Average — CMS composite of the measures below.
The next survey window likely opens around November 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Norwalk Nursing And Rehabilitation Center during CMS and state inspections, most recent first.
A resident with diabetes and intact cognition had insulin orders for basal insulin, BID blood sugar checks, and sliding scale Novolog. The MAR showed many blood sugar readings that met the sliding scale criteria, but the ordered insulin was repeatedly not given. The NP said the sliding scale was meant to be given PRN whenever blood sugar was high, but the order had been transcribed with an every-8-hour timeframe and signed without verification, and staff said it was listed as PRN on the MAR and was easily missed.
Staff transported two residents with severe cognitive impairment and mobility limitations in wheelchairs without foot pedals, resulting in their feet being near or brushing the floor during movement. Both residents had care plans indicating fall risk and required staff assistance for wheelchair use. The DON confirmed foot pedals should be used, and the facility lacked a policy for safe wheelchair transport.
A facility failed to maintain accurate code status documentation for a resident with Parkinson's disease, leading to a discrepancy between the electronic health record and the IPOST form. The resident's electronic record indicated a FULL CODE status, while the IPOST document directed a DNR status. The DON reported a recent change to CPR was not updated in the code status book, and staff interviews revealed inconsistencies in accessing code status information.
The facility did not complete a child abuse background check for a CNA before employment, as required by policy. The CNA's file lacked documentation of an abuse registry check, and a background check indicated the need for further evaluation by DHS. The Administrator confirmed the absence of necessary documentation, contrary to the facility's policy to screen potential employees for abuse history.
A facility failed to update a resident's care plan to reflect a change in their advance directives. The resident, with intact cognition and medical conditions including Parkinson's disease, had initially elected hospice care with a DNR status. However, the resident later changed their preference to FULL CODE, wanting CPR, which was not updated in the care plan. The DON and Administrator acknowledged the oversight, which was against the facility's policy requiring care plan revisions when a resident's condition or preferences change.
A facility failed to follow proper infection control techniques during incontinence care for a resident with a history of UTIs. The resident, who is severely cognitively impaired and dependent on staff for toileting hygiene, was observed during care where staff did not change gloves or wash hands appropriately. The DON acknowledged the lapse in hand hygiene, which is crucial to prevent infections. The resident had a history of UTIs and had been on multiple antibiotics, highlighting the importance of strict infection control practices.
A resident with severe cognitive impairment experienced an undignified meal service due to inconsistent assistance from multiple staff members. The resident, dependent on assistance for eating, was left without consistent support, and her remaining food was cleared away while she was still chewing. Staff interviews indicated that the frequent switching of staff was unusual and attributed to a busy day with state surveyors present.
Insulin order transcription and administration errors
Penalty
Summary
The facility failed to ensure insulin orders were accurately transcribed and administered for a resident with diabetes. The resident had a quarterly MDS assessment indicating diabetes and insulin use, a BIMS score of 15 out of 15, and a care plan documenting diabetes with risks including hyper/hypoglycemia, renal failure, and cognitive/physical impairments. The resident’s medication record listed Lantus insulin 5 units in the morning, Lantus insulin 20 units at bedtime, blood sugar checks twice daily, and Novolog sliding scale insulin for elevated blood sugars. The MAR for December 2025 showed multiple blood sugar results that met the sliding scale parameters for additional insulin, but the ordered insulin was not administered on numerous occasions. The missed doses included readings in the 150s, 160s, 170s, 180s, 190s, 200s, 200s and above, and one reading of 331, with the corresponding 2-unit, 4-unit, 6-unit, or 8-unit doses not given. The NP stated the sliding scale order was intended to be given as needed whenever blood sugar was high, including during routine checks and when the resident overate, and acknowledged the insulin was not given as intended. The NP also acknowledged signing the transcribed order without verifying its accuracy, and stated the order had been incorrectly written with an every-8-hour timeframe. RN staff stated the ADON had transcribed the order, that clarification could not be obtained while the ADON was on vacation, and that the sliding scale was easily missed because it appeared on the PRN medication list. The Administrator stated the order had been missed by nurses because it had no time frames and was only transcribed as PRN on the MAR.
Failure to Use Wheelchair Foot Pedals During Resident Transport
Penalty
Summary
Staff failed to appropriately and safely transfer two residents who required assistance with mobility. One resident with Parkinson's Disease, severe cognitive impairment, and a history of falls was observed being pushed in a high back wheelchair without foot pedals, with her feet near the floor, as she was transported approximately 60 feet from her room to the dining room. The resident's care plan indicated a risk for falls, limited mobility, and dependence on staff for wheelchair propulsion. Another resident with Alzheimer's Disease, dementia, severe cognitive impairment, and muscle weakness was also observed being pushed in a wheelchair without foot pedals, with the bottom of her feet brushing the floor during transport for about 50 feet. Both residents' care plans documented the need for staff assistance with wheelchair use and highlighted their fall risks. During interviews, the DON confirmed that foot pedals should be used whenever staff transport residents in wheelchairs, and the Administrator reported the facility lacked a policy for transporting or pushing residents in wheelchairs.
Failure to Ensure Accurate Code Status Documentation
Penalty
Summary
The facility failed to ensure accurate code status documentation for a resident, leading to a discrepancy between the electronic health record and the physical IPOST form. Resident #28, who had medical diagnoses including Parkinson's disease, peripheral vascular disease, and respiratory disease, was cognitively intact and had elected hospice care. The resident's clinical profile in the electronic health record indicated a FULL CODE status, while the care plan and IPOST document signed by the resident directed a Do Not Resuscitate (DNR) status. The Director of Nursing (DON) later reported that there had been a recent change from DNR to CPR, but the updated form was not reflected in the code status book. Interviews with staff revealed inconsistencies in how code status information was accessed, with some staff relying on the electronic record and others on the code status binder. Staff G, an LPN, mentioned being aware of the change to a full code through staff updates, while Staff H, an RN, indicated she would check both the electronic record and the binder. The facility's policy required changes to advance directives to be submitted in writing to the Administrator, with the Care Plan Team informed to update the resident's assessment and care plan. However, this process was not followed, resulting in the discrepancy.
Failure to Complete Child Abuse Background Check for CNA
Penalty
Summary
The facility failed to ensure that all employees had a child abuse background check completed prior to employment as a Certified Nursing Assistant (CNA). Specifically, the personnel file for one CNA, hired on 2/28/24, did not contain an abuse registry check prior to the hire date. The background check conducted on 2/27/24 indicated that a child abuse record check evaluation was required by contacting the Department of Human Services (DHS). During an interview, the Administrator confirmed the absence of documentation in the CNA's personnel file regarding the results of the DHS child abuse evaluation. The facility's policy mandates screening all potential employees for a history of abuse, neglect, exploitation, misappropriation of property, or mistreatment of residents, and prohibits employing individuals found on the abuse registry.
Failure to Update Care Plan for Advance Directives
Penalty
Summary
The facility failed to update the care plan for a resident to reflect a change in their choice of advance directives. Resident #28, who has medical diagnoses including Parkinson's disease, peripheral vascular disease, and respiratory disease, was assessed with intact cognition and had elected hospice care. However, the clinical resident profile in the electronic health record indicated a FULL CODE status, while the care plan documented a Do Not Resuscitate (DNR) status. The Director of Nursing (DON) confirmed that there was a recent change in the resident's code status choice, as the resident had signed an updated form indicating they wanted CPR. The DON and the Administrator acknowledged that the care plan should have been updated to reflect this change, as per the facility's policy that care plans are revised when a resident's condition or preferences change.
Inadequate Infection Control During Incontinence Care
Penalty
Summary
The facility failed to utilize proper infection control techniques during incontinence care for a resident with a history of multiple urinary tract infections (UTIs). Resident #3, who has severe cognitive impairment and is dependent on staff for toileting hygiene, was observed during an incontinence care procedure. Despite being always continent according to the Minimum Data Set, the resident was incontinent of bowel and bladder during the observation. Staff C and Staff D, both Certified Nurse Aides (CNAs), were involved in the care process. Staff D did not change gloves or wash hands after opening the resident's incontinence brief and before performing peri care, which is a breach of infection control protocols. The Director of Nursing (DON) acknowledged that the staff did not wash their hands as frequently as required during the procedure. The facility's policy, revised in February 2018, emphasizes the importance of hand hygiene to prevent infections and skin irritation. The resident had a history of UTIs and had been on multiple antibiotic treatments, including Keflex, Levofloxacin, Bactrim DS, Amoxicillin-Pot Clavulanate, and Cephalexin, indicating a recurring issue with infections. The failure to adhere to infection control practices during incontinence care potentially contributed to the risk of infection for Resident #3.
Inconsistent Assistance During Meal Service for Resident
Penalty
Summary
The facility failed to provide a dignified eating experience for a resident with severe cognitive impairment during a noon meal service. The resident, who was dependent on assistance for eating, was observed to have multiple staff members come and go while assisting her, leading to a disjointed and undignified meal experience. The resident's care plan indicated that she required assistance with meals, and staff were expected to be present at all times during her meals. During the meal service, the resident was initially assisted by a staff member who then engaged in conversation with another staff member while assisting the resident. Subsequently, several staff members alternated in assisting the resident, with some leaving the table to attend to other duties, resulting in inconsistent assistance. At one point, the resident was left without assistance while still chewing her food, and her remaining food was cleared away by dietary staff. Interviews with staff revealed that the frequent switching of staff during the meal was not typical and was attributed to the presence of state surveyors and a busy day. Staff members acknowledged that the resident sometimes prefers to feed herself and that a consistent presence is usually maintained during her meals. The facility's policy on dignity emphasizes treating residents with respect and honoring their preferences, which was not adhered to in this instance.
What surveyors are citing around you — mapped
All 10 risk areas, ranked with evidence
Repeat citations, what's rising near you, and quality measures — ranked so department heads know exactly where to look first.
Illustrative
What surveyors actually found near you
We read the 429 citations issued within 25 miles in the last 12 months — including the 6 immediate-jeopardy cases — and tell you exactly what happened, in plain English, matched to your record.
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.
Illustrative
A prioritized, do-first checklist
Every risk area becomes concrete audit steps drawn from real citations at facilities like yours — run them this week, before your window opens.
Illustrative
Risk indicators are statistical estimates from public CMS data — not predictions, findings, or compliance advice.
Nursing homes near Norwalk
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Regency Care Center | 1.3 mi | ★★★★★ | 16 | 1 |
| Accura Healthcare Of South Des Moines | 5.6 mi | ★★★★★ | 1 | 0 |
| Greater Southside Health And Rehabilitation | 5.7 mi | ★★★★★ | 16 | 1 |
| Harmony West Des Moines | 6.9 mi | ★★★★★ | 21 | 0 |
| Wesley On Grand | 8.4 mi | ★★★★★ | 0 | 0 |
Every risk area ranked, a do-first checklist, and your local survey patterns
Built specifically for Norwalk Nursing And Rehabilitation Center.
100% money-back within 48 hours.
Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.