Belle Plaine Specialty Care

In the surveyor’s words

From the most serious findings on record at Belle Plaine Specialty Care, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF851Aug 28, 2025

  Based on The Centers for Medicare and Medicaid Services (CMS) Payroll Based Journal Staffing (PBJ) Data Report (January 1, 2025 -March31, 2025), schedule review, time card review and staff interviews the facility failed to submit accurate staff reports for the PBJ Staffing Data Report. The facility reported a census of 34 residents.Findings Include:The PBJ Staffing Data Report with a run date of 8/21/25 triggered for excessively low weekend staffing and for failing to have licensed nursing coverage 24 hours/day (4 or more days within the quarter with less than 24 hours per day licensed nursing coverage.) The report reflected 10 days with a failure to provide 24/day licensed nurse coverage during January, February and March 2025.A review of the schedules for the days listed in the PBJ… […]

• No harm, potential for more than minimal, widespreadF727Feb 23, 2024

  Based on clinical record review, staff interviews, and observations the facility failed to employ a full time Director of Nurses since 1/26/2024. The facility reported a census of 39. Findings include: During an interview with Staff B, Administrator on 2/19/24 at the start of the survey, Staff B stated the former Director of Nurses (D.O.N.) left facility employment on 1/26/24 after working in facility for approximately 1 year. Staff B provided the surveyor a staff list which identified the D.O.N. as Staff E. Staff E is the full time D.O.N. from one of the corporation's sister facilities. Staff B stated Staff E was interim until a replacement for the former D.O.N. could be found and then stated Staff E will be transferring to this facility. […]

• No harm, potential for more than minimal, widespreadF801Feb 23, 2024

  Based on clinical record review, staff and resident interviews, observations, and dietary schedules the facility failed to employ a full time Dietary Manager since 12/31/23. The facility reported a census of 39. During an interview with Staff B, Administrator on 2/19/24 at the start of the survey, Staff B stated the former Food Service Supervisor left facility employment on 12/31/23. Staff B provided a staff list which failed to identify a Dietary Manager. Staff B stated the Certified Dietary Manager from a sister facility is providing coverage. Staff B acknowledged the facility does not have a Certified Dietary Manager at this time. Staff B stated the Certified Dietary Manager who has been covering occasionally at the facility did not obtain her certification until Feb. 4, 2024. […]

• No harm, potential for more than minimal, widespreadF836Feb 23, 2024

  Based on clinical record review, staff interviews, and observations the facility failed to employ an Assistant Administrator to provide Administrator coverage due to the Administrator being responsible for 2 facilities at the same time. The facility reported a census of 39 residents. Findings include: During an interview with Staff B, Administrator on 2/20/24 at 1:40 pm revealed she is the official administrator for 2 buildings, [NAME] and a sister facility which is 42.9 miles from [NAME]. Staff B stated she does not have an Administrative Assistant in either building. During an interview with Staff A, B.O.M on 2/19/24 at 1:00 pm, Staff A stated the Administrator is responsible for 2 facilities, this facility and a sister facility south of here. […]

• No harm, potential for more than minimal, patternF805Oct 17, 2024

  Based on observations, interviews, and record review, the facility served 1 resident the wrong diet (Resident #27) and failed to initially set up the appropriate diets for 4 other residents with the intention to serve them prior to the Dietician stopping the kitchen staff from serving the wrong diets (Residents #12, #18, #26 and #28). The facility served 37 residents on the day of kitchen observation. The facility reported a census of 37 residents. Findings include: 1. A physician's diet order dated 2/20/24, documented that Resident #12's diet was to be mechanical soft texture. 2. A physician's diet order dated 10/1/21, documented that Resident #18's diet was to be mechanical soft texture. 3. […]