Accused of covering up violations, nursing home administrator surrenders license

An Iowa nursing home administrator accused of threatening workers with retaliation and falsifying records has agreed to surrender her license to the state.

State records indicate Sammarra Smith, 55, served as the administrator of West Des Moines’ Promedica Skilled Nursing & Rehabilitation Center, later renamed Harmony West Des Moines, from November 2020 through June 2023.

The Iowa Board of Nursing Home Administrators alleges that in June 2023, when Smith was still overseeing the day-to-day operations of the home, the Iowa Department of Inspections, Appeals and Licensing identified several regulatory violations related to Smith’s work.

Earlier this year, the Iowa Board of Nursing Home Administrators charged Smith with violating an unspecified rule or regulation related to the profession.

The board noted that while Smith was in charge at Harmony West, state inspectors cited the home for failing to administer a home in a way that maintained the well-being of all residents; failing to adequately evaluate residents’ needs in terms of the home’s staffing needs; failing to make a good-faith effort to correct deficient practices at the home; failing to ensure a qualified infection preventionist was employed at the home; and failing to ensure that nurse aides completed their training.

To resolve the licensing-board charges, Smith recently agreed to surrender her license — although that action has little practical effect given the fact that her license expired in December 2023. Smith agreed to surrender the license with the understanding that she can apply for reinstatement in one year.

State inspection reports indicate Harmony West was cited for numerous violations, in addition to those cited by the Board of Nursing Home Administrators, during Smith’s time at the home.

In February 2023, state inspectors visited the home to investigate a backlog of 23 complaints, and cited the home for 20 state and federal violations. One of the issues related to a resident who died after being sent to the emergency room with an anal fissure and gangrene that the home allegedly failed to treat. The resident had been “screaming and you could hear it down the hall,” a licensed practical nurse reportedly told inspectors.

In May 2023, inspectors returned to investigate a backlog of 11 additional complaints, some of which were directly related to Smith’s conduct. During interviews with state inspectors, two workers at the home reported they were hesitant to speak due to fear of retaliation. Four workers alleged the administrator and director of nursing had told them that when the inspectors asked questions “they needed to respond everything was fine” and “if they wanted a paycheck they better not say anything bad.”

One worker reportedly told inspectors the administrator was falsifying records by backdating documents and directing other workers to falsify records. Other workers alleged the daily work-assignment sheets made it appear the home was adequately staffed, but in reality some of the employees were not actually scheduled to work.

State records show a federal fine of $101,177 was later imposed against the home, and a temporary manager was placed in charge of the facility.