An Iowa nursing home that's mired in bankruptcy is now facing an additional $85,225 in fines for poor quality care. (Photo illustration by Iowa Capital Dispatch)
An Iowa nursing home that’s mired in bankruptcy and been hit with almost $40,000 in fines this year is now facing an additional $85,225 in fines for poor quality care.
Last December, the QHC Facilities chain that operates the QHC Winterset-North nursing home, along with nine other skilled-nursing facilities or assisted-living centers in Iowa, filed for bankruptcy.
As part of that process, the court appointed an ombudsman to oversee the quality of care being delivered in the QHC facilities while the bankruptcy case proceeded and the owners pursued a sale of the chain.
The ombudsman has been filing regular reports with the court, but they are entirely sealed from public view because the ombudsman opted to include in them nonpublic information – such as resident names or other identifiers – rather than the numerical identifiers used in state inspectors’ reports.
The Iowa Department of Inspections and Appeals, which oversees nursing homes, has informed the judge that it, too, may be filing reports with the court on patient-care issues, but those, too, will be filed under seal.
Days after QHC Facilities filed for bankruptcy, federal officials fined QHC Winterset-North in Madison County $61,320 for violating 29 quality-of-care standards. Because the home didn’t appeal the penalty, the fine was automatically reduced 35% to $39,858.
Last week, the state proposed, and then suspended, an $8,500 fine against QHC Winterset-North after a resident wandered away from the home and was spotted a half-hour later walking along a road. During a subsequent investigation, it was found that at least some of the devices residents wore to sound an alarm when they passed through an exit door had expired in July of last year and were non-functional.
Separate from the state action, the federal government has imposed a series of daily fines – so far totaling $85,225 – for each day the home remains out of compliance with federal care standards. The federal government has also cited the home for failure to keep the home free of accident hazards; failure to develop plans of care for residents; failure to meet professional standards; failure to provide care for dependent residents; and failure to employ a sufficient number of nursing staff.
According to state records, a nurse aide at the home told inspectors last month that due to staffing issues, workers failed to provide care for one resident who then had to sit or lie in soiled clothing for more than two hours.
Residents were not being given baths or showers as required, call lights took two hours or more to answer, and one resident had not been receiving the prescribed physical therapy “due to no facility transportation,” inspectors noted.
The Winterset home is not the only QHC facility to experience problems during the bankruptcy. According to state reports, inspectors visited QHC Humboldt-North care facility iin January and cited the owners for eight federal regulatory violations.
State reports indicate a resident was injured in a mechanical lift; there was a “thick brown substance” on the floors and appliances; and inspectors noted evidence of vermin, with a large amount of dead bugs and worms at the end of one hall, and insects and spiders seen elsewhere. At the time, workers confirmed the facility was so short-staffed that call lights weren’t being answered and one resident was left to sit on the toilet for an hour and 15 minutes.
Real estate developer to take over QHC
In March, a federal judge approved the sale of the QHC chain to an East Coast developer who specializes in acquiring bankrupt properties.
The buyer is Cedar Health Group, a holding company based in Lakewood, N.J., that is part of a network of companies run by real estate developer Mark Tress.
Under the terms of the sale, QHC creditors who have claims against the company will be barred from pursuing those claims against Cedar Health Group – although they can continue to pursue their claims against QHC, which will soon have cash generated by the sale to satisfy at least a portion of the company’s debts.
The Centers of Medicare and Medicaid Services filed claims against QHC for $1.2 million for Medicare overpayments, advanced payments, and civil monetary penalties. In addition, the Health Resources and Services Administration said it planned to file claims against QHC “in an amount no greater than $5.2 million.”
QHC is also facing a wrongful death lawsuit brought by the estate of Ellen McCullough, a former QHC Humboldt-South resident who died of sepsis in October 2017, allegedly as the result of an untreated pressure sore on one foot. That case is expected to go to trial next month.
QHC is also facing wrongful death claims, including a lawsuit filed by the family of Gladys Van Sickle, who died after allegedly sustaining broken bones in a fall at Winterset-North. A trial in that case is scheduled for October 2023.
QHC’s 10 Iowa care facilities have a combined capacity of almost 750 residents. The Winterset-North facility is home to 44 residents.
In recent years, QHC homes have been hit with some of the largest federal fines ever imposed against an Iowa nursing home chain, with inspectors stating the company placed residents in immediate jeopardy due to substandard care. Inspectors alleged last year that the chain’s Mitchellville home was at times staffed by only one low-level nurse aide to look after 40 or more residents.
At the time, the director of nursing allegedly told inspectors the home was “falling apart” with “bed-ridden, weakened residents with no one to help them.” A nurse aide told inspectors that “everything in the facility is a mess,” and a registered nurse reportedly described the situation for inspectors as a “free-for-all, with no leadership from management.”
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