Accura Healthcare Of Pleasantville, Llc

Based on record review, observations, staff interviews, and policy review the facility staff failed to change gloves when performed cares and then touched other objects for one of four residents sampled for cares (Resident #18).

The facility staff also failed to disinfect a mechanical lift after use for one of three residents observed for transfers.

The facility reported a census of 45 residents.

• The Quarterly Minimum Data Set (MDS) assessment dated [DATE] revealed Resident #18 had diagnoses

of cerebrovascular accident (CVA)(stroke), hemiplegia (paralysis on one side of the body) and neurogenic bladder (loss of bladder control).

The MDS recorded the resident had an indwelling catheter.

The MDS documented the resident required partial to moderate assistance for toileting hygiene and substantial to maximum assistance for lower body dressing.

The Care Plan revised 2/17/25 revealed the resident required Assistance with activities of Daily Living (ADL's) related to cerebral infarction and hemiplegia and had a catheter.

The Care Plan revealed the resident transferred and moved in bed independently and required staff assistance as needed.

The Care Plan directed staff to use enhanced barrier precautions related to the catheter.

During observations on 5/1/25 at 10:25 AM, Staff G, Certified Nursing Assistant (CNA) and Staff B, Certified Medication Aide (CMA) washed their hands, then donned a gown, mask with a face shield, and gloves.

Staff G removed Resident #18's brief tabs, then took disposable wipes as Staff B handed the wipes to her and cleansed the resident's peri-area and groin.

Staff assisted the resident to roll onto his right side.

Staff G changed her gloves, then took disposable wipes and cleansed the buttocks area.

Staff B placed a clean brief under the resident and staff assisted the resident to roll onto his left side.

Staff G continued to wear the same gloves and touched the back of the resident's shirt as she supported the resident and as Staff B cleansed the buttocks.

The resident rolled onto his back and the brief tabs were attached.

Staff G placed a blanket over the resident, placed the call light by the resident, then handed the resident a grabber device.

Staff B picked up a beverage mug and offered the resident a drink of water.

Staff G and Staff B removed their gown and gloves.

Staff B then reached into her uniform pocket and applied hand sanitizer to her hands.

The Assistant Director of Nursing stood in the room and observed staff with the surveyor.

In an interview 5/6/25 at 9:47 AM, Staff D, Licensed Practical Nurse (LPN) reported gloves changed whenever staff did cares and went and did something else.

In an interview 5/6/25 at 11:30 AM, the Director of Nursing (DON) reported she expected staff changed gloves before and after cares, and anytime staff went from a dirty to a clean task or area.

In an interview 5/7/25 at 2:40 PM, the Administrator confirmed no other policy for glove changes found.

08/27/2025

N o. 0938-0391

IDENTIFICATION NUMBER:(X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY COMPLETED

05/08/2025 Accura Healthcare of Pleasantville, LLC 909 North State Street Pleasantville, IA 50225

potential for actual harm

A Using Gloves policy updated on 11/13/24 revealed gloves worn to prevent contamination of the employee's hands whenever services provided to the resident.

Gloves must be replaced as soon as practical when contaminated.

• During continuous observations on 4/30/25 at 2:01 PM, Staff H, CNA wore gloves as she pushed a

mechanical lift out of room [ROOM NUMBER] into the hallway.

Staff H parked the mechanical lift along the hallway railing, then told the resident to have a good nap.

Staff H walked back into the room and removed the gloves from her hands. At 2:03 PM, a hospice CNA took the mechanical lift and pushed the lift into room [ROOM NUMBER].

The mechanical lift was not disinfected before or after use.

In an interview 5/6/25 at 9:47 AM, Staff D, Licensed Practical Nurse (LPN) reported equipment such as a mechanical lift needed to be disinfected after use.

In an interview 5/6/25 at 11:30 AM, the DON reported equipment such as mechanical lifts needed disinfected before and after use.

An untitled facility policy updated on 11/13/24 under Miscellaneous revealed equipment cleaned and sanitized prior to using in other areas.

08/27/2025

N o. 0938-0391

IDENTIFICATION NUMBER:(X2) MULTIPLE CONSTRUCTION (X3) DATE SURVEY COMPLETED

05/08/2025 Accura Healthcare of Pleasantville, LLC 909 North State Street Pleasantville, IA 50225

potential for actual harm

Ensure nurse aides have the skills they need to care for residents, and give nurse aides education in dementia care and abuse prevention.

Based on employee roster review, education transcript review and staff interviews, the facility staff failed to complete a minimum of 12 hours of regular in-service education for 3 of 4 Certified Nursing Assistants (CNAs) sampled who had worked at the facility greater than 1 year (Staff G, Staff M, and Staff N).

The facility identified a census of 45.

• A CNA-CMA Roster revealed Staff G, CNA, had a hire date 5/20/21, Staff M, CNA, had a hire date of

10/9/23 and Staff N, CNA, had a hire date 7/6/22.

The Relias Education Transcripts reviewed 5/2024 - 4/2025 revealed the education and number of hours completed for the following: Staff G =8.95 hours completed Staff M = 1.0 hours completed Staff N = 0 hours completed During interview on 5/6/25 at 11:30 AM, the Director of Nursing reported mandatory staff in-services held monthly and education courses set up on Relias for staff to complete.

The DON reported staff needed to complete at least 12 hours of education each year.

During an interview on 5/7/25 at 11:10 AM, the Administrator reported the staff who worked nights don't attend the staff meetings and in-service training.

She tried to get the staff to attend the meetings/in-services but when they worked nights, it was hard.

08/27/2025