Nurse tells inspectors of ‘horrific’ conditions in Des Moines nursing home

An Iowa nursing home where residents were deemed to be in immediate jeopardy delivered a “horrific” level of care, a staff nurse recently told state inspectors.

The inspectors visited the Genesis Senior Living nursing home in Des Moines last month and investigated a backlog of nine complaints against the facility. The home, which has roughly 70 residents, was cited for 13 federal violations and two state violations, including failure to notify family members of residents’ worsening conditions; failure to protect residents from abuse and neglect; failure to investigate or respond to alleged violations; failure to meet quality-of-care standards; and failure to adequately protect residents from infections.

A registered nurse who worked at Genesis Senior Living late last year told state inspectors that one resident had an open wound on her foot in December. The wound, she said, had a “horrid” odor that she could smell as soon she entered the woman’s room, adding that it “smelled like gangrene.”

According to the inspectors, on Dec. 9 of last year the nurse had removed from the resident’s foot a dressing that had been applied to the wound eight days earlier. At the time, the wound was noted to be foul smelling and draining fluid with signs of an infection. An antibiotic was ordered, but six weeks later the woman’s condition had grown worse and a licensed practical nurse reported that by then she could smell the wound from the hallway outside the woman’s room. The resident’s daughter asked Genesis to take her mother to the hospital.

The woman was admitted to the hospital where doctors assessed her wound as very large – at least 3 inches by 3 inches – with exposed bone that was infected. The woman remained hospitalized for at least 10 weeks, during which she underwent four surgeries including bone grafts.

The registered nurse at Genesis “said the lack of care the residents in the facility get is why she is no longer an employee,” state inspectors wrote in their report. “She described the care as horrific. She said when she would arrive to work the night shift, multiple day-shift medications were often not given.”

According to the inspectors, residents of Genesis Senior Living had complained that the certified nurse aides who worked in the home hid in closets, talked on their personal phones, delivered little care and were rude and disrespectful. After one resident complained to an aide about the length of time she had waited to have her undergarments changed, the aide threw a pair of briefs and a glove at her, saying, “F—ing change yourself,” and walked out. The aide was fired for the offense.

Residents who were to receive a shower twice a week sometimes had to wait seven days for a shower. On one occasion, a resident who preferred to have daily showers had to wait 14 days.

In January, a female resident fell from a tipped-over mechanical lift, began having seizures and was rushed to a hospital. In February, a different resident fell from the mechanical lift while being transferred to bed and sustained a head laceration that required a trip to the emergency room and five staples to close.

Inspectors reviewed seven patient files and concluded that in six of the seven cases, Genesis Senior Living failed to provide safe mechanical-lift transfers for residents. Based on that finding, the home was found to have placed residents in immediate jeopardy from Jan. 9, the date of the first incident, through April 26.

Fines of $9,500 and $6,250 were imposed by the state but have been held in suspension to allow the federal Centers for Medicare and Medicaid Services to consider imposing a penalty.

In the past two years, CMS has fined the home 10 times, with the penalties ranging from $650 to $71,761. Based on its five-star quality scale, CMS has awarded Genesis Senior Living a one-star rating for state inspectors’ findings, a two-star rating for its staffing levels, and a three-star rating based on various quality measures.

The home’s temporary administrator, Cody Petrich, could not be reached for comment. The home is owned by DSM Healthcare Management, a for-profit company owned in part by Judah Bienstock of MGM Healthcare, a St. Louis company that manages seven Iowa nursing homes and 18 facilities in Missouri and Oklahoma.