Federal Report Highlights Shortage of Nursing Home Inspectors in Iowa

In 2023, the U.S. Senate Special Committee on Aging’s released a report that has shed light on concerning issues related to nursing home oversight in Iowa. Here are the key findings:

Low Inspector-to-Facility Ratio

Iowa ranks among the worst in the nation for its ratio of nursing home inspectors to care facilities – there is one inspector for every nine facilities. In 2022, there were just 46 inspectors charged with oversight of 414 nursing homes. States with a similar number of nursing homes had twice as many inspectors.

For example, Nebraska has one inspector for every 5.7 homes, Missouri has 2.7 for every nursing home and Minnesota has 4.5.

Unfilled Inspector Positions

As of 2022, nine percent of inspector positions in Iowa remain unfilled, putting significant strain on the workforce, according to the report.

High Costs to Taxpayers

Iowa’s reliance on private contractors to perform inspections has incurred significant expenses for taxpayers. The state paid contractors up to $40,950 for a single inspection of nursing homes with 175 or more beds.

Quality of Contractor Work

Iowa officials have praised the quality of inspection reports produced by private contractors, noting that the reports are concise.

However, officials in other states have raised concerns about the quality of contractors’ work, raising questions about diligence and conflicts of interest.

Some private companies contracted for nursing home inspections also provide consulting services to the same nursing homes, potentially leading to conflicts of interest. Iowa also lacks a mechanism to track consulting services provided by contractors.

Delays in Inspections

Delays in inspections pose risks to nursing home residents, compromising their safety and well-being.

Pine Acres Rehabilitation and Care Center in West Des Moines is under scrutiny because inspectors did not do an investigation until the facility had accumulated 13 complaints. One complaint was made on March 3, 2023, but the facility was not investigated until July.

Promptly responding to nursing home complaints has been a problem in Iowa for a long time, well before the COVID-19 pandemic.

Legislative Response to the Report

State Senator Claire Celsi has expressed concern over the report’s findings, indicating that legislators need to address the problem, including mandatory staffing levels for inspectors. However, achieving a consensus on what to do next may take time.

Despite challenges, advocates for senior citizens stress the importance of prioritizing the health, safety and welfare of vulnerable seniors.

While Governor Kim Reynolds’ office has not responded to the report, the 2024 legislative session may have more discussions about addressing these concerns and prioritizing nursing home residents’ well-being.

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