‘No idea what I was doing:’ Altoona home added to federal list of worst nursing homes
An Iowa nursing home where workers were not trained in CPR and a nurse allegedly refused to perform CPR on a resident who later died was placed on the list of the worst nursing homes in the country.
The Altoona Nursing & Rehabilitation Center was charged with 12 violations of the law in June and found that all 95 residents of the home were in imminent danger.
The Altoona Home is one of 10 Iowa care facilities eligible for inclusion on the CMS Special-Focus Facility List.
The Altoona house was only recently added to the list of eligible homes due to poor performance.
After a state inspection in June, DIA officials reported that in the early hours of June 14th, a domestic worker heard a resident shout, “I think I have a heart attack.” The worker went into the resident’s room and found that the woman had a seizure and was then no longer responsive.
A registered nurse initiated chest compressions and CPR, but the resident was still in bed and not lying on a hard surface as recommended. The nurse reportedly performed CPR for a few minutes, got tired, and asked a licensed general practitioner who was in the room to take the lead.
The inspectors later reported that the LPN responded to the request with the words “She was tired, not feeling well and did not want cardiopulmonary resuscitation” and that she also whispered to one of her colleagues that she was “too scared” Perform CPR.
A third worker then attempted chest compressions and CPR. This worker later told inspectors that she had taken a CPR course in high school five years earlier but had never done CPR and “had no idea what I was doing.”
Several workers later told inspectors that they had not used a defibrillator on the resident and were unsure if the home even had one. One worker said she was last certified in CPR 13 years ago.
The nurse reportedly told inspectors that she had not received any medical emergency training at the home, was not CPR certified, and did not know if the home had a defibrillator.
The resident was taken to a hospital in an ambulance, where she was pronounced dead.
The Altoona home was charged not only with failing to respond to the woman’s needs, but also with failing to verify the criminal background of half of the eight workers whose files were examined and with several other rule violations.
DIA noted that the home’s residents were in imminent danger, but within 24 hours the state agency claimed the situation had been corrected and the home had its staff on CPR, medical records, acute changes in conditions, medical notice, defibrillators and other problems cleared up. and so the severity of the violation was reduced.
The state agency considered fines totaling $ 9,750 but instead opted for a state fine of $ 500 tied to the criminal background checks.
Eight months ago, DIA was considering a US $ 17,750 state fine on the home, but it was not imposed, in part because a resident failed to provide adequate treatment for hospitalized for a bone infection.
According to the CMS consumer website CareCompare, the Altoona house was last penalized in 2019. However, DIA’s consumer website states that the federal agency fined the home $ 145,945 as a result of the January inspection and that no federal fine was imposed for the CPR-related violations found during the June inspection .
The nine other Iowa facilities that are eligible for Special Focus Status include:
Aspiration of Primghar – This house has been entitled to special focus status for a month. In May, the state cited the home for having put residents in immediate danger by failing to adequately assess and intervene in four of the five residents whose care was being reviewed. One resident missed many doctor’s appointments because no trips had been arranged; a resident who was due to have surgery to remove kidney stones missed his surgery appointment; and a third resident was not monitored for fluid overload after a medication switch, then became breathless and died. During their inspection, DIA officials said the home’s residents were in imminent danger, but within hours the agency found that staff training and policy changes had corrected the situation, reducing the severity of the violation. DIA contemplated government fines of $ 17,500 but imposed none. The last federal fine imposed on the house was imposed in June 2020, according to CMS.
Cedar Falls Health Center – This home has been eligible for special focus status for 27 months. In May, inspectors cited the house for failing to protect residents from burns by placing residents’ beds, some of which were floor-to-ceiling, next to baseboard heaters. In April, a resident rolled out of bed and was found lying directly on a heating element by workers. The resident suffered burns covering up to a fifth of his body, with up to half classified as third degree burns. The worst of the burns resulted in white, charred meat, with part of the resident’s skin being cooked on the heater itself. The burns “could also have damaged the bones, muscles and tendons underneath,” inspectors said. A nurse’s assistant told inspectors that she had been telling people in the home for “years” that the heaters needed to be removed from the beds During the inspection, DIA officials told the home that the residents were at immediate risk, but according to agency records, they had already stated that corrective action by the facility could resolve the situation, which would reduce the severity of the violation Fines of $ 7,250, but none, were imposed. The last federal fine imposed on the house was imposed in June 2019, according to CMS.
Rock Rapids Health Center – This home has been entitled to special focus status for four months. In January, state inspectors cited the home for failing to provide adequate assessments and interventions in six out of seven residents whose cases were being reviewed. One resident with COVID-19 lacked adequate examinations for breathing difficulties and low oxygen levels and was admitted to an emergency room in severe acute emergency while extremely dehydrated. Another resident, whose blood sugar was not checked, was hospitalized for treatment for hypoglycemia. A third resident who tested positive for COVID-19 suffered from pneumonia and sepsis and was hospitalized for an acute kidney injury likely caused by severe dehydration. It turned out that the house had put local residents in immediate danger. DIA contemplated fines totaling $ 27,750 but imposed none. The last federal fine imposed on the house was imposed in June 2020, according to CMS. DIA’s website states that CMS fined the house $ 280,955 as a result of the January inspection.
The other Iowa homes eligible for a particular focus are: Aspire of Muscatine; The Fleur Heights Center for Wellness and Rehabilitation in Des Moines; The ivy in Davenport; Oakland Mansion; QHC Fort Dodge Mansion; and QHC Mitchellville.
The Special-Focus Facility List is updated quarterly by CMS and includes properties that have been classified by CMS as “serious quality problems in the past”. These homes are included in a special program that aims to improve the quality of their care through increased supervision.
While 10 Iowa homes are eligible for this type of assistance, they are not actually enrolled in the program or receiving the assistance.
This is because the number of facilities on the list remains relatively constant, so new facilities cannot be designated as special focus facilities regardless of how poorly their care is until other homes in the same state improve and are off the list “Complete” – a process that can take four years or more.
Nationwide, there are usually around 88 care facilities on the list, with one or two places to be filled from each federal state. DIA nominates Iowa facilities for listing, and CMS selects two from the state to be included in the program.
Typically, homes eligible for a specific focus area have about twice the average number of violations reported by state inspectors; they have more serious problems than most other nursing homes, including damage or injury to residents; and they have identified a pattern of serious problems that has persisted over a long period of time.