Nursing home was on lockdown after worker waved a gun in the air

A suspended employee of an Iowa nursing home brought a gun to work in September and waved it in the air while threatening to “take care” of a problem with a colleague, according to state inspectors.

Two workers who witnessed the incident did not immediately report it but first went to another meeting and then to lunch.

State records indicate that a nurse aide at Heritage Specialty Care in Cedar Rapids came to work  about 10 a.m. Sept. 26 to give a written statement related to an argument she had with another staff member the night before. That argument had resulted in the aide being suspended.

When the aide entered the home, she had her “hood up and sunglasses on,” workers later told police. While speaking to the home’s scheduling coordinator and a human resources employee about the argument, the aide allegedly became “very upset” and pulled a small firearm from her purse.

The aide allegedly waved the gun in the air, without aiming it at anyone, and said, “If you don’t handle it, I’ll take care of it myself.” She eventually placed the gun back in her purse, according to inspectors.

The staff coordinator and human resources worker then left the aide in an office, went to another meeting, and then left for lunch. While at lunch, the two discussed the incident and decided it probably should be reported up the chain of command. While the two were at lunch, the aide, presumably still armed, left the building.

After lunch, the staff notified the administrator of the incident and the facility went into lockdown. The aide was fired and barred from reentering the building, and the home established a “police presence” in or around the building for a full week.

The police told Heritage officials they could not charge anyone with a crime because the aide did not threaten anyone, according to the inspectors’ report. The staff coordinator and human resources worker were later given “verbal education regarding the necessity of reporting a firearm immediately,” according to inspectors.

However, the human resources worker denied this, telling inspectors she “never received reeducation or discipline” in the wake of the incident. She also told inspectors and police that while she never felt threatened, the gun incident did leave her feeling concerned for the safety of the residents.

The home’s interim director of nursing told inspectors an investigation into the incident was never completed.

Heritage cited for six violations

While inspectors were at Heritage investigating the matter, they also looked into several other complaints and self-reported incidents. The home was cited for six regulatory violations, including failure to meet professional standards, failure to keep the home free of hazards, insufficient nursing staff and failure to follow federal guidelines on COVID-19 vaccinations.

A state fine of $9,500 has been proposed but held in suspension so the Centers for Medicare and Medicaid Services can determine whether to impose a federal penalty.

The inspectors reported that while they were at the home in October, they heard someone yelling for help, and upon investigating they found a female resident who said her call-light had gone unanswered for more than 40 minutes while she waited for assistance in getting to the bathroom.

In addition, the inspectors found that one employee had worked 348 hours, and two others had worked 30 hours and 97 hours, respectively, without proof of a COVID-19 vaccination or an approved request for exemption. The business office manager admitted to the inspector that two of the home’s unvaccinated workers had not even requested an exemption.

In the previous four months, eight workers at Heritage had tested positive for COVID-19. In addition, 22 residents had tested positive for COVID-19 in September and October.

Earlier this year, Heritage Specialty Care was cited for the financial exploitation of a resident and for using untrained caregivers.

State inspectors say the exploitation involved a worker who allegedly took $1,625 from a resident with a spinal cord injury and then taunted the man with text messages referring to him as a “vegetable” and “veggie boy.”

Heritage is owned and managed by Care Initiatives of West Des Moines. Six other Iowa nursing homes run by the company 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 CMS.

Care Initiatives has not responded to requests for comment.