Care facility hit with more than $900,000 in fines for alleged abuse

A Taylor County nursing home is facing one of the largest fines ever imposed against an Iowa care facility by the federal government.

The Centers for Medicare and Medicaid Services has fined the Lenox Care Center in Taylor County a total of $909,600. That fine stems from state inspectors’ recent findings that a resident of the home was physically abused in August.

According to state records, a registered nurse at the care center was observed by co-workers forcefully yanking a wandering resident through an exit door, taking the woman’s walker, and then tying the woman down in a chair with a bed sheet.

Information about the incident wasn’t relayed to the home’s administrator for two days, during which time the accused nurse was allowed to continue working in the facility with the alleged victim, state inspectors found.

According to the inspectors, the female victim was cognitively impaired, possibly due to a stroke and a brain tumor, and had a tendency to wander. According to workers at the home, the woman was trying to leave the facility the evening of Aug. 20.

When the woman failed to respond to a registered nurse’s commands, the nurse went to the doorway where the woman was trying to leave and grabbed her by the arm to force her back into a common area used by residents. As she was pulled backward, the woman allegedly began to scream and cry out, saying, “Ow, stop, you are hurting me … You are abusing me, I know my rights.”

According to workers at the home, the woman fell to the floor and the nurse took away her walker, left the area and then returned with a dining room chair. After the woman pulled herself up from the floor, the nurse grabbed her by the shoulders and forcibly “slammed” her into the chair, the nurse’s colleagues later told inspectors.

‘Residents were scared to death, it was bad.’

Workers said the nurse then told a certified nursing assistant, or CNA, to get a bed sheet while the nurse pinned the “hysterical” woman to the chair. The nurse allegedly instructed the CNA to hold the woman down while the nurse wrapped the sheet around the woman’s legs. According to the workers’ description of the incident, the woman “was fighting like hell to get out of the chair” and was screaming, “Help! Why are you doing this?”

While that was happening, two of the home’s employees walked out of the building and telephoned the director of nursing to report what they had just seen. When interviewed later by inspectors, the director of nursing acknowledged that she should not have waited two days to report the incident to the administrator, saying she had never had anyone do that before and did not know what to do.

When the accused nurse was interviewed, she allegedly said the woman had been wandering earlier in the evening and was going up and down the halls, in and out of other residents’ rooms. “Other residents were running out of their rooms, almost falling, residents were crying,” the nurse told inspectors. “Residents were scared to death, it was bad.”

The nurse denied forcefully pulling the resident out of the doorway and said she had merely “linked arms” with her and guided her out of the doorway while the woman patted her hand. The nurse also denied forcing the woman to sit in the chair. As for her colleagues’ claims that the woman had fallen to the floor, the nurse said the woman had merely knelt to pray.

Asked why she had asked a colleague to bring her a bed sheet, the nurse admitted making the request but said she quickly decided she “just could not do it” and so she never used the sheet.

The state inspection report gives no indication as to whether the Lenox Care Center disciplined any workers involved in the incident, or whether the matter was referred to a licensing board, police or prosecutors.

In response to the incident, the state proposed $10,000 in fines that were held in suspension while CMS determined what action to take at the federal level. CMS then imposed two separate daily fines – one for $13,695 and one for $360 — for each day the facility remained out of compliance with federal regulations.

Those fines eventually totaled $909,600. State records indicate they have yet to be paid. If the facility chooses not to appeal the penalty, the fines will be reduced by 35%.

Lenox Care Center’s new administrator, Rae Tucker, declined to comment on the matter. The home is owned by Florida’s Arboreta Healthcare chain, which operates 21 care facilities in Iowa.

Editor’s note: Two days after this story was published, the Iowa Department of Inspections and Appeals revised its published report on the fines imposed against the Lenox Care Center to indicate the federal fines totaled $75,645, not $909,600 as the agency had previously reported. DIA did not respond immediately to questions about the change.