Some Iowa care facilities with virus have a history of infection-control issues

Some of the Iowa nursing homes with confirmed COVID-19 outbreaks have a history of infection-control violations, rodent infestations or unsanitary conditions.

Currently, 48 percent of all COVID-19 deaths in Iowa have been residents of nursing homes, retirement centers and other types of long-term care facilities.

The most recent cluster of COVID-19 cases is at the Bishop Drumm Retirement Center in Johnston, which on Monday became the 10^th Iowa care facility with a confirmed outbreak.

In March 2019, Bishop Drumm was cited for improper infection-control techniques related to a lack of handwashing by workers after they cleaned an incontinent resident. In December 2018, the home was cited for failure to maintain a clean and sanitary kitchen, with inspectors noting evidence of mice, cockroaches, spiders, centipedes, ants and moths.

Gov. Kim Reynolds said Monday at her daily press briefing that the number of COVID-19 cases in long-term care facilities is likely to grow.

“We will continue to see clusters of positive cases in these types of facilities because COVID-19 spreads quickly and easily among people in close proximity,” she said.

Here’s a look at some of the 2018-2020 violations reported by state inspectors at the 10 Iowa facilities with confirmed outbreaks:

Heritage Specialty Care, Cedar Rapids (Linn County), capacity of 201 residents: In April 2019, the home was cited for inadequate infection control. Inspectors saw one resident seated in the dining room with his or her catheter tubing lying directly on the floor. The resident had been hospitalized a few months before and had been diagnosed with septic shock and a urinary tract infection. Inspectors saw another resident of the home being wheeled about the facility with his or her catheter bag dragging on the floor. They also observed workers delivering clean laundry to residents by throwing it over their shoulder and by allowing some of it to drag on the floor.

In January 2018, inspectors observed an employee change a resident’s catheter bag by attempting to clean it with an aloe vera “wet wipe” typically used to clean skin rather than with an alcohol-soaked pad.

McCreedy Home in Washington (Washington County): As a retirement home that provides independent living services, this home is not regulated by state health-facility inspectors.

Premier Estates in Toledo (Tama County), capacity of 75 residents: In July 2019, inspectors saw a resident lying in urine and watched as an employee failed to adequately clean the resident. The home also failed to check the state’s registry of nurse aides to ensure three of its employees were eligible to work; failed to provide adequate training to nurse aides; failed to give residents on special diets the full prescribed portion of their meals; and was using a broken refrigerator-freezer to store food that needed to be discarded.

In May 2019, the home was cited for failing to have sufficient staff on hand to answer residents’ call lights. Residents reported that at times they had to use their personal cell phones to call the facility and contact caregivers, and even then they had to wait 30 to 60 minutes for a response. One resident reported having to wait 20 minutes to have his or her airway suctioned in order to breathe normally.

In February 2019, the home was cited for attempting to defy a judge’s order by involuntarily discharging a resident.

In November 2018, the home was cited for failing to have sufficient staff on hand on to answer residents’ call lights. An inspector, alerted by the sound of “loud crying” and someone moaning in pain observed a resident waiting 22 minutes for his or her call light to be answered.

In April 2018, the home was cited for failing to observe proper infection-control techniques in caring for residents and in handling laundry.

Pleasantview Home in Kalona (Washington County), capacity of 80 residents: In August 2019, the home was cited for giving a resident antipsychotic and antidepressant medication when some of the resident’s medical records indicated he or she had no major mental illnesses, including psychotic disorders.

Linn Manor Care Center in Marion (Linn County), capacity of 38 residents: In December 2019, the home was cited for infection-control deficiencies related to resident care and the handling of pillows and laundry; failing to keep copies of its past inspection reports accessible to residents and visitors; and failing to investigate resident bruises and injuries of an unknown origin. The state imposed and immediately suspended a $7,500 fine for failing to initiate CPR on a resident found unresponsive with no pulse. The home failed to properly document the protocol for life-saving measures for that resident.

Lutheran Living Senior Campus in Muscatine (Muscatine County), capacity of 155 residents: In October 2019, the home was cited for failing to properly secure narcotic medications.

In August 2019, the home was cited for inadequate resident-care plans; failure to follow physicians’ orders; failure to prevent or treat bed sores; failure to provide adequate pain management; failure to adequately assess dialysis patients; and failure to properly administer psychotropic drugs.

In August 2018, the home was cited for failing to check the state’s nurse-aide registry to ensure two newly hired aides were eligible for employment.

In April 2018, the facility was cited for failing to provide adequate nursing supervision to prevent accidents. A $9,000 fine for that violation was imposed but immediately suspended.

Trinity Center at Luther Park in Des Moines (Polk County), capacity of 120 residents: In January, the home was fined $22,500, but the fine was immediately suspended. The home was cited for failure to adequately supervise a resident who sustained a broken leg in a fall.

In November 2019, the home was fined $7,500 after a resident sustained a broken leg in a fall.

In October 2019, the home was cited for a narcotic error and for failure to properly assess two residents who had been engaged in a fistfight.

In May 2019, the home was fined $6,250 for failure to prevent and treat bed sores, one of which was large, bone deep and resulted in sepsis, a life-threatening infection. The home was also cited for a medication error rate of 7.4%; failure to inform the state of potential resident abuse by a staff member who roughly shoved a resident down into a chair; failure to keep residents’ care plans up to date; failure to intervene when a resident showed signs of deteriorating health; failure to provide adequate incontinence care; failure to properly administer psychotropic drugs; and failure to employ a fulltime dietician or qualified food-and-nutrition director.

In February 2018, the home was cited for infection-control violations tied to a staffer who came into contact with a resident who had a respiratory infection. The home was also cited for failing to help residents who needed assistance to eat their meals, and failure to adequately assess residents’ bruises.

Bartels Lutheran Retirement Community in Waverly (Bremer County): As a retirement home that provides independent living services, this home is not regulated by state health-facility inspectors.

Bishop Drumm Retirement Center in Johnston (Polk County), capacity of 150 residents: In March 2019, the home was cited for improper infection-control techniques related to a lack of handwashing after dealing with an incontinent resident. The home was also cited for failure to have adequate, up-to-date care plans, and failure to have an adequate supply of hot water for the dishwasher to clean meal-service supplies.

In December 2018, the home was cited for failure to maintain a clean and sanitary kitchen, and for failure to keep the area free of vermin, with inspectors noting evidence of mice, cockroaches, spiders, centipedes, ants and moths.

In October 2018, the home was cited for failing to adequately monitor a resident who had been prescribed a coagulant. Inspectors reported the resident was hospitalized where the medical staff suspected an “obvious” blood disorder tied to the coagulant, resulting in a serious loss of blood, acute renal failure and organ damage. A $5,750 fine was imposed, but immediately suspended.

In February 2018, the home was cited for failure to safety transfer residents in and out of bed after a resident fell from a mechanical lift and sustained a broken clavicle.

On With Life in Ankeny (Polk County), capacity of 28 residents: Zero deficiencies were cited by state inspectors during annual visits dating back to 2014.