legal resources necessary to hold negligent facilities accountable.
Regency Care Center (SFF) Abuse and Neglect Attorneys
Both the State of Iowa and the Centers for Medicare and Medicaid Services (CMS) conduct routine investigations, surveys, and inspections on every nursing home statewide. Their efforts help to identify serious concerns, violations, deficiencies, and health hazards that injured or could injure residents. In recent years, personal injury lawyers have seen a significant rise in the number of cases involving neglect and abuse occurring in nursing facilities in Iowa.
In the most serious cases, regulators will designate the nursing home as a Special Focus Facility (SFF) and add the Center to the National Medicare deficiency watch list. These nursing facilities must make significant changes to the level of care they provide and adjustments to their policies and procedures. Any failure to make significant improvements promptly could force Medicare and Medicaid to withdraw their agreement to allow the nursing facility to provide care to government-funded patients.
In 2017, regulators designated Regency Care Center as a Special Focus Facility. Some of the serious concerns, violations, and deficiencies involving this facility are documented below.Regency Care Center
This facility is a 101-certified bed ‘for profit’ Nursing Home providing services and cares to residents of Norwalk and Warren County, Iowa. The Medicare/Medicaid-approved Nursing Center is located at:
815 High Road
Norwalk IA 50211
In addition to providing around the clock skilled nursing care, the facility also offers:
- Physical, occupational and speech therapies
- IV (intravenous) therapy
- Memory care
- Hospice care
Federal and state regulators have the legal authority to impose monetary penalties against any nursing home identified with serious grievances, violations, and deficiencies. These fines are meant to dissuade substandard performance that harms or could harm residents.
Over the last thirty-six months, regulators have levied four substantial fines against Regency Care Center. These penalties include an $8500 fine of May 7, 2015, a $62,909 fine on November 10, 2015, a $43,150 fine on April 22, 2016, and a fine of $17,559 on October 4, 2016. During the same time, Medicare denied three requests for payment due to substandard care. These denials came on May 7, 2015, November 10, 2015, and April 22, 2016.
Within the last three years, surveyors have handled nineteen formally filed complaints and nine facility-reported issues. Each of these incidents after investigations resulted in formal citations.Current Nursing Home Safety Concerns
To be fully informed on the level of care nursing homes provide, families routinely research the Medicare.gov database system for a complete list of dangerous hazards, health violations, safety concerns, incident inquiries, opened investigations, and filed complaints. This information provides valuable content to make a well-informed decision of where to place a loved one who requires the highest level of nursing care and hygiene assistance.
Currently, Regency Care Center maintains an overall two out of five stars compared to all nursing homes in the United States. This ranking includes one out of five stars for health inspections, three out of five stars for staffing issues, and five out of five stars for quality measures. Some serious concerns, violations, and deficiencies involving this facility include:
- Failure to Develop, Implement and Enforce Policies That Forbid Mistreatment, Neglect or Abuse of Residents
- Failure to Ensure Residents Receive Proper Treatment to Prevent New Bedsores or Heal Existing Pressure Sores
- Failure to Provide Residents an Environment Free of Accident Hazards [recurring deficiency]
- Failure to Follow Protocols and Procedures to Prevent the Spread of Infection throughout the Facility
- Failure to Allow Residents to Refuse Treatment and Formulate Advance Directives
- Failure to Follow Protocols and Procedures to Prevent the Spread of Infection throughout the Facility
In a summary statement of deficiencies dated January 28, 2016, the state surveying team opened a formal complaint against the facility to identify deficiencies and failures. The team noted a facility’s failure “to report abuse to the Iowa Department of Inspections and Appeals within 24 hours. A missing vial of a Schedule IV medication belonging to [the resident] was missing and unaccounted for.”
The surveyor reviewed the facility’s Verification of the Investigation Report that revealed that “on January 11, 2016, one vial of [a Schedule IV controlled medication] was identified as missing during the 6:00 AM shift change narcotic count. The administrative staff initiated an investigation into the missing medication and interviewed staff. The investigation identified multiple nurses had access to the narcotic keys between the last correct count on January 10, 2016, at 12:30 PM and the count at 6:00 AM on November 11, 2016,” when the vial was identified as missing. “The key investigation revealed that nursing staff and not completed the count and exchanging keys or at the end of the shift change at 6:00 PM on January 10, 2016.”
Documentation revealed that the facility staff was “unable to locate the missing vial and unable to identify who might have taken the vial. The administrator reported the incident on January 14, 2016, at 12:20 PM.” The facility Administrator said that the “incident was discussed during a January 11, 2016, morning meeting of Department Heads and a full investigation was initiated.” Administrator “stated they discussed reporting to the State, but she wanted to gather more information to staff interviews and record review. A day or two later, she asked the Consultant Nurse who stated she needed to report the incident to the Department of Inspections and Appeals immediately.” The Administrator stated that “she was unaware of the 24-hour deadline and took responsibility for not reporting the incident within the deadline.”
In a summary statement of deficiencies dated January 20, 2016, the state investigator documented the facility’s failure to “ensure [the resident] receives services to prevent pressure ulcers.” The incident involved the staff placing “a bedpan under the resident’s buttocks and did not return to check [on] the resident. The resident went to sleep with the bedpan under the buttocks, which resulted in an avoidable pressure ulcer. The resident lacked pressure relieving devices for both heels and had pressure ulcers on each heel.”
In a summary statement of deficiencies dated April 22, 2016, the state surveying team opened a formal investigation of a complaint to identify violations and deficiencies. The team documented the facility’s failure to protect a resident “against environmental hazards.” A record review and interview with the staff established that the resident required a walker “when walking into [their] room. Staff interviews revealed a resident’s walker had been in the hallway for cleaning when [they] fell and sustained a pelvic and left hip fracture.”
One staff member that provided the resident care reported that “the resident’s Walker had been in the hallway for cleaning [and stated] the resident is independent with ambulation with a walker and staff is well aware of that.” The staff member also reported that “the resident always used [their] walker, all of the time [and stated that] the walker should have been washed and returned right away to the Certified Nursing Aides for the resident use.”
The facility Director of Nursing stated that before “the fall, the staff was aware [that the resident] ambulated independently with the use of the Walker.” The Director “stated the resident’s Walker should have never been taken out of the resident’s room for the without another walker replacing it.”
In a separate summary statement of deficiencies dated January 20, 2016, the state investigator opened a formal investigation to identify failures, deficiencies, and violations. The surveyor documented a facility’s failure “to provide adequate supervision and assistance to the bathroom [to] prevent against hazards and potential accidents.”
The resident’s MDS (Minimum Data Set) reflected the resident “required extensive physical assistance of one staff member for transfers, toileting, personal hygiene, and bathing needs.” The document also indicated that “the resident had balance deficits and could only stabilize themselves with staff assistant. The MDS indicated the resident [is] always continent of bowel and bladder [but] exhibited dyspnea (shortness of breath) with exertion and when lying flat.” The resident’s Care Plan “identify the resident to be at risk for falls and instructed staff that the resident required extensive assistance for Activities of Daily Living and transfers related to periods of confusion.”
The resident’s nurses note dated January 13, 2015, identified the resident’s family member had “found the resident in the bathroom in a wheelchair. The resident’s pants were down. The bathroom door had been closed when the resident was found. The resident’s oxygen saturation registered 79%. The resident’s vital signs were blood pressure at 143/72, pulse rate at 102 and respiratory rate at 20.” While the resident in the wheelchair had a portable tank to provide oxygen per nasal cannula, the portable tank was empty.
In a third summary statement of deficiencies dated October 4, 2016, the state investigator documented the facility’s failure to “provide adequate supervision and assisted devices to ensure against an injury.” The deficiency noted the facility’s failure “to provide enough assistance to assist the resident when unsteady, leading to a fall occurrence with a fracture of the left ankle.”
A review of the facility Fall Incident Report documented by a Registered Nurse occurring on August 27, 2016, and revised on August 29, 2016, recorded that “the resident fell in the shower room. The report recorded [that the Registered Nurse] found the resident sitting on the floor in front of the whirlpool, fully dressed. The report documented the resident stated [their] knee buckled and [they] went down.” The Registered Nurse “wrote the incident [as] witnessed by the Shower Aides who stated the resident only landed on [their] knee, and the Aides had the resident sit down until assistance arrived.”
In a summary statement of deficiencies dated June 30, 2016, the state surveying team identified a series of failures and deficiencies including a failure “to appropriately clean and disinfect reusable equipment to minimize the chance for infections.” The state investigator observed during an initial tour the facility at noon on June 28, 2016, signs in thirteen resident bathrooms that read:
“Attention Nursing Staff:
Please break all solid materials into small pieces, then hold the handle down for a count of 15-20 seconds before letting go. This should allow BM [bowel movement] to go down the sewer. The toilets on Ambassador all go into the wall and then down. The toilets on Royal have very old, very small pipes. 4 BM can't go down the 2 pipe!! Thanks, Maintenance.”
In addition to observing the above notice, the surveyor observed: “a plunger on the floor to the right of the bathroom” in one resident’s room. During an interview with a Certified Nursing Assistant on June 29, 2017, it was reported that “when having to break up large waste, which [the CNA] indicated if it is beyond a certain size, gloves would be applied in she would physically break up the waste or use a wire hanger.” The CNA “would then throw the wire hanger away after.” The Certified Nursing Assistant reported that “there are times when the toilet will need to be flushed more than once to dispose of the waste.”
The state investigator interviewed the facility’s Administrator and June 29, 2016, reported that “he asked the Maintenance Director and the Environmental Director to remove the signs in the bathroom about a month ago. The Administrator was informed of the signs [on] June 1, 2016, after the Social Worker completed a tour with family members looking to place their loved one in the facility.” The administrator reported that “if the waste is too big, he would not expect staff to break it up. The Administrator stated staff should remove the waste from the toilet and dispose of it in the hopper located in the soil utility room or the trash appropriately.”
In a summary statement of deficiencies dated January 19, 2016, state investigators opened a formal complaint against the facility to identify violations and failures. The surveying team noted the facility’s failure to “assess and provide CPR (cardiopulmonary resuscitation) to an unresponsive resident with no heartbeat or breathing.” The surveyor documented that the facility “identified 27 residents with advance directives to receive CPR.” A review of the resident’s Regency Care Center and Assisted Living Resuscitate Form that was signed by the resident’s family member and witnessed by two staff members “identified the resident requested to receive CPR.”
The surveyor interviewed a family member who “confirmed that it had been [their mother or father’s] wishes to have [the resident] receive CPR in the event [that they require to].” The same family member confirmed that they “had been aware that the facility failed to perform the procedure when [their] family member had been found non-responsive and without respiration.”
The state investigator then interviewed the resident’s physician who confirmed that they “expected staff to perform CPR if the resident had been a Full Code status.”
In a summary statement of deficiencies dated January 19, 2016, the state surveyor team opened a complaint investigation to identify failures and deficiencies. The team identified the facility’s failure “to ensure staff performed proper contact precautions per accept the professional standards [for one resident] reviewed with a contagious disease.”
A review of the resident’s Care Plan dated November 28, 2015, identified that the “resident had been unable to perform [their] own Activities of Daily Living (ADLs).” The facility failed to “identify the resident had Clostridium difficile (C-diff) or had been on any …protective precautions.” During an interview with the facility’s Administrator, it was confirmed that “the resident had not been listed on the Certified Nursing Assistant Care Information Sheet Hall 1, revised January 4, 2016” with precautions.
If you believe your loved one is the victim of mistreatment, neglect or abuse while residing in any nursing facility, including Regency Care Center, hiring an attorney can help. A law firm specializing in neglect and abuse cases can gather evidence, file your claim, present your case in court, or negotiate an acceptable out of court settlement. You will not make any upfront payments for legal services because the attorneys working on your behalf are paid only after they have resolved your case successfully and obtained financial compensation to recover your monetary damages.