Lauded nursing home drew citations 7 weeks earlier

An eastern Iowa nursing home recognized by Gov. Terry Branstad as one of the best in the state was cited by inspectors seven weeks earlier for widespread unsanitary conditions and failure to meet residents’ nutritional needs.

The 126-bed Woodland Terrace care facility in Waverly was written up May 13 for a variety of problems, including a food-preparation area that inspectors described as “highly soiled” and littered with dust, debris and discarded food.

Branstad’s office announced July 9 that Woodland Terrace was one of three Iowa care facilities to receive the 2014 Governor’s Award for Quality Care in Health Care Facilities. Christine Frederick of Clearwater, Fla., nominated the home for the honor, noting that her mother is a longtime resident of the facility and has received the best “physical, emotional and spiritual care.”

“The fact that the nominator’s loved one has resided in the Waverly facility for more than 13 years speaks volumes about the care provided by the Woodland Terrace staff,” Lt. Gov. Kim Reynolds said in a news release announcing the award. “While conducting an on-site evaluation of the facility’s nomination, staff from the Iowa Department of Inspections and Appeals were approached by numerous residents who praised the dedicated personnel and caring environment at the nursing home.”

Branstad and Reynolds have repeatedly said that under previous administrations, Iowa’s state regulators — and nursing home inspectors, in particular — embraced “a ‘gotcha’ attitude” that focused on punishing corporate violators instead of helping them improve and meet minimum standards. Branstad has credited his administration with changing that approach to regulation.

Dean Lerner, who headed the state inspections department under former Gov. Chet Culver, said the award is indicative of the Branstad administration’s industry-friendly approach to regulation.

“The nursing home industry continues to be a significant, loyal contributor to Gov. Branstad’s political campaigns,” Lerner said. “If fines were imposed for these shameful conditions — and in an amount greater than the nursing homes’ cost savings that created them — maybe residents wouldn’t have to suffer.”

According to state records, an inspection of Woodland Terrace’s kitchen in early May revealed “highly soiled floors” littered with dust, food particles, paint chips, cookies, jelly and other debris. One area of the kitchen floor had three inches of an unidentified “dried substance,” and kitchen carts were described as highly soiled with debris and food.

Inspectors said the food preparation counter was visibly soiled; window screens were highly soiled; a steam table was crusted with food and debris; plastic tubs used to store newly washed utensils contained a large amount of debris; ready-to-use appliances were soiled with dried pancake batter from meals served four days earlier; and a walk-in cooler was littered with shredded cheese, onion peels and debris.

Kitchen workers told inspectors they had no cleaning duties and no time to clean the area. The home’s “executive chef,” who was also in charge of maintaining a clean kitchen, told inspectors he ranked the quality of his work as a “3” on a scale of 1 to 10, with 10 being the best.

Inspectors reviewed five residents’ diets and determined none had received the food they were supposed to be served according to their care plans. At one meal, for example, some residents received too little meat and protein, and some received none of the noodles and vegetables on the menu. Inspectors also determined that prior to being served, the food was not being kept at the recommended minimum temperature, with ground meat served at only 118 degrees.

No fines were imposed as a result of the inspectors’ findings. Woodland Terrace has submitted a plan of correction outlining the steps taken to address the problems. The facility’s CEO told inspectors the executive chef has left the home’s employment and the other staff have been re-educated on food service.

A spokesman for Branstad declined to comment on the inspectors’ findings until he could look into the matter further.

The Governor’s Award for Quality Care is based on special programs and activities offered by the facilities, as well as each home’s compliance with federal health care regulations.

Woodland Terrace was recognized in part for a pet therapy program that allows residents to socialize with Lucy, a specially trained black Labrador retriever.

In 2013, state inspectors cited Woodland Terrace for the legal agreement residents had to sign upon admission to the facility. That agreement made any individual who signed it — including third parties, such as family members — personally liable for cost of the resident’s care.

At the time, inspectors also cited the home for inadequate infection control, saying that as they watched, the facility staff repeatedly failed to sanitize the glucose meter used to test residents’ blood-sugar levels.

The other winners of the 2014 Governor’s Award for Quality Care in Health Care Facilities were Friendship Haven in Fort Dodge and Prairie View Home in Sanborn.

Prairie View Home was last inspected in November. Inspectors reported no violations at the facility.

Friendship Haven was last inspected in November and was cited for failure to provide adequate incontinence care for residents; failure to adequately treat bedsores; and failure to keep food at the proper temperature before serving.