Below average — CMS composite of the measures below.
The next survey window likely opens around February 2027
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 Sunny Hill Care Center during CMS and state inspections, most recent first.
Delayed response to call lights affected two residents with mobility and cognitive impairments. One resident reported waiting more than 30 minutes and said the delay made him feel miserable, while the other said waits could be a half hour or more. Call light reports showed repeated response times over 15 minutes, and multiple staff members, including CNAs, an RN, and the DON, acknowledged that call lights sometimes exceeded 15 minutes, especially during busy morning and meal periods.
Failure to prime an insulin pen before administration: A resident with diabetes, HF, and SOB had an order for Tresiba insulin pen 40 units qAM. During observation, an RN attached a new needle and dialed the pen to 40 units without priming first, then later reset it to 0, primed with 2 units, and redialed the dose after being questioned. The RN stated she did not think she had primed the pen before, and the DON later stated staff should prime insulin pen needles prior to administration.
The facility did not ensure that an area was free from accident hazards and failed to provide adequate supervision to prevent accidents. Surveyors observed environmental hazards and insufficient staff monitoring, leading to increased risk for residents.
The facility failed to include residents in the care planning process, as identified in a previous deficiency. Despite a corrective response, interviews with two cognitively intact residents revealed they were not aware of or involved in care plan meetings. The facility's policy required resident participation, but this was not implemented effectively.
The facility failed to ensure resident participation in care planning meetings for two residents with intact cognition. Both residents had care conference forms that lacked documentation of their involvement, and they reported not being aware of or participating in any care plan meetings. The facility's policy required resident awareness of such meetings, but this was not followed, as confirmed by the administrator.
A facility failed to notify the Long-Term Care Ombudsman of a resident's unplanned discharges to the hospital, as required by federal regulation. The resident was hospitalized twice and reentered the facility shortly after each discharge. The facility's Discharge Tracking form lacked documentation of these discharges, and the Administrator acknowledged the oversight. The facility's policy requires notification of all monthly discharges to the Ombudsman, which was not followed.
A resident with ALS, heart failure, and diabetes was left on the toilet for 2.5 hours due to a malfunctioning call light system. Despite being dependent on staff for transfers, the resident was not checked on as required by facility policy. Staff interviews confirmed the call light battery was changed and tested earlier, but it failed, leaving the resident upset and unattended.
Delayed Response to Resident Call Lights
Penalty
Summary
The facility failed to answer call lights in a timely manner for 2 of 3 residents reviewed for staffing concerns, including residents with mobility and cognitive impairments. Resident #23’s MDS listed difficulty walking, weakness, and a history of falling, with partial to moderate assistance needed for chair-to-bed and toilet transfers and substantial to maximal assistance needed for walking. The resident’s BIMS score was 12 out of 15, indicating moderately impaired cognition. Resident #22’s MDS listed fibromyalgia, weakness, difficulty walking, need for assistance, anxiety, and depression, and the BIMS score also indicated moderate cognitive impairment. Resident #23 stated on interview that call lights took more than 30 minutes and that he timed the wait by looking at the clock, saying it made him feel miserable to sit and wait. The resident’s call light report showed multiple response times over 15 minutes, including waits of 29, 16, 21, 18, and 20 minutes during the review period. Resident #22 stated that after pushing the call light, it could be a half hour or more, depending on the shift and time of day. The call light report for Resident #22 showed repeated response times over 15 minutes, including waits of 33, 21, 28, 32, 34, 22, 34, 21, 21, 21, 43, 19, and 21 minutes. Staff interviews confirmed that call lights could exceed 15 minutes, especially during busy times such as mornings and meal periods. A CNA, RN, housekeeping staff, activity assistant/CNA, and another CNA all acknowledged delayed response times at times, and one CNA stated there were not enough caregivers around during breakfast and lunch. The Administrator stated mornings and supper times could be busy and expected staff to answer call lights within 15 minutes. The facility policy stated all staff were responsible for responding to activated call lights, but it did not include a specific time frame for response.
Failure to Prime Insulin Pen Before Administration
Penalty
Summary
The facility failed to prime an insulin pen before administering Tresiba to a resident with diabetes, heart failure, and shortness of breath. The resident’s MDS listed a BIMS score of 14 out of 15, indicating intact cognition, and the care plan directed staff to administer diabetes medication as ordered. The March 2026 MAR included an order for Tresiba FlexTouch Pen-injector 100 units/mL, 40 units in the morning. During observation, a RN placed a new needle on the resident’s Tresiba insulin pen and dialed the pen to 40 units without first priming the needle. The RN then prepared Novolog from a vial and was ready to administer both insulins. When asked whether the pen had been primed before dialing up the dose, the RN reset the pen to 0, primed it with 2 units, and then redialed it to 40 units. The RN stated she did not think she had primed the pen before. The DON later stated staff should prime insulin pen needles prior to administration, and another RN stated she primed insulin pens prior to dialing up the dose.
Failure to Maintain Safe Environment and 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 contained hazards that could lead to resident accidents, and staff did not implement sufficient measures to monitor or protect residents from these risks. This deficiency was identified based on direct observations and findings during the survey, which indicated lapses in maintaining a safe environment and in providing necessary supervision to prevent accidents.
Failure to Include Residents in Care Planning Process
Penalty
Summary
The facility failed to ensure an effective Quality Assurance Performance Improvement (QAPI) process by not including residents in the care planning process, as identified in a previous deficiency during the facility's prior recertification. The CMS-2567 form from the recertification survey dated 12/8/22 highlighted a deficient practice where residents were not participating in quarterly interdisciplinary meetings for care planning. Despite a corrective response from the facility dated 1/1/23, which included plans to invite residents to these meetings, interviews with residents indicated a lack of awareness and participation in care planning discussions. Specifically, two residents with intact cognitive assessments, as indicated by their Brief Interview for Mental Status (BIMS) scores of 15 out of 15, reported not being involved in care plan meetings. One resident, interviewed on 2/3/25, was unaware of any care plan discussions or meetings, while another resident, interviewed on the same day, could not recall participating in any such meetings. The facility's policy stated that residents and/or their representatives are crucial members of the care planning team and should be informed of meeting dates and times. However, the facility's failure to adhere to this policy resulted in the deficiency.
Failure to Ensure Resident Participation in Care Planning Meetings
Penalty
Summary
The facility failed to ensure resident participation in quarterly interdisciplinary team meetings for care planning for two residents. Resident #31, with diagnoses including anemia, heart failure, peripheral vascular disease, anxiety, and depression, had a BIMS score indicating intact cognition. Despite this, the Care Conference Summary form for Resident #31 showed that the section for resident discussion and agreement was left blank, and the resident reported not being aware of or participating in any care plan meetings. Similarly, Resident #38, with diagnoses of anemia, atrial fibrillation, inflammatory bowel disease, and obstructive uropathy, also had a BIMS score indicating intact cognition. The Care Conference Summary form for Resident #38 had a vertical line drawn through the section for resident discussion, and the resident could not recall any care planning discussions or meetings. The facility's policy stated that residents should be made aware of care meetings, but this was not followed, as confirmed by the administrator, who acknowledged that the previous Director of Nursing did not adhere to best practices for resident inclusion.
Failure to Notify Ombudsman of Resident Discharges
Penalty
Summary
The facility failed to notify the Long-Term Care Ombudsman of the discharge or transfer of a resident as required by federal regulation. Specifically, the facility did not document the unplanned discharges of a resident to the hospital on two separate occasions. The resident was hospitalized and then reentered the facility shortly after each discharge. The facility's Discharge Tracking form, which is used for Ombudsman notification, lacked documentation of these discharges. The Administrator acknowledged the omission during an interview, noting that the information is typically obtained from electronic medical records and manually recorded. The facility's policy, dated 2018, mandates notification of all monthly discharges to the Ombudsman, which was not adhered to in this case.
Resident Left Unattended Due to Call Light Malfunction
Penalty
Summary
The facility failed to provide adequate supervision and timely assistance to a resident with amyotrophic lateral sclerosis (ALS), heart failure, and diabetes, who was dependent on staff for transfers and position changes. The resident, who had intact cognition, was left on the toilet for 2.5 hours due to a malfunctioning call light system. Staff A, a CNA, reported that during a shift change, the resident was assisted to the toilet, but the call light did not turn back on. The resident was found by staff after banging for attention, and it was discovered that the call light did not work properly. Staff interviews revealed that the call light malfunction was not intentional, and the resident was upset about the incident. Staff B, an RN, confirmed that the call light battery had been changed and tested earlier in the day, but it failed to work when needed. The facility's policy required staff to check on residents every 15 minutes during toileting, but this was not adhered to, leading to the resident being left unattended for an extended period.
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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 Tama
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Accura Healthcare Of Toledo | 0.8 mi | ★★★★★ | 10 | 0 |
| Westbrook Acres | 16 mi | ★★★★★ | 8 | 0 |
| Sunrise Hill Care Center | 16 mi | ★★★★★ | 7 | 0 |
| Harmony Marshalltown | 16.6 mi | ★★★★★ | 18 | 0 |
| Belle Plaine Specialty Care | 17.1 mi | ★★★★★ | 6 | 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 July 2026) and official state health department websites.