BUFFALO CENTER, Iowa (AP) — The state has proposed fining a northern Iowa nursing home nearly $30,000, in part over the treatment of an 87-year-old woman officials said was in pain and may not have had water several days before her death. The Iowa Inspections and Appeals Department hasn’t imposed the fine yet against Timely Mission Nursing Home in Buffalo Center, so the federal Centers for Medicare and Medicaid Services could take over the case. The Des Moines Register reports that no state or federal fine has yet been imposed.

A spokesman for the Iowa department, David Werning, said Tuesday the proposed fines covered the woman’s case and two others: the lack of proper assessment and care of another patient who died at the home the same day and the lack of proper assessment and care of a woman who was diagnosed at a local hospital with infectious colitis, a painful inflammation of the colon. Trinity Mission is run by a tax-exempt nonprofit corporation headed by President Lorie Bierle and Vice President Larry Weaver. Staffers told inspectors that the 87-year-old woman, Virginia Olthoff, was often in pain in the days before her death. Before she went to a hospital Feb. 27, the state citation said, Olthoff was crying, moaning, screaming and bleating “like a sheep” but was given only a nonprescription pain reliever.

Timely Mission staffers noticed Olthoff’s eyes were sunken and dark and told inspectors they couldn’t get a blood pressure reading or feel her pulse. Nearly three hours later Olthoff taken by ambulance to the hospital. Inspectors said a registered nurse at the home explained the delay by saying she didn’t think Olthoff was “that bad yet” and said the staff “had other things to do besides sit there and watch the clock go by.” A hospital emergency room doctor later told inspectors that laboratory tests indicated Olthoff probably hadn’t consumed any fluids for four to five days and might have had very limited fluids for weeks. Olthoff was comatose when she arrived, the doctor said, but was awake and alert after receiving a more than 2 pints (1 liter) of water.
She died after being returned to the home that same day, the report said.