Federal nursing home survey record · CMS-certified nursing home· Not a state assisted-living licensing record

Centerville Specialty Care

Centerville, IA · 46 certified beds · Last Life Safety survey October 17, 2024

CMS Certification Number 165225 · first certified July 1994

Ownership

Operated by CARE INITIATIVES · Non profit - Corporation

No change of ownership on CMS record since January 1, 2016, when the records begin.

38
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
10
Tags cited more than once
Across separate surveys
20
Inspection & testing records
Of the citations on file

Position within IA

38 citations — more than 100% of the 387 certified nursing homes in IA. Compared within IA rather than nationally because which state a facility is in explains about 30% of the variation in citation counts between facilities, while bed count explains under 1%. State survey agencies differ far more than the buildings do. How this is calculated

Improvingfewer citations at the latest survey than at its earlier surveys in the window.

The latest survey found 9 citations; the earlier surveys in the window averaged 14.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

Well past the typical window (September 2025 to November 2025), and past the point by which nine in ten IA facilities have been surveyed. This facility’s last Life Safety survey was October 2024. Facilities in IA are typically surveyed 11–13 months after the last one (median 12), measured over 700 consecutive surveys in the last two years of CMS records.

A range the record supports, not a prediction of a date. State agencies vary widely — from about 11 months in Pennsylvania to three years in Maryland. How the window is measured

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Which alerts

7 inspection-and-testing tags have been cited here at more than one survey. Nationally, that pattern is common: about three quarters of cited facilities have at least one repeated tag, and half of the facilities ever cited for sprinkler inspection and testing are cited for it again. A repeat is usually a recordkeeping gap rather than a new hazard.

Emergency preparedness

1 of the 38 citations on file is Emergency Preparedness E-tags. E-tags are cited under 42 CFR §483.73 and concern the emergency plan, training, drills, communications and supplies. Nationally about half of certified facilities have at least one. The Emergency Preparedness Index

Physical environment (health survey)

6 physical-environment citations on the health survey. Cited by the health surveyors under Appendix PP, not the Life Safety Code surveyor: equipment in safe operating condition, the call system, bed rails, pest control, hazards, the environment. Counted separately from the 38 Life Safety citations above. The Physical Environment Index

  • F-0880 Provide and implement an infection prevention and control program.
  • F-0689 Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
  • F-0584 Honor the resident's right to a safe, clean, comfortable and homelike environment, including but not limited to receiving treatment and supports for daily living safely.
  • F-0919 Make sure that a working call system is available in each resident's bathroom and bathing area.

How that compares

Citations on file over three years

Compared with the median facility in IA, and nationally. Surveyors differ markedly between states, so the IA figure is the meaningful one.

This facility38IA median12National median11
Citations on file over three years, compared
MeasureCitations
This facility38
Median facility in IA12
Median facility nationally11

Survey history

Citations at each Life Safety survey
162022-07132023-0992024-10
Citations at each Life Safety survey
Survey dateCitations
July 9, 202216
September 18, 202313
October 17, 20249

Most-cited tags

Most-cited tags at this facility
K-02913K-09143K-09183K-03213K-01613K-03533K-07122K-03242
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0291Install emergency lighting that can last at least 1 1/2 hours.32024-10-17
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.32024-10-17
K-0918Have generator or other power source capable of supplying service within 10 seconds.32024-10-17
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.32024-10-17
K-0161Use approved construction type or materials.32024-10-17
K-0353Inspect, test, and maintain automatic sprinkler systems.32024-10-17
K-0712Have simulated fire drills held at unexpected times.22024-10-17
K-0324Provide properly protected cooking facilities.22024-10-17

What the citations cover

Citations by CMS category
  • Smoke Deficiencies 16
  • Gas, Vacuum, and Electrical Systems Deficiencies 9
  • Egress Deficiencies 4
  • Miscellaneous Deficiencies 3
  • Other 6
Citations by CMS category
CategoryCitations
Smoke Deficiencies16
Gas, Vacuum, and Electrical Systems Deficiencies9
Egress Deficiencies4
Miscellaneous Deficiencies3
Construction Deficiencies3
Services Deficiencies2
Emergency Preparedness Deficiencies1

Every citation on file

As published by CMS, newest survey first. Descriptions are CMS’s own wording.

October 17, 2024 — 9 citations

Citations issued on October 17, 2024
TagWhat the surveyor checksStatus
K-0161Use approved construction type or materials.Deficient, Provider has date of correction (October 25, 2024)
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (November 6, 2024)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (October 25, 2024)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (November 24, 2024)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (November 6, 2024)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (November 24, 2024)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (October 25, 2024)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (November 24, 2024)
K-0920Ensure proper usage of power strips and extension cords.Deficient, Provider has date of correction (October 24, 2024)

September 18, 2023 — 13 citations

Citations issued on September 18, 2023
TagWhat the surveyor checksStatus
K-0161Use approved construction type or materials.Deficient, Provider has date of correction (September 19, 2023)
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (September 27, 2023)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (September 19, 2023)
K-0351Install an approved automatic sprinkler system.Deficient, Provider has date of correction (September 25, 2023)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (September 18, 2023)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (September 28, 2023)
K-0372Ensure smoke barriers are constructed to a 1 hour fire resistance rating.Deficient, Provider has date of correction (September 19, 2023)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (September 19, 2023)
K-0712Have simulated fire drills held at unexpected times.Deficient, Provider has date of correction (September 26, 2023)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (September 28, 2023)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (September 27, 2023)
K-0922Meet requirements for the use and maintenance of medical gas equipment.Deficient, Provider has date of correction (September 26, 2023)
K-0929Ensure precautions for handling oxygen cylinders and equipment are correctly followed.Deficient, Provider has date of correction (September 26, 2023)

July 9, 2022 — 16 citations

Citations issued on July 9, 2022
TagWhat the surveyor checksStatus
E-0030List the names and contact information of those in the facility.Deficient, Provider has date of correction (July 8, 2022)
K-0161Use approved construction type or materials.Deficient, Provider has date of correction (July 21, 2022)
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (July 12, 2022)
K-0293Have properly located and lighted "Exit" signs.Deficient, Provider has date of correction (July 11, 2022)
K-0321Ensure that special areas are constructed so that walls can resist fire for one hour or have an approved fire extinguishing system.Deficient, Provider has date of correction (July 20, 2022)
K-0324Provide properly protected cooking facilities.Deficient, Provider has date of correction (July 21, 2022)
K-0345Have approved installation, maintenance and testing program for fire alarm systems.Deficient, Provider has date of correction (July 12, 2022)
K-0346Follow proper procedures when the fire alarm was out of service for more than 4 hours.Deficient, Provider has date of correction (July 14, 2022)
K-0353Inspect, test, and maintain automatic sprinkler systems.Deficient, Provider has date of correction (July 21, 2022)
K-0355Properly select, install, inspect, or maintain portable fire extinguishes.Deficient, Provider has date of correction (July 7, 2022)
K-0362Ensure that corridors are separated from use areas by walls constructed to limit the passage of smoke.Deficient, Provider has date of correction (July 12, 2022)
K-0363Install corridor and hallway doors that block smoke.Deficient, Provider has date of correction (July 21, 2022)
K-0511Have properly installed electrical wiring and gas equipment.Deficient, Provider has date of correction (July 20, 2022)
K-0741Have posted "No-smoking" signs in areas where smoking is not permitted or ashtrays provided where smoking was allowed.Deficient, Provider has date of correction (July 8, 2022)
K-0914Ensure receptacles at patient bed locations and where general anesthesia is administered, are tested after initial installation, replacement or servicing.Deficient, Provider has date of correction (July 22, 2022)
K-0918Have generator or other power source capable of supplying service within 10 seconds.Deficient, Provider has date of correction (August 7, 2022)

Reflects the CMS posting of August 1, 2026. Surveys conducted in the last few months may not appear yet.