The Aspire of Washington nursing home. (Photo via Google Earth)
An Iowa nursing home run by an out-of-state company with a long history of regulatory violations has been hit with $64,750 in state fines tied to 28 state and federal violations.
The state fines against the Aspire of Washington nursing home are currently being held in suspension while the federal government determines whether any federal penalties should be imposed in the case. The suspended fines include two separate sets of penalties that were tripled in size due to the repeat nature of the offenses.
The violations stem from a January investigation, conducted by the Iowa Department of Inspections, Appeals and Licensing, into a backlog of six complaints at the facility, four of which were substantiated.
Some of the allegations are tied to alleged abuse, although the state did not specifically cite the facility for resident abuse or failing to report allegations of abuse.
According to the state inspectors, one worker reported that a certified nursing assistant “treated residents terribly,” saying things like, “Get out of my face,” “I’m sick of you,” “Stop your boo-hooing, I’m sick of it,” and, “Stop your crying, it’s all you do.” The worker said she had worked in “health care a long time and never heard someone be so awful to those residents,” inspectors alleged.
A second employee of the home reported the same concerns with the same CNA, alleging the aide told residents to “shut up” all the time, and would say, “I’m sick of you, stop your whining, you’re driving me crazy.” The second worker told inspectors she had informed the administrator “it was abuse,” and added that the CNA would tell residents she wouldn’t come to their rooms anymore because she was “sick of taking care” of them.
Among the other problems cited by DIAL’s inspectors in a 190-page report of deficiencies:
— Food and nutrition: The staff was not providing eating assistance to residents who needed the help. The home was also cited for failing to intervene in cases where residents had sustained a severe, unplanned weight loss.
— Medical care: The staff failed to complete a baseline care plan for residents within 48 hours of their admission. In one instance, a care plan still hadn’t been developed for a resident 39 days after he arrived at the home by ambulance.
— Dental care: One quadriplegic resident who was admitted with a painful broken tooth had not been taken to the dentist despite repeated requests for dental care. The staff also failed to brush the woman’s teeth, despite her complete dependence on the staff for oral care. A male resident with broken teeth told inspectors he had not been offered dental care at the facility and had talked to the administrator about the problem but never heard anything back.
— Management: The home was cited for failing to have an administrator who enabled the home to use its resources effectively and efficiently, as evidenced by a lack of prompt and thorough responses to allegations of abuse; a failure to update the license registration for a resident-transport van whose tags had expired in 2023; and a failure to ensure narcotics were consistently counted.
— Daily living: The home failed to provide at least two baths or showers per week to residents, with one resident going four to six weeks without a shower or bath. The director of nursing reportedly told inspectors it was difficult to provide showers and baths “because sometimes they only have two aides on second shift.” The home was not cited for insufficient staff.
— Interventions: The home failed to provide effective pain management or treatments and failed to ensure timely assessments of wounds. One resident was hospitalized as a result, and another experienced a “worsening” of a bone fracture, inspectors alleged. The home also failed to monitor a resident’s blood sugar after a recent hospitalization that was related to life-threatening blood-sugar levels.
— Immediate jeopardy: The home failed to implement adequate pain management with a resident who had fallen at the home, was crying out in pain, and reported pain at a level of “10” on a scale of one to 10. This failure “resulted in immediate jeopardy to the health, safety, and security” of the home’s 35 residents, inspectors concluded.
— Competent staff: The home was cited for a lack of competent nursing staff, with one nurse failing to conduct neurological assessments on a resident after a fall. The home was also cited for failing to ensure the staff had the necessary skill to address the needs of residents with mental health disorders. One aide reportedly told inspectors the staff intended to ask the administrator if they could take a class online or have someone come in to provide instruction on how to help residents.
Lawsuit: Homes owe $1.8 million in rent
Aspire of Washington is a for-profit home that is owned and operated by Beacon Health Management, a Florida company run by businessman Bruce Wertheim of Tampa. Beacon owns at least seven other Iowa care facilities.
Until late last year, the Iowa homes were managed by a Beacon affiliate called Black Hawk Healthcare, also run by Wertheim. Black Hawk was the legal “tenant” of the seven facilities, while the real estate itself was owned by a network of companies run by Ryan Scates and North Cape Investments of Georgia, which acted as the landlord.
In November 2024, Scates’ companies went to court to have the management of the facilities placed in the hands of a receiver. At the time, Scates claimed Wertheim and his companies owed more than $1.8 million in past-due rent on the Iowa homes and were “in a dire financial position, with insufficient cash available to continue to operate,” according to court records.
The court appointed as receiver Michael Flanagan, a Kansas-based businessman who specializes in receiverships and has taken over dozens of financially distressed nursing homes around the nation. Flanagan did not respond to calls to his office Monday.
Court records show that in 2021, Beacon acquired the Iowa homes when it purchased the Pearl Valley chain of facilities for $24.2 million. At the time, the entity that brokered the deal said the homes were generating $35 million in annual revenue, with cash profits totaling $3.5 million per year.
According to federal data compiled and analyzed by Propublica, Beacon facilities now have almost three times the national average of serious regulatory violations, have significantly higher staff turnover and lower than average staffing levels.
Over the years, several of the Beacon-owned Iowa facilities have failed to make their legally required payments to the State of Iowa in the form of “quality assurance assessment fees” intended to produce higher wages for front-line caregivers. Collectively, the homes owed the state $1.8 million in 2024.
Last year, the Aspire of Washington facility agreed to make an escalating series of 18 monthly payments, beginning in April 2024, to repay the $580,175 it owed to the State of Iowa for its share of the unpaid fees. Other Aspire facilities agreed to similar payment plans.