Investigation Reveals Flow of Money From Iowa Nursing Home Industry to State Lawmakers

The Iowa Capital Dispatch conducted an extensive analysis of the state’s nursing home industry. The investigation details a consistent flow of cash from those in the nursing home industry to political action committees (PACs), directly into the campaign funds for state lawmakers.

These lawmakers then advance bills that favor the interests of the nursing home industry. At the same time, they do not advance proposed legislation focused on strengthening protections for nursing home residents.

The Iowa Capital Dispatch reached these conclusions after examining legislation, campaign contributions, federal tax records, inspection reports and industry lobbyist recordings. Journalists uncovered a clear pattern of financial influence that seems to steer decision-making about nursing home regulations.

For example, Iowa Health PAC, the political action committee (PAC) representing Iowa’s nursing home industry contributed $30,000 to Governor Kim Reynolds’ 2022 reelection campaign. Significant donations were also made by key figures within the industry, including president of HealthCARE of Iowa David Chensvold ($20,000), Ted LeNeave, CEO of Accura Healthcare ($10,000), Acurra Healthcare President Lisa Toti ($10,000), Richard Allbee, CEO of ABCM nursing homes ($5,000), and Blue Stone Therapy CEO Douglas Johnson ($5,000).

Since 2016, the Iowa Health PAC has spent over $1.49 million on campaign donations and related expenses. A significant portion of these funds, $132,785, was directed to Governor Reynolds – this surpasses donations from other major Iowa PACs.

This pattern of contributions extends back to Reynolds’ predecessor, Terry Branstad, who received $155,288 from Iowa Health PAC between 2010 and 2016. Branstad had vowed to reform the state’s nursing home inspection process, advocating for a less punitive system.

John Hale, a consultant and advocate for older Iowans, criticized the nursing home industry’s tactics, highlighting the substantial taxpayer dollars flowing annually to nursing home operators without clear expectations for their use. Hale also pointed out the stark contrast between the high compensation of industry officials and the low wages paid to frontline caregivers, contributing to staffing shortages.

Staff shortages have been a longstanding problem at Iowa nursing homes. A U.S. Senate report ranks Iowa 49th among the 50 states for the ratio of state inspectors to nursing homes. The ratio is one inspector for every nine facilities. This is a much higher ratio than neighboring states:

• Kansas has 5.7 facilities per nursing home inspector.
• Nebraska has the same ratio as Kansas.
• Missouri has 2.7 facilities for every inspector.
• Illinois has 2.2 facilities for each inspector.