01 / INSPECTION LEDGER
Survey cycles in this release
| Cycle | Health date | Health deficiencies | Fire date | Fire deficiencies |
|---|---|---|---|---|
| Cycle 1 | 2025-05-22 | 2 | 2025-05-22 | 2 |
| Cycle 2 | 2024-08-01 | 0 | 2024-08-01 | 0 |
| Cycle 3 | 2023-12-21 | 6 | 2023-12-21 | 1 |
CMS CCN 1654372026-08-01 PROCESSING DATE
NURSING HOME PUBLIC RECORD
Maple Crest Manor
100 Bolger Drive · Fayette, IA 52142 · Fayette County
Certified beds46CMS provider file
Recent citation rows11current CMS citation release
Penalty rows0current 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
11 rows in the current release
0 rows carry G–L scope/severity codes; 0 carry J–L. 1 tag codes appear on more than one survey date. These counts describe citation rows, not residents or incidents.
2025-05-22 · FIREE0013Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Develop Emergency Preparedness policies and procedures.
Correction field: Deficient, Provider has date of correction · 2025-05-292025-05-22 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2025-06-042025-05-22 · HEALTHF0698Severity D · isolated; potential for more than minimal harm
Quality of Life and Care Deficiencies
Provide safe, appropriate dialysis care/services for a resident who requires such services.
Correction field: Deficient, Provider has date of correction · 2025-06-102025-05-22 · HEALTHF0880Severity D · isolated; 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 · 2025-06-102023-12-21 · FIREE0039Severity F · widespread; potential for more than minimal harm
Emergency Preparedness Deficiencies
Conduct testing and exercise requirements.
Correction field: Deficient, Provider has date of correction · 2024-01-172023-12-21 · HEALTHF0582Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
Give residents notice of Medicaid/Medicare coverage and potential liability for services not covered.
Correction field: Deficient, Provider has date of correction · 2024-01-082023-12-21 · HEALTHF0625Severity B · pattern; potential for minimal harm
Resident Rights Deficiencies
Notify the resident or the resident’s representative in writing how long the nursing home will hold the resident’s bed in cases of transfer to a hospital or therapeutic leave.
Correction field: Deficient, Provider has date of correction · 2024-01-082023-12-21 · HEALTHF0640Severity B · pattern; potential for minimal harm
Resident Assessment and Care Planning Deficiencies
Encode each resident’s assessment data and transmit these data to the State within 7 days of assessment.
Correction field: Deficient, Provider has date of correction · 2024-01-082023-12-21 · HEALTHF0641Severity B · pattern; potential for minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure each resident receives an accurate assessment.
Correction field: Deficient, Provider has date of correction · 2024-01-082023-12-21 · HEALTHF0658Severity D · isolated; potential for more than minimal harm
Resident Assessment and Care Planning Deficiencies
Ensure services provided by the nursing facility meet professional standards of quality.
Correction field: Deficient, Provider has date of correction · 2024-01-082023-12-21 · HEALTHF0865Severity D · isolated; potential for more than minimal harm
Administration Deficiencies
Have a plan that describes the process for conducting QAPI and QAA activities.
Correction field: Deficient, Provider has date of correction · 2024-01-0803 / 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 |
|---|---|---|---|
| No penalty row appeared in the August 2026 penalties file. | |||
04 / OWNERSHIP DISCLOSURES
Who appears in the CMS file
- ASPEN FARMS LLCOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST5% · since 04/01/1976
- MARY JEAN MARTIN ESTATEOrganization · 5% OR GREATER DIRECT OWNERSHIP INTERESTNO PERCENTAGE PROVIDED · since 09/01/2022
- WILLIAM KAUTEN REVOCABLE TRUSTOrganization · 5% OR GREATER DIRECT OWNERSHIP INTEREST5% · since 05/23/2014
- HUMESTON, PATRICIAIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST5% · since 04/01/1976
- LARSON, LAURITZIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST8% · since 04/01/1976
- MARTIN, DENNISIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST5% · since 04/01/1976
- MARTIN, SUSANIndividual · 5% OR GREATER DIRECT OWNERSHIP INTEREST5% · since 08/16/2019
- ARNETTA M PATTISON LIVING TRUSTOrganization · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 05/05/2022
- TRAEGER, EDGARIndividual · DIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 11/02/2020
- MARY JEAN MARTIN ESTATEOrganization · INDIRECT OWNERSHIP INTERESTNOT APPLICABLE · since 09/01/2022
- BROWN, JANANIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/06/2023
- INGLES, JEFFREYIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 03/04/2024
- LARSON, LAURITZIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/01/1976
- LYNCH-MARTIN, KATHLEENIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 04/17/2025
- MARTIN, DENNISIndividual · CORPORATE DIRECTORNOT APPLICABLE · since 01/17/2012
- INGELS, CHADIndividual · CORPORATE OFFICERNOT APPLICABLE · since 07/01/2018
- MARTIN, DENNISIndividual · CORPORATE OFFICERNOT APPLICABLE · since 04/01/1976
- PATTISON, KYLEIndividual · CORPORATE OFFICERNOT APPLICABLE · since 03/06/2023
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 hours3.85per resident day
RN hours0.72per resident day
Weekend nurse hours3.26per resident day
Staff turnover43.2%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.