Iowa Department of Inspections

The Iowa Department of Inspections, Appeals and Licensing is responsible for overseeing the state’s 264 assisted living centers.

Eleven of Iowa’s 264 state-regulated assisted living centers were subject to fines last year for failing to meet regulatory standards.

While nursing homes that accept Medicaid and Medicare money for patient care are federally regulated, with state inspectors tasked with inspecting homes and enforcing those regulations, Iowa’s assisted living centers are regulated and inspected by the state.

Compared to nursing homes, Iowa’s assisted living centers are rarely fined by the state agency that handles inspections, the Iowa Department of Inspections, Appeals and Licensing. The agency’s website indicates that in 2024, 11 assisted living centers were cited for violations that, to date, have resulted in financial penalties from DIAL.A few of the assisted living facilities that were fined:

According to inspectors, a resident’s family came to the facility to check on a female relative and found the woman on the floor where she had fallen two days earlier. The woman was treated for dehydration and seven cracked ribs, then moved to a hospice program where she died within a few weeks. Northridge Village officials later told inspectors the woman’s pendant had been deactivated by mistake. In addition, management was unable to locate any policies related to personal emergency response systems.

Assisted Living at Copper Shores Village, Pleasant Hill – In April, this facility was fined $7,500 for its response after a female resident sustained serious injuries in a fall. The woman, who had dementia, was “discovered standing in her apartment with blood on her face” about 4:30 a.m. Feb. 16, 2024, inspectors reported. The woman had a bump on her head, a possible broken nose and a swollen face, the staff later reported. The home’s registered nurse, who was not on site, wanted to do a video chat with the staff and the resident, inspectors reported, but the staff could not figure out how to set that up and so the nurse ordered Steri-Strips to be applied to a cut on the woman’s face and ice for her face and head.

Within a few hours, another worker arrived at Copper Shores and concluded the woman needed to be evaluated at a hospital. However, her colleague advised her the registered nurse had already ordered that the woman be treated in-house and not sent to a hospital. Later an “assistant registered nurse” arrived at Copper Shores for work and called the registered nurse to say she, too, wanted the woman sent to the hospital for an evaluation. When the nurse again rejected that option, the assistant registered nurse became upset and one of the two eventually telephoned the on-call physician who ordered a hospital evaluation.

At the hospital, the woman was diagnosed with a fractured vertebrae in her neck and a broken nose. Inspectors later concluded that that the registered nurse had documented, in the resident’s file, an assessment of the woman’s injuries “even though she had not come to the facility” to provide such an assessment.

Heritage Court Assisted Living, West Des Moines – In June, this facility was fined $500 for failing to conduct the required background checks on workers. One worker’s background check was performed nine months after she was hired. Others were hired one, two or eight months before their background checks were completed.

Independence Village, Ankeny – In June, this facility was fined $7,000 after inspectors reviewed care provided to six residents and determined that in five of the six cases, the facility failed to provide the necessary treatment. One of the residents, who was diabetic, had a foot amputated, after which the home allegedly failed to provide assistance with wound care, which meant the man had to undergo an infusion of antibiotics. The facility also failed to provide him with the prescribed pain killers, resulting in what the resident called a period of “excruciating pain.”

A resident who didn’t receive his meal trays told inspectors he believed the facility had cut staffing levels and there was no longer enough employees to meet residents’ needs. Other violations were tied to residents not receiving their prescribed physical therapy or medications.

Irving Point, Cedar Rapids – In September, the facility was fined $3,500 for failing to have a nurse review a resident’s health after a change in that resident’s condition. In November 2023, a female resident’s daughter came to the facility and found her mother seated on a couch, “soaked in urine without pants,” and unable to answer questions. There were four containers of meals on a nearby table that had not been touched except for one dessert that had been consumed. The daughter called 911 and the resident was taken to a hospital and admitted with a diagnosis of sepsis and a urinary tract infection.

Eagle Pointe Place, Dubuque – In November, this facility was fined $3,500 for failing to follow proper protocols for the administration of medication. On Oct. 8, 2024, a resident alerted the staff to the fact that she had just been handed someone else’s medication – raising the question of who had received the woman’s intended drugs. An investigation showed another resident had received the six drugs and had subsequently become lethargic. That resident was taken to a hospital for treatment, placed on oxygen, and discharged a short time later. Had the woman not been taken to the emergency room, she “may not have made it,” inspectors reported.

Keystone Cedars Assisted Living, Cedar Rapids – In September, this facility was fined $500 for failing to conduct the required criminal history and abuse background checks for two of the eight workers whose files were reviewed. One worker, who was a minor when hired, was employed beginning in July 2023, but a background check had never been performed.