Cedar Rapids care facility cited for untrained workers, resident abuse

A Cedar Rapids nursing home previously fined for the financial exploitation of a resident has now been cited for using untrained caregivers.

State inspectors say the abuse involved a worker at Heritage Specialty Care who allegedly took $1,625 from a resident with a spinal cord injury. The worker then taunted the man, sending him text messages calling him a “vegetable” and “veggie boy.”

The state inspectors also allege that Heritage, which is home to 156 older Iowans and is operated by West Des Moines’ Care Initiatives, has failed to provide its training nursing assistants, or TNAs, with either the state-approved training or the required competency evaluations.

The company has not responded to requests for comment.

According to inspectors, the TNAs are supposed to complete an eight-hour, online training course and then complete a skills-competency checklist through job-shadowing with a licensed worker before working on their own.

Heritage’s nurse manager told inspectors in August that he felt an eight-hour online course was not sufficient training to perform the duties of a fully certified nurse aide and so before June 2020, he did not hire a single TNA to work in the home. After that, he said, the home’s owner began hiring TNAs.

⧉ Related article: Cedar Rapids nursing home was on lockdown after worker waved gun

One TNA at the home told inspectors the home’s training program was “not so good” and said she had worked independently at the home before completing the required competency checklist. She said it seemed to her that “everyone hired as a TNA worked with someone for four to five days and then went out on their own,” working independently, because the home was “so short-staffed.”

Another TNA agreed and said she had refused to work on her own until completing the required skills checklist.

A third TNA confirmed the practice and said the home failed to provide adequate training to do her job. She said she had failed her community college exam to become a certified nurse aide and felt she needed more training, but still worked independently in the home caring for residents.

A fourth worker told inspectors she was trained not by a certified nurse aide but by another TNA who had let her certified nurse aide’s license lapse. That trainer told inspectors she was given no training herself when hired at the home, and said management gave her a certified nurse aide badge and then “acted like” she was certified.

Inspectors reported the nurse said it “made no sense” to her that she was used to train other TNAs, adding, “what else was I supposed to do” when residents needed help.

Cook tried to serve oatmeal from garbage

Inspectors also cited the home for unsanitary practices. A cook at the home, when asked by a nurse for a bowl of oatmeal for a resident, opted not to make a fresh bowl and instead went to a garbage can intending to scoop out some of the discarded oatmeal that was sitting in the trash receptacle.

The nurse refused to accept the oatmeal from the trash, telling the cook, “Absolutely not.”

In addition, the home was cited for inadequate infection control. Inspectors reported that while on site, they observed a dietary aide, a certified nurse aide and an occupational therapist working with residents without the required face mask in place.

The home also was cited for insufficient staff, with one resident complaining she had to wait up to an hour to have her call light answered.

No fines were imposed by the state as a result of the inspectors’ findings in August. The home filed a plan of correction with the state that indicates it will address the citation for insufficient staff by providing “staff education.” The home has also indicated it will ensure TNAs receive the required training.

Worker accused of taking $1,625 from resident

In April, the home paid a total of $650 in fines for resident abuse related to financial exploitation and for failure to conduct adequate background checks on workers.

At the time, inspectors alleged a nurse aide at the home had sold her cellphone to a resident late last year for $800 and then failed to turn over the phone. A few weeks later, when the worker was on a trip with her family, she sent a message to that same resident’s old phone, asking him to send her more money.

“Can you do $200 and I’ll pay you back when I start working more hours again,” the message read, according to inspectors. The resident then provided the money through an app on his phone.

The same resident told inspectors that after he loaned the worker his debit card to order him a pizza, unauthorized charges for Door Dash showed up on his bill and he had to cancel his card. In January, when the worker asked the man for another $200 and he refused, the worker sent him what the man called “mean and hateful” messages, calling him a “vegetable” and “veggie boy.”

According to inspectors, the messages, which were archived on the resident’s phone, stated: “Thanks again for saying you would help us and then go back on your own word … Have fun sitting in that (expletive) with that big ego of yours.”

At one point, the worker indicated she’d soon be leaving her job at Heritage, stating, “I’m not there for the rest of my life … 11 days and I’m out sweetie … How many days ya got in heritage? Yikes, I think it’s more than 11 … But enjoy.”

When the man indicated he might report his debit card as stolen, the worker wrote back, “Good luck. LOL. I’ll tell them you let me use your card … You’ll look like a retarded vegetable lol.”

A review revealed 10 transactions, indicating the resident had transferred $1,625 to the worker.

This article first appeared in the Iowa Capital Dispatch.