Residents affected by call light response deficiency: 5
Resident affected by psychotropic medication GDR deficiency: 1
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Certified Nurse Aide | Named in finding for failure to complete Dependent Adult Abuse training within 6 months of hire |
| Staff B | Registered Nurse | Named in infection control deficiency related to improper hand hygiene and glove use during medication administration and resident care |
| Director of Nursing | Director of Nursing | Provided statements regarding staff training, call light response expectations, and medication management |
| Social Worker | Social Worker | Provided information regarding missing physician signature on IPOST and behavior documentation |
| Minimum Data Set Coordinator | MDS Coordinator | Provided information on care plan revision process and physician rounds |
| Maintenance Director | Maintenance Director | Provided information regarding lack of water management program and responsibilities |
| Environmental Services Director | Environmental Services Director | Provided information on flushing procedures for water management |
Inspection Report
Annual Inspection
Census: 40
Deficiencies: 7
Date: Jul 25, 2024
Visit Reason
The inspection was conducted as the facility's annual recertification survey and included investigation of a reported incident #122266-I from July 22, 2024 to July 25, 2024.
Findings
The facility was found deficient in several areas including failure to have a doctor signature on an advance directive for one resident, incomplete dependent adult abuse training for staff, failure to revise care plans timely for residents, insufficient nursing staff response to call lights, improper use and documentation of psychotropic medications, and inadequate infection prevention and control measures including water management for Legionella risk.
Deficiencies (7)
Failure to have the Doctor signature on the Iowa Physician Orders for Scope of Treatment (IPOST) for 1 of 16 residents reviewed.
Failure to ensure 1 of 5 staff members completed dependent adult abuse training within 6 months of hire.
Failure to revise the care plan timely for 1 of 16 residents reviewed.
Failure to respond to resident call lights in a timely manner for 5 of 5 residents reviewed.
Failure to ensure psychotropic medications were used appropriately and documented for 1 of 1 resident reviewed.
Failure to implement a comprehensive infection prevention and control program including water management to reduce Legionella risk.
Failure to ensure proper hand hygiene and cleaning procedures during medication administration.
Report Facts
Residents reviewed for advance directives: 16
Staff reviewed for dependent adult abuse training: 5
Residents reviewed for care plan revision: 16
Residents reviewed for call light response: 5
Resident reviewed for psychotropic medication use: 1
Facility census: 40
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Certified Nurse Aide | Failed to complete dependent adult abuse training within required timeframe. |
| Staff B | Registered Nurse | Observed failing to clean hands and gloves properly during medication administration. |
| Director of Nursing | Director of Nursing (DON) | Provided statements regarding staff training, call light response expectations, and infection control. |
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Mar 22, 2024
Visit Reason
The document serves as a Plan of Correction following acceptance of a credible allegation of substantial compliance for the facility.
Findings
The facility was found to be in substantial compliance based on the credible allegation and Plan of Correction, resulting in certification of compliance effective March 22, 2024.
Inspection Report
Complaint Investigation
Census: 33
Deficiencies: 1
Date: Feb 29, 2024
Visit Reason
The inspection was conducted due to concerns about the facility's infection prevention and control practices, specifically related to COVID-19 protocols and staff adherence to testing and return-to-work guidelines.
Complaint Details
The investigation was complaint-related, focusing on a staff member (Staff C) who tested positive for COVID-19 but returned to work after only 5 days instead of the required 7-10 days, without documented negative test results. The complaint was substantiated based on staff interviews and record reviews.
Findings
The facility failed to follow proper infection control practices to mitigate the risk for the spread of infectious disease. Staff did not adhere to the facility's COVID-19 testing and return-to-work policies, returning to work earlier than allowed without documented negative tests.
Deficiencies (1)
Failure to follow proper infection control practices to mitigate the risk for the spread of infectious disease.
Report Facts
Resident census: 33
Days staff returned early: 2
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff C | Dietary Aide | Named in infection control deficiency related to COVID-19 positive test and early return to work |
| Dietary Supervisor | Instructed Staff C to test and go home after positive COVID test | |
| Director of Nursing | Reported no testing records found for Staff C and explained facility COVID-19 return-to-work policy |
Inspection Report
Complaint Investigation
Census: 33
Deficiencies: 1
Date: Feb 29, 2024
Visit Reason
The inspection was conducted as a result of complaints #114942-C, #115057-C, #115669-C, #116565-C and a facility self-report from February 26 to February 29, 2024.
Complaint Details
Complaint #115669-C was substantiated. The investigation found failures in infection control practices and COVID-19 return to work procedures for staff.
Findings
The facility failed to follow proper infection control practices to mitigate the risk of spreading infectious disease, specifically related to COVID-19 return to work protocols for staff. Complaint #115669-C was substantiated.
Deficiencies (1)
The facility did not conduct an annual review of its infection prevention and control program as required, and failed to follow proper infection control practices related to COVID-19 staff return to work protocols.
Report Facts
Resident census: 33
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff C | Dietary Aide | Named in findings related to COVID-19 infection and return to work |
| Dietary Supervisor | Instructed Staff C regarding COVID-19 testing and return to work | |
| Director of Nursing | Director of Nursing | Provided statements regarding testing records and facility protocols |
| Rose Saxton | Administrator | Signed the report and plan of correction |
Inspection Report
Plan of Correction
Deficiencies: 0
Date: Jun 16, 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 a credible allegation of compliance and plan of correction effective June 16, 2023.
Inspection Report
Routine
Census: 34
Deficiencies: 4
Date: May 24, 2023
Visit Reason
The inspection was conducted to assess compliance with regulatory requirements related to resident bed hold notification, medication storage, kitchen sanitizing procedures, and staff training on abuse reporting at Westview Acres Care Center.
Findings
The facility was found deficient in notifying residents or their representatives about bed hold during hospital transfers, storing food and medications together in medication refrigerators, maintaining proper sanitizing solution concentrations in the kitchen, and ensuring all staff completed mandatory abuse reporting training.
Deficiencies (4)
Failed to provide bed hold notice for 1 of 1 residents transferred to hospital.
Food and medications stored together in 2 unit medication storage refrigerators.
Sanitizing solution used to clean kitchen equipment did not maintain proper dilution levels.
One of five staff files reviewed did not have up-to-date Dependent Adult Abuse Mandatory Reporter Training.
Report Facts
Census: 34
Sanitizing solution concentration: 0
Sanitizing solution concentration: 150
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff A | Social Services | Reported no bed hold notice was completed for Resident #25 |
| Director of Nursing | Director of Nursing | Confirmed expectation that bed hold notice be completed for hospital transfers and medication storage policy |
| Staff C | Licensed Practical Nurse (LPN) | Explained applesauce was stored in medication refrigerator door |
| Staff D | Dietary Cook | Performed sanitizing solution concentration checks |
| Staff E | Dietary Cook | Performed sanitizing solution concentration check |
| Dietary Manager | Dietary Manager | Described sanitizing solution change schedule |
| Staff B | Certified Nursing Assistant | Had expired Dependent Adult Abuse Mandatory Reporter Training |
| Administrator | Administrator | Stated expectation for all employees to be up to date on training |
Inspection Report
Annual Inspection
Census: 34
Deficiencies: 4
Date: May 24, 2023
Visit Reason
The inspection was conducted as the facility's Annual Recertification Survey from May 21, 2023 to May 24, 2023.
Findings
The facility was found deficient in several areas including failure to provide proper bed hold notice before resident transfers, improper labeling and storage of drugs and biologicals, inadequate food procurement and sanitation practices, and incomplete abuse, neglect, and exploitation training for staff.
Deficiencies (4)
Failure to provide bed hold notice for resident transfers as required by policy and regulations.
Failure to ensure drugs and biologicals were properly labeled and stored separately from food in locked compartments.
Failure to ensure food procurement, storage, preparation, and serving met sanitary requirements, including proper sanitizing solution concentration.
Failure to ensure all employees received required education and training on abuse, neglect, and exploitation, including dependent adult abuse mandatory reporter training.
Report Facts
Census: 34
Deficiencies cited: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Staff B | Certified Nursing Assistant | Named in abuse training deficiency for incomplete dependent adult abuse mandatory reporter training |
| Staff C | Licensed Practical Nurse (LPN) | Interviewed regarding medication storage practices |
| Staff D | Dietary Cook | Observed and interviewed regarding food sanitation and sanitizing solution concentration |
| Staff E | Dietary Cook | Performed sanitizing solution concentration checks |
| Director of Nursing | Interviewed regarding bed hold policy and medication storage policy | |
| Social Services Staff A | Interviewed regarding bed hold notice completion | |
| Dietary Manager | Interviewed regarding sanitizing solution change frequency | |
| Administrator | Named in training deficiency and plan of correction |
Inspection Report
Annual Inspection
Deficiencies: 0
Date: Apr 20, 2023
Visit Reason
Annual inspection survey of Westview Acres Care Center to assess compliance with health and safety regulations.
Findings
No health deficiencies were found during the inspection.
Inspection Report
Complaint Investigation
Census: 37
Deficiencies: 0
Date: Apr 20, 2023
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted along with a complaint investigation for complaints #104912-C, #107894-C, and #111386-C, as well as facility reported incidents #107764-I and #108347-I.
Complaint Details
Complaint investigation was conducted for complaints #104912-C, #107894-C, and #111386-C, and facility reported incidents #107764-I and #108347-I. The facility was found to be in substantial compliance.
Findings
The facility was found to be in compliance with CMS and CDC recommended practices for COVID-19 preparation and was found to be in substantial compliance during the complaint investigation.
Inspection Report
Annual Inspection
Census: 39
Deficiencies: 4
Date: Jan 13, 2022
Visit Reason
The annual recertification survey was conducted from January 10, 2022 to January 13, 2022 to assess compliance with federal regulations.
Findings
The survey identified deficiencies related to coordination of PASARR and assessments, development and implementation of comprehensive care plans, drug regimen management, and provision of specialized rehabilitative services. The facility failed to meet requirements in these areas as evidenced by clinical record reviews, staff interviews, and observations.
Deficiencies (4)
Coordination of PASARR and Assessments was not met as the facility failed to refer one out of one resident reviewed for a level II evaluation following a change in psychiatric diagnosis and medications.
The facility failed to update a comprehensive person-centered care plan for 2 of 16 residents reviewed.
The facility failed to follow physician orders to draw Prothrombin time (PT)/International normalized ratio (INR) for 3 of 4 residents receiving warfarin on a daily basis.
The facility failed to ensure a resident received specialized rehabilitative services to restore their highest practicable level of physical and functional well-being.
Report Facts
Census: 39
Residents reviewed for care plan deficiency: 16
Residents with care plan deficiencies: 2
Residents with warfarin PT/INR monitoring deficiency: 3
Residents receiving warfarin: 4
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Rosa Saxton | Administrator | Signed the statement of deficiencies on 2/11/2022 |
| Director of Nursing | Director of Nursing (DON) | Interviewed regarding PT/INR monitoring and care plan updates |
| Assistant Director of Nursing | Assistant Director of Nursing (ADON) | Interviewed regarding PASARR resubmission policy |
| MDS Coordinator | Interviewed regarding care plan expectations and catheter care |
Inspection Report
Complaint Investigation
Census: 38
Deficiencies: 6
Date: Jul 29, 2021
Visit Reason
The inspection was conducted as part of an investigation of multiple complaints and a facility-reported incident between June 28 and July 29, 2021. The visit aimed to assess compliance with federal regulations related to resident care and facility operations.
Complaint Details
The visit was triggered by complaints numbered 87931-C, 89085-C, 89761-C, 90470-C, 92583-C, 92855-C, 93437-C, 94447-C, 94963-C, 95073-C, and 98610-C, as well as a facility-reported incident 95230-I. Complaints 92855-C, 95073-C, and 92855-C were substantiated.
Findings
The facility was found to have multiple deficiencies including failure to notify families and physicians of significant resident changes, inadequate assistance with activities of daily living, failure to provide proper treatment and prevention of pressure ulcers, incomplete pharmacy service procedures, infection control lapses, and ineffective pest control. Several residents were affected by these deficiencies.
Deficiencies (6)
Failure to ensure timely notification of resident changes to physician and family.
Failure to provide adequate ADL care including toileting, bathing, and catheter care for dependent residents.
Failure to provide appropriate treatment and prevention of pressure ulcers.
Failure to maintain accurate pharmacy drug records and secure narcotic E-kit.
Failure to properly disinfect shower rooms and maintain infection prevention and control program.
Failure to maintain an effective pest control program resulting in fly infestation.
Report Facts
Resident census: 38
Deficiency counts: 6
Employees mentioned
| Name | Title | Context |
|---|---|---|
| Ross Saxton | Administrator | Signed the initial comments and plan of correction. |
| Staff M | Named in re-education regarding perineal care and catheter care. | |
| Staff K | Named in re-education regarding perineal care and catheter care and infection control. | |
| Staff N | Named in re-education regarding perineal care and catheter care and infection control. | |
| Staff P | Business Office Manager | Informed about resident assistance needs. |
| Staff J | Certified Nurse Aide | Provided assistance and care to residents. |
| Staff A | Registered Nurse | Involved in narcotic E-kit handling and re-education. |
| Staff B | Involved in narcotic E-kit handling and re-education. | |
| Staff C | Licensed Practical Nurse | Involved in narcotic E-kit handling and re-education. |
| Staff D | Involved in narcotic E-kit handling and re-education. | |
| Staff E | Certified Nurse Aide | Assisted with resident care and narcotic E-kit handling. |
| Staff F | Assisted with resident care. | |
| Staff G | Housekeeping Supervisor | Responsible for pest control spray. |
| Staff H | Housekeeping Supervisor | Responsible for pest control spray. |
| Staff I | Re-educated on pest control monitoring and reporting. | |
| Staff J | Re-educated on infection prevention and control. | |
| Staff L | Re-educated on infection prevention and control. | |
| Staff U | Hospice Nurse | Interviewed regarding resident wound assessment. |
Inspection Report
Abbreviated Survey
Census: 37
Deficiencies: 0
Date: Dec 2, 2020
Visit Reason
A focused COVID-19 infection control survey was conducted 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: 37
Inspection Report
Abbreviated Survey
Census: 45
Deficiencies: 0
Date: Jun 23, 2020
Visit Reason
A COVID-19 Focused Infection Control Survey was conducted by the Department of Inspection and Appeals on 6/23/20 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
Viewing
Loading inspection reports...
