SIOUX CITY -- A Sioux City nursing home with a long list of alleged violations that include staff ignoring residents' cries for help is among the nation's worst, according to a government agency.
Countryside Health Care Center, 6120 Morningside Ave., is one of only 10 Iowa care facilities now eligible to be placed on the Centers for Medicare and Medicaid Services' Special-Focus Facility List. The national list identifies facilities with “repeated cycles of serious deficiencies, which pose risks to residents’ health and safety."
Countryside was cited for 25 federal violations and one state violation following a April 16 state inspection consisting of interviews with the 33 residents and the staff, on-site observations and document reviews.
An average nursing home will have 6 to 7 deficiencies per inspection, according to the CMS.
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The Journal's attempts to contact Countryside administrators for comment were unsuccessful.
Countryside Health Care’s alleged deficiencies included:
- A female resident yelled “help me” and “hurry up” from her bed for 47 minutes with no response from nurses. The inspector watched the situation and said the yells could be heard from the nurse’s station. After 23 minutes, a nurse walked by without stopping to check. The cries continued for 47 minutes before the resident passed out and two nurses entered the room.
- The director of nursing at the time waited over 40 minutes before performing CPR on an individual without a pulse despite documentation stating basic life support for patients was required;
- The facility failed to ensure the physician saw the resident at least once every 30 days for the first 90 days after admission, and at least once every 60 days thereafter. A nurse practitioner with five patients at the facility said her office tried several times to schedule visits and nobody returned her calls or letters.
- An interviewed resident said he sometimes waited over an hour after activating his call light for someone to arrive. The investigator witnessed a call light on for 28 minutes before staff responded. At other times the call light remained on with staff not attempting to respond;
- The home did not alert a patient’s physician when he went from 176.2 pounds to 151 pounds in 30 days;
- A male resident asked a nurse twice to empty his urinal and both times the nurse said “it was not her job.” The resident said he had to wet through his clothes and the next shift came in later to clean him up;
- A criminal background was not conducted on a staff member who was identified to have three misdemeanor convictions which included theft and assault;
- Room trays of food were not served at a safe temperature, the kitchen was not adequately cleaned and hand hygiene rules during meal service were not followed and;
- The inspector noted three occasions in which staff failed to provide the proper treatment or follow the proper treatment protocol, such as using the wrong ointment, failing to properly prepare insulin and not applying compression stockings for someone who needed them.
As a result of the alleged violations, the Iowa Department of Inspection and Appeals levied a federal fine of $58,095 on the home, which is owned by Propco, a New York-based real estate firm.
This is not the first time inspectors have found deficiencies at Countryside. In 2019, the home was ordered to pay $59,346 in fine from two separate inspections.
An April 2019 inspection reported 30 deficiencies, one of which resulted in a resident death. These deficiencies included a variety of minimal harm or potential for harm violations along with incidents of immediate jeopardy to the resident health or safety.
One resident died after choking on a piece of food. The resident had a documented history of eating rapidly and reportedly required a soft diet with staff assistance, which they reportedly did not receive.
A different resident received a second degree burn on his lap while drinking an unlidded cup of coffee, despite documentation requiring the use of lidded cups for the resident. A physician order treatment for the burn was not completed for 14 days in a row.
The Special-Focus Facility List consist of care facilities with about twice the average number of deficiencies, mores serious problems including harm or injury experienced by residents and a pattern or serious problems that have persisted for more than three years, according to the CMS.
The homes are enrolled in a special program and receive onsite inspections every six months until the home either graduates from the program or is terminated from the Medicare or Medicaid programs.
Of the 88 spots on the Special-Focus Facility List, two are reserved for Iowa. Another Sioux City facility, Touchstone Healthcare Community, has been on the list for 44 months. Only two others in the nation have been on longer, according to CMS records.