Methodist Manor Retirement Community
Inspection Findings
F-Tag F0684
F 0684 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few
FORM CMS-2567 (02/99) Previous Versions Obsolete
doctor did not want to order UA's when confusion was the only complaint. On 10/16/25 at 1:15 PM, Staff B, Certified Nurse Aide (CNA) said that she worked with Resident #1 in the days leading up to her hospitalization and she provided incontinence care. She said that the resident had reported that it was hurting when they wiped her, and her skin was pink. She had also noticed that her urine had a stronger odor than normal. Staff B said that she told Staff D, RN and nurses' response was to continue to do peri care and let her know if it got worse and to push fluids. The chart for Resident #1 lacked Nursing Progress Notes from 9/4/25 - 9/10/25.The chart for Resident #1 lacked any vital signs from 9/3/25- 9/13/25. A Urinalysis Laboratory Report dated 9/13/25 at 2:37 PM, showed Resident #1 had a UA that was positive for bacteria. The Orders tab showed on 9/13/25 at 6:00 PM Resident #1 was started on an antibiotic for a UTI.
A Performance Improvement Plan dated 9/17/25, showed Staff D was presented with performance concerns including communication with residents and families. The expectation was to ensure all interactions with resident and or resident families were respectful, timely and professional. A hand written note on the bottom of the document showed that Staff D did not sign the document and terminated her employment at that time. On 10/16/25 at 3:30 PM, the Director of Nursing (DON) acknowledged that the nurses should put notes in the residents' chart regarding changes such as burning with urination or odorous urine. She said she had talked to several staff members and none reported to her that Resident #1 had any symptoms before they discovered the UTI. With a change in condition, the DON said that she would expect a note and vital signs if applicable. She said that there were some conflicts between a nurse and the family that caused a breakdown in communications. According to the facility policy titled: Assessment of Changes in Condition; condition change was defined as alteration from normal status.
Clinical record documentation, assessment and follow up was necessary. The licensed nurse would be completed head to toe assessments to include full vital signs. Documentation requirements included nurses' notes, description of problem, vital signs and documentation must show consistent follow up.
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Methodist Manor Retirement Community in Storm Lake, 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 Storm Lake, 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 Methodist Manor Retirement Community or from the state Department of Health. Reports include deficiency codes, facility responses, and correction timelines.