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Iowa agency plans to release more data on nursing home inspections
State agency and Iowa Auditor have been

Oct. 28, 2024 11:40 am
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A state agency says it plans to release quarterly updates on its progress in meeting federal requirements for nursing home inspections after questions were raised by Iowa’s State Auditor.
The Iowa Department of Inspections, Appeals and Licensing announced late last week that its health facilities surveyors have met the federal mandate for nursing home inspections for federal fiscal 2024. While the inspection materials still were being uploaded to federal databases, a department spokesperson said the department’s health facilities website contains updated information regarding a long-term care facility’s inspection frequency. Iowa has about 400 nursing homes.
Federal regulations dictate nursing homes be inspected at least once every 15.9 months. A review of inspection reports compiled by the department and provided to The Gazette show all of Iowa’s nursing homes had been inspected at least once in the last 16 months.
In March 2020, in an effort to control the spread of COVID-19, Medicare and Medicaid halted most nursing home surveys, which resulted in a backlog of complaint and recertification surveys to be investigated nationwide.
The inspections department has pushed back on a report from State Auditor Rob Sand released last month that asserted the state lags behind the federal requirement and is failing to provide timely nursing home inspections. The report states Iowa also lags behind neighboring states in the frequency of inspections and having licensed staff levels at nursing homes that impact the quality of nursing care.
Iowa Department of Inspections, Appeals and Licensing Director Larry Johnson contends Sand, a Democrat, relied on outdated numbers and incorrect federal performance measurements, “which could have been avoided if the auditor’s office engaged with DIAL before issuing its inaccurate report.”
“In line with DIAL’s mission to be transparent and provide accurate and updated information to the public, all long-term care facilities’ inspection histories are available” on its site, Johnson said in a statement. “I am incredibly proud of the work our dedicated staff has done to inspect Iowa nursing homes in a timely manner. We expect to meet CMS’ performance guidance for federal fiscal year 2025 as well.”
The Auditor’s Office used publicly available data from the Centers for Medicare and Medicaid Services. The data set used in its report was updated as of June 1.
Sand’s office, in a statement to The Gazette, the most recent numbers cited by the department show short-term improvements in the frequency of inspections.
“We applaud this,” the Auditor’s Office said, adding, “We cannot ignore the fact that over the last three inspections, based on CMS data as recent as September 1, 2024, 77 percent of Iowa nursing homes had at least one gap greater than the federal mandate of 15.9 months. Additionally, over the last three inspections, 21 percent of Iowa nursing homes had multiple instances of inspection gaps greater than 15.9 months. DIAL may be meeting the federal minimum standard today, but that hasn’t been the case over an extended period of time, and the most vulnerable Iowans deserve better than the bare minimum.”
The Auditor’s Office also noted the Centers for Medicare and Medicaid Services has not yet released data on inspection rates for federal fiscal 2024.
“We will continue to monitor the CMS data and hope to see additional progress,” Sand’s office said.
The department said it plans to provide more information and materials on the nursing home inspections process, and will release quarterly updates on its progress with recertification surveys and how it is meeting federal guidelines. The department has also produced a new podcast to address questions surrounding its work, including nursing home surveys, fraud investigations and more. The first podcast discusses how the department and the federal government issue fines and citations.
Inspection reports and fine information for nursing homes and other health care facilities regulated by the department can be found on its website.
Comments: (319) 398-8499; tom.barton@thegazette.com