Nursing home cited for a meth-smoking resident and a threatening nurse

An Iowa nursing home where a resident was smoking methamphetamine and a tyrannical nurse allegedly left residents in fear for their safety could be facing fines from the federal government.

State records indicate the Osage Rehab and Heath Care Center in Mitchell County was cited recently by state inspectors for 16 regulatory violations, including a failure to address the illegal drug use of a male resident who had a psychoactive substance abuse disorder.

In mid-September, the care facility received a lab report that indicated the man had tested positive for methamphetamine. Days later, the man was observed screaming at the staff, upset over a television that he claimed was his but which belonged to the facility. The man yelled, “Get me my f—ing TV right now or I am going to start breaking s—!” The man then went into another resident’s room and ripped away that individual’s oxygen supply.

When the staff told the man to stay out of other residents’ rooms, the man replied, “I don’t give a f—, I am going to start tearing s— apart!’

According to inspectors, the man’s chart indicates that days after that incident, a nurse reported the police had been called to the facility several times in the previous seven days but the officers could not do anything because the man refused to let anyone search through his belongings.

It was around that time that a nurse walked into the man’s room while he was smoking methamphetamine from a meth pipe. The police returned to the care facility and searched the man’s room, finding three meth pipes and a white residue inside on his scooter. The substance later tested positive for methamphetamine.

A few weeks later, on Oct. 12, a nurse documented having told the man, “We did find methamphetamine in your room with pipes. It does bother me.”

Nine days later, on Oct. 21, a state inspector interviewed the man and he confirmed the staff had caught him smoking methamphetamine in his room “not too long ago.”

A week after that interview, on Oct. 28, a worker approached a nurse in the home and reported that it smelled bad in the man’s room. The nurse later reported that she approached the man’s room and could smell the methamphetamine even before entering. “It smelled very strong,” the nurse reported.

‘If you don’t like it here, you can leave.’

Earlier in the day, the staff had noticed the man attempting to clean his toilet and sink by using a broom. The man was also washing his clothes in the sink and then submerging the clothes in the toilet before placing them back in the sink.

Later, the man was found resting in his chair “with a lot of drool coming from his mouth,” and the staff had some difficulty waking him.

On Nov. 2, the home attempted to discharge the man to his home, but without an effective plan to ensure a safe transition. The home’s interim director of nursing told an inspector the man had to be discharged that day because another resident was threatening to call the local television station and report the facility was housing a drug user.

As a result of the inspector’s findings, the Iowa Department of Inspections and Appeals determined residents of the home had been placed in immediate jeopardy due to insufficient competent staff and a failure to adequately assess residents’ needs. Two state fines totaling $15,000 were proposed but held in suspension so the federal Centers for Medicare and Medicaid Services can consider taking action in the matter.

The inspectors also cited the facility for a series of incidents involving the director of nursing. After an ambulance crew brought a resident back to the home after a hospital stay, the staff was helping the man into bed when the director of nursing entered the room and started to rummage through the man’s belongings, yanking items from his dresser drawers.

According to one employee, the director of nursing was yelling at the man as she rummaged through his things, responding to his objections by saying, “Is that all you got?” and, “If you don’t like it here, you can leave.”

The man became angry when the director of nursing “totally ignored him,” workers told inspectors. The workers said the director of nursing slammed shut the door of the resident’s room and then approached the man in his bed, yelling at him “at the top of her lungs,” almost in his face, and saying, “You do not talk to me and my staff that way,” in a threatening manner.

One worker said she attempted to de-escalate the situation by placing her hand between the resident and the director of nursing, only to have the director of nursing push it away. Workers said the director of nursing “antagonized and badgered” the resident repeatedly, and that the two “yelled and screamed for 10 minutes” before the man yelled, “Get the f— out,” and the confrontation ended. The resident later told inspectors he felt “belittled” by the incident.

Two other residents told inspectors they felt unsafe in the home due to the director of nursing’s behavior. One female resident recounted an incident in which the director of nursing entered her room one night and then stood against the wall, saying, “Come on, come on and get me,” while gesturing with her hands as if to suggest she wanted to fight. The resident reported the director of nursing then said to the woman, “Oh, yeah. You cannot get up.”

A licensed practical nurse told inspectors she had witnessed the director of nursing threaten workers and said residents had complained about the director of nursing “poking at them.” Another licensed practical nurse wept as she spoke to inspectors and said residents of the home were afraid to be there.

The inspector’s report gives no indication as to whether the home’s administrator or owner were asked about their responsibility in the matter.

‘See? I did not kill you.’

The facility was also cited for unsanitary conditions, with inspectors noting that all 16 rooms on one side of the building had a buildup of a black substance that appeared to be mold. A maintenance supervisor explained to an inspector that water pipes in the facility’s 50-year-old heating system contained mold.

Inspectors also reported that while they watched, a worker went into several residents’ rooms and placed their pills on a bedside table and then walked out without assisting the residents or making sure they took their pills.

In addition, inspectors reported that an unqualified aide had given a diabetic resident an injection of insulin and then said to the resident, “See? I did not kill you. Don’t tell anyone I gave it to you.”

Osage Rehab and Heath Care Center is owned and managed by Arboreta Healthcare, which is headquartered in Lakewood Ranch, Florida. Arboreta said in a written statement that it took immediate action after the Osage facility was cited for placing residents in immediate jeopardy, and the company said it intends to file a written plan of correction with the state within the next nine days.

The director of nursing involved in the incident is no longer employed by Arboreta, the company said, and the staff has now been trained on recognizing substance abuse disorder.

“Arboreta Healthcare is committed to continuous improvement,” the company said. “Our swift action to resolve these findings reflect our commitment to providing quality care, with continued focus on the quality of staffing and clinical support for our patients.”

Arboreta Healthcare, headed by CEO Louis Collier, operates 21 health care facilities in Iowa and a total of 10 facilities in Nebraska, Texas, Florida and Georgia.

According to Securities and Exchange Commission filings, Collier was paid $550,000 in salary and bonuses in 2021. He was also awarded 1.25 million shares of phantom stock in the company, which provides him with all of the financial benefits of stock ownership without owning the actual stock.