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State Orders Iowa Nursing Home to Pay $15,000 Fine

WASHINGTON, Iowa (AP) An Iowa nursing home where a resident fell and lay on the floor with a head injury for nearly an hour while workers enjoyed a Christmas party faces a $15,000 state fine for failing to provide the necessary intervention and treatment.

According to state records, the woman was walking down a hallway in a dementia unit at All American Restorative Care in Washington, Iowa, on Dec. 23 when she stumbled backward and fell to the floor, unobserved by staff, the Des Moines Register reported ( Wednesday.

A videotape of the incident from the home's monitoring system shows the woman on the floor while workers milled about, according to inspectors and nursing home owner Jerry Rhodes, of Muscatine.

Rhodes is appealing the findings and fine from the Iowa Department of Inspections and Appeals.

"We certainly didn't provide substandard care," Rhoads told the newspaper.

He said since it wasn't unusual for the woman to be lying on the floor, the staff appeared to show no concern.

"This was a lady that had been pretty combative," he said. "She had a habit of lying on the floor in her room, in her closet, and in the hallway, and it got to the point where the staff just kind of let her do that."

According to inspectors, within seconds of the fall, two staffers appeared at the nurse's station within view of the resident. The video showed neither worker offer to assist the woman, who inspectors alleged was "barely moving."

One of the two workers later told inspectors she called down the hallway to ask if the resident was OK, and the resident responded, "Yes."

Workers helped the resident into bed 46 minutes after the fall. She later was taken to a hospital because of a cut on her head that required four staples.

Rhoads said he was disappointed that the state used the video against the home, "taking it out of context" and then imposing the fine. He said Iowa's inspectors use "the fear factor" when they visit a nursing home.

State officials denied the newspaper's request for a copy of the videotape.

The 90-bed facility has maintained an average of 55 residents over the past two years. It's owned by Rhoads, his wife, Sharon, and their son, Kip. A company called Caregiver Management Systems Inc., also owned by the Rhoads family, manages the facility.

The nursing home faces an additional $3,000 in state fines because of other incidents, including a resident who was injured while being transferred into bed by a mechanical lift.

David Werning, spokesman for the Iowa Department of Inspections and Appeals, declined Wednesday to comment on the state's actions. He said as a result of the findings, the federal government in March barred the nursing home from admitting any resident whose care is funded through Medicare or Medicaid.

The nursing home, Werning said, has now met minimum standards for compliance, but is appealing the sanctions. The state's actions are on hold pending the outcome on the federal level, he said.

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