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

Pleasantview Home

Kalona, IA · 66 certified beds · Last Life Safety survey April 2, 2026

CMS Certification Number 165470 · first certified September 2002

Ownership

Independently operated (no chain recorded by CMS) · Non profit - Corporation

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

7
Citations on file
Rolling three-year window
3
Life Safety surveys
In the same window
1
Tags cited more than once
Across separate surveys
2
Inspection & testing records
Of the citations on file

Position within IA

7 citations — more than 19% 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

Holding steadyabout the same at the latest survey as at its earlier surveys in the window.

The latest survey found 2 citations; the earlier surveys in the window averaged 2.5. With 3 surveys on file this is a direction of travel, not a conclusion.

When is the next survey likely?

The window opens February 2027 — about 5 months from now. This facility’s last Life Safety survey was April 2026. 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

Emergency preparedness

2 of the 7 citations on file are 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)

3 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 7 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.

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 facility7IA median12National median11
Citations on file over three years, compared
MeasureCitations
This facility7
Median facility in IA12
Median facility nationally11

Survey history

Citations at each Life Safety survey
22024-0632025-0322026-04
Citations at each Life Safety survey
Survey dateCitations
June 13, 20242
March 27, 20253
April 2, 20262

Most-cited tags

Most-cited tags at this facility
K-07112K-02911E-00041K-03461K-09231E-00391
Most-cited tags at this facility
TagWhat the surveyor checksTimes citedLast cited
K-0711Provide a written emergency evacuation plan.22025-03-27
K-0291Install emergency lighting that can last at least 1 1/2 hours.12024-06-13
E-0004Develop and maintain an Emergency Preparedness Program (EP).12026-04-02
K-0346Follow proper procedures when the fire alarm was out of service for more than 4 hours.12025-03-27
K-0923Have proper medical gas storage and administration areas.12025-03-27
E-0039Conduct testing and exercise requirements.12026-04-02

What the citations cover

Citations by CMS category
  • Emergency Preparedness Deficiencies 2
  • Miscellaneous Deficiencies 2
  • Gas, Vacuum, and Electrical Systems Deficiencies 1
  • Egress Deficiencies 1
  • Other 1
Citations by CMS category
CategoryCitations
Emergency Preparedness Deficiencies2
Miscellaneous Deficiencies2
Gas, Vacuum, and Electrical Systems Deficiencies1
Egress Deficiencies1
Smoke Deficiencies1

Every citation on file

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

April 2, 2026 — 2 citations

Citations issued on April 2, 2026
TagWhat the surveyor checksStatus
E-0004Develop and maintain an Emergency Preparedness Program (EP).Deficient, Provider has date of correction (April 13, 2026)
E-0039Conduct testing and exercise requirements.Deficient, Provider has date of correction (April 13, 2026)

March 27, 2025 — 3 citations

Citations issued on March 27, 2025
TagWhat the surveyor checksStatus
K-0346Follow proper procedures when the fire alarm was out of service for more than 4 hours.Deficient, Provider has date of correction (April 4, 2025)
K-0711Provide a written emergency evacuation plan.Deficient, Provider has date of correction (April 4, 2025)
K-0923Have proper medical gas storage and administration areas.Deficient, Provider has date of correction (April 4, 2025)

June 13, 2024 — 2 citations

Citations issued on June 13, 2024
TagWhat the surveyor checksStatus
K-0291Install emergency lighting that can last at least 1 1/2 hours.Deficient, Provider has date of correction (June 21, 2024)
K-0711Provide a written emergency evacuation plan.Deficient, Provider has date of correction (June 28, 2024)

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