Nursing home improvements are critical

Democratic State Auditor Rob Sand took aim this week at an issue plaguing the state and some among Iowa’s most vulnerable population.

“This is just an issue that has been the subject of lots of questions, been the subject of lots of coverage, and we thought that this information would be hopefully useful to policymakers as they decide whether or not they want to do something about the crisis in Iowa’s nursing homes,” Sand said Monday during a virtual news conference.

Sand contends, according to federal data, 85% of Iowa’s nursing home went more than 15.9 months between inspections. That breaks federal rules. Sand said Iowa lags its neighbors in terms of inspection frequency.

He highlighted a shortage of licensed nurses in care facilities and high workforce turnover due to low pay. More than 40% of nursing homes don’t meet federal staffing mandates that are slated to go into effect.

The Department of Inspections, Appeals and licensing disputed Sand’s findings. A spokesperson claimed Sand is citing “outdated and/or incorrect data and inaccurate performance measurements.” The department argued it is closing the inspection gap.

“Right now, Iowa has more five- and four-star rated nursing homes than the national average,” said DIAL Director Larry Johnson in a Gazette Column in January. “We also rank in the top eight states for the number of filled nursing home inspector positions. Many states have a 50% vacancy rate for these positions; Iowa only has a vacancy rate of 2%.”

It’s not surprising that Sand and bureaucrats would see the problem differently. It seems like a good time for the Legislature use its oversight and legislative powers to dig into the facts and approve new laws aimed at addressing problems.

But so far, the Republican-controlled Legislature has shown little interest in providing oversight. And this past session, the majority passed no major legislation addressing nursing home issues.

A package of reforms proposed by Democrats — imposing more frequent inspections and stricter penalties; studying alternatives to institutional long-term care, raising the minimum wage for nursing home workers and an increase the monthly -allowance for long-term care residents on Medicaid — swiftly died in the Senate. The House quietly shelved a bill allowing residents or their families to install a camera in their room to monitor the quality of care their loved one receives.

One measure tucked into a budget bill, requiring the department to provide training sessions to nursing homes on common problems cited by the state, did pass.

Other ideas can be considered. Meeting federal staffing guidelines is a must. Having a trained nurse on staff 24/7 like the feds require could be a smart policy.

Sand is right to demand action. Improvements can and must be made.

(319) 398-8262; todd.dorman@thegazette.com