Friendship Home Association
Inspection Findings
F-Tag F0580
F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
physician's response of yes, may use wander guard dated 9/1/25.Review of Resident #3's EHR titled, Progress Report documented no notification of new order for wander guard to Resident #3's representative / Power of Attorney (POA).On 9/3/25 at 2:06 PM Resident #3's POA stated she knew that Resident #3 had
a wander guard because Resident #3 talked to her about it. Resident #3's POA stated she was not notified by the facility staff that Resident #3 had a wander guard placed on her. Resident #3's POA stated Resident #3 had talked to her on the phone and was upset about the wander guard. Resident #3's POA explained that was how she found out Resident #3 had a wander guard placed. On 9/4/25 at 4:04 PM Staff A, Licensed Practical Nurse (LPN) stated she had applied a wander guard to Resident #3 because on 9/1/25 Resident #3 was trying to leave with her sister out the double doors. Staff A explained she requested the order for the wander guard from the physician and did not notify the residents representative / POA of new order or placement of the wander guard. Staff A acknowledged she should have notified Resident #3's representative / POA.On 9/3/25 at 3:11 PM the DON stated Resident #2 had a wander guard on and it was removed. The DON explained she had left it to Staff B to notify Resident #2's family. The DON acknowledged there was no documentation for family/representative/POA notification for wander guard use
on Resident #2 or #3. The DON stated she would expect that there would be family notification of the wander guard placement as well as any new order for a resident at the facility. On 9/4/25 at 11:36 AM the Administrator stated the facility's expectation was the resident's family / POA would be notified of new orders, change in orders, medication changes, or incidents. The Administrator explained there would be an order from a physician for the wander guard use. The Administrator acknowledged she would expect notification to the resident's family / POA of the wander guard application. On 9/4/25 at 9:00 AM the DON explained the facility had no policy with family/POA notification of change in condition, new orders, change
in orders or application of wander guard.
Event ID:
Facility ID:
If continuation sheet
Printed: 04/13/2026 Form Approved OMB No. 0938-0391
Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
B. Wing
A. Building
(X3) DATE SURVEY COMPLETED
09/04/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Friendship Home Association
714 Division Audubon, IA 50025
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)
F-Tag F0689
Federal health inspectors cited Friendship Home Association in Audubon, IA for a deficiency under regulatory tag F-F0689 during a complaint investigation conducted on 2025-09-04.
Category: Quality of Life and Care Deficiencies
The facility was found deficient in the following area: Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Scope/Severity Level D: isolated, no actual harm with potential for more than minimal harm.
While no actual harm was documented, there was potential for more than minimal harm to residents.
This was one of 2 deficiencies cited during this inspection of Friendship Home Association.
Correction Status: Deficient, Provider has date of correction.
The facility reported correction as of 2025-09-05.
Friendship Home Association in Audubon, IA inspection on recent inspection.
Found 0 violation(s). Severity: Standard violations. Status: 0 corrected, 0 pending.
Frequently Asked Questions
- What is an F-tag violation?
- F-tags are federal deficiency codes used by CMS to categorize nursing home violations. Each F-tag corresponds to a specific federal regulation (42 CFR Part 483). For example, F607 relates to abuse prevention policies, F880 relates to infection control.
- Were these violations corrected?
- Facilities must submit plans of correction and implement changes within required timeframes. CMS conducts follow-up inspections to verify corrections. Check the inspection report for specific correction dates and follow-up verification status.
- How often do nursing home inspections happen?
- CMS conducts unannounced inspections of all Medicare/Medicaid-certified nursing homes at least once per year. Additional inspections may occur based on complaints, facility-reported incidents, or follow-up to verify previous violations were corrected.
- What should families do about these violations?
- Families should: (1) Review the full inspection report for details, (2) Ask facility administration about specific corrective actions taken, (3) Check if this represents a pattern by reviewing prior inspections, (4) Compare with other facilities in Audubon, IA, (5) Report new concerns to state authorities.
- Where can I see the full inspection report?
- Complete inspection reports are available on Medicare.gov's Care Compare website (www.medicare.gov/care-compare). You can also request copies directly from Friendship Home Association or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.