Agency says it denied access to records because it ‘didn’t expect’ to have them

The state agency that denied a request for inspection reports on a Cedar Rapids home health agency now says that denial was based on an incorrect assumption that it wouldn’t have any such records.

On July 9, the Iowa Capital Dispatch asked the Iowa Department of Inspections, Appeals and Licensing for a copy of a private accreditation agency’s inspection report for the home health agency Compassion North America.

Compassion came under scrutiny earlier this year after the Iowa Board of Nursing presented evidence of falsified records, billing for services that were never delivered, and the employment of an unlicensed nurse to provide patient care.

In response to the Capital Dispatch’s request for the documents, DIAL spokesperson Diane McCool said DIAL “does not receive” such records.

After the Capital Dispatch reported DIAL’s claim that it didn’t have the requested records, the Accreditation Commission for Health Care contacted the news organization and said that it had, in fact, provided DIAL with a copy of the documents via email on Sept. 16, 2024.

The Capital Dispatch asked DIAL again for the records. DIAL then acknowledged it had the documents but refused to release them, stating that it is not the “official” custodian of such documents.

Asked why the agency initially denied having the records, McCool said Thursday that “since the accrediting organizations are not required to send the survey reports to DIAL, the department didn’t expect that it would have the report.”

Her response didn’t indicate whether, after receiving the Capital Dispatch’s request for records, anyone at DIAL actually looked for the records or made any internal inquiries as to whether someone at DIAL might have them.

Because DIAL has never conducted its own inspection of Compassion North America, and because it won’t release its copy of the accrediting commission’s findings, there is no public record of any regulatory oversight of the home health provider, which was first incorporated in June 2017.

McCool has said DIAL is not investigating Compassion North America, despite the findings of the Board of Nursing and its investigator that the company appeared to have falsified records, billed for services that were never delivered, and employed an unlicensed nurse to provide patient care.

Those allegations surfaced at a disciplinary hearing for registered nurse M’balu Madlene Kebbie, who is married to Compassion North America’s CEO, Joseph Lemor.

A state investigator who reviewed the work schedules of Compassion employees as part of a board investigation allegedly found that the license of one of the company’s nurses had expired in January 2021 but she had continued to provide patient care in June and July 2022.

In addition, a comparison of Compassion’s billing records with the staff work schedule allegedly showed the company had submitted payment claims for services for which there was no corresponding documentation to indicate the care was provided. There were also payment claims for services provided by a registered nurse that exceeded 24 hours in a single day, the state investigator testified.

According to the board, Kebbie had no explanation for the irregularities in the nursing documentation — including instances where it appeared Compassion had billed Medicaid twice for some services.

Citing what it called Kebbie’s “lack of previous disciplinary history,” the board ruled that she could retain her Iowa nursing license subject to two years of probation. However, the board’s own records indicate that in 2012, it disciplined Kebbie for working as a nurse while her license was inactive.

Kebbie’s attorney has filed an appeal of the board’s recent decision in Polk County District Court, arguing the sanctions against her are “unreasonable, arbitrary, and excessive.” The state has denied any wrongdoing in the matter.

Lemor has said the state is engaged in a “witch hunt” with regard to Kebbie. “We did not do anything improper,” he told the Iowa Capital Dispatch last month. “We have nothing to hide.”

This article was first published by the Iowa Capital Dispatch.