Washington Evening Journal

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Neighbors Growing Together | Nov 18, 2017

All-American Care’s future uncertain

By David Hotle | Dec 03, 2013
Photo by: David Hotle City council member Fred Stark, left, and Mayor Sandra Johnson get ready to take a tour of All-American Care from owner Jerry Rhoads.

Jerry Rhoads, owner and administrator of All-American Restorative Care in Washington, said Monday that the nursing home is filing for bankruptcy later this week and if it doesn’t pass a state inspection it can possibly be closed.
Rhoads also said that since an investigation into an incident where nurses allegedly failed to attempt to resuscitate a patient, the state has placed a hold on the nursing home, keeping it from receiving any new clients. He said this destroys relationships with referral agencies and the community. He also said that this has happened four times in 18 months. He also said in 18 months, the nursing home had been on hold for seven months. He said this has cost the nursing home about $1.4 million.
“We are questioning why, under these rules, you are doing that to us and you didn’t do it under the prior owner,” Rhoads said, during a press conference and tour of the facility Monday, which included media and members of the city council. “They were left to do whatever they wanted for 10 years.”
He said shortly after his family purchased the nursing home, the number of patients had gone up to 60, but quickly fell to 40 after the holds were placed. He feels the allegations against the home are “superfluous,” but said the state had published them on the Internet. Rhoads specified he believes the business is over-regulated.
“They fined us, they threatened us, they told us that they were going to close us down,” he said. “They put us in special focus and told us that we were one of the four worst facilities in the state.”
The Iowa Department of Inspections and Appeals (IDIA) Health Facilities Division administrator Dawn Fisk referred questions to media relations specialist David Werning. Werning was not available for comment before press time.
The facility was fined $30,000 on Nov. 4, after an investigation stemming from the death of a resident, according to the IDIA Web site where the citation is listed. On June 2, a resident was found not breathing in his or her room, the citation said. There was no visible sign of the chest rising, and the skin was yellowish in color and the body had passed fluids, according to staff members. The family was contacted, and a funeral home left with the body that day.
Upon further review and interviews of staff done by the Department of Inspections and Appeals Health Care Facilities Division investigators, it was found the resident’s doctor’s orders said cardiopulmonary resuscitation (CPR) should have been administered but none was documented as being administered on the day of the death. The investigators also interviewed the medical examiner, not identified in the citation, on Oct. 1. She said she never saw the resident on the day of the death. She said she was informed by the facility on Sept. 30, of the resident’s condition at the time of death. The IDIA had imposed a fine because, it alleged, the facility did not have a policy in place to ensure the staff knew about resuscitation orders. Jerry Rhoads said that the facility does have such a policy in place.
Kip Rhoads, Jerry Rhoads’ son and the head of the Information and Technology department for the facility, said that Rhoads’ parents had died as a result of abuse in nursing homes, and that his family would not condone the mistreatment of patients. He explained that state investigations into a nursing home could come with little prompting. 
“In this business, if we terminated an employee for not doing their job, they can go home and get on the phone and call the state and tell them we are abusing someone and (the state) will be out here for the next week to two weeks getting copies and doing everything they can to find out you are doing that,” he said.
Kip Rhoads stressed the need for a regulatory system, but also the need to look at the situation and the statistics of the nursing home before trying to fine the home.
Shari Rhoads, Jerry Rhoads’ wife and Kip Rhoads’ mother and also owner of the facility, said that the patient in question had been sent to the hospital and that the nursing home had hopes they would keep him. Rhoads said that they sent the patient back. She said the nurses had been giving the patient a two-hour watch. She said that when the nurses went to check on the subject, they found him dead.
“They want us to take the license of three of our nurses because they didn’t do CPR,” Shari Rhoads said. “(The patient’s) father said to us, ‘Thank goodness you didn’t do CPR, because they did it on his mother and she ended up on a respirator and had a miserable life for the rest of her life.’”
The family feels that mistakes were made, but that the state should punish the nurses and not the facility for the incident.
Jerry Rhoads said that the medical director and attending physician in the case had both said CPR wasn’t appropriate. He said the state report was written as if the patient were still alive and the nurses should have done CPR. He said the home had a policy that the nurses should have done CPR. He said that the nurses in the incident are no longer employed at All-American Care.
He also said that if the state revisits the home and the home doesn’t pass inspection, the state would close the home.
City council member Fred Stark said that the community wants to see the nursing home succeed and the community also wants to see things that aren’t done right corrected.
City council member Bob Shellmyer said that the Rhoadses should have invited the senator and representative for the area to the meeting. Rhoads said he had sent them details, including a video, on another incident involving a patient who had fallen and was on the floor for 40 minutes.
“I have called them,” Jerry Rhoads said. “They won’t touch this.”
State Representative Jarad Klein said today, after searching his e-mails, that he hadn’t been informed of the meeting. He said that he had spoken with Rhoads about a year ago and had referred him to Muscatine Rep. Mark Lofgren.
“There are other avenues he can pursue if he feels he is being unjustly targeted,” Klein said. “The state ombudsman’s office reviews state agencies.”
State Senator Sandra Greiner also said that she had not received an e-mail invitation or a phone call. She explained that legislation regarding nursing homes is meant to keep patients safe who may rely entirely on the personnel of the home for care.
“I’m not sure we can go overboard in our efforts to protect defenseless people,” she said. 
There were four other incidents in 2013 in which the home was fined. Rhoads said that the home has appealed all the fines, but had to give up the appeals because legal expenses were too high.
“I think it has been a retaliation on the basis of my big mouth or big ego,” Jerry Rhoads, who is running for governor, said. “We are here to make a difference. That is why we are here.”
He stressed it is a family-run business and that his staff cares about the patients.
Jerry Rhoads said they want people to come in and see the facility for themselves.

Comments (1)
Posted by: Glen Peiffer | Dec 03, 2013 18:47

Regulations are stifling business and adding onerous cost with just the paper work necessary to document compliance with the regulations. Nurses now spend half of their time charting and documenting what they have done rather than taking care of the patients. Just to get approval from the Joint Commission on Accreditation of Healthcare Organizations, JCAHO,  to purchase a new Cat Scan machine or build a sky walk in California can take years and can double the cost. As just one small example, an office chair has to have four legs not three in case one leg fails and JCAHO will investigate for compliance. Do you want to know why health care costs keep going up?


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