MercyOne Dyersville Senior Care

In the surveyor’s words

From the most serious findings on record at MercyOne Dyersville Senior Care, in the surveyor’s own words.

• No harm, potential for more than minimal, patternF812Jan 10, 2024

  Based on observation, policy review, and staff interview the facility failed to serve and distribute meals under sanitary conditions. The facility reported a census of 30 residents. Findings include: During an observation on 1/7/24 at 10:21 AM the 2 garbage cans at the end of the prep table were uncovered and approximately 1/2 full. There was baked chicken on the prep table. During an observation on 1/7/24 at 12:11 PM Staff C served 13 cups to 11 residents handling the cups with her palm over the open beverage and fingers on the drinking rim surface. During an observation on 1/8/24 at 4:49 PM the 2 garbage cans at the end of the prep table remained uncovered and approximately 1/3 full. There was bacon, lettuce, tomatoes, toast, and a bin of assembled BLT sandwiches on the table. […]

• No harm, potential for more than minimal, patternF882Jan 10, 2024

  Based on policy review and staff interview the facility failed to have an Infection Preventionist that worked at the facility at least part time. The identified Infection Preventionist worked at a location in a different city. The facility reported a census of 30 residents. Findings include: The undated MercyOne [NAME] Medical Center policy titled Infection Prevention Surveillance Program DB documents the Infection Preventionist services are provided at 96 hours per pay period as identified needs and functions of the hospital. During an interview on 1/9/24 at 2:15 PM Staff B, RN identified herself as the Infection Preventionist. She explained her office was in [NAME] and the facility was treated as a unit of [NAME] even thought the location was in a different city. […]

• No harm, potential for more than minimal, isolatedF880Nov 7, 2024

  Based on observation, staff interview, and policy review the facility failed to wear appropriate Personal Protective Equipment (PPE) when handling soiled laundry. The facility reported a census of 33 residents. Findings include: In an observation on 11/04/24 at 11:18 AM the Environmental Services (EVS) Coordinator donned a pair of gloves and failed to put on a gown before she took soiled clothes out of the bin and placed them into the washer. The soiled clothes came into contact with her scrubs. Chemicals were placed in the tub and the washer was started. She then removed and discarded her gloves. In an interview on 11/04/24 at 11:08 AM the EVS Coordinator explained soiled laundry comes in from Senior Care in clear linen bags. […]

• No harm, potential for more than minimal, isolatedF640Jan 10, 2024

  Based on clinical record review, Center for Medicare and Medicaid Long-Term Care Facility Resident Assessment Instrument (RAI) 3.0 User's Manual review, and staff interview the facility failed to submit a MDS assessment within 14 days of the MDS completion date for 1 of 1 residents sampled for submission (Resident #28). The facility identified a census of 30 residents. Findings include: Resident #28's Minimum Data Set (MDS) assessment dated [DATE] showed a completion date of 11/06/23. An Electronic File Batch Report dated 1/09/23 provided by the MDS Coordinator documented Resident #28's quarterly 10/30/23 MDS as accepted into the data base on 1/09/24 at 9:53 AM. […]

• No harm, potential for more than minimal, isolatedF641Jan 10, 2024

  Based on clinical record review, Center for Medicare and Medicaid (CMS) Long-Term Care (LTC) Facility Resident Assessment Instrument (RAI) 3.0 User's Manual review, and staff interview, the facility failed to accurately code the Minimum Data Set (MDS) Assessment with diagnosis and medication classification for 3 of 3 residents sampled (Resident #5, #21 and #29). The facility identified a census of 30 residents. Finding include: 1. Resident #5's Urology Consultation Note dated 5/31/23 documented long-term use of an indwelling catheter (a catheter which is inserted into the bladder, via the urethra and remains in place to drain urine from the bladder) due to incomplete bladder emptying, likely secondary to neurogenic bladder. […]