Nurse claims care facility wanted her to falsify records, violate state regulations

A nurse who resigned from an Iowa care facility, which has been cited in multiple deaths, testified at a hearing recently that she was instructed to falsify medical records and have unqualified aides administer medications to residents.

The testimony of Teressa A. Hansen came during a Sept. 13 hearing on her request for unemployment benefits.

In late June, Hansen resigned Countryside Health Care Center in Sioux City where she had worked for six months as a registered nurse. As a charge nurse in the facility, Hansen was responsible for overseeing certified nursing assistants and passing out medications to residents.

In the spring and early summer of 2023, she testified, management at Countryside cut the number of employees working in the home to the point where it was difficult to maintain the staffing levels needed to provide care to the home’s 52 residents.

In June 2023, she testified, the facility’s management instructed her to train a certified nursing assistant, or CNA, on how to perform the duties of a licensed registered nurse. According to state records, she also testified that managers informed her that moving forward, the CNA would take over certain nursing duties, such as passing out medication, and that Hansen would be required to sign off on the related documentation – making it appear she had performed the work.

When Hansen objected, management allegedly told her not to question the decision. The next day, Hansen testified, she resigned, effective immediately.

At the recent hearing on her claim for unemployment benefits, Hansen testified that providing medical treatment to residents falls outside a CNA’s scope of practice, and that signing false documentation would be illegal and would jeopardize her nursing license. Countryside opted not to have a representative testify at the hearing, according to state records.

Administrative Law Judge Patrick B. Thomas ruled that Hansen’s allegations were credible and that she had resigned for good cause attributable to the nursing home. She was awarded benefits.

Nursing home cited in multiple deaths

Countryside closed in late July, one month after Hansen’s departure. State records indicate the home’s administrator in early June was Jackie Loghry-Pirner, and that before the home closed in late July, Loghry-Pirner was replaced by Scott Mow. The nursing home administration licenses of both Mow and Loghry-Pirner are in good standing with the state, with no public record of disciplinary action.

In the seven months leading up to Countryside’s closure, the home was cited for several violations related to resident injuries and deaths:

One resident death: In January, the home was cited for an incident that involved a female resident who was found unresponsive on the floor of her room. The woman was sent by ambulance to a hospital and died en route. Countryside was cited for failing to provide the woman with adequate supervision and for failing to report the incident to the state.

Two resident deaths: In April, state inspectors visited the facility in response to a backlog of 19 uninvestigated complaints. While there, they cited the home for 20 federal violations and five state violations. The state proposed $44,000 in fines but held those in suspension to give federal regulators at the Centers for Medicare and Medicaid Services an opportunity to impose penalties. One of the citations was for failing to inform the state about a resident who fell and died, while another was for failure to intervene when open, foul-smelling wounds on a resident’s legs led to her hospitalization and, one week later, her death.

One resident death: In May, inspectors returned to Countryside in response to three complaints, all of which were substantiated. While there, they cited the home for four federal violations and one state violation. The state proposed $30,000 in additional fines but held those penalties in suspension. One of the citations was for failing to check vital signs and contact a physician after a resident’s blood pressure and urinary output dropped and her abdomen became distended. The resident died shortly after being hospitalized.

Unreported injuries: In June, inspectors were back at the facility and cited the home for eight federal violations and one state violation. The state’s proposed $500 fine was held in suspension. The violations included failure to report to the state major injuries sustained by residents of the home, and failure to report a resident being hospitalized with sepsis, a life-threatening blood infection.

The Centers for Medicare and Medicaid Services reports that Countryside Health Care Center was fined 14 times by the federal government in three years leading up to its closure. The most recent fine, imposed in June 2022, was for $28,191.

Countryside Health Care Center was owned 6120 Morningside Avenue Propco, a New York-based real estate company, and operated by Opco Sioux City, a for-profit Iowa corporation tied to Isaac Dole, the CEO of the investment firm Birchwood Healthcare Partners. Dole is also the former managing director of acquisitions at Aviv REIT, one of the nation’s largest nursing home real estate owners.

The Iowa Capital Dispatch was not able to reach Dole for comment.

Countryside and Opco are currently being sued by former resident Darcy Basalyga and her family. The lawsuit alleges that during the eight weeks in 2021 that Basalyga lived at Countryside, the home repeatedly failed to check her blood-sugar levels, resulting in two separate hospitalizations and a diagnosis of infection, diabetic coma, pneumonia, dehydration and severe open wounds.

State records indicate the Iowa Department of Inspections, Appeals and Licensing cited the facility for the alleged deficiencies in Basalyga’s care. Opco has denied any wrongdoing and the case is scheduled for trial in June 2024.