Iowa Lawmakers must address long-term care

Iowa’s long-term care ombudsman is urging the Republican-controlled Legislature and Gov. Kim Reynolds to take a series of actions to improve care for vulnerable residents in care centers and address crises before they lead to closures.

During fiscal year 2024, State Long-Term Care Ombudsman Angela Van Pelt resolved 1,086 complaints, compared to 653 in 2021. Most of the complaints come from families and residents concerned about the quality of care and staffing. Other issues, including resident rights and autonomy, are also yielding complaints.

What Van Pelt is advocating is straightforward stuff. Lawmakers should listen.

Recruiting and retaining staff are significant challenges. Workers in these roles are often poorly compensated for difficult, meaningful work. Staffing shortages can lead to a lack of needed care, less time spent with residents, medication errors and injuries.

Van Pelt wants to tie Medicaid funding for facilities to care quality and workforce outcomes. Lower turnover, stable staffing and better care could mean more funding. She argues that the state should adopt a bonus system for positive results rather than blanket funding for all facilities, regardless of quality.

Dollars spent on temporary staffing should be used to improve wages and benefits for permanent workers. A career ladder program could enable staff to develop skills and advance to higher-paying roles. State funding, VanPelt contends, should be invested in a facility’s workforce rather than simply adding to its bottom line.

Van Pelt would like to see the state create a “SWAT team” that can respond rapidly to struggling facilities facing the prospect of closure. The state has a stake in avoiding chaotic closures that disrupt residents’ care and force families to scramble for a new care center.

Convincing lawmakers to adopt any of these measures would take a significant shift in how the Legislature considers long-term care policy. For years, policy has centered on measures sought by the owners of nursing homes. Lawmakers must make helping residents, families and front-line employees the primary goal of state policy.

That won't be easy. The heartbreaking and tragic incidents we regularly see in the headlines have not been enough to convince lawmakers to take serious action on the core problems identified by Van Pelt.

That must change for progress to be made. Iowans affected by these issues can be powerful advocates for that change. Iowans can no longer tolerate placing our older loved ones in nursing facilities with substandard care and dangerous conditions. It’s long past time for our Statehouse leaders to act.

(319) 398-8262; editorial@thegazette.com