Perry Lutheran Homes Eden Acres Campus
Inspection Findings
F-Tag F0689
F 0689 Level of Harm - Actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
the resident. Staff F further stated the gait belt is part of the uniform and it is in the employee handbook that
they are required to be worn. Staff F stated extra gait belts are in the supply room and the report sheet provided information on the residents' care and assistance needed. Facility Gait Belts Policy dated 2/2025, directed that all employees providing direct resident care are required to utilize a gait belt whenever hands
on assistance is needed for resident transfer and/or ambulation unless otherwise indicated with the rationale to ensure that the residents and employees' safety is protected during transfers and ambulation.
The gait belt is to be considered a part of the uniform. All direct care staff are required to wear the gait belt while on duty and things to remember include: the gait belt can be used to assist with walking, it can serve as a handle if the resident begins to fall, and this can help to prevent the fall or control the resident's descent. Facility form with Topics: Basic AM and hour of sleep cares, Gait Belts, Empathy, and Care of Skin dated 9/16/25 revealed Staff A signed as completing the training. Interview on 10/28/25 at 3:45 PM, the Administrator stated her expectation for staff to always use the gait belt for transfers/ambulation with residents that require assistance.
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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
10/30/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Perry Lutheran Homes Eden Acres Campus
1300 28th Street Perry, IA 50220
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 F0943
F 0943 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
Give their staff education on dementia care, and what abuse, neglect, and exploitation are; and how to report abuse, neglect, and exploitation.
Based on record review, staff interview, and policy review the facility failed to have staff currently certified in Dependent Adult Abuse Mandatory Reporter Training for 1 of 1 staff reviewed. Facility reported a census of 47.Findings include:Review of Staff A's, Certified Nurse Aide, education file lacked an Iowa Department of Health and Human Services certificate for Dependent Adult Mandatory Reporter Training. On 10/29/25 at 7:20 PM, the Administrator (ADM) sent via email a certificate for Dependent Adult Abuse Mandatory Reporter Training dated 10/29/25 for Staff A. Facility Abuse Policy dated 2/2025, revealed upon initial employment, each employee shall be provided with a copy of the facility's policies and procedures relating to abuse identification and reporting requirements. Each employee shall be required to complete two hours of training relating to the identification and reporting of dependent adult abuse within six months of initial employment. Each employee shall complete at least two hours of additional dependent adult abuse identification and reporting training every five years. Interview on 10/30/25 at 9:45 AM, the ADM stated she was unable to provide no other Dependent Adult Abuse Mandatory Reporter Training certification prior to
the certificate she provided on 10/29/25 at 7:15 PM for Staff A. The ADM stated she had a spread sheet that documented Staff A was due in October for the training but was unable to find the certificate that shows the staff was due. The ADM stated her expectation for staff to be current with training.
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Perry Lutheran Homes Eden Acres Campus in Perry, 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 Perry, 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 Perry Lutheran Homes Eden Acres Campus or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.