CEDAR FALLS - Two Iowa nursing homes, including one in Cedar Falls, are on a federal list of centers with persistent problems.

The Polk City Nursing and Rehabilitation Center and the Cedar Falls Health Care Center have not improved since their most recent inspections noted problems, according to the list released Tuesday and compiled by the Centers for Medicare & Medicaid Services. The list only measures care at Centers for Medicare & Medicaid Services facilities.

The report lists nursing homes in various categories, such as not improved or improving. It also includes nursing homes added to Centers for Medicare & Medicaid Services within the past six months, those that have demonstrated significant improvement over the past 12 months and homes that were either terminated by the agency from participating in Medicare or voluntarily chose not to continue participation.

Some of the serious deficiencies cited in nursing home reports vary from failing to give residents medication in proper doses, taking steps to prevent abuse or neglect, inappropriate use of restraints or failure to properly treat bed sores.

Nathan Greiner, the administrator of the Cedar Falls Health Care Center, said he was disappointed to see his facility on the list. Greiner has asked for an explanation about the center's continued inclusion on the list from a regional Centers for Medicare & Medicaid Services representative and was told they couldn't give him an answer because it came from the federal government.

"The criteria is still very vague as far as how you get on the list," Greiner said. "Where we are today and where we were two years ago is not the same place. It was a little disconcerting when we found we were still on the list, but they do look at our survey history and we did get a fine on our last survey visit,"

The center's most recent survey, completed on Jan. 18, showed 13 "regulatory violations" which ranged from not providing patients privacy and confidentiality to not developing a comprehensive care plan for all residents. The center was also charged at $3,000 fine for failing "to promote the healing of current pressure sores and failed to prevent additional pressure ulcers" for two of the four patients surveyed.

Greiner said those violations have already been corrected.

"A lot of the stuff we were cited for is very minimal compared to what I have seen here in previous years," he said. "But, it is what it is. Everybody knows the state is looking more critically at how care centers are operating and coming down with a heavy hand. As long as it is across the board and all nursing homes are getting the same treatment, that is just the system we are working in."

Since 2006, inspectors have visited the home at least five times for survey revisits and complaint investigations.

In February 2007, the state levied $6,500 in fines against the center for failure to assess and provide timely intervention for three of the seven residents reviewed and for failure to ensure each resident was provided proper supervision to prevent accidents for two of the seven reviewed.

In November 2007, the state levied a $10,000 fine against the center, the most the state department can fine a health care facility. The fine was the result of an Oct. 3 altercation between John Virgil Osborn, 82, and Orlin Thompson, 72. Osborn died following the incident. An autopsy showed he died of a "heart attack occurrence that could have resulted from the fight."

Kristy Payne, the administrator of the Polk City facility, declined comment and referred questions to the nursing home's management company, Preferred Care Partners Management Group of Plano, Texas. A telephone message left there Tuesday afternoon was not immediately returned.

Two other Iowa nursing homes, the Blair House in Burlington, and The Abington on Grand in Ames, were on a list of nursing homes that have shown improvement.