Nursing home fined for denying Iowan's plea to say goodbye to her dying mother

Cindy Lyons said she could see through a nursing home window that her mother was dying. But, because of strict enforcement of pandemic rules, she never got the chance to say goodbye.

Lyons said staff members at the New Homestead Care Center in Guthrie Center rebuffed her pleas in May to be let in to see her mother. Betty Hansen, 86, had terminal kidney disease and was put on hospice care. She had stopped eating and could no longer hold herself up.

Lyons said the family should have qualified for an end-of-life exemption to the nursing home’s visitor ban, which is intended to limit residents’ exposure to the coronavirus.

“They kept saying, ‘It isn’t time yet. It isn’t time yet,’” Lyons recalled. “I said, ‘I’m going to have to watch my mom die from a window, aren’t I?' And they said, ‘No, that won’t happen.’ But that’s what happened.”

Lyons contends the nursing home violated her mother's dignity and rights. State inspectors agreed.

In a report posted Aug. 13, they proposed fining the nursing home $3,250, mainly for the incident Lyons described.

The nursing home’s administrator declined to comment on specifics of the case, but she said she disputes the allegations and plans to appeal the fine.

The issue arose as nursing homes around Iowa and the nation struggled to prevent outbreaks of COVID-19, the disease caused by the coronavirus. The virus has swept through dozens of Iowa care centers, where frail elderly people live close together. By Monday, nursing home residents had accounted for 556 of Iowa’s 1,040 COVID-19 deaths.

Lyons said she understands that nursing home administrators must take precautions. But she said they shouldn’t use the pandemic as an excuse to avoid serving their residents and families.

'We would have done anything to get in that building'

The last time Lyons saw Hansen alive was on Mother’s Day, May 10. Lyons and two other family members stood outside the nursing home, looking in. Hansen no longer had the strength to sit, so aides lifted her up in her bed. Lyons could see that her skin had turned a grayish-yellow, and her eyes were rolling back in her head.

“We yelled at her through the window, but I don’t know if she heard us,” Lyons said. “The aides told her, ‘Wave to your kids.’ She raised her hand, and they laid her back down.”

Lyons said she was so upset that she was tempted to smash the window. She said she asked again to be let in to say goodbye and was told it wasn’t time yet.

“We would have done anything to get in that building,” she said through tears. “If they’d told us to put on a spacesuit, we’d have done it.”

She said she called the nursing home the next morning and asked again to visit; she received the same answer. Then, less than an hour later, a staff member called back to say Hansen had died. Now the family could come in and see her, the staff member said.

Lyons said staff members looked away as she was led to her mother’s room.

An obituary said Hansen had lived on the family farm near Guthrie Center until November 2019, when she moved to the nursing home. Besides farming with her late husband, Chuck, she'd worked at the Guthrie County Jail, delivering meals to prisoners and doing laundry there before retiring in 2014. She was a devoted Hawkeyes fan and loved to watch her grandchildren's sports events.

The state inspectors' report doesn't name the resident, but the facts match the account Lyons gave to the Des Moines Register before the agency took action.

The inspectors cited the New Homestead Care Center for violating the resident's rights, including the right to interact with others. It also says the staff failed to keep the resident's family and physician informed of her declining condition, including a drop in weight from 129 pounds to 116 pounds in seven weeks.

Additionally, the inspectors cited unrelated issues with the facility's infection-control efforts. 

Hilaree Stringham, the New Homestead's administrator, said privacy rules prevented her from commenting on specific residents. But she said in an email to the Register that the facility's leaders do not agree with the state inspectors' findings, and they plan to challenge them on appeal.

"On behalf of The New Homestead Care Center team, I extend our heartfelt thoughts and prayers to all families who have lost loved ones during the current health crisis," Stringham wrote. "We know these are difficult times, made even more difficult with the pandemic and the additional precautions now necessary to keep people safe. We also appreciate how important it is to family members to have the ability to visit their loved ones, especially when that loved one is nearing the end of his or her life."

Stefanie Bond, a spokesperson for the Iowa Department of Inspections and Appeals, said she didn't think any other Iowa nursing homes had been cited for failing to allow end-of-life visits during the pandemic.

Lyons said she hadn't heard from the care facility since her mother died.

She wasn't sure if filing a complaint would make a difference and said she's grateful that state inspectors looked into it and filed a public citation. She wants nursing home residents and their families to know they have rights.

"I hope this won't happen to another family," she said.

Tony Leys covers health care for the Register. Reach him at tleys@registermedia.com or 515-284-8449. 

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