Iowa Senate Republicans reject call for nursing home probe

Iowa Senate Republicans have rejected a formal request by Democrats for a state oversight meeting to investigate nursing home care in the state in the wake of recent reported deaths, abuse and neglect in Iowa care facilities.

Iowa Senate Democrats and advocates for Iowa seniors held a news conference Thursday at the Iowa Capitol calling on the GOP-controlled Senate Oversight Committee to launch a bipartisan investigation into Iowa’s nursing homes.

Sen. Claire Celsi, D-West Des Moines, the ranking member on the oversight committee, sent a letter to Sen. Amy Sinclair, R-Allerton, the committee chair and president of the Iowa Senate, requesting the investigation.

Celsi and advocates pointed to documented instances of resident deaths, abuse and neglect of residents at long-term care facilities in the state, including lack of access to food and water, and lack of access to adequate medical care, including medications, wound care and pain management and lack of access to ambulance services.

Sinclair, in a statement sent to The Gazette, said she will not schedule an oversight meeting on the topic “because it would distract department staff from performing their important work monitoring these facilities.”

She pointed to more than 2,800 citations issued in the past 12 months by the Iowa Department of Inspections and Appeals, the state agency responsible for inspecting the state’s nursing homes.

“That number of citations demonstrates how serious the state takes the issue of elder care,” Sinclair said in the statement.

The Iowa Senate president also pointed to legislative efforts to address workforce shortages in the industry.

“(S)ince 2017, the Senate has increased funding for nursing home care by nearly $75 million, increased incentives for high quality of care to over $111 million, and passed critical tort reforms to ensure nursing homes can continue to provide services in rural Iowa,“ Sinclair said.

‘Grave danger’

Celsi, in her letter, said “it is painfully clear that the State of Iowa is not taking its responsibility to care for vulnerable Iowans seriously.“

“Consequently, some residents of Iowa’s nursing facilities are in grave danger of neglect, abuse and death,” she wrote.

She said Iowans “want and deserve full accountability and transparency” from state officials, calling it “a matter of life and death for impacted Iowans.”

“We have a critical responsibility to ensure state departments are carrying through their legislatively assigned functions,” Celsi told reporters during the Thursday news conference. “The nursing home crisis is real, and the state has an obligation to investigate and provide workable solutions.”

Celsi on Thursday said legislative Democrats might have the option of holding meetings on their own in the event Sinclair did not agree to hold an official inquiry involving Republicans.

Citations, ratio

Last week, a Woodbury County care facility was cited by the state for retaliating against a woman who reported she was raped by one of her male caregivers, the Iowa Capital Dispatch reported. The woman allegedly was given 30 minutes to pack up her things before a taxi was summoned to drop her off at a homeless shelter.

A West Des Moines nursing home was cited for 62 violations, one of which is tied to a resident who contracted gangrene and had to have a leg amputated, the Capital Dispatch’s Clark Kauffman reported.

According to federal data, Iowa is responsible for 3 percent of the nation’s nursing facility citations, and 4.1 percent of the nation’s immediate jeopardy and life-threatening situations — despite accounting for just 1 percent of the nation’s 65-plus population.

Iowa ranks 49th among states in ratio of nursing home inspectors. A report by the U.S. Senate Special Committee on Aging suggests Iowa has one of the nation’s worst ratios of nursing home inspectors to care facilities, and that the state’s use of private contractors to inspect homes is extraordinarily costly to taxpayers.

“In some instances, the cost of two or three recertification surveys is equal to an annual surveyor employee salary,” the report states. “For example, in Iowa, the pay range for an RN surveyor employed by the State is $66,600 to $93,800,222 while CertiSurv charged the State $33,300 to survey a single nursing home with 96 to 174 beds, and $40,950 for a nursing home with 175 or more beds.”

Staffing shortages

Nursing home officials have said workforce challenges, including high turnover rates and worker shortages fueled by low wages, have impacted patient care. Industry officials say they also have felt financial strain from low Medicaid reimbursement that has not kept up with rising costs, making it harder to offer competitive wages.

More than two dozen nursing homes across the state have closed since June of last year. Iowa currently has more than 400 facilities across the state and more than 28,000 nursing home beds.

Funding increases

State lawmakers this year provided an additional $15 million to nursing homes through Medicaid reimbursement funding.

“Gov. Reynolds has increased Medicaid funding every rebase year as governor, leading to $163 million of new funding going to nursing facilities to increase quality of care for residents,” Kollin Crompton, deputy communications director for the governor’s office, said in a statement to The Gazette on Thursday.

Crompton also pointed to efforts by Gov. Reynolds to alleviate stress on nursing homes, including investing more than $24 million into programs like the Rural Health Care Loan Repayment and Recruitment Program, which recruits doctors and other health care professionals to rural communities, and creation of health care apprenticeship programs.

“Governor Reynolds believes solving the health care workforce shortage and addressing funding is the path to improving long-term care for Iowa’s seniors,” Crompton said.

The governor’s office also raised concerns over a recent proposal from the Biden administration to implement minimum staffing requirements in nursing homes. Reynolds joined 14 other U.S. governors who issued a statement opposing the federal mandate.

“The additional government regulation could unravel the workforce progress in Iowa and lead to facilities being closed,” Crompton said.

The governor’s office did not immediately respond Friday to a request seeking comment specifically on Democrats’ call for a state oversight meeting to investigate nursing home care.

Comments: (319) 398-8499; tom.barton@thegazette.com