Iowa City Rehab & Health Care

In the surveyor’s words

From the most serious findings on record at Iowa City Rehab & Health Care, in the surveyor’s own words.

• Immediate jeopardy, isolatedF689Dec 8, 2022

  Based on observation, clinical record review, policy review, and staff interviews, the facility failed to ensure the functioning of a wanderer alert device worn by a resident with a known history of leaving the building, in order to prevent an elopement for 1 of 3 residents reviewed for elopement (Resident #3). Resident #3's wanderer alert device was not in functioning order allowing Resident #3 to exit the facility on [DATE] and staff only became aware of the elopement when another resident observed Resident #3 walking down a highly traveled street in front of the facility. The facility also failed to check the wanderer alert device on a regular basis to know the resident's wanderer alert device was not in working order due to the fact the device was expired. […]

• No harm, potential for more than minimal, widespreadF882Mar 4, 2025

  Based on clinical record review, staff and resident interviews and observations the facility failed to employ an Infection Prevention Specialist. The facility reported a census of 45. Findings include: Observation of a facility provided list of all staff on 3/3/25 at approximately 10:00 am failed to include an Infection Prevention Specialist or and Infection Control Nurse. During an interview with Staff F-Administrator on 3/4/25 at 9:00 am, she stated that approximately 1 month ago she lost her Director of Nurses and Assistant Director of Nurses. She stated the Assistant Director of Nurses did the infection control for the facility and she did not have anyone to fulfill this role as she left. […]

• No harm, potential for more than minimal, widespreadF572May 25, 2023

  Based on a Resident Council Meeting, staff interviews, document review, and policy review, the facility failed to ensure residents were provided their resident rights both orally and written annually for 10 of 10 residents interviewed in resident council (Resident #2, #47, #31, #24, #13, #15, #36, #44, #11, and #21). This had the potential to affect all 51 residents residing in the facility. Findings Include: During a Resident Council Meeting on 05/24/23 at 10:01 AM, the residents were not aware of their resident rights. […]

• No harm, potential for more than minimal, widespreadF680May 25, 2023

  Based on a review of the facility's policy, Employee Termination Notice, and staff interview, the facility failed to ensure the facility's Activity Program was under the direction of a qualified therapeutic recreation specialist or activities professional. The facility's failure had the potential for activities not to be individualized for the skills, abilities, interests, and preferences of all 51 facility residents. Findings Include: Review of the facility's policy titled, Recreational and Therapeutic Activities Manual, Program Guide, dated 01/2013, provided by the facility, indicated the Recreational and Therapeutic Activity staff utilizes programming opportunities to offer variety to residents/patients. […]

• No harm, potential for more than minimal, widespreadF727May 25, 2023

  Based on record review, document review and staff interview, the facility failed to ensure a Registered Nurse (RN) was on duty eight consecutive hours per day seven days a week. This had the potential to affect all 51 residents residing in the facility. Findings include: Review the [NAME] Payroll Based Journal (PBJ), First Quarter 2022 for dates October 1 -December 31, 2022, revealed during the first quarter the facility was identified as not having a RN working on the dates of 10/01, 10/02, 10/07, 10/08, 10/09, 10/13, 10/14, 10/15, 10/16, 10/22 10/23, 10/29, 10/30, 11/05, 11/06, 11/12, 11/13, 11/25, 11/26, 11/30, 12/10, 12/13, 12/14, 12/15, 12/16, and 12/23, for 8 consecutive hours each day. […]