from the Iowa District Court for Linn County, Patrick R.
appeals the district court decision affirming the ruling of
the Iowa Department of Human Services finding plaintiff
committed dependent adult abuse. AFFIRMED.
R. Hinchliff and Andrew B. Howie of Shindler, Anderson,
Goplerud & Weese, PC, West Des Moines, for appellant.
J. Miller, Attorney General, and Charles K. Phillips,
Assistant Attorney General, for appellees.
by Tabor, P.J., and Mullins and Bower, JJ.
Olutunde appeals the district court decision affirming the
Iowa Department of Human Services (DHS) ruling finding she
committed dependent adult abuse. We find DHS properly
interpreted the term "caretaker" and concluded
Olutunde was a caretaker of the patient in question during
the relevant period of time. We also find there is
substantial evidence in the record to show staff trained by
Olutunde were not consistent in providing medication to the
patient in a timely manner, or at the very least, were not
consistent in providing documentation to show whether or not
the patient was receiving her medication as prescribed. We
affirm the district court's decision, affirming the
decision of DHS finding Olutunde committed dependent adult
Background Facts & Proceedings
time of the incidents in this case in March 2014, J.N. was a
fifty-five year old person unable to care for herself due to
physical and mental health problems. In particular, J.N.
needed assistance in managing her medications. J.N. did not
have the ability to know which medications to take or when to
take them. The parties agree J.N. was a dependent adult
within the meaning of Iowa Code section 235B.2(4) (2014).
December 2013, J.N. began living at All Ages Care Services,
LLC (All Ages). Olutunde, a certified nursing assistant, was
the owner and clinical director of All Ages, and she provided
training and supervision of employees working there. Olutunde
was not present at All Ages every day. All Ages had an
administrator who provided day-to-day supervision of
employees. At times, when no one else was available,
Olutunde would work a shift for an absent employee and
provide direct care for the patients. Olutunde testified she
never administered medication to J.N.
March 6, 2014, J.N. began attending Robert E. Miller Iowa
Developmental Services (REM) from 8:45 a.m. to 2:15 p.m. each
day, then returning to All Ages. When J.N. first began
attending REM, the day program did not have authorization to
administer J.N.'s medication to her. An employee of All
Ages was supposed to go to REM every afternoon to give J.N.
her medication. REM received permission on March 25, 2014, to
give J.N. her afternoon medication. J.N.'s DHS case
manager, Angela Albers, moved J.N. from All Ages to a
different residential facility on May 1, 2014.
March 28, 2014, DHS received an allegation J.N. had been
subjected to dependent adult abuse. The allegation claimed
J.N. had been denied critical care due to failure to ensure
she was receiving her medications as prescribed. Three areas
of complaint were raised: (1) whether someone from All Ages
went to REM to give J.N. her medication every afternoon from
March 6 to 25; (2) during the same time period, whether
J.N.'s medication was sometimes placed in her backpack to
be transported to REM although J.N. was not to have access to
the medication; and (3) after March 25, whether bubble packs
containing J.N.'s medication showed she had not been
receiving all of her medication while at All Ages.
issued a founded report against Olutunde, finding she was
"responsible for making sure that the staff has the
necessary training to care for [J.N.] and in dealing with
crisis situations." The report stated:
There is evidence that the dependent adult does not have
adequate medical care. [A DHS worker] reviewed the medication
log for March 2014 for [J.N.] and there are a lot of
questions, regarding inconsistencies that no one seems to be
able to answer to. REM staff have also reported that
medication in [J.N.]'s bubble packs was still there for
several days, indicating she was not getting it. This was
apparent after viewing the log. [Olutunde] did not provide
her staff with All Ages the appropriate training to know and
understand medication passing in order to ensure that [J.N.]
was getting the adequate medical care she needed daily.
[Olutunde] admits to being the one responsible for all
consumers' care, however, she is unable to answer
questions regarding the agency or consumers, as [Soji] is the
primary one to run the agency.
filed an administrative appeal of the founded report with the
Iowa Department of Inspections and Appeals (DIA). A hearing
was held in which evidence both supporting and contrary to
the findings in the founded report was presented.
administrative law judge (ALJ) reversed the founded report
against Olutunde. The ALJ found Olutunde was not a caretaker
within the meaning of Iowa Code section 235.2(5)(a)(1)(d) and
Mosher v. Department of Inspections & Appeals,
671 N.W.2d 501, 511-12 (Iowa 2003). The ALJ determined DHS
did not show Olutunde was present during acts of dependent
adult abuse or personally deny J.N. adequate medical care.
The ALJ also found J.N. was not given her afternoon
medication on March 6, 2014, but concluded, "I cannot
base 'Founded' determinations of dependent adult
abuse against Olutunde based on evidence that on one date,
J.N. was not given her medications as
prescribed." The ALJ determined Olutunde's name
should be removed from the adult abuse registry.
appealed the ALJ's decision to the DHS director. In a
final decision, the director adopted the ALJ's factual
findings but came to different legal conclusions. He affirmed
the founded report of dependent adult abuse. The director
disagreed with the ALJ's interpretation of
Mosher, finding Olutunde was J.N.'s caretaker
because she was responsible for the care J.N. received in the
facility and the training of J.N.'s caregivers. The
director also found there were ongoing problems with
J.N.'s medications, noting REM often needed to remind
staff from All Ages to come over to give J.N. her afternoon
medication, J.N. would bring her medications in her backpack,
and the bubble packs showed J.N. was not ...