SIOUX CITY, Iowa (KCAU) – A Sioux City nursing home has had 23 federal citations after a spring inspection and is now a candidate for a federal list of candidates to make improvements.

According to the Centers for Medicare & Medicaid Services (CMS), Countryside Health Care Center, a nursing home in Sioux City located at 6120 Morningside Avenue, qualifies for the Special Focus Facility Program (SFF).

Qualification for the SFF Program is based on a five-star rating system that rates inspections over the course of 3 years. Facilities with the most deficiencies in each state qualify for the program. Up to 30 facilities can qualify per state. Countryside Health Care Center is one of 10 Iowa facilities on the SFF candidate list.

The SFF Program states most facilities will have six or seven deficiencies, but the ones that qualify for the program have about twice the normal amount. The problems at the facility are also more serious, and there is usually a pattern of serious problems over three years.

An inspection report shows 23 federal violations and one state violation were filed in April against Countryside Health Care Center. The citation was issued on April 21 by the Health Facilities Division of the Iowa Department of Inspections and Appeals. The report shows a survey was conducted by officials from March 22 through April 6.

The citation report describes that the facility failed to initiate CPR “immediately after the absence of pulse and respirations,” saying staff waited 20 to 30 minutes before initiating CPR on a patient who later died on December 11, 2020. The report said that a staff member had checked the resident’s blood sugar at 7:40 p.m. The staff member said the director of nursing entered the room at 9:30 p.m. to administer mediations. The director of nursing then emerged from the room and said the resident passed away.

When a second staff member arrived around 9:55 p.m., the director of nursing asked them when to start CPR when a resident already felt cold. The staff member then told the director of nursing to start CPR on the resident while they called emergency services. CPR was done until EMS arrived and took over. The resident was later declared deceased. The facility administrator stated on March 24 that they investigated the delay of starting CPR and fired the director of nursing.

In another citation, the report said that the facility didn’t provide proper medications, causing rehospitalization for a resident with diabetic ketoacidosis. The resident was admitted to the facility on January 5 and was supposed to have blood sugars taken 4 times a day, once before meals and again before bed. There was a lack of blood sugar checks from January 5 through January 10 on the record.

On January 10, the resident was unresponsive with warm and clammy skin. A blood sugar check read high for the resident, and they were taken to the ER. The new director of nursing said she didn’t know why blood sugar checks weren’t done at the time, but they developed a plan of correction. An RN said that the life-threatening diabetic ketoacidosis could have been prevented if the blood sugars had been regularly checked.

A third citation said that the facility failed to request a criminal background evaluation from the Department of Human Services (DHS) for three staff, of one which did have one. The facility hired a staff member as a CNA on November 19, 2020. The criminal background report identified three misdemeanor convictions, but a DHS evaluation wasn’t documented. The facility administrator later revealed on March 29 that no DHS evaluation had been completed in response to the criminal background report. The facility’s policy would conduct a criminal record check on employees prior to hiring.

Read the full citation report from the Iowa Department of Inspections and Appeals Health Facilities Division below.

You can read the full report of the 23 violations from the DHHS Centers for Medicare and Medicaid Services below.

Nursing homes that are selected as an SFF have full inspections done every six months with recommended progressive enforcement until the facility is no longer part of the SFF program or is terminated from the Medicare and/or Medicaid program. A June 2021 listing of SFF candidates shows that Countryside Health Care Center has been with the SFF program for one month.

Anyone considering going to a nursing home on the SFF candidate list is asked to do the following:

  • Visit the Nursing Home Compare website to view information about the nursing home’s star ratings, staffing, quality measures, and inspection results.
  • Visit the nursing home. Talk to staff, residents, physicians, and other families. Ask the nursing home staff what they are doing to improve the quality of care for residents in the nursing home.
  • Call the State survey agency (agency contact information is posted on Nursing Home Compare) to find out more about the nursing home.
  • If the nursing home is an SFF, look at the length of time that a nursing home has been on the SFF list. This is particularly important if the nursing home has been an SFF nursing home for more than 18-24 months, since such nursing homes are closer to either graduating (due to improvements) or ending their participation in Medicare and Medicaid.
  • Call your local State Ombudsman, Administration on Aging, and local groups to find out more about the nursing home.

Read more about the SFF program and the candidates documented in the June 2021 report below.

Anyone worried about people residing in an SFF nursing home is asked to be aware that the facility is being closely monitored and being inspected twice as often. They add that nursing homes in the SFF program will usually improve the quality of care within 18 to 24 months.

The owners of Countryside Health Care Center sent a statement, saying these citations were filed before they owned the facility, and they are working towards improving procedures. Read that statement here.