Rehabilitation Centers Of Independence West Campus
Inspection Findings
F-Tag F0584
F 0584 Level of Harm - Minimal harm or potential for actual harm
The last time the carpets were cleaned was right before Mother’s Day 2025, they spot clean the carpets regularly but it did not help. The carpet was very dirty and ground in dirt and spots. The carpet had been dirty since she transferred from the sister facility down the street.
Residents Affected - Some
FORM CMS-2567 (02/99) Previous Versions Obsolete
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
08/12/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Rehabilitation Centers of Independence West Campus
1610 Third Street NE Independence, IA 50644
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 F0658
F 0658
Ensure services provided by the nursing facility meet professional standards of quality.
Level of Harm - Minimal harm or potential for actual harm
Based on clinical record review and staff interviews, the facility failed to follow physician orders for one of three residents reviewed (Resident #2). The facility reported a census of 56 residents. Findings include:Resident #2's MDS (Minimum Data Set) dated 7/18/2025 revealed he had no cognitive impairment, had diagnoses including diabetes, absence left toes, anemia, heart failure, renal insufficiency, hypertension and had diabetic foot ulcers. The Care Plan identified the resident had a risk for alteration in skin integrity related to type two diabetes and other circulatory complications. It directed staff to administer treatments per physician orders, encourage good nutrition and hydration in order to promote healthier skin, and observe skin with ADL's (activities of daily living). A Wound Clinic Note dated 7/31/2025 included an order to provide one serving of Prostat AWC (advanced wound care), a protein supplement, one serving daily.
Protein to assist with wound healing.On 8/12/2025 at 12:50 Staff B, DON (Director of Nursing) reported a staff nurse missed the wound clinic order for Prostat. It was hidden in the note dated 7/31/2025.On 8/12/2025 at 1:10 P.M., Staff G, LPN (Licensed Practical Nurse) reported she worked at the facility for 8 years. Resident #2 had a wound clinic order dated 7/31/2025. Staff G revealed she missed the Prostat order from the wound clinic, it was considered an order, and did not know how she missed it. Staff B put the order in the resident's record and notified the physician today. The facility policy titled Physician Orders/Transcription of Orders revised 7/2023 included the following: PURPOSE: To correctly and safely receive/transcribe physician's orders so correct order can be followed/administered. To ensure that patient medications, treatments, and plan of care are in accordance with the licensed providers orders.
Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
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
08/12/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Rehabilitation Centers of Independence West Campus
1610 Third Street NE Independence, IA 50644
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 F0725
F 0725 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
episodes as a result. The resident stated she had kept records of the call lights but only recently started the log. During an interview on 8/12/25 at 10:10 am, the resident revealed that last evening at 6:00 pm she put
on her call light and the staff failed to answer her call light until 6:50 pm.
Interview and review of the computerized Call Light Wait time logs on 8/12/25 at 10:30 am with Staff C-Quality Assurance/Certified Medication Aide revealed the following extended call light response times for Resident #1: a. On 8/5/25 the resident activated her call light at 10:16 am, the staff failed to answer the call light for 28 minutes and 48 seconds. b. On 8/6/25 the resident activated her call light at 8:44 am, the staff failed to answer the call light for 31 minutes and 34 seconds. At 6:21 pm the resident activated her call light,
the staff failed to answer the call light for 20 minutes and 24 seconds. c. On 8/7/25 the resident activated her call light at 5:09 am, the staff failed to answer the call light for 25 minutes and 25 seconds. At 12:04 pm
the resident activated her call light, the staff failed to answer the call light for 40 minutes and 10 seconds. d.
On 8/9/25 the resident activated her call light at 6:36 am, the staff failed to answer the call light for 33 minutes and 6 seconds. At 1:00 pm the resident activated her call light, the staff failed to answer the call light for 19 minutes and 6 seconds. e. On 8/10/25 at 6:16 am the resident activated her call light, the staff failed to answer her call light for 19 minutes and 9 seconds. At 6:18 pm the resident activated her call light,
the staff failed to answer her call light for 23 minutes and 45 seconds. e. On 8/11/25 at 8:03 am the resident activated her call light, the staff failed to answer the call light for 22 minutes and 9 seconds. At 12:36 pm the resident activated her call light, the staff failed to answer her call light for 22 minutes and 4 seconds. At 1:55 pm the resident activated the call light, the staff failed to answer her call light for 17 minutes and 2 seconds.
At 6:10 pm the resident activated her call light, the staff failed to answer her light for 42 minutes and 14 seconds.
Event ID:
Facility ID:
If continuation sheet
Rehabilitation Centers of Independence West Campus in Independence, 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 Independence, 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 Rehabilitation Centers of Independence West Campus or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.