Pearl Valley Rehab cited for COVID-19 violations

MUSCATINE, Iowa–Pearl Valley Rehab in Muscatine received citations from the Iowa Department of Inspections and Appeals Health Facilities Division for violations relating to how it handled COVID-19 cases in its facility. In April, Pearl Valley had a COVID-19 outbreak in which 81 residents and staff members contracted the virus, resulting in nine deaths. The facility could face fines of up to $19,500.

Near the start of the outbreak, Pearl Valley failed to transfer at least three patients with COVID-19 symptoms and preexisting conditions to the emergency room and did not provide their physicians with timely updates.

In the first case, a woman’s primary care physician requested Pearl Valley send her to the emergency room because of COVID-19 symptoms April 28. However, the assistant director of nursing refused to authorize her transfer. Later, a staff member reported her saying, “they do not have any COVID-19 in the building and we want to keep it that way,” despite a number of staff and residents already testing positive. The director of nursing also said the patient refused to go to the emergency room, though the resident herself does not remember having any such conversation and found it unlikely as she has requested all lifesaving efforts made for her. Only after two days did Pearl Valley transfer her to the hospital.

A second patient contracted COVID-19 and displayed concerning symptoms April 25. Pearl Valley’s medical director requested the man stay at the facility, despite fever, chills, chest pain, and dropping oxygen levels. Though they informed his doctor and family of a previous infection, they failed to mention his COVID-19 symptoms. Only after five days did his condition deteriorate to the point Pearl Valley staff authorized him to go to the hospital.

The third patient developed COVID-19 symptoms April 29, and his physician requested him transferred to the emergency room if his oxygen dropped too severely. Despite reaching the criteria sooner, Pearl Valley did not send him until May 7.

In another instance, where a COVID-19 positive individual at Pearl Valley died from the disease, his family did not receive notification until several hours after the fact. They also revealed they had spoken with a Pearl Valley staff member the night before who did not tell them he had any concerning symptoms at all.

Additionally, Pearl Valley delayed placing COVID-19 patients in isolation and did not provide nurses with the proper personal protective equipment. Several nurses reported having to reuse personal protective equipment when working with COVID-19 positive and negative patients and having to work with COVID-19 positive patients without isolation gowns and similar equipment.

At their complaint revisit June 23, the Department of Inspections considered each violation resolved. They also ruled two additional complaints unsubstantiated.

In other infection control visits to Muscatine County long term care facilities, including Lutheran Living and the Wilton Retirement Community, which both had COVID-19 outbreaks, and Sunnybrook at Muscatine, which reportedly had one positive case, the department found them in compliance and without any substantiated complaints. The Department of Inspections and Appeals has received no complaints against UnityPoint Trinity Muscatine Hospital.