Iowa Jewish Senior Life Center

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on observations, staff interviews, facility record review, and facility policy review, the facility failed to ensure sanitary conditions in the main kitchen and failed to properly sanitize the dining room tables in one of the two facility dining rooms used by the residents for their mealtimes. These failures posed the risk of food borne illness to the residents receiving food from the kitchen and eating in the main dining room. The facility reported a census of 40 residents. Findings include: During an interview on 3/31/26 at 12:51 p.m. with the Dietary Manager, he revealed he had been promoted to the Dietary Manager position three months ago. When asked regarding the sanitizing solution used to clean and sanitize surfaces and equipment in the kitchen and how staff test the sanitizing solution for proper chemical sanitization, he provided a small plastic container of a roll of chemical sanitizer test strips. The plastic container was without a label and he stated he was not sure where the product label…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observations, staff interviews, and facility policy review the facility staff failed to perform appropriate hand hygiene with preparation, and administration of medication to four of four residents observed for medication administration (Resident #4, #17, #24, and #27). The facility reported a census of 40 residents. Findings include: During a continuous observation on 4/1/26 from 7:28 a.m. to 8:25 a.m. with Staff D, Certified Medication Aide (CMA), failed to clean and sanitize her hands prior to preparing thirteen medications for Resident #4. Staff D then knocked on Resident #4's room door and gave Resident #4 her medication cup filled with twelve of those oral medications, an oral inhaler medication, and a glass of water. After Resident #4 took her medications, Staff D returned to the medication cart and documented the resident's medication administration in the facility's electronic medical record (EMR) and documented the narcotic medication given in the narcotic binder located on the medication cart. Continued observation; Staff D, CMA failed to clean and sanitize her…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, staff interviews and policy review, the facility failed to ensure code status between the Iowa Physician Orders for Scope of Treatment (IPOST), the electronic health record (EHR) and the Care Plan were congruent for 1 of 1 residents reviewed for advanced directives (Resident #46). The facility reported a census of 40 residents. Findings include: Review of the admission Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #46 had a Brief Interview for Mental Status (BIMS) of 6 indicating severe cognitive impairment. Review of the IPOST dated [DATE] revealed Resident #46 had an order for cardiopulmonary resuscitation (CPR) signed by the physician and the resident's responsible party. Review of the EHR for Resident #46 revealed a physician's order with revision date of [DATE] documented as follows; CPR; limited additional interventions; no artificial nutrition by tube. Review of the Care Plan for Resident #46 with a focus area of advanced directives initiated [DATE] and…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, staff interview and the Resident Assessment Instrument (RAI) manual, the facility failed to complete a significant change Minimum Data Set (MDS) assessment after a resident's hospice level of care was discontinued for 1 of 2 residents reviewed for change of condition (Resident #25). The facility reported a census of 40 residents. Findings include: The census in the Electronic Health Record (EHR) revealed on 9/24/25 Resident #25 transitioned from hospice private care to private-pay status. Review of Advance Beneficiary Notice of Non-coverage (ABN) dated 9/22/25 revealed hospice services for Resident #25 would end 9/24/25. Review of the MDS assessment dated [DATE] revealed Resident #25 was not receiving hospice services. Review of the MDS assessment dated [DATE] revealed Resident #25 was not receiving hospice services. Review of the MDS tracking schedule for Resident #25 lacked a significant change assessment following the discontinuation of hospice services. During an interview…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, staff interview and Maximus Preadmission Screening and Resident Review (PASRR) policies and procedures, the facility failed to submit a Level II PASRR evaluation for 1 of 1 residents reviewed with a new mental health diagnosis (Resident #4). The facility reported a census of 40 residents. Findings include: A Level 1 PASRR screening completed by a local hospital prior to admission dated [DATE] revealed Resident #4 had a diagnosis of depression/depressive disorder and a Level II evaluation was not required. The Level 1 PASRR evaluation lacked additional mental health diagnoses and revealed if new information refuted the findings, a new screen must be submitted. The admission Minimum Data Set (MDS) assessment dated [DATE] for Resident #4 revealed a diagnosis of post traumatic stress disorder (PTSD). The MDS further revealed the resident received antidepressant and antianxiety medication during the 7 day look back period. The Care Plan initiated [DATE] indicated Resident #4 had a…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, staff interview, and policy review, the facility failed to ensure proper infection control practices to reduce the risk of contamination and food-borne illness during meal service. The facility reported a census of 40 residents. Findings include: On 3/11/25 the facility lunch menu included the following: lemon scallopini with pasta seasoned peas breadstick fresh fruit cup funfetti blondie In an observation on 3/11/25 starting at 11:45 AM during the lunch meal service, Staff J, Cook, used gloved hands to serve the meal and only changed his gloves and performed hand hygiene one time throughout the entire meal service. Staff J touched plates, utensils, refrigerators, lids, and transportation carts with gloved hands during the service. He further touched the seasoned peas on each plate he prepared with gloved hands to keep them from rolling around the plate, used his gloved hands to get parsley from a bowl to sprinkle on top of the scallopini, and touched the spaghetti with his gloved hands to remove dark overcooked pasta from the residents plates or pasta that was…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, observations, staff interviews, and policy review the facility failed to develop and implement a comprehensive person-centered care plan for 2 of 16 residents sampled (Residents #3 and #32). The facility reported a census of 40 residents. Findings include: 1. The Minimum Data Set (MDS) Assessment tool dated 1/23/25 revealed Resident #3 had diagnoses of Alzheimer's Disease and diabetes. The MDS recorded the resident took an antibiotic. The Order Summary revealed Resident #3 on droplet precautions since 3/5/25. The Progress Notes revealed the following: a. On 3/5/25 at 10:59 AM, the resident tested positive for RSV (respiratory syncytial virus) (infection of the lungs and respiratory tract) on 3/5/25 and placed on droplet isolation. b. On 3/12/25 at 10:41 AM, resident continues on droplet precautions. The Care Plan lacked information or directives for staff to follow current policy and protocol guidelines related to RSV and droplet precautions. 2. The MDS assessment dated [DATE]…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, staff interviews, and policy review the facility staff failed to assess and document an injury of unknown origin and perform a skin assessment for 1 of 3 residents reviewed for skin injuries (Resident #33). The facility reported a census of 40 residents. Findings include: The Minimum Data Set (MDS) assessment dated [DATE] reveals Resident #33 had diagnoses of Alzheimer's disease, dementia, and muscle weakness. The MDS recorded the resident had a Brief Interview for Mental Status (BIMS) score of 0, indicating severely impaired cognition. The resident also had inattention, disorganized thinking, and wandered daily. The MDS documented the resident had no falls and no skin issues. The MDS indicated the resident had dependence on staff for toileting, bathing, and transfers, and required substantial to maximum assistance for bed mobility. The Care Plan revised 2/9/25 revealed the resident required assistance with activities of daily living (ADL's) related to dementia and confusion. The…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, observation, staff interview, facility policy review, and the Center for Disease Control (CDC) guidelines, the facility failed to follow infection control practices for three of three residents on droplet precautions (Resident # 3, #30, and #32) and prevent the potential spread of infection to other residents and staff. The facility staff also failed to handle soiled linens to prevent the potential spread of infection for 1 of 2 nursing units. The facility reported a census of 40 residents. Findings include: 1. The Minimum Data Set (MDS) Assessment tool dated 1/23/25 revealed Resident #3 had diagnoses of Alzheimer's Disease and diabetes. The MDS indicated the resident required supervision and touching assistance for eating. The MDS recorded the resident took an antibiotic. The Care Plan lacked information or directives for staff to follow current policy and protocol guidelines related to respiratory syncytial virus (RSV) (a respiratory infection) and droplet precautions. The…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observation, record review and staff interview, the facility failed to meet professional standards by not observing a resident take their medications for 1of 8 residents (Resident #18) reviewed. The facility reported a census of 51 residents. Findings include: A Minimum Data Set (MDS) for Resident #18, dated 3/12/24, included diagnoses of heart failure, anxiety, and depression. The MDS documented the resident had a Brief Interview for Mental Status score of 15, indicating no cognitive impairment. Observation on 4/15/24 at 12:05 PM, resident in room and holding medication cup with several pills in the cup. Resident stated they always leave them for me, they know I will take them as they are good for me. Review of the resident's Medication Administration Record dated 4/1/24 - 4/30/24, documented the following medications ordered and administered at noon: a. ascorbic acid (supplement) b. aspirin c. buspirone (anti-anxiety) d. cholecalciferol (supplement) e. ditiazem (high blood pressure) f. duloxetine (anti-depressant) g. ferrous gluconate (iron supplement) h. furosemide…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY Based on clinical record review, family and staff interview and policy review, the facility failed to prevent a significant medication error for 1 of 11 residents reviewed (Resident #155). The facility reported a census of 51 residents. Findings Include: The Baseline Care Plan of Resident #155 reflected a date of 4/10/24. The Care Plan documented the resident unable to easily communicate with staff, and to be vision and hearing impaired. The Admit/Readmit Summary, dated 4/10/24 at 7:35 pm, documented the resident admitted to the facility on [DATE], was oriented to self and to place, not to time. The Summary also documented the resident to have moderately impaired vision and moderate difficulty hearing. The Health Status Note, dated 4/13/24 at 7:20 am, documented the resident to be very confused and anxious and not able to follow direction. The Health Status Note, dated 4/13/24 at 11:22 am, documented Resident #155 was in a wheelchair in the dining room when approached by a medication aide and called by a name…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.

Based on observations, clinical record review, staff interview and policy review, the facility failed to maintain infection control standards due to lack of hand hygiene when providing cares and assisting residents to dine for 2 of 23 residents (Resident #15, and Resident #24). The facility reported a census of 51 residents. Findings include: 1. On 4/15/24 at 12:18 pm, dining room observation began for the 200 and 300 hallway of the facility. On 4/15/24 at 12:26 pm, Staff A, Certified Medication Aide (CMA) sat down at a table wearing single use disposable gloves. Resident #15 was to her right and Resident #24 was to her left. Staff A provided set up assistance to Resident #24, removing covers from food and cutting up food. On 4/15/24 at 12:33 pm, Staff A stood up, keeping her gloves on, walked across the dining room to speak to a dietary staff member and then returned to the table. Using her left hand, she picked up the built up silverware for Resident #15 and began to feed him. She alternated, using her right hand to offer assistance to Resident #24. After alternating between…

This is the beginning of the surveyor’s statement, cut to keep the page readable — the full 2567 continues past this point and often ends with the findings that matter most, such as whether an immediate jeopardy was removed before the surveyors left. The complete statement of deficiencies is a public record: request it from your state survey agency, or ask the home for its 2567 and plan of correction — it must make them available to residents and families.