Iowa nursing homes wait up to 41 months for an ‘annual’ inspection

The state of Iowa isn’t meeting the federally mandated standards for nursing home oversight, with some care facilities waiting up to 41 months for an annual inspection.

Federal regulations require that no more than 15.9 months elapse between annual inspections at individual Medicaid-certified nursing homes. The regulations also require that, collectively, the state inspect all nursing homes on an average of 12.9 months, if not sooner.

However, state records and published industry reports indicate that between October of last year and September of this year, the state agency tasked with inspecting nursing homes hasn’t met either of those standards.

For example, the records show the Northcrest Community facility in Ames went 41 months between annual inspections before it was visited by state inspectors earlier this year. The Good Samaritan Home in Holstein went 34 months between annual inspections, and the nursing home that’s part of MercyOne Medical Center in Centerville went almost 28 months without an annual inspection.

Even the state-run Iowa Veterans Home in Marshalltown went 22 months between annual inspections, as did Genesis Senior Living in Des Moines, West Ridge Specialty Care in Knoxville, Garden View Care Center in Shenandoah and Aspire of Pleasant Valley.

In all, more than 150 care facilities waited 16 months or longer for their annual inspection. Between their delayed annual inspections, some of those same homes were the subject of numerous complaints that resulted in fines and citations from the Iowa Department of Inspections, Appeals and Licensing.

For example, 22 months passed between Genesis Senior Living’s annual inspections in December 2021, when it was cited for 45 violations, and September 2023. During that gap, 34 complaints triggered several investigations that led to an additional 32 violations being cited and $25,250 in fines being proposed.

The records also show that DIAL failed to meet the 12.9-month statewide average for nursing home inspections in each of the 12 months between October 2022 and September 2023. The delays appear to have peaked in late 2022 and early 2023 when the gap between annual inspections was, on average, close to 18 months.

The Iowa Capital Dispatch provided the Department of Inspections, Appeals and Licensing with a partial list of the facilities with long-delayed annual inspections and asked about the reason for the delays.

In response, DIAL spokeswoman Diane McCool noted that state agencies conduct their annual inspections — which are called re-certification surveys — at the behest of the federal Centers for Medicare and Medicaid Services. She said DIAL anticipates “all recertifications will be caught up” in the upcoming federal fiscal year, which begins in October 2024.

Asked whether the federal timeliness standards were in effect for Iowa during 2023 or whether they had been waived or suspended, McCool said, “We have nothing further at this time.”

DIAL Director Larry Johnson did not respond to follow-up calls and text messages.

In early 2020, before the pandemic resulted in the temporary suspension of certain inspection standards, DIAL was reported as having failed to meet the federal standard of a 12.9-month average inspection cycle every month since October 2017.

At that time, department officials said the bureaus responsible for inspecting nursing homes were close to being fully staffed and the department was utilizing contracted inspectors to catch up on some of the work.

This article first appeared in the Iowa Capital Dispatch.