Accura Healthcare of Pomeroy: Staff Training Failures - IA
The woman, identified in federal inspection records only as Resident 5, told inspectors on August 12 that she was worried about good staff leaving and that the temporary aides coming in to replace them "don't know what they are doing." She was on dialysis. She said she was feeling better. She also said she had to walk a stranger through her own intimate care because that stranger had arrived for a shift without knowing how to do it.
Federal inspectors cited Accura Healthcare of Pomeroy following a complaint inspection completed August 13, 2025, finding the facility had failed to ensure that temporary nurses and aides were trained before working independently with residents. The facility had 36 residents at the time.
The staffing agency workers inspectors interviewed, one registered nurse and three certified nurse aides, each described some version of the same experience: they showed up, they worked, and nobody made sure they knew what they were doing first.
Staff L, a CNA with a staffing agency, was in the middle of helping residents with transfers when inspectors observed her on the afternoon of August 12. It was her second day at the facility. She told inspectors the last time she had worked there was six months earlier. She said she had not received an orientation. She did not remember anyone offering her an education checklist before she started working with residents on her own.
Staff E, another agency CNA, had worked the overnight shift the previous Sunday. She told inspectors it was a difficult night because she was the only aide on the floor. At some point during that shift, she tried to transfer Resident 2 without the mechanical lift because he told her he could stand. He couldn't. She realized it mid-transfer, lowered him back onto the bed, and that was that. She told inspectors she had worked several shifts at the facility and had never received an orientation or any education before working independently with residents.
Working alone overnight. One aide. Thirty-six residents. A mechanical lift bypassed on the word of a resident who turned out not to be able to stand.
Staff M, a CNA who also worked overnight shifts, told inspectors she had received no orientation and no education either. She said she knew how to transfer residents and provide care because she had been a CNA for a long time. That may be true. It may also be true that knowing how to be a CNA is not the same as knowing this facility, these residents, this building's layout, which residents require which equipment, which doors have alarms, who to call when something goes wrong at 3 in the morning.
Staff D, a registered nurse who worked weekends at the facility, told inspectors that when she first started, she was expected to come in an hour early and another nurse showed her around the building. She did not remember receiving a complete orientation. She did not remember signing a checklist.
The facility had a checklist. That's the thing. Accura Healthcare of Pomeroy had a form, titled Agency Staff Checklist, that laid out exactly what orientation was supposed to cover: a tour of the facility, shift routines, resident care procedures, how to use the mechanical lifts, how to document, how to handle narcotic counts, medication delivery, what to do when a resident's condition changes, how to use the 24-hour report, how to access pocket care plans. The list went further. Door alarms. Telephone use. Walkie-talkies. The abuse policy, what to report and when. How to handle falls, skin issues, medication errors, deaths. Emergency procedures for fire, weather, elopement. How to reach a physician. How to contact a hospital. The form ended with a signature line where staff acknowledged they had received training on all of it.
The form existed. The training, for at least four of the agency workers inspectors asked about, did not happen.
On the afternoon of August 12, the Administrator and the Assistant Director of Nursing told inspectors they had orientation checklists for agency staff. The Director of Nursing was absent. They said they would look for documentation showing that Staff C, Staff E, and Staff D had been oriented. The next morning, administration told inspectors that many orientation checklists were on the DON's desk, but the three that had been specifically requested were not among them.
The checklists for the staff inspectors asked about were missing. The training those checklists were supposed to document had not happened, or if it had, nobody could show it.
There is a particular quality to what Staff M said, that she knew how to do the work because she had been a CNA for a long time, that deserves some attention. It is the reasonable thing to say. It is also the response of someone who was never given another option. Nobody sat her down. Nobody walked her through the building. Nobody told her which residents used mechanical lifts, which doors alarmed, who to call if something happened. She came in and she worked and she figured it out or she didn't, and so far nothing catastrophic had been documented as a result, and so the arrangement continued.
Staff E's night, working alone on the floor, illustrates how close the margin can get. A resident says he can stand. Maybe he has said it before and been right. Maybe he said it because he wanted to help, wanted to make the transfer easier for the one aide managing the whole floor. She starts the transfer without the lift. He can't stand. She gets him back down. Nobody is hurt. The incident ends up in an inspection report rather than an incident report.
Resident 5 sat in the dayroom that morning, on dialysis, bruised from a recent hospitalization, and explained to an aide how to help her with her catheter. She is not identified by name in the report. She told inspectors she was feeling much better. She also told them what she had noticed happening at the facility, the good staff leaving, the temporary workers arriving who didn't know what they were doing. She had watched it long enough to have a theory about it.
She was right. Inspectors confirmed it.
The violation was cited at a level of minimal harm or potential for actual harm, which is the lower end of the federal harm scale. That designation reflects what inspectors could document, not the full range of what was possible on an overnight shift with one untrained aide and thirty-six residents.
The Director of Nursing was not in the building during the inspection. The checklists were on her desk.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Accura Healthcare of Pomeroy, LLC from 2025-08-13 including all violations, facility responses, and corrective action plans.
Download the official CMS inspection PDF from Medicare.gov
Additional Resources
Data source: This article is based on inspection data downloaded directly from the Centers for Medicare & Medicaid Services (CMS) via Medicare.gov. CMS releases inspection reports in bulk; we publish the findings as documented by state surveyors in the official Form CMS-2567 Statement of Deficiencies.
Plan of correction: The CMS report we receive does not include the facility's plan of correction. Facilities submit plans of correction separately to state survey agencies and those responses may not be reflected in CMS data at the time of publication. The absence of a plan of correction in our data does not mean one was not filed. Readers who want information about corrective steps taken are encouraged to contact the facility directly or their state survey agency.
Corrections may have occurred: Inspection reports reflect conditions observed on the date of the survey. Facilities may have implemented corrections, staffing changes, additional training, or other remediation since the report was issued. We report what CMS provides and encourage readers to seek current information from the facility.
Editorial process: Inspection findings are extracted from CMS source documents and synthesized using AI, reviewed for factual accuracy against the original report by our editorial team.
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Last verified: November 3, 2026 · Our methodology
Accura Healthcare of Pomeroy, LLC in Pomeroy, IA was cited for violations during a health inspection on August 13, 2025.
She said she was feeling better.
Health inspections identify deficiencies that facilities must correct. Violations range from minor documentation issues to serious safety concerns. Review the full report below for specific details and facility response.