Cedar Rapids care facility cited for untrained workers, resident abuse

By: - November 11, 2022 12:28 pm

Heritage Specialty Care in Cedar Rapids was fined for the financial exploitation of a resident earlier this year and is now accused of using untrained caregivers. (Photo via Google Earth)

A Cedar Rapids nursing home previously fined for the financial exploitation of a resident has now been cited for using untrained caregivers.

State inspectors say the abuse involved a worker at Heritage Specialty Care who allegedly took $1,625 from a resident with a spinal cord injury. The worker then taunted the man, sending him text messages in which she called him a “vegetable” and “veggie boy.”

The inspectors also allege that Heritage, which is home to 156 older Iowans and is operated by West Des Moines’ Care Initiatives, has failed to provide its training nursing assistants, or TNAs, with either the state-approved training or the required competency evaluations.

According to inspectors, the TNAs are supposed to complete an eight-hour, online training course and then complete a skills-competency checklist through job-shadowing with a licensed worker, before working on their own.

Heritage’s nurse manager told inspectors in August that he felt an eight-hour online course was not sufficient training to perform the duties of a fully certified nurse aide and so prior to June 2020, he did not hire a single TNA to work in the home. After that, he said, the home’s owner began hiring TNAs.

Heritage Specialty Care in Cedar Rapids. (Photo via Google Earth)

One TNA at the home told inspectors the home’s training program was “not so good” and said she had worked independently at the home before completing the required competency checklist. She said it seemed to her that “everyone hired as a TNA worked with someone for four to five days and then went out on their own,” working independently, because the home was “so short-staffed.”

Another TNA agreed with that assessment and said she had refused to work on her own until completing the required skills checklist.

A third TNA confirmed the practice and said the home failed to provide adequate training to do her job. She said she had failed her community college exam to become a certified nurse aide and felt she needed more training but still worked independently in the home caring for residents.

A fourth worker told inspectors she was trained not by a certified nurse aide but by another TNA who had let her certified nurse aide’s license lapse.

That trainer told inspectors she was given no training when hired at the home and said management gave her a certified nurse aide badge and then “acted like” she was fully certified. Inspectors reported the nurse said it “made no sense” to her that she was used to train other TNAs, adding, “what else was I supposed to do” when residents needed help.

Cook tried to serve oatmeal from garbage can

Inspectors also cited the home for unsanitary practices. A cook at the home, when asked by a nurse for a bowl of oatmeal for a resident, opted not to make a fresh bowl of oatmeal and instead went to a garbage can intending to scoop out some of the discarded oatmeal that was sitting in the trash receptacle.

The nurse refused to accept the oatmeal from the trash, telling the cook, “Absolutely not.”

I'll tell them you let me use your card ... You'll look like a retarded vegetable lol.

– Nurse aide's text message to a resident of Heritage Specialty Care

In addition, the home was cited for inadequate infection control. Inspectors reported that while on site, they observed a dietary aide, a certified nurse aide and an occupational therapist working with residents without the required face mask in place.

The home also was cited for insufficient staff, with one resident complaining she had to wait up to an hour to have her call light answered.

No fines were imposed by the state as a result of the inspectors’ findings in August. The home filed a plan of correction with the state that indicates it will address the citation for insufficient staff by providing “staff education.” The home has also indicated it will ensure TNAs receive the required training.

Worker allegedly took $1,625 from resident

In April 2022, the home paid a total of $650 in fines for resident abuse related to financial exploitation and for failure to conduct adequate background checks on workers.

At the time, inspectors alleged a nurse aide at the home had sold her cell phone to a resident late last year for $800 and then failed to turn over the phone. A few weeks later, when the worker was on a trip with her family, she sent a message to that same resident’s old phone, asking him to send her more money.

“Can you do $200 and I’ll pay you back when I start working more hours again,” the message read, according to inspectors who examined the resident’s phone. The resident then provided the money through an app on his phone.

The same resident told inspectors that after he loaned the worker his debit card to order him a pizza, unauthorized charges for Door Dash showed up on his bill and he had to cancel his card. In January, when the worker asked the man for another $200 and he refused, the worker sent him what the man called “mean and hateful” messages, calling him a “vegetable” and “veggie boy.”

According to inspectors, the messages, which were archived on the resident’s phone, stated: “Thanks again for saying you would help us and then go back on your own word … Have fun sitting in that s— hole with that big ego of yours.”

At one point, the worker indicated she’d soon be leaving her job at Heritage, stating, “I’m not there for the rest of my life … 11 days and I’m out sweetie … How many days ya got in heritage? Yikes, I think it’s more than 11 … But enjoy.”

When the man indicated he might report his debit card as stolen, the worker wrote back, “Good luck. LOL. I’ll tell them you let me use your card … You’ll look like a retarded vegetable lol.”

A review of transactions on resident’s cash app revealed 10 transactions, indicating the resident had transferred $1,625 to the worker.

Six other Iowa nursing homes run by Care Initiatives have been cited for major violations in recent weeks. They face fines of up to $80,250, and additional penalties may yet be imposed by the federal Centers for Medicare and Medicaid Services. The company has not responded to requests for comment.

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Clark Kauffman
Clark Kauffman

Deputy Editor Clark Kauffman has worked during the past 30 years as both an investigative reporter and editorial writer at two of Iowa’s largest newspapers, the Des Moines Register and the Quad-City Times. He has won numerous state and national awards for reporting and editorial writing. His 2004 series on prosecutorial misconduct in Iowa was named a finalist for the Pulitzer Prize for Investigative Reporting. From October 2018 through November 2019, Kauffman was an assistant ombudsman for the Iowa Office of Ombudsman, an agency that investigates citizens’ complaints of wrongdoing within state and local government agencies.

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