Nora Springs Care Center

In the surveyor’s words

From the most serious findings on record at Nora Springs Care Center, in the surveyor’s own words.

• No harm, potential for more than minimal, widespreadF812Jul 23, 2026

  Based on observation and interview, the facility failed to maintain kitchen equipment and clean dishes in a sanitary condition due to a white residue buildup. The facility reported a census of 39 residentsFinding includes:On 7/20/26 at 9:15 AM, an observation during an initial kitchen walkthrough revealed a buildup of white residue on the dishwasher and clean dishes. On 7/20/26 at 10:50 AM, an observation in the kitchen revealed the white residue remained on the dishes and in the dishwasher. On 7/21/26 at 11:05 AM, Staff E, Cook, reported facility staff attempted weekly descaling (removing mineral buildup) on the dishwasher, but dishes still retained the buildup. Staff E reported the Administrator held awareness of the issue. […]

• No harm, potential for more than minimal, isolatedF578Jul 23, 2026

  Based on record review and interview, the facility failed to ensure staff obtained a completed and signed Iowa Physician Orders for Scope of Treatment (IPOST) (end-of-life care order) from a physician for 1 of 8 residents (Resident #4) reviewed for advance directives. The facility reported a census of 39 residents. Findings include: Resident #4's Minimum Data Set (MDS) assessment dated [DATE] documented a Brief Interview for Mental Status (BIMS) score of 8, indicating moderately impaired cognition. Resident #4's Minimum Data Set (MDS) assessment dated [DATE] documented a BIMS score of 12, indicating moderately impaired cognition. […]

• No harm, potential for more than minimal, isolatedF679Jul 23, 2026

  Based on record review, resident and staff interviews, the facility failed to provide resident centered activities that incorporated the resident's interests and hobbies for 1 of 13 residents reviewed (Resident #29). The facility reported a census of 39 residents. Findings include:Resident #29's Minimum Data Set (MDS) assessment dated [DATE] documented a Brief Interview for Mental Status (BIMS) score of 14, indicating intact cognition. Resident #29 reported high importance regarding engaging in favorite activities, attending religious practices, keeping up with news, listening to music, and reading books, newspapers, and magazines. Resident #29's MDS documented diagnoses including anxiety (excessive worry) and depression (mood disorder). […]

• No harm, potential for more than minimal, isolatedF755Jul 23, 2026

  Based on record review, policy review and staff interviews, the facility failed to follow professional standards for reconciling controlled drugs (medication with a high potential for abuse) for 1 of 3 residents reviewed (Resident #36). The facility reported a census of 39 residents. Findings include:Based on observation, record review, and interview, the facility failed to ensure staff members accurately counted and reconciled controlled medications (narcotics), and failed to immediately report a narcotic count discrepancy for 1 of 1 resident (Resident #36) reviewed for medication administration. Resident #36's Minimum Data Set (MDS) assessment dated [DATE] documented a Brief Interview for Mental Status (BIMS) score of 15, indicating intact cognition. […]

• No harm, potential for more than minimal, isolatedF760Jul 23, 2026

  Based on record review and interview, the facility failed to ensure staff administered insulin according to physician orders and failed to notify the physician when holding or altering insulin doses for 2 of 5 residents reviewed (Residents #30 and #22). The facility reported a census of 39 residents. Findings include:1. Resident #30's Minimum Data Set (MDS) assessment dated [DATE] documented a Brief Interview for Mental Status (BIMS) score of 2, indicating severely cognitively impaired. […]