01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2026-01-14 | 5 | 2026-01-14 | 4 |
| Cycle 2 | 2024-11-14 | 8 | 2024-11-14 | 4 |
| Cycle 3 | 2023-10-05 | 6 | 2023-10-05 | 2 |
CMS CCN 1653722026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Elm Crest Retirement Community
2104 12Th Street · Harlan, IA 51537 · Shelby County
Certified beds50CMS provider file
Recent citation rows29current CMS citation release
Penalty rows1current CMS penalties file
Read this record carefully.
The citation files cover the three most recent standard inspections plus qualifying complaint and infection-control inspections in the prior three years. A correction date is a CMS field; this site does not independently verify conditions. Absence from a file is not proof that no issue exists.
02 / CITATION DETAIL
29 rows in the current release
2 rows carry G–L scope/severity codes; 0 carry J–L. 5 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2026-06-10 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Past Non-Compliance · complaint2026-01-14 · FIREE0004Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop and maintain an Emergency Preparedness Program (EP).
Correction field: Deficient, Provider has date of correction · 2026-01-282026-01-14 · HEALTHF0804Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure food and drink is palatable, attractive, and at a safe and appetizing temperature.
Correction field: Deficient, Provider has date of correction · 2026-02-122026-01-14 · HEALTHF0805Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Ensure each resident receives and the facility provides food prepared in a form designed to meet individual needs.
Correction field: Deficient, Provider has date of correction · 2026-02-122026-01-14 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2026-02-122026-01-14 · FIREK0291Severity E · pattern; potential for more than minimal harm
Egress Deficiencies
Install emergency lighting that can last at least 1 1/2 hours.
Correction field: Deficient, Provider has date of correction · 2026-01-142026-01-14 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2026-01-262026-01-14 · FIREK0921Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure that testing and maintenance of electrical equipment is performed.
Correction field: Deficient, Provider has date of correction · 2026-01-222025-11-13 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2026-01-06 · complaint2024-11-14 · HEALTHF0550Severity D · isolated; potential for more than minimal harm
Resident Rights Deficiencies
Honor the resident's right to a dignified existence, self-determination, communication, and to exercise his or her rights.
Correction field: Deficient, Provider has date of correction · 2024-12-03 · complaint2024-11-14 · HEALTHF0636Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Assess the resident completely in a timely manner when first admitted, and then periodically, at least every 12 months.
Correction field: Deficient, Provider has date of correction · 2024-12-032024-11-14 · HEALTHF0656Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop and implement a complete care plan that meets all the resident's needs, with timetables and actions that can be measured.
Correction field: Deficient, Provider has date of correction · 2024-12-032024-11-14 · HEALTHF0688Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate care for a resident to maintain and/or improve range of motion (ROM), limited ROM and/or mobility, unless a decline is for a medical reason.
Correction field: Deficient, Provider has date of correction · 2024-12-032024-11-14 · HEALTHF0689Severity G · isolated actual harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2024-12-03 · complaint2024-11-14 · HEALTHF0695Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe and appropriate respiratory care for a resident when needed.
Correction field: Deficient, Provider has date of correction · 2024-12-032024-11-14 · HEALTHF0812Severity E · pattern; potential for more than minimal harm
Nutrition and Dietary Deficiencies
Procure food from sources approved or considered satisfactory and store, prepare, distribute and serve food in accordance with professional standards.
Correction field: Deficient, Provider has date of correction · 2024-12-032024-11-14 · HEALTHF0880Severity E · pattern; potential for more than minimal harm
Infection Control Deficiencies
Provide and implement an infection prevention and control program.
Correction field: Deficient, Provider has date of correction · 2024-12-032024-11-14 · FIREK0353Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Inspect, test, and maintain automatic sprinkler systems.
Correction field: Deficient, Provider has date of correction · 2024-11-202024-11-14 · FIREK0354Severity F · widespread; potential for more than minimal harm
Smoke Deficiencies
Follow proper procedures when the automatic sprinkler systems was out of service for more than 10 hours.
Correction field: Deficient, Provider has date of correction · 2024-11-142024-11-14 · FIREK0712Severity F · widespread; potential for more than minimal harm
Miscellaneous Deficiencies
Have simulated fire drills held at unexpected times.
Correction field: Deficient, Provider has date of correction · 2024-11-142024-11-14 · FIREK0920Severity F · widespread; potential for more than minimal harm
Gas, Vacuum, and Electrical Systems Deficiencies
Ensure proper usage of power strips and extension cords.
Correction field: Deficient, Provider has date of correction · 2024-12-142024-07-21 · HEALTHF0657Severity E · pattern; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Develop the complete care plan within 7 days of the comprehensive assessment; and prepared, reviewed, and revised by a team of health professionals.
Correction field: Deficient, Provider has date of correction · 2024-08-21 · complaint2024-07-21 · HEALTHF0684Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide appropriate treatment and care according to orders, resident’s preferences and goals.
Correction field: Deficient, Provider has date of correction · 2024-08-21 · complaint2023-10-05 · HEALTHF0689Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Ensure that a nursing home area is free from accident hazards and provides adequate supervision to prevent accidents.
Correction field: Deficient, Provider has date of correction · 2023-11-0303 / ENFORCEMENT FILE
Penalties reported by CMS
Fine amounts and payment-denial days are shown exactly as aggregated from the current penalties file. They do not imply an unpaid balance.
| Date | Type | Fine amount | Payment-denial days |
|---|---|---|---|
| 2024-11-14 | Payment Denial | $0 | 8 |
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- AMERICAN BAPTIST HOMES OF THE MIDWESTOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST100% · since 03/03/1967
- KOTZ, CHRISTINAIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 08/01/2019
- NAUSLAR, TIMIndividual · W-2 MANAGING EMPLOYEENOT APPLICABLE · since 05/01/2014
- ALLEN, RYANIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/01/2012
- DAVIDSON, ROGERIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/01/2019
- FORD, ASHLEYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/01/2019
- HANSON, PHILLIPIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/01/2012
- HONGSLO, JEFFREYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 11/01/2006
- JOHNSON, DOROTHYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/01/2019
- JOHNSON, JAMESIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/01/2019
- KILLIAN, GEORGEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/01/2019
- NEIMAN, RUTHIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2021
- PETERS, MARSHALLIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/01/2012
- VAN DER BEEK, BRUCEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2021
- VANOSTRAM, STEVENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 05/01/2012
- VAUGHN-GRAY, STEPHANIEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/01/2019
- WAGONER FORD, ANNEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 08/01/2019
- WHITAKER, BRUCEIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/01/2014
Names and roles are self-reported CMS disclosure fields. Exact-name pages do not prove that similarly named people or organizations are the same entity.
05 / CMS STAFFING FIELDS
Reported hours and turnover
Staffing fields are provider-reported and case-mix context matters. CMS applies footnotes and exclusions not reproduced as a new score here.
Total nurse hours3.99per resident day
RN hours0.74per resident day
Weekend nurse hours3.45per resident day
Staff turnover71.7%CMS reported field
06 / LOCAL RECORDS
Open the Iowa ledger →Other published facilities nearby
No second facility in the same city met the directory rule.