Iowa care facility now the subject of a criminal investigation
State officials say they are conducting a criminal investigation into the treatment of residents at a southern Iowa nursing home.
State inspectors say a female resident of Sigourney’s Windsor Place Senior Living Campus was left in a vegetative state in November after the facility’s administrator ignored the staff’s concerns about the woman’s worsening condition and her requests to be taken to a hospital.
The administrator is also alleged to have “badgered” and then evicted a male resident of the home by having the staff dump his belongings outside and then wheel him to the exit with nowhere to go. The eviction stemmed from efforts to force Medicaid-dependent residents into shared rooms, staffers at the home told inspectors.
Iowa Department of Inspections and Appeals spokeswoman Stefanie Bond said Tuesday that the agency’s Medicaid Fraud Control Unit – which investigates allegations of dependent-adult abuse as well as fraud – is now conducting a criminal investigation related to the matter. It’s not clear whether the investigation is focused on one or both incidents.
Bond said DIA also made a criminal referral in the matter to the Keokuk County Attorney’s Office on Dec. 12, 2022, which was two weeks before DIA’s inspectors finished their investigation at Windsor Place.
The letter Bond refers to informed the county prosecutor that an allegation of abuse had been received by DIA’s intake unit. The letter states that DIA had yet to investigate the matter to determine whether there was evidence to support the allegation.
Keokuk County Attorney Amber Thompson said she received the letter and had read an Iowa Capital Dispatch story about the situation at Windsor Place, but DIA had not referred the case to her for criminal prosecution.
“There has not been a criminal referral to my office,” she said. She said she considers the Dec. 12 letter from DIA to be notice that an allegation had been made but not yet investigated. “What I would expect is that when their investigation is complete, that then I would get some follow-up.”
She said that due to limited resources, her office relies on DIA to investigate such matters.
“We do not have the staff within my office to do our own investigation,” she said. “It’s just myself and one other person, a full-time secretary. So, we’re not able to do investigations. Generally, those have to come from law enforcement.”
Thompson noted that Keokuk County is one of Iowa’s smaller counties, with only four sheriff’s deputies. The town of Sigourney, with a population of just under 2,000 people, has no police department.
“I generally prefer that the Department of Inspections and Appeals investigate those kinds of cases when they involve a nursing home,” Thompson said. “They’re just more equipped to do that and they have more experience doing that. I’m not saying that’s right or wrong but that’s how things are done in our county.”
Investigation tied to two incidents
The most serious allegation against Windsor Place is tied to its treatment of a female resident of the home in November. State records indicate the woman was up earlier than usual on the morning of Nov. 29, 2022, and was complaining of a severe headache. Her condition allegedly worsened throughout the day and, according to inspectors, several residents and workers at the home told the administrator, Aimee K. Crow, the woman was screaming in pain and was asking to be taken to a hospital.
Crow, who was also the charge nurse on duty at that time, allegedly failed to assess the woman or take any other action, even when the woman was showing symptoms of a stroke.
The next day, the woman was unresponsive, unable to talk, couldn’t see out of her right eye and couldn’t move her right side.
The report doesn’t indicate whether the woman survived the incident or was transferred elsewhere.
When interviewed by inspectors, Crow reportedly acknowledged that staff members had come to her about the resident having a “headache,” but said no one ever told her the woman wanted to go to the hospital. She acknowledged she never assessed the woman’s condition, consulted a physician or notified the resident’s family of the situation.
The other incident at Windsor Place involved a male resident who objected to Crow’s insistence that he share a room with another resident. The home’s social worker told inspectors that last August Crow yelled at the man, wouldn’t let him speak, and kept saying, “You are getting a roommate, or you are leaving against medical advice. What’s it going to be?”
A sheriff’s deputy was summoned to help escort the man outside after a maintenance worker stacked the man’s belongings outside the door in trash bags.
The man, who was insulin dependent, told inspectors he wasn’t given any medications and had nowhere to go. He said he called his nephew and got a ride to his ex-wife’s home, where he fell down the steps and was taken by ambulance to a local hospital.
Crow reportedly told state inspectors she was the man’s niece. Asked why she felt it was necessary for the man to share a room when there were vacant rooms at the facility, she allegedly said she couldn’t recall as it was “a long time ago.”
Windsor Place is managed by a Florida company, Mission Management Services. Karla Baum, a regional vice president for Mission, declined to comment on the state’s findings.
Crow, who also serves as the administrator at Keota Health Care Center, declined to comment when asked about the state’s findings. Her nursing home administrator’s license and her Iowa nurse’s license are each in good standing with no public record of any discipline.
Two deaths, one prosecution
Iowa’s dependent-adult abuse law makes it a crime for a caregiver to neglect an individual by failing to provide the care necessary to maintain the patient’s health.
A caretaker who intentionally or recklessly commits dependent-adult abuse is guilty of murder in the second degree if the abuse results in death.
In cases of serious injury, a caretaker who intentionally commits dependent-adult abuse is guilty of a Class C felony, but if the abuse was reckless rather than intentional, the offense is downgraded to a Class D felony. In cases with no injury, the matter is likely to be prosecuted as a serious misdemeanor.
The law, however, is rarely enforced in cases where professionals are accused of wrongdoing within a health care facility – although there have been prosecutions of that type.
A former aide at Courtyard Estates in Bondurant is currently charged with second-degree murder for having to failed to check on 77-year-old Lynne Stewart the night of Jan. 21, 2022, which led to the woman wandering outside unnoticed and freezing to death. Catherine Forkpa has pleaded not guilty in the case, and a trial is scheduled for March 6.
A very similar death occurred six weeks earlier at the Keelson Harbor assisted living center in Spirit Lake. In that case, a 27-year-old nurse who was on duty, Brooke Arndt, allegedly failed to check on 95-year-old Elaine Creasey during the night. Creasey wandered outside and froze to death. No charges were filed in that case.