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Nursing home care for sale in Iowa
Iowans are concerned, anxious, angry about an $85 million nursing home sale.
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Amid a flurry of news stories about the upcoming election, a recent headline grabbed Iowans’ attention: an out-of-state private equity firm purchased 29 Iowa nursing homes for $85 million.
Why are people concerned? Among other reasons, because of the secrecy involved, the enormous size of the payment, and the fact that other nursing homes owned by this for-profit firm have a history of poor care. Based on their record, as reported by the Iowa Capital Dispatch the negative impact on Iowa residents, workers and communities could be staggering.
This sale should never have been authorized by Iowa’s state government. Approved in darkness, the vetting appears to have been limited to the buyer’s financial viability. Our state’s failure to scrutinize whether the health, safety, and welfare of the homes’ residents would be enhanced, or even protected, is inexcusable. The responsible parties seemingly disregarded what should have been the only consideration — Iowans.
Social media comments and conversations occurring across the state demonstrate that Iowans are deeply concerned, anxious, and angry. Understandably so!
Here are some of their expressions:
“Customers will be poorly served, and prices will go up.”
“Staff levels are already too low and will only get worse.”
“Health and long-term care should not be for profit.”
“Governor, what is your response to this sale?”
“Nursing home care is bad now and will get worse. I will never be put in one, and I would never want a loved one to be there.”
“Private equity firms are not altruistic; they are in it to make lots of money.”
“Why wasn’t there any transparency to the details of this sale?”
“It’s a disaster waiting to happen.”
“This won’t end well.”
“It’s the grift that keeps on giving.”
These comments are just the tip of the iceberg, and they lead to a serious question:
Did any government official charged with oversight, or who was a part of the approval process, bother to research the available reports on the performance of the nursing homes already owned by this private equity buyer? It appears not.
The shocking negative data on staffing levels, health and safety violations, the number and amount of fines assessed, instances of resident abuse, and overall quality ratings should have been a deal breaker. The fact that it wasn’t makes us, and Iowans we’re hearing from, ask: “What were they thinking?”
Last year, amid countless stories of neglect and abuse of nursing home residents, Republican legislators and Gov. Kim Reynolds rejected Democrats’ request to even hold oversight hearings on nursing home care. In light of this sale, we challenge our elected officials to address, rather than avoid, the issues.
Here are a few recommendations; we’re available to offer many more concrete ideas to improve the lives of residents and staff, and to vastly improve long-term care in Iowa.
- Enact a law that puts an indefinite pause on any proposed nursing home sales to private equity, real estate investment trusts, or other entities that view nursing homes purely as investments, rather than homes to ensure residents thrive.
- Require that nursing homes that rely on the steady flow of taxpayer dollars from Medicare and Medicaid be treated like a public utility and limit the amount of profit that can be diverted from care for residents.
- Adopt minimum staffing levels for nursing homes, as proposed by the Biden Administration, that are known to keep residents safe and save lives. Yes, these are the staffing requirements that Attorney General Bird and Reynolds have overtly opposed. It’s time to set politics and special interests aside and to do what’s in the best interest of nursing home residents, staff and communities.
- Strengthen the 2023 law that established new rules for nursing home sales. Require more transparency on the details of the sales. Include quality of care standards that a potential buyer must be meeting in homes currently owned, and must commit to meeting in homes being purchased.
- Explore granting “provisional” licenses to new care facility owners to send the message that approval comes with expectations to meet performance standards. If standards aren’t met, a permanent license should not be granted.
- Establish clawback provisions to require that when nursing homes are sold, a percentage of profits should be returned to the original and primary investors: taxpayers who funded substantial Medicare and Medicaid payments.
- Provide immediate additional appropriations for the Long-Term Care Ombudsman’s Office and the Department of Inspections, Appeals and Licensing to make more unannounced visits to newly purchased facilities to identify and address any concerns.
- Establish a non-partisan Citizen Advocacy Board within state government to be included in discussions and decision-making about nursing home sales and mergers.
The public is becoming more aware of issues in nursing home funding, profit-taking, staffing, and caregiving. Iowa citizens are the sleeping giants who have been awakened.
They expect action. Who will step up to take it?
John and Terri Hale own The Hale Group, an Ankeny-based advocacy firm focused on older Iowans. terriandjohnhale@gmail.com Dean Lerner is a former Director of the Iowa Department of Inspections and Appeals. dean@kelinsonlaw.com
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