The managers of a Dallas County nursing home accused of contributing to resident injuries, sexual abuse and a death, say they are trying to fix longstanding issues at the facility but “such matters take time to remedy.”
In a written statement, the home’s new administrator, Greg Greenwood, said Wednesday, “We are aware of the long-term, historical challenges at Rowley Masonic Community. The issues outlined by the Iowa Department of Inspections and Appeals are complex and being seriously addressed. However, such matters take time to remedy.”
The Iowa Capital Dispatch reported Tuesday that internal auditing reports of the home’s owner, the Herman L. Rowley Memorial Trust, show the organization began losing money in 2017 and embarked on a cost-cutting plan that entailed “adjusting staffing ratios to be as cost effective as possible while maintaining quality care.”
The number of quality-of-care violations cited by state regulators subsequently tripled, and over the next two years, the home was repeatedly written up for insufficient staff, although no state fines were imposed.
At various times, state inspectors reported, the home was using an unlicensed caregiver who had repeatedly failed to pass the skills test needed for certification, and allowed a kitchen employee to work shifts as the sole employee in the dementia ward.
Financial troubles at the home were so serious that in May of last year the facility was unable to buy bottled oxygen for the elderly residents who needed it simply to breathe, according to state records. The inspectors then discovered there were 31 vendors – including suppliers of medical equipment – that were owed almost $600,000. Seven vendors that provided essential resident-care services told inspectors they would no longer do business with the home. In addition to that, the facility was $600,000 behind on its mortgage, inspectors said.
At the time, the facility was also cited for a 16% medication-error rate. One resident had to be taken by ambulance to a hospital after being found unresponsive in bed after a staff-induced drug overdose. Residents reported soiling themselves as they waited 60 minutes or more for someone to come to their aid.
The home is now on the Centers for Medicare and Medicaid Services’ Special Focus Facilities list, which identifies homes that have an established pattern of numerous, serious violations related to resident care. The home is currently operating on a conditional license from the state.
In his written statement, Greenwood said, “We are dedicated to identifying and taking the corrective steps necessary to improve the wellbeing of our residents. To date, we have installed new leadership, as well as implemented new clinical systems, operational procedures, and staff training to assure the care and safety of residents.
“Throughout this process, the executive leadership and management teams have collaborated closely with State of Iowa officials and established open lines of communication. We have shared updates with the state on our progress, including providing a regular report regarding the operations, regulatory compliance, and long-term financial health of RMC. Additionally, a plan of correction has been submitted to, and accepted by, the Iowa Department of Inspections and Appeals and Centers for Medicare and Medicaid Services. Due to the required privacy of our residents and staff, we cannot provide further comment at this time.”
State records indicate the facility is home to roughly 40 older Iowans. It is part of the Rowley Masonic Community complex in Perry, which includes assisted living units and independent living apartments. The facility is run by Health Dimensions Group, a Minnesota company that manages nursing homes in Iowa, Colorado, Wisconsin, Illinois and other states.
According to Rowley’s financial audits, one of the trust’s main problems is the accumulation of long-term debt. The 2018 audit shows that in recent years the annual payments on the principal that is owed by the trust has been in the neighborhood $300,000. Next year, those payments are expected to balloon to $4.6 million, according to the audit. It’s not known whether the trust has restructured its debt since the 2018 audit was prepared.
On Tuesday, the Iowa Capital Dispatch asked the state Department of Inspections and Appeals what steps were being taken to ensure the home’s financial issues don’t pose a threat to residents’ access to health care. The agency has yet to respond.