Adel Acres: Doctor Ignores Urgent Calls for Days - IA
That account came from the Director of Nursing herself, during a federal inspection completed October 16. It was not an isolated breakdown. It was, by the accounts of multiple nurses at the facility, the routine.
A licensed practical nurse who works full time at the facility told inspectors the provider does not return calls for two to three days. If something is critical, she said, she escalates to the Medical Director. When new lab results come in with abnormal values, she calls the provider. If no one calls back by the end of her shift, she calls again. She also described a pattern where the provider calls the pharmacy directly to order medications, the drugs arrive at the facility, and nurses have no idea a new order exists. They find out when they go to administer medications and discover something new in the delivery. Then they have to call the provider again to get the order documented. X-ray reports presented the same problem. The provider orders an imaging study, receives the results, and never forwards them to the facility. Nurses don't know the report has come back. They call the provider to find out what it said.
The Director of Nursing told inspectors she had read through progress notes from multiple residents and found repeated entries documenting that the provider hadn't returned a call, or had returned it several hours later. For urgent calls, she said she would expect a callback within five to ten minutes. That standard, she acknowledged, had not been met.
A third nurse, an LPN who also serves as the facility's MDS Coordinator, told inspectors the provider is hard to work with and does not return calls. During business hours, when the provider goes silent, she contacts a transition nurse care manager. After hours, if the provider still hasn't responded to something urgent, she calls repeatedly until she reaches someone, or goes to the Medical Director.
The facility's own physician services policy, last reviewed in April 2022, states that a physician will be available 24 hours a day for the provision or arrangement of emergency care.
The Director of Nursing told inspectors the facility had tried to address the communication breakdown directly. They scheduled a meeting with the provider to work through the problems, including confusion about who was even supposed to be the point of contact. The facility had to cancel that meeting. They planned to reschedule it.
Federal inspectors cited the facility under F0710, which covers physician services, and rated the level of harm as minimal harm or potential for actual harm.
What the citation doesn't capture is the texture of what nurses described: a care system that functions only because individual nurses keep calling back, keep escalating, keep improvising workarounds for a provider who doesn't respond. The LPN who works full time has built a personal protocol around the provider's unavailability. The MDS Coordinator has a separate escalation chain she runs in parallel. The Director of Nursing has read enough progress notes documenting unreturned calls that she can speak to the pattern without hesitation.
A blood sugar of 600 is a medical emergency. The call dropped. The doctor didn't call back. The Director of Nursing told inspectors about it as an example of the communication problems. She did not describe it as the worst thing that had happened. She described it as an example.
The meeting with the provider to discuss the problems had not yet been rescheduled as of the inspection date.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Adel Acres from 2025-10-16 including all violations, facility responses, and corrective action plans.
Additional Resources
Data source: Official federal inspection data from the Centers for Medicare & Medicaid Services (CMS).
Editorial process: AI-synthesized regulatory data, reviewed for accuracy by our editorial team.
Professional review: All content reviewed by Christopher F. Nesbitt, Sr., NH EMT & BU-trained Paralegal.
Last verified: June 24, 2026 · Our methodology
Adel Acres in Adel, IA was cited for violations during a health inspection on October 16, 2025.
That account came from the Director of Nursing herself, during a federal inspection completed October 16.
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.