Nursing home administrator cited after man was locked outside overnight

By: Clark Kauffman

The Dubuque Specialty Care nursing home, accused of deliberately locking a resident of the home outside overnight, was fined $131,640. (Photo via Google Earth)

An Iowa nursing home administrator, accused of deliberately locking a resident outside of the building in a wheelchair for 11 hours overnight, is now facing disciplinary charges from a state licensing board.

The Iowa Board of Nursing Home Administrators has charged Scott Morton with professional incompetence; negligence in the practice of the profession; and violating unspecified regulations, rules or laws related to the practice of nursing home administrators.

According to the board, the violations are tied to health-facility citations issued last July against an unspecified care facility. The alleged conduct that gave rise to the charges are being kept confidential pursuant to a 2021 Iowa Supreme Court order.

However, state officials have identified Morton as the administrator of the Dubuque Specialty Care nursing home on June 22, 2022, when regulators found that a resident of the home who uses a wheelchair was deliberately locked outside overnight.

At 5 p.m. that day, a male resident of the home became upset when he was informed of a new policy that barred residents from smoking anywhere outside the building on company property. “I’m getting the hell out of here,” the man reportedly told the staff.

A nurse asked him to sign papers acknowledging that he was leaving the facility against medical advice, telling him once he exited the building, he wouldn’t be let back in and was no longer the responsibility of Dubuque Specialty Care.

A staff member then let the man outside. He sat in his wheelchair at the end of the driveway to the home, waiting for a ride from a friend. He eventually migrated to a location on the sidewalk across the street from the facility and remained there until 4 a.m. the next day, eventually calling a taxi service.

He then fell and soiled himself while trying to get into the taxi. The driver summoned an ambulance, and the man was taken to a hospital.

During the man’s 11 hours outdoors, Dubuque Specialty Care failed to provide him with food, transfer assistance, treatments or any of his medications, which included insulin, placing him in immediate jeopardy, state inspectors later reported.

Those same inspectors interviewed a licensed practical nurse who was on duty the night of the incident, and she alleged that Morton, the administrator, had said, “We can no longer allow them to smoke. If they have a ride, they can go somewhere else, but they cannot smoke near the grounds.”

“We did not ask him to come back inside because the administrator had told us we could not,” one nurse reportedly told inspectors. “The administrator told me if he went out, he was not allowed back.”

‘If you go out that door, you are out!’

Another nurse allegedly told inspectors, “I got a phone call from a gentleman across the street in the condominiums. He went and checked on (the resident) and he offered him a glass of water.”

About 10 p.m., a nurse asked a certified nurse aide to go outside, check on the man, and take him a sweatshirt since it was getting cool outside, telling the aide, “He’s still human.” The aide brought the man the sweatshirt, which he accepted, and a beef stick from the nurse’s dinner, which he rejected.

Another nurse aide told inspectors she went outside to offer the man water, although some of her colleagues had advised against it. “The nurses directed me to stay away from him,” she said, according to the inspectors’ reports. “They were worried about losing their jobs. ‘You are going to get fired if they find out you are out there,’ is what they said.”

“No, I did not tell staff residents were not allowed back in the building,” Morton allegedly said when interviewed by inspectors. “Technically, he discharged (himself) from the facility, so we were not responsible for him,” Morton added, according to the inspectors’ reports.

Two days after that interview, Morton was questioned again by inspectors. On that occasion, he allegedly stated the staff and residents had all misunderstood the policy and that residents had always been allowed to go outside to smoke.

“I learned about (the man) being outside all night the next morning,” he allegedly said. “I followed up with our admissions coordinator the next day. I had her check on him, and I think he is currently in the hospital.”

The admissions coordinator denied that, telling inspectors Morton never directed her to follow up with the hospital or check on the man’s well-being.

Inspectors also interviewed the resident who had been left outside. He reportedly stated the director of nursing had said to him, “You ain’t going nowhere. If you go out that door, you are out!” He said the director of nursing later drove by him in a car, warning him, “You better not put one foot on my property.”

The man told inspectors that after being taken to the hospital, he was given pain pills and discharged. He ended up at a hotel, he said, and was doing well there for a few days until he started to feel weak, which he attributed to his lack of insulin. He then went back to the hospital.

The Centers for Medicare and Medicaid Services fined Dubuque Specialty Care $131,640 as a result of the incident.

Dubuque Specialty Care currently has since hired a new administrator who referred all questions on the incident to the home’s corporate owner, Care Initiatives of West Des Moines. The company did not respond to several calls from the Iowa Capital Dispatch.

Morton could not be reached for comment, and it’s not known whether he’s currently employed by another Iowa care facility. A hearing on the licensing board charges against him is scheduled for May 23.

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Nursing home administrator cited after man was locked outside overnight