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Complaint Investigation

Community Memorial Health Center

October 7, 2025 · Hartley, IA · 231 North Eighth Avenue West
Citations 2
CMS Rating 3/5
Beds 62
Provider ID 165177
Healthcare Facility
Community Memorial Health Center
Hartley, IA  ·  View full profile →
Inspection Summary

Community Memorial Health Center in Hartley, IA — inspection on October 7, 2025.

Found 2 citations. Severity: Standard violations.

Health inspections identify deficiencies that facilities must correct within required timeframes. Violations range from minor documentation issues to serious safety concerns and are subject to follow-up verification.

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Inspection Findings

FF0609
Freedom from Abuse, Neglect, and Exploitation Deficiencies
Potential for More Than Minimal Harm

Review of the facility Incident Report titled Alleged Abuse dated 3/8/25 at 6:02 p.m. revealed incident description received a phone call from staff regarding Staff A, Certified Nursing Assistant (CNA) and the approach she was using when she was providing total assistance with Resident #1 supper meal.

Review of facility provided documentation titled Self Report of incident occurring on 3/8/25 at 6:05 p.m Review of written statement by Staff B, CNA, dated 3/8/25 at 6:10 p.m., I was feeding across from Staff A when she was feeding Resident #1.

When Staff A offered Resident #1 a bite Staff A shoved the spoon into her mouth hitting her tooth and not paying any attention to where her mouth was.

Staff A hit Resident #1's tooth hard enough to hear across the table.

Staff A shoved another bite in Resident #1's mouth and when she didn't respond she forcefully shook her saying wake up, eat.

After supper was over I called the Director of Nursing (DON) and let her know the situation.

Interview on 10/6/25 at 3:44 p.m., with Staff B revealed she was feeding at the same table as Staff A and Staff A was roughly shaking Resident #1 saying wake up.

Staff B explained Staff A was shaking Resident #1 that her body was shaking and she was not responding to her.

Staff A attempted to give Resident #1 a bite of food and hit her tooth which she heard it across the table.

Staff B explained she called the DON and told about the situation and Staff A was sent home immediately.

Review of the facility intake information the facility submitted a self report on 3/10/25 at 2:24 p.m

Review of the facility policy titled Abuse Policy and Procedure with a revision date of 7/2025 revealed all allegations of Resident abuse shall be reported to the Iowa Department of Inspections and Appeals not later than two (2) hours after the allegation is made.

Interview on 10/7/25 at 11:34 a.m., with the Administrator revealed he thought the DON at the time had submitted the information to the state office.

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

Facility ID:

IDENTIFICATION NUMBER:

A.

Building

COMPLETED

10/07/2025

STREET ADDRESS, CITY, STATE, ZIP CODE

Community Memorial Health Center

231 North Eighth Avenue West Hartley, IA 51346

SUMMARY STATEMENT OF DEFICIENCIES

Review of the facility Incident Report titled Alleged Abuse dated 3/8/25 at 6:02 p.m. revealed incident description received a phone call from staff regarding Staff A, Certified Nursing Assistant (CNA) and the approach she was using when she was providing total assistance with Resident #1 supper meal.

Review of facility provided documentation titled Self Report of incident occurring on 3/8/25 at 6:05 p.m. submitted to the state agency on 3/10/25 at 2:24 p.m Interview on 10/6/25 at 3:44 p.m., with Staff B revealed she was feeding at the same table as Staff A and Staff A was roughly shaking Resident #1 saying wake up.

Staff B explained Staff A was shaking Resident #1 that her body was shaking and she was not responding to her.

Staff A attempted to give Resident #1 a bite of food and hit her tooth which she heard it across the table.

Staff B explained she called the DON and told about the situation and Staff A was sent home immediately.

Review of Resident #1's Progress Notes lacked documentation of the incident from the incident occurring on 3/10/25.

Interview on 10/7/25 at 11:24 a.m., with the Director of Nursing revealed she expects something to be in the chart about the incident.

Facility ID:

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 Hartley, 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 Community Memorial Health Center or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.


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