Not rated by CMS — ratings are suppressed for new or low-volume facilities.
A standard survey is most likely before around November 2026
Estimate from public CMS data, current as of June 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at The Cottages during CMS and state inspections, most recent first.
The facility did not ensure that an area was free from accident hazards and failed to provide adequate supervision to prevent accidents, as observed by surveyors.
A resident admitted with multiple diagnoses did not receive several scheduled doses of prescribed medications, including Alrex eye drops, Pregabalin, and Duloxetine, due to the medications not being available at the facility. Documentation showed that staff did not follow up with the pharmacy or provider when the medications failed to arrive, and the resident eventually left the facility against medical advice. Staff interviews indicated uncertainty about the appropriate steps to take when medications were missing.
A resident with severely impaired cognition left a facility unsupervised due to inadequate supervision and security measures. The resident, who had a history of confusion and exit-seeking behavior, was found outside in cold weather. The facility's elopement precautions were not followed, as door alarms were not activated, and the resident was not identified as at risk for elopement.
A facility failed to accurately document a resident's code status, leading to discrepancies between the EHR and the IPOST form. The resident was initially listed as Full Code in the EHR, while the IPOST indicated a DNR status. Staff interviews revealed a breakdown in the process of updating the EHR, with the SW responsible for obtaining signatures and updating records. The inconsistency was not corrected until several days later, despite staff reliance on the EHR for code status verification.
A facility failed to implement necessary nutritional interventions for a resident experiencing significant weight loss and poor meal intake. Despite the resident's cognitive impairments and medical conditions, the care plan was not updated to address low food intake. The RD did not document any interventions or rationale for the lack of action, even with significant weight loss identified. Staff interviews revealed a lack of awareness and documentation regarding the resident's dietary needs, and the facility's policy on nutritional interventions was not followed.
The facility failed to follow enhanced barrier precautions and infection control practices, risking infection spread for two residents. An LPN did not wear a gown while administering IV medication to a resident with a PICC line, and an RN did not properly clean a g-tube extension, risking cross-contamination. Additionally, a cook did not perform hand hygiene during meal preparation, as noted by the Director of Dining.
A resident with intact cognition and physical limitations due to a stroke, osteoporosis, and anxiety received only 3 baths/showers over a one-month period, despite the care plan directing staff to assist with bathing twice a week. The Clinical Quality Specialist confirmed the deficiency and noted the facility follows standards of care without a specific policy for baths/showers.
Failure to Maintain Safe Environment and Adequate Supervision
Penalty
Summary
The facility failed to ensure that an area was free from accident hazards and did not provide adequate supervision to prevent accidents. Surveyors observed that the environment posed risks for accidents, and there was insufficient oversight to mitigate these hazards. Specific details regarding the nature of the hazards, the supervision provided, or the individuals affected were not included in the report.
Failure to Ensure Timely Availability of Routine Medications for New Admission
Penalty
Summary
The facility failed to ensure the timely availability of routine medications for a newly admitted resident with diagnoses including rheumatoid arthritis, weakness, and depression. Upon admission from a hospital, the resident had physician orders for Alrex eye drops, Pregabalin, and Duloxetine. Multiple doses of these medications were not administered as indicated by missing checkmarks and staff initials on the Medication Administration Record (MAR), with corresponding progress notes documenting that the medications were not available at the facility. The facility's policy outlined the process for obtaining medications from the pharmacy but did not address steps to take if medications did not arrive as expected. Progress notes and staff interviews confirmed that the medications were not available for several scheduled doses, and there was no documentation that staff contacted the pharmacy to follow up on the missing medications. The resident ultimately left the facility against medical advice. Staff interviews revealed a lack of clarity and action regarding obtaining the missing medications, with one RN stating she had received education to call the provider but had previously waited for the pharmacy. The DON stated that staff could request a stat delivery or contact the provider for orders, but this was not documented as having occurred during the incident.
Resident Elopement Due to Inadequate Supervision and Security Measures
Penalty
Summary
The facility failed to provide adequate supervision and interventions for a resident who displayed exit-seeking behaviors, resulting in the resident leaving the building without staff knowledge. The resident, who had a severely impaired cognition with a BIMS score of 3 out of 15, was found outside in 29-degree Fahrenheit weather. The resident had a history of confusion and agitation, as documented in various notes, but the facility did not implement additional nursing supervision interventions despite these warning signs. The facility's elopement precautions policy required electronic door alarms to be activated at all times and for residents consistently seeking exits to have electronic monitoring devices. However, the facility did not identify the resident as at risk for elopement, and the resident was able to exit the building independently. Staff interviews revealed that the door did not require a code to exit, and the alarm did not sound when the door was opened, allowing the resident to leave unnoticed. Observations during a facility tour showed that several doors did not require a code to exit and did not alarm upon exit, providing residents with the ability to leave the building without staff knowledge. This lack of security measures and supervision led to the resident's unsupervised exit, posing an immediate jeopardy to the health, safety, and security of the resident and other cognitively impaired residents in the facility.
Removal Plan
- Wanderguard placed on Resident #1.
- Staff education regarding elopement policy, elopement drills, significant change assessments, response to door alarms.
- Elopement assessments on all residents with a Brief Interview for Mental (BIMS) score less than 11.
- Sign placed on exit doors for families as reminder to not assist someone out the door and to notify team members.
- Alarms activated on egress doors in Overijessel (OV) and Utrecht (UT) households.
- Barrel lock installed on patio door connecting OV/UT.
- Remote notification alarm installed between the long-term care area and the assisted living area.
- Door lock installed on Gelderland household dining room door.
Inaccurate Documentation of Resident's Code Status
Penalty
Summary
The facility failed to accurately document the code status for Resident #147, who had diagnoses including multiple sclerosis, thyroid disorder, and a left fibula fracture. The Minimum Data Set (MDS) assessment and the Care Plan indicated that the resident's advance directives should be routinely reviewed and updated. However, discrepancies were found between the electronic health record (EHR) and the Iowa Physician's Orders for Scope of Treatment (IPOST) form. The EHR initially listed the resident as a Full Code, while the IPOST signed by the physician indicated a Do Not Resuscitate (DNR) status. This inconsistency was not corrected in the EHR until several days later. Interviews with staff revealed a breakdown in the process of updating the resident's code status in the EHR. The Social Worker (SW) was responsible for obtaining the resident's or representative's signature on the IPOST and updating the EHR, but the code status was not accurately reflected in the system. Staff members, including Licensed Practical Nurses (LPNs) and Registered Nurses (RNs), relied on the EHR to verify code status, leading to potential confusion. The Director of Nursing acknowledged ongoing efforts to improve the process, and the Clinical Quality RN Specialist admitted to not comparing IPOST information with the EHR to ensure consistency.
Failure to Implement Nutritional Interventions for Resident
Penalty
Summary
The facility failed to evaluate and implement necessary nutritional interventions for Resident #72, who was experiencing ongoing weight loss and poor intake at meals. Despite the resident's cognitive impairments and diagnoses, including Alzheimer's and Parkinson's disease, the care plan was not updated to reflect current interventions for weight loss. The care plan included goals for food intake and various interventions, but none specifically addressed the resident's low food intake since July 2023. The facility's records showed a significant weight loss trend for Resident #72, with weights dropping from 144.8 lbs in January 2024 to 127.8 lbs in September 2024. Despite this, the Registered Dietitian (RD) did not document any nutritional interventions or rationale for the lack of interventions, even when significant weight loss was identified. The RD noted that weight loss and other health issues might be expected as the disease progresses, but no specific actions were taken to address the resident's nutritional needs. Interviews with staff revealed a lack of awareness and documentation regarding the resident's dietary needs and family preferences. The Director of Dining and the RD discussed weight loss and potential interventions in weekly meetings, but no formal records were kept, and no interventions were implemented for Resident #72. The facility's policy required nutritional interventions for significant weight loss, but this was not followed, leading to a deficiency in the care provided to the resident.
Infection Control and Hygiene Deficiencies
Penalty
Summary
The facility failed to adhere to enhanced barrier precautions (EBP) and infection control practices, leading to potential infection risks for two residents. One resident, who was readmitted from the hospital with a methicillin susceptible staphylococcus aureus (MSSA) infection and an epidural abscess, did not receive proper infection control measures during intravenous (IV) medication administration. The Licensed Practical Nurse (LPN) involved did not wear a gown while handling the resident's peripherally inserted central catheter (PICC) line, despite the presence of the Director of Nursing (DON) in the room. The facility lacked a specific policy for IV medication administration, and staff were not consistently informed about the necessity of wearing gowns and gloves when dealing with PICC lines. Another deficiency was observed during the administration of tube feeding and medications for a resident. The Registered Nurse (RN) involved did not follow proper hygiene protocols, as the gastric-tube extension was placed in the bathroom sink and rinsed alongside other used supplies, increasing the risk of cross-contamination. The Director of Nursing acknowledged that the g-tube extension should have been rinsed first to minimize contamination risks. Additionally, during lunch preparation and service, a cook failed to perform hand hygiene after handling soiled equipment and before engaging in food preparation. This lapse in hand hygiene was noted by the Director of Dining, who was present during the meal preparation. The facility did not have a separate hand hygiene policy for dietary staff, relying instead on the general infection control manual, which contributed to the oversight.
Failure to Provide Required Bathing Assistance
Penalty
Summary
The facility failed to ensure a resident had at least 2 baths/showers per week. Resident #1, who had intact cognition and required physical assistance with bathing due to a stroke, osteoporosis, and anxiety, was documented to have received showers/baths only 3 times over a one-month period. The resident's care plan directed staff to provide assistance with bathing twice a week. The Clinical Quality Specialist confirmed the deficiency, acknowledging that the facility's standard is to provide a bath or shower a minimum of 2 times a week and to document any refusals. However, the facility did not have a specific policy related to baths/showers, relying instead on standards of care.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Pella
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Accura Healthcare Of Knoxville, Llc | 11.4 mi | — | 10 | 1 |
| West Ridge Specialty Care | 12.9 mi | — | 3 | 0 |
| Oskaloosa Care Center | 15.5 mi | — | 10 | 1 |
| Crystal Heights Care Center | 15.9 mi | — | 1 | 0 |
| Northern Mahaska Specialty Care | 16 mi | — | 9 | 0 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release August 2026) and official state health department websites.