The true story of Iowa nursing homes

In response to countless articles detailing unimaginable treatment, harms, and avoidable deaths in Iowa's nursing homes, the director of the Iowa agency responsible for oversight of these facilities, Larry Johnson Jr., (and, consequently, preventing these all-too-common occurrences) published his (and his boss, Gov. Kim Reynolds') defense in The Gazette Sunday, contending that Iowa's nursing home challenges are being addressed. As the former director of that department, before Gov. Terry Branstad and his successor Reynolds ordered a "collaborative," "consultative" approach to the department's oversight, I beg to differ.

The true story is the majority of Iowa's over 400 nursing homes are for-profit, it is impossible to know where hundreds of millions of taxpayer dollars are going and caregiving suffers horribly because of industry understaffing, turnover, and lack of training. Staff are poorly paid and scapegoated when inevitable tragedies happen, largely attributable to ownership's selfish financial interests. Private equity and out-of-state owners expect a healthy return on their investment.

Before retiring from nearly 30 years of Iowa service, I added several more surveyors to inspect these homes, and the acuity of residents is even more challenging today. Federal research shows many more surveyors are needed throughout the nation, and in Iowa. Branstad immediately reversed my hires, pronouncing that our administration had a "gotcha" approach to regulation, and that industry "collaboration" was his solution. Of course, news articles at that time exposed the industry's generous campaign contributions to Branstad and just recently revealed Reynolds' and her Republican colleagues' feeding at the industry trough: Nursing homes invest in campaigns, reap millions in taxpayer money.

The inevitable result of industry's influence has been a failure in oversight, and resulting harms. Republican elected officials are directly responsible. Industry's goals are twofold: more government money, and less government oversight. It has achieved both, and nothing that Mr. Johnson says can undo the true story. Iowa's crisis in care is out of control, his gratuitous "sincerest admiration and gratitude" to caregivers should fall on deaf ears. What, may we ask, has he done to help them, or to address the state's failing our vulnerable seniors?

Finally, despite all of the accumulating horrifying nursing home tragedies, Johnson, like Reynolds and his Republican legislative leadership, deliberately choose to blindly ignore Iowa's crisis in care. Senate Democrats made a simple request to hold Senate Oversight hearings to discuss health, safety, and welfare solutions. The Republican response was nearly immediate: "there's nothing to see here, everything's just fine."

Those familiar with caregiving in Iowa's nursing homes would likely advise others to consider this Administration's neglect when they next go to the polls.

Dean Lerner is a former Iowa assistant attorney general, former chief deputy secretary of state, and former Director of the Iowa Department of Inspections and Appeals.