Valley View Village
Inspection Findings
F-Tag F0578
F 0578 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
Honor the resident's right to request, refuse, and/or discontinue treatment, to participate in or refuse to participate in experimental research, and to formulate an advance directive. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on clinical record review, staff interviews, and policy review, the facility failed to ensure resident preferences for end of life treatments were followed as indicated on their Iowa Physician Orders for Scope of Treatment (IPOST). for 1 of 1 resident reviewed for advance directives (Resident #2). The facility reported a census of 79 residents.Findings include:The admission Minimum Data Set (MDS) assessment dated [DATE REDACTED] revealed Resident #2 had diagnoses that included hypertension (high blood pressure), Type 2 diabetes, cerebral infarction, heart failure and cardiomyopathy.The Care Plan initiated [DATE REDACTED] for Resident #2 lacked information on end of life treatment for a Full Code Cardiopulmonary Resuscitation (CPR) status with limited interventions.The electronic medical record (EHR) included an IPOST signed [DATE REDACTED] that indicated Resident #2 wanted CPR attempted with limited additional interventions including do not use intubation or mechanical ventilation.In an interview on [DATE REDACTED] at 1:29 PM Staff A, RN was very concerned that she should not talk with me as she no longer works there. She stated that Resident #2 was found unresponsive and they started CPR and called 911 as he was a full code. She stated they put on the AED and it did not advise shock as he was deceased . Staff A, RN then stated that Emergency Medical Services (EMS) arrived and took over CPR. Stated she does not remember if EMS intubated Resident #2 but they may have. She added that she did not remember if Resident #2 was a Do Not Intubate (DNI) as it was very chaotic.In an interview on [DATE REDACTED] at 2:35 PM Staff B, Educational Nurse stated she was pulled into the room by a Certified Nursing Assistant (CNA) who said the resident was unresponsive and she assessed him he was still warm no pulse or respirations. She stated Staff A, RN initiated CPR and not sure who but someone called 911. Staff C, CNA was also present and was quite distressed as she had found Resident #2. Staff B, Educational Nurse then said that EMS arrived and Staff A, RN discussed Resident #2's code status verbally with EMS but did not present the IPOST. Confirmed EMS did intubate Resident #2. Staff B, Educational Nurse stated that no staff tried to stop EMS from intubating. The Power of Attorney (POA) was contacted and CPR was discontinued.In an interview on [DATE REDACTED] at 2:45 PM the Director of Nursing (DON) confirmed that Resident #2 was a full code with DNI. The DON reported typically, if sending someone out,
they present the IPOST but this was very chaotic and both aids were extremely distressed, and that they don't usually do CPR. The DON did state that the IPOST or wishes should have been presented to EMS.In
a policy updated [DATE REDACTED] titled IPOST-Advance directive form implementation it stated in the event of a crisis situation with a resident, staff will be instructed to look at the resident's order for code status and IPOST if
the resident has one. It also indicated that upon discharge or transfer to another facility, the original IPOST form will be included in the discharge papers.
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99) Previous Versions Obsolete
Facility ID:
If continuation sheet
Event ID:
Valley View Village in Des Moines, 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 Des Moines, 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 Valley View Village or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.