Clark Kauffman

The Des Moines Register

John Chedester was removed in July from his house in Ute%2C Iowa%2C because he could not care for himself

He was taken to Elmwood Care Centre%2C a nursing home in Onawa%2C Iowa

The nursing home kicked him out Nov. 1%3B tenant in apartment building saw the situation%2C intervened

ONAWA, Iowa — A seriously ill, disabled Navy veteran was evicted from an Iowa nursing home for failure to pay his bill then was dropped off at an unfurnished apartment with no food, medication or phone.

John Chedester, 65, was suffering from a life-threatening blood infection, congestive heart failure, insulin-dependent diabetes and other ailments when he was dropped off Nov. 1, alone, at an apartment building 20 miles away in Mapleton, Iowa, according to state and county records.

"He was, for all practical purposes, dumped by the care facility into a vacant apartment," said David Werning, spokesman for the Iowa Department of Inspections and Appeals.

After a neighbor and police intervened the next day, Chedester was rushed via ambulance to a hospital.



"This is a gut-wrenching and disturbing story," said John Hale of the Hale Group, an Ankeny, Iowa, consulting firm that focuses on long-term care. "What happened to Mr. Chedester should not have happened, and we need to make sure that it never happens again — to anyone, anywhere."

Although Chedester was dropped off at the empty apartment in November, the incident became public only this past month when state inspectors issued a report on their investigation into the matter.

"They dropped me off at the apartment on a Friday, and the next thing I can remember was when I came to in the hospital on Sunday," Chedester told The Des Moines Register.

Chedester since has been readmitted to the same nursing home that discharged him to the unfurnished apartment: Elmwood Care Centre of Onawa, Iowa. The federal government has fined the western Iowa home a total of $5,752.

"I don't think he would have lasted one more night there in the apartment," said Sgt. Roger Krohn of the Monona County Sheriff's Department. "We would have found a dead body there the next day."

Marla Cleghorn, an executive of the home's Florida-based management company, said Trillium Health Care Group does not condone the manner in which the Elmwood staff handled the situation. Elmwood Care Centre is owned by Aviv, a large real-estate investment trust that owns more than 260 nursing homes, including seven in Iowa.

"It really and truly was an unfortunate situation," she said.

According to the report, Chedester was removed in July from his private residence in Ute, Iowa, after local police and state social workers determined he could not take care of himself.

"That house was in terrible condition," Krohn said. "He couldn't take care of himself. He couldn't bathe himself or take care of the house. It was just a deplorable state for anyone to be living in."

Veteran wouldn't sign up for Medicaid

When Chedester was admitted to Elmwood Care Centre, he was diagnosed with post-traumatic stress disorder, diabetes, elevated blood pressure, congestive heart failure, sleep apnea and other ailments. He had little or no family support, and he required supervision and assistance with walking and hygiene, according to state reports.

Chedester, who served in the Navy from 1968 through 1988, asked to be taken to the Iowa Veterans Home in Marshalltown, a state-run nursing home specifically for veterans about 150 miles east of his house, but state records do not indicate why he wasn't admitted there.

Sixty days after his admission to Elmwood, the home gave Chedester a letter indicating he would be discharged involuntarily Oct. 23 because of nonpayment for services.

Cleghorn said Chedester — who showed signs of disorganized thinking, as well as incoherent and illogical, rambling speech — did not cooperate with staff when they tried to sign him up for Medicaid, which would have paid for his care.

"He was not willing to participate in that process," she said.

Chedester's file at the home indicates that as the eviction date drew near, he told nurses he was having trouble sleeping because of the uncertainty over his living situation, according to state inspection reports.

The Elmwood staff arranged for his placement in the Mapleton apartment building and offered to transport furniture from his house, but he allegedly declined the offer. He also refused home health services, his medications and the bottled oxygen he often relied upon to help him breathe.

The Elmwood staff gave Chedester the phone number of his Department of Human Services case worker, and on Nov.1 an employee of the home took him to the unfurnished apartment and dropped him off.

The driver told inspectors it was "a pretty poor setup" and said the director of nursing didn't know what else to do.

Tenant finds man, brings him blanket

A tenant in the apartment building, Kathleen James, checked on Chedester after the driver left and realized the apartment had no food, phone or furniture. She brought Chedester a blanket, silverware, a bowl and a microwave oven. The apartment manager brought Chedester some food.

Later that day, James called the administrator at Elmwood, Stephanie Morris.

"I was not nice when I called," James said. "I said, 'What are you people thinking by dropping off this man with no food or medicine or furniture?' The administrator said if John needed to eat, he could walk to the Maple Heights Nursing Home across the street. She said John was 'manipulative' and wanted people to think he can't care for himself.

"I said, 'He can't even walk to the refrigerator. Are you for real?' I said, 'This is a Navy vet, somebody who fought for our country.' "

When James asked about the lack of medication, Morris said that was not her problem, according to state inspectors' reports.

That night, James heard Chedester reading his Bible aloud inside the unfurnished apartment. The next morning, she called the county sheriff's office. By chance, Krohn responded to the call.

"I was shocked to see that it was John in the apartment," Krohn said. "I was floored by it. It was so sad. Here's this man who has served his country — he's a veteran. He shouldn't have to live like that."

Krohn said he called Elmwood Care Centre and asked a nurse there why the facility had dropped off Chedester with no medicine, food or phone. The nurse referred Krohn to the home's administrator.

"So I tried to call her, but she never answered and she wouldn't return my calls," Krohn said.

Veteran sent back to original care site

An ambulance took Chedester to a local hospital, where he was treated in the emergency room for severe respiratory distress then transferred to another hospital for more intensive care.

At the second hospital, his condition was considered "extremely guarded." He showed signs of pneumonia, and he was treated for sepsis, anxiety and an uncontrolled heart rate.

On Nov. 11, he was discharged from the hospital and sent back to the Elmwood Care Centre, where he remains today.

It's not clear why Chedester's Department of Human Services caseworker didn't intervene to prevent him from being discharged to an unfurnished apartment. Spokesman Amy McCoy said the department cannot discuss its handling of any specific case.

Elmwood's director of nursing told state inspectors that she considered intervening before and after Chedester was discharged, but Morris assured her "everything was taken care of," according to the inspection reports.

Morris, who no longer works at Elmwood, could not be reached for comment.

No criminal charges were filed in the case. Although the denial of critical care is a form of criminal dependent-adult abuse in Iowa, that law is rarely enforced.

State regulators initially proposed an $8,500 fine against Elmwood Care Centre. The state fine was set aside when the federal government decided to impose its own fine of $8,850 for the same violation.

The federal fine was then reduced by 35%, to $5,752, because the home agreed to forgo an appeal.

"A $5,000 fine is nothing," James said. "That's nothing compared to the cost of 10 days in the hospital. It doesn't come close to paying for what they did to this man."

Deanna Clingan-Fischer, Iowa's long-term care ombudsman said her office didn't become aware of the situation until Nov. 9, more than a week after the nursing home discharge. She said Elmwood Care Centre failed to comply with the law that requires her office to be informed of all involuntary discharges.

The home also failed to tell Chedester that he could contact the ombudsman's office if he objected to the discharge, she said. State records show the home was not cited for either of those violations.

Chedester said he still would like to live at the Iowa Veterans Home in Marshalltown, if possible.

"It seems like I'd have more in common with the people there," he said. "I don't really have anyone to talk to here."

Clingan-Fischer said her office would contact Chedester about where he'd like to live.

"We didn't know he had expressed an interest in going to the Iowa Veterans Home," she said.