The state-run Iowa Veterans Home in Marshalltown has been fined a third time in four months for not meeting care standards.

The federal government imposed a $250-per-day fine and extended restrictions on new admissions, which will remain in place until the facility can demonstrate that a series of problems have been corrected, The Des Moines Register reported Monday.

The most recent sanctions stem from the Sept. 13 death of a 91-year-old woman who fell when she was getting out of bed. The Department of Inspections and Appeals said Vivian Knoll suffered leg fractures, which were blamed for her death.

According to the department's report, staffers at the home later determined that although Knoll's bed was equipped with an alarm designed to alert workers when Knoll tried to get out of bed, the volume setting was on "low." Workers were allegedly unaware of the volume-setting control and hadn't tested the alarm the night Knoll fell.

Knoll was the wife of Donald Knoll, a World War II veteran. He died at the Iowa Veterans Home two years ago. He was 89.

One of their sons, Patrick Knoll of Des Moines, said the home provided good care to his parents.

"I do not blame the home in any way, shape or form for what happened with my mother," he said. "I don't think they were at fault in any way."

he Iowa Veterans home was established 125 years ago and is the nation's third-largest state veterans' home, with 517 residents on a 150-acre campus.

The facility's administrator, David Worley, said it is working on improving resident care.

"We have very good staff and we have plenty of staff," he said. "We just, you know, it is just something that led to this serious issue that we have to get much better at. We're still providing quality care for over 500 nursing care residents, and I still believe we do it better than most."

The $250 daily fine is the result of Knoll's death being the third serious incident at the home this year.

In June, it was fined $2,000 for failing to prevent pressure sores on the foot of a resident who sustained a broken leg while being helped into bed. In August, state inspectors imposed a $5,500 fine after reviewing a sampling of five resident case files and finding that one of the five had sustained multiple injuries, including a broken hip, after falling to the floor.

Since Sept. 22, the home has been operating under a moratorium on new admissions for residents whose care is billed to Medicare or Medicaid.

Worley said the facility will continue to admit veterans who depend on Medicaid and Medicare but will absorb the expense until the staff can show full compliance with minimum-care requirements and the moratorium is lifted.