Company Cited For Death, Injuries At Two Iowa Nursing Homes

Accura Healthcare of Manning. (Photo via Google Earth)

Two Iowa nursing homes run by the same company are facing up to $36,500 in potential fines for a series of quality-of-care violations, including one resident death.

State inspectors visited Accura Healthcare of Manning in mid-August, partly to investigate eight separate, backlogged complaints, but also to conduct the home’s annual recertification inspection. Five of the eight complaints were substantiated by inspectors.

The Manning home was cited for overall poor quality of care, failure to report alleged regulatory violations, failure to develop or implement comprehensive care plans for residents, failure to prevent and treat pressure sores, failure to keep the environment free of hazards, failure to adequately respond to incontinence, and failure to have adequate infection-control measures in place.

Several of the violations were tied to findings that the home failed to prevent residents from developing pressure sores, sometimes called bed sores, after being admitted to the home, then failed to treat those sores or complete the required assessments of residents’ skin.

According to inspectors, one resident fell seven times over the course of 23 days, including three falls that took place on one day. None of the falls was investigated and no steps were taken to reduce the risk of additional falls. On the seventh occasion, the resident was found on the floor of her room, between her bed and a recliner, with her waist under the bed railing. She had sustained two fractured ribs.

State records initially indicated the home was fined $7,500 by the Iowa Department of Inspections and Appeals, with the fine trebled to equal $33,000 – although a trebled fine of $7,500 would equal $22,500, not $33,000. On Thursday, the department attributed the $33,0000 figure to a mathematical error on its part and said its records had been corrected to reflect an actual fine of $22,500.

The home was fined an additional $7,000 for violations related to residents’ pressure sores.

Both fines have been suspended by DIA, providing the federal Centers for Medicare and Medicaid Services the opportunity to impose a fine of its own for the same violations.

At the same time state inspectors were at the Manning home, another set of inspectors was at a western Iowa nursing home run by the same company, Accura Healthcare, where they cited the facility for 15 regulatory violations and imposed a state fine of $7,000.

Accura Healthcare of Sioux City was inspected in response to five separate complaints, none of which were substantiated by inspectors. The inspectors did, however, substantiate violations related to a self-reported incident of some kind.

One of the violations was tied to a female resident who fell at the home on July 15, within 48 hours of admission to the home, and sustained a serious head injury. The staff at the home was unaware the resident was at risk of falling but allegedly acknowledged never having completed a risk assessment for falls, as required. The woman was found on the floor of her room with her face lying in a “large amount of blood,” inspectors reported.

She was taken to a hospital where she was admitted with a laceration to one eye and significant bruising and abrasions on the left side of her head and face. The woman’s doctor reported the woman was unresponsive and was likely to face continuing “neurologic decline.” On July 21, she was returned to the Sioux City home in an unresponsive state and died within seven hours.

A licensed practical nurse at the home reportedly told inspectors she was the only charge nurse on duty at the time of the woman’s fall and “she didn’t have support.” She allegedly told inspectors information about the woman being at risk for falls “was there but not really available.”

“She said they admitted too many residents at once, resulting in them not knowing important information” about residents, state inspectors reported.

In recent years, the owner of the Accura chain has donated more than $85,000 to the political campaigns of the governor and four Republican state legislators.

American Healthcare Associates, which does business in Iowa as Accura Healthcare, operates 21 senior-care facilities throughout Iowa, and more than a dozen others in South Dakota, Minnesota and Nebraska. Federal records indicate Ted LeNeave of Waukee owns 70% of American Healthcare and is the owner and founder of Accura Healthcare.

Data from the Iowa Ethics and Campaign Disclosure Board indicates that since 2018, LeNeave has donated $37,000 to the campaign committee of Republican Gov. Kim Reynolds, and $46,000 to the campaign committee of Senate Majority Leader Jack Whitver, an Ankeny Republican.

Since 2018, LeNeave has contributed an additional $88,700 to the political action committee of the trade association that represents many of Iowa’s nursing home owners.

He has also contributed to the political campaigns of Senate President Jake Chapman, R-Adel; House Majority Leader Matt Windschitl, R-Missouri Valley; and House Speaker Pat Grassley, R-New Hartford.

Earlier this year, Medicaid temporarily suspended payments to Accura Healthcare of Newton-East, which had been cited for 10 violations of federal quality-of-care standards.

Editor’s note: This story has been revised to reflect the state’s newly corrected calculation of fines imposed against Accura Healthcare of Manning.

by Clark Kauffman, Iowa Capital Dispatch September 7, 2022