An Iowa nursing home with a major outbreak of COVID-19 has been cited by the state for refusing physicians’ orders to send residents to the hospital for treatment.
The Pearl Valley Rehab and Health Care Center in Muscatine, where at least 81 residents and staffers have tested positive for COVID-19 and nine residents have died of coronavirus, is facing a potential fine of $19,500.
According to the Iowa Department of Inspections and Appeals, a resident of the home who had a history of respiratory problems was running a fever on April 28 and her doctor ordered that she be taken immediately to the local hospital’s emergency room.
When informed of the order, the home’s assistant director of nursing allegedly refused, citing the advice of the medical director who had allegedly said no residents should be transferred to the hospital, if at all possible, to avoid the spread of COVID-19.
At the time, the assistant director of nursing told a state inspector the home did not have any COVID-19 in the building “and we want to keep it that way.” In reviewing state records, however, inspectors saw that 11 residents and two staffers had already tested positive for COVID-19.
On April 29, the female resident tested positive for COVID-19 and was hospitalized. Five days later, the director of nursing told state inspectors the home had at least 20 cases of COVID-19 in the home with more test results still to come in.
Inspectors found that the director of nursing later wrote in the female resident’s medical records that the resident had “refused” an offer to be taken to the hospital. A registered nurse told inspectors she had written in the resident’s chart that the resident’s doctor was angry the home hadn’t sent his patient to the hospital, but when inspectors reviewed the file, those notes couldn’t be found.
By May 14, the home had documented 61 cases of residents testing positive for COVID-19. Nine of them had died. The number of infections would later grow to 81. The home has only about 67 residents, according to state records.
Inspectors also found that the home had overruled a physician in refusing to take a male resident of the home to the hospital. That resident, along with two others, had symptoms of COVID-19, but were not kept in isolation, inspectors said.
One of the other residents was found dead in his bed on May 8 not long after testing positive for COVID-19 and showing a “significant decline” in his physical status. A relative of the resident told inspectors the home hadn’t said the man was sick and hours earlier had reported the man was having a “good night.”
The $19,500 fine is being held in suspension by the state, giving federal authorities the opportunity to impose a fine of their own for the same violations.
Earlier this week, Iowa Capital Dispatch reported the number of COVID-19 outbreaks in nursing homes had risen sharply, involving more than 500 residents and workers around the state.