PEARL VALLEY REHABILITATION AND NURSING AT GOWRIE,
Inspection History Overview
Health Violations by Year
2025 18 violations
Ensure that residents are fully informed and understand their health status, care and treatments.
Allow residents to self-administer drugs if determined clinically appropriate.
Prevent the use of unnecessary psychotropic medications or use medications that may restrain a resident's ability to function.
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Provide the required documentation or notification related to the resident's needs, appeal rights, or bed-hold policies.
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Ensure each resident receives an accurate assessment.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Provide safe and appropriate respiratory care for a resident when needed.
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Have a plan that describes the process for conducting QAPI and QAA activities.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Provide enough food/fluids to maintain a resident's health.
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Have a plan that describes the process for conducting QAPI and QAA activities.
2024 25 violations
Ensure services provided by the nursing facility meet professional standards of quality.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Electronically submit to CMS complete and accurate direct care staffing information, based on payroll and other verifiable and auditable data.
Have a plan that describes the process for conducting QAPI and QAA activities.
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Ensure services provided by the nursing facility meet professional standards of quality.
Provide care and assistance to perform activities of daily living for any resident who is unable.
Provide appropriate treatment and care according to orders, residentβs preferences and goals.
Provide appropriate pressure ulcer care and prevent new ulcers from developing.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Provide enough food/fluids to maintain a resident's health.
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Ensure meals and snacks are served at times in accordance with residentβs needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
2023 43 violations
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Ensure services provided by the nursing facility meet professional standards of quality.
Provide appropriate treatment and care according to orders, residentβs preferences and goals.
Ensure meals and snacks are served at times in accordance with residentβs needs, preferences, and requests. Suitable and nourishing alternative meals and snacks must be provided for residents who want to eat at non-traditional times or outside of scheduled meal times.
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Make sure that the nursing home area is safe, easy to use, clean and comfortable for residents, staff and the public.
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Provide appropriate care for residents who are continent or incontinent of bowel/bladder, appropriate catheter care, and appropriate care to prevent urinary tract infections.
Ensure that the resident and his/her doctor meet face-to-face at all required visits.
Provide pharmaceutical services to meet the needs of each resident and employ or obtain the services of a licensed pharmacist.
Ensure that residents are free from significant medication errors.
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Employ sufficient staff with the appropriate competencies and skills sets to carry out the functions of the food and nutrition service, including a qualified dietician.
Provide sufficient support personnel to safely and effectively carry out the functions of the food and nutrition service.
Ensure menus must meet the nutritional needs of residents, be prepared in advance, be followed, be updated, be reviewed by dietician, and meet the needs of the resident.
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Honor the resident's right to manage his or her financial affairs.
2022 39 violations
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Ensure services provided by the nursing facility meet professional standards of quality.
Plan the resident's discharge to meet the resident's goals and needs.
Ensure necessary information is communicated to the resident, and receiving health care provider at the time of a planned discharge.
Provide care and assistance to perform activities of daily living for any resident who is unable.
Provide activities to meet all resident's needs.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Ensure that nurses and nurse aides have the appropriate competencies to care for every resident in a way that maximizes each resident's well being.
Ensure that residents are free from significant medication errors.
Set up an ongoing quality assessment and assurance group to review quality deficiencies and develop corrective plans of action.
Provide and implement an infection prevention and control program.
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
Report COVID19 data to residents and families.
Perform COVID19 testing on residents and staff.
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Honor the resident's right to voice grievances without discrimination or reprisal and the facility must establish a grievance policy and make prompt efforts to resolve grievances.
Protect each resident from all types of abuse such as physical, mental, sexual abuse, physical punishment, and neglect by anybody.
Develop and implement policies and procedures to prevent abuse, neglect, and theft.
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
2021 22 violations
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.
Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident.
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Ensure a qualified health professional conducts resident assessments.
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Ensure services provided by the nursing facility meet professional standards of quality.
Provide care and assistance to perform activities of daily living for any resident who is unable.
Provide appropriate treatment and care according to orders, residentβs preferences and goals.
Provide safe and appropriate respiratory care for a resident when needed.
Provide enough nursing staff every day to meet the needs of every resident; and have a licensed nurse in charge on each shift.
Implement gradual dose reductions(GDR) and non-pharmacological interventions, unless contraindicated, prior to initiating or instead of continuing psychotropic medication; and PRN orders for psychotropic medications are only used when the medication is necessary and PRN use is limited.
Ensure drugs and biologicals used in the facility are labeled in accordance with currently accepted professional principles; and all drugs and biologicals must be stored in locked compartments, separately locked, compartments for controlled drugs.
Ensure the facility is licensed under applicable State and local law and operates and provides services in compliance with all applicable Federal, State, and local laws, regulations, and codes, and with accepted professional standards.
Conduct and document a facility-wide assessment to determine what resources are necessary to care for residents competently during both day-to-day operations and emergencies.
Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards.
Arrange for the provision of hospice services or assist the resident in transferring to a facility that will arrange for the provision of hospice services.
Provide and implement an infection prevention and control program.
Designate a qualified infection preventionist to be responsible for the infection prevent and control program in the nursing home.
2020 7 violations
Provide and implement an infection prevention and control program.
Provide and implement an infection prevention and control program.
Timely report suspected abuse, neglect, or theft and report the results of the investigation to proper authorities.
Coordinate assessments with the pre-admission screening and resident review program; and referring for services as needed.
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Observe each nurse aide's job performance and give regular training.
2019 12 violations
Not transfer or discharge a resident without an adequate reason; and must provide documentation and convey specific information when a resident is transferred or discharged.
Honor the resident's right to and the facility must promote and facilitate resident self-determination through support of resident choice.
Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
Not hire anyone with a finding of abuse, neglect, exploitation, or theft.
Provide timely notification to the resident, and if applicable to the resident representative and ombudsman, before transfer or discharge, including appeal rights.
Notify the resident or the residentβs representative in writing how long the nursing home will hold the residentβs bed in cases of transfer to a hospital or therapeutic leave.
Create and put into place a plan for meeting the resident's most immediate needs within 48 hours of being admitted
Ensure services provided by the nursing facility meet professional standards of quality.
Provide care and assistance to perform activities of daily living for any resident who is unable.
Provide activities to meet all resident's needs.
Have a registered nurse on duty 8 hours a day; and select a registered nurse to be the director of nurses on a full time basis.
Verify that a nurse aide has been trained; and if they haven't worked as a nurse aide for 2 years, receive retraining.
2017 9 violations
Provide medically-related social services to help each resident achieve the highest possible quality of life.
Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible.
Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Ensure services provided by the nursing facility meet professional standards of quality.
Provide care by qualified persons according to each resident's written plan of care.
Ensure that each resident's 1) entire drug/medication regimen is free from unnecessary drugs; and 2) is managed and monitored to achieve highest level of well-being.
Reasonably accommodate the needs and preferences of each resident.
Provide necessary care and services to maintain or improve the highest well being of each resident .
Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
2016 9 violations
Protect each resident from all abuse, physical punishment, and involuntary separation from others.
1) Hire only people with no legal history of abusing, neglecting or mistreating residents; or 2) report and investigate any acts or reports of abuse, neglect or mistreatment of residents.
Ensure residents have the right to have a choice over activities, their schedules, and health care according to their interests, assessments, and plans of care.
Provide a safe, clean, comfortable and home-like environment; and allow residents to use personal belongings to the extent possible.
Develop a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Provide care by qualified persons according to each resident's written plan of care.
Ensure that a nursing home area is free from accident hazards and provide adequate supervision to prevent avoidable accidents.
Have enough nurses to care for every resident in a way that maximizes the resident's well being.
Store, cook, and serve food in a safe and clean way.
Detailed Inspection Reports
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Fines and Penalties by Year
2022 5 penalties totaling $689,425
2021 6 penalties totaling $26,551
Fire Safety Deficiencies
No description available