An Iowa nursing home has been placed on the Centers for Medicare & Medicaid Services (CMS) Special Focus Facilities list. Official records indicate that the facility has had a greater than five-year financial struggle that included cutting staffing to reduce financial losses.
Recently, inspectors issued citations involving the following incidents: a resident’s death, employment of unlicensed nursing staff, failure to protect residents from sexual abuse, and allowing a non-professional employee to supervise the facility’s dementia ward. The facility, which has about 40 elderly residents, is currently operating under a state-issued conditional license.
The facility’s history of sub-quality care citations has been increasing from 6 in 2017, 22 in 2018, to 36 in 2019, and it has also been cited repeatedly for insufficient staffing.
In May 2019, the facility was in such a deficient financial state that it was cited for failing to have portable oxygen tanks on hand for residents requiring continuous oxygen. Inspectors traced that failure to the facility’s non-payment of past due bills and the oxygen-tank supplier’s stopping of deliveries.
After discovering the oxygen-tank deficiency, inspectors found that there were 31 other medical equipment suppliers that the nursing home owed nearly $600,000 in unpaid bills. Seven of those suppliers informed inspectors that they would no longer do business with the facility. Additionally, the facility was behind another $600,000 on its mortgage payments.
Citations given in the May 2019 inspection included an unacceptable medication error rate and failure of staff to respond to call-lights — audits indicated 472 instances in a 7-week period of residents waiting 15 minutes or more. The nursing home was also fined more than $106,000.
Compliance Perspective
Allowing a facility to be continually fiscally irresponsible and without resources necessary to employ adequate numbers of qualified staff, to pay suppliers, for building operations’ costs, and for mortgage expenses, may be considered provision of substandard quality of care, in violation of state and federal regulations, potentially resulting in fines and other sanctions and placement on the CMS Special Focus Facilities List.
Discussion Points
- Review policies and procedures regarding fiscal responsibility for maintaining staffing levels and the resources needed to provide quality care for residents.
- Train staff regarding residents’ rights to be free from abuse, neglect, and exploitation and to report any suspected violation to their supervisor or through the Hotline.
- Periodically audit to determine if staffing levels are adequate and that only competent and appropriate staff members are assigned to provide care and supervision for residents.
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