The Vistas At Bettendorf

F 0677 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

comes to the floor, but she is on the floor often and she does the nail care. On 8/13/25 at 11:45 AM Staff H, Registered Nurse (RN) stated activities does nail painting and the restorative aides do nail care as an extra from time to time. He had never observed there is any routine nail care that the aides provide. An 8/14/25

review of Resident #58 Shower Sheets showed no nail care documented as completed for the following showers:a. 6/03/25b. 6/13/25c. 6/24/35d. 6/27/25e. 7/04/25f. 7/11/25g. 7/15/25h. 7/18/25Interview on 8/14/25 at 9:48 AM the Assistant Director of Nursing (ADON) reported she expects the CNAs to completed fingernail care with showers/baths and as needed. During an interview on 8/14/25 at 9:51 AM the Director of Nursing (DON) reported activities does a trim and nail polish activity, but it is the responsibility of the CNAs to trim and clean the fingernails with the showers/baths twice a week and as needed. The Undated Nail Care Policy provided by the facility documented a purpose to promote cleanliness, prevent the spread of infection and to prevent injury to the resident or others due to jagged, sharp edges. The Policy lacked direction to the staff on when nail care was to be provided.

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

08/14/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

The Vistas at Bettendorf

2500 Grant Street Bettendorf, IA 52722

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 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

Cincinnati, Ohio to have the culture and sensitivity completed. Then they finally get the laboratory report faxed to the facility. The MDS Coordinator didn't know where the laboratory faxes are received at the facility.

The MDS Coordinator voiced she feels the facility should have some sort of urinary assessment based on

the Mc Geer criteria for at least 48 hours to monitor the resident's condition when they are symptomatic for

a UTI, but to her knowledge, there is no protocol or assessment processes in place to monitor for urinary symptoms until the urinalysis results return. The laboratory takes a long time to get the reports back. An 8/14/25 review of Resident #37 Urinalysis collected on 7/13/25 (per the Progress Notes) documented a specimen collection date of 7/17/25 at 4:11 PM and a Reported date of 7/25/25 at 11:38 AM. The MDS Coordinator explained the Specimen Collection date is the date and time the specimen is processed by the laboratory service and the Reported date/time is when the results are sent back to the facility. The UA had a lapse of 9-10 days from the time of collection to the return of final results. Interview on 8/14/25 at 9:48 AM

the Director of Nursing (DON) reported the facility had no system in place to direct the assessment/monitoring of a resident's change in condition regarding UTI's. The Change of Condition Policy, undated, provided by the facility documented a procedure to assess change of condition and take appropriate actions; document observations, actions taken and response, record at consistent time intervals; report at change of shifts, using the eight-hour report and communication book as a reporting guide. Documentation provides data to ensure continuity of care, written evidence of reason resident received care, a method to review and evaluate care, a legal record and records used to legally prove or disprove failure by the licensed nursing staff, in determining the extent of an injury, the series of events, the actions take by the staff. The Change of Condition Documentation Guidelines under Burning and/or Discomfort in Urination directed to take a full set of vital signs, perform a head to toe physical assessment, assess color, consistency, and odor of urine, signs and symptoms, intake and output each shift for 24 hours

after symptoms have subsided and results of laboratory work if applicable. The Policy directed the licensed staff nurse will make the initial assessment of the change of condition, report the findings to the DON/ADON and document the findings in the electronic medical record progress notes and flag the chart.

The charge nurse and the DON/ADON will monitor residents with a condition change until the condition is resolved or stabilized. Documentation must reflect ongoing assessment/progress or lack of progress. Any licensed nurse on any shift may place a resident on the 24-hour report. The resident's name on the 24-hour report will identify which residents require follow-up documentation during each shift. Only the DON or ADON may remove a resident from follow-up documentation, after they believe the resident is stable.

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

08/14/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

The Vistas at Bettendorf

2500 Grant Street Bettendorf, IA 52722

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 0689 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few

FORM CMS-2567 (02/99) Previous Versions Obsolete

end of the shift. The DON expects the charge nurse to check the 15-minute sheets to ensure the checks are getting done and the documentation is complete. The DON voiced they had a change-over in staff and

they had gotten lax on training the new nurses and that falls on the them. The DON stated the facility did not have a policy or procedure guiding the 15-minute supervision checks.A 8/14/25 review of the Fall Assessment Policy and Protocol, revised 2/26/20, lacked any guidance or direction to the staff regarding 15-minute supervision checks.

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

08/14/2025

NAME OF PROVIDER OR SUPPLIER

STREET ADDRESS, CITY, STATE, ZIP CODE

The Vistas at Bettendorf

2500 Grant Street Bettendorf, IA 52722

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 0726 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Some

During an interview on 8/14/25 at 9:44 PM the DON reported there are no residents that self-administer their medications at this time. They provided an education back in June 2025 specifically about not leaving medications in resident rooms. In order for a resident to have medications in their room, a self-medication administration assessment would be completed by herself, the Assistant Director of Nursing (ADON) or the charge nurse followed by an observation of the resident for medication safety. The resident or legal representative would have to sign a medication administration safety form. The DON reported there is no medication safety assessment for Resident #54 because he cannot self-administer his medications and the nurses should not have left any medication in the resident’s room.

During an interview on 8/14/25 at 11:09 AM the DON explained they utilize the medication administration competency form for training new nurses. A charge nurse would be responsible for training and observing

the new nurse complete medication administration for competency. Each year they do nurse medication competency where she or the ADON watch each nurse complete three resident medication passes. 3.) The Minimum Data Set (MDS) dated [DATE REDACTED] identified Resident #9 as cognitively intact with a BIMS (Brief Interview for Mental Status) score of 14 and had the following diagnoses: Cerebral vascular accident (CVA) , depression and hemiplegia The MDS also identified Resident #9 as partial to moderate assist with most activities of daily living.

On 08/12/2025 at 3:14 PM Resident #9 medications on overbed table next bed, 6 pills in a medication cup.

She just woke up when entered the room and no staff present in the room.

On 08/14/2025 at 11:04 AM Resident #9 Staff U, RN stated I did work Tuesday on the day shift. I did administer Resident #9 medications. I do not leave her medication in her room because sometimes she will not take her medications. She shouldn't have had them in her room she has been know to store them.

Resident #9 takes them in front of me. She should not have medications sitting in her room. I have no idea why they would have been in her room. There were not any medications in the room when I was in the room. Staff U stated medications should not be left in a residents room. 08/14/2025 at 11:15 AM Assistant Director of Nursing (ADON) states medications should not be left at the bed side. Resident #9 would not be appropriate to take medications by herself independently or self administer. We did inservice in June at the nurses meeting about medication administrations. We did bring up to the nurses that medications should not be left at the bedside. Our policy is they should watch them take the medications and swallow the medications.

FORM CMS-2567 (02/99) Previous Versions Obsolete

Event ID:

Facility ID:

If continuation sheet