A Laurens nursing home is facing a proposed $10,000 state fine after inspectors alleged employees failed to properly perform CPR on a resident who later died.
According to an Iowa Department of Inspections, Appeals and Licensing investigation, the incident happened Oct. 6 at the Laurens Care Center.
State inspection records indicate a female resident was in the dining room when she began making repeated sneezing noises. A nurse checked on her and found her eyes closed. The woman had lost consciousness and did not respond when shaken.
Staff moved the resident to her room, where they observed that she still had a pulse but had critically low oxygen levels and was gasping for breath. She was then transferred to her bed.
Inspectors questioned the facility’s response to the medical emergency after reviewing police body camera footage.
According to the inspection report, the facility’s medical records indicated an employee began cardiopulmonary resuscitation, or CPR, at 8 a.m. However, video showed a police officer arriving just before 8:02 a.m. to find the director of nursing standing in the doorway, with two nurses and an aide inside the room. Inspectors said no CPR was being performed.
One nurse asked the director of nursing whether they should start CPR. The director of nursing reportedly responded that there was nothing they could have done by the time the resident was transferred and told the officer she was fairly certain the woman had died.
Inspectors said the footage showed the employees standing around the bed and talking rather than performing CPR. Within a few minutes, the director of nursing told the officer the resident’s daughter wanted CPR performed.
By 8:05 a.m., the officer had applied a defibrillator to the woman’s chest. The device indicated chest compressions were needed, and the officer began administering them. For approximately the next 10 minutes, the officer and facility employees performed chest compressions, but inspectors reported that no rescue breaths, or ventilations, were provided during that time.
A nurse later told inspectors she had performed approximately 20 chest compressions before the officer arrived. She said that after a backboard was placed beneath the resident, no one in the room continued doing anything. The nurse also reportedly told inspectors she was unsure of the facility’s policy regarding CPR.
The medical examiner’s report listed the woman’s cause of death as cardiac arrest resulting from a foreign object obstructing her airway.
In proposing the $10,000 state fine, inspectors allege the facility failed to provide appropriate CPR, which includes opening and maintaining an airway and providing rescue breaths in addition to chest compressions. The proposed fine is currently being held in suspension while the federal Centers for Medicare and Medicaid Services determines whether a federal penalty is warranted.
The case is among four Iowa nursing homes recently cited by state inspectors for alleged resident injuries or abuse. The other nursing homes cited for violations include Luther Manor at Hillcrest in Dubuque, Azria Health Prairie Ridge in Mediapolis and Bedford Specialty Care in Taylor County.
