Complaints about Iowa's long-term care oversight increase

AFSCME seeks meeting with state official after hearing concerns

A woman holds her nurse's hand. (Gazette file photo)
A woman holds her nurse’s hand. (Gazette file photo)

When Barb Buchanan’s mother was a resident at UnityPoint Health-St. Luke’s Living Center West, Buchanan saw how vital it was for nursing home residents to have advocates.

For 10 years now, Buchanan, 71, of Cedar Rapids, has been a volunteer long-term care ombudsman at Living Center West, visiting the Cedar Rapids facility nearly every week to talk with residents and staff to ensure quality care.

Buchanan and other volunteers are adding their voices to growing concerns about leadership at the Office of the State Long-Term Care Ombudsman after the office announced earlier this year its leaders would consider outsourcing local ombudsmen.

“My concern is about the well-being of the residents,” Buchanan said Monday. “The people in those positions now have been doing this for a long period of time and they know the facilities, they know the volunteers and the staff.”

AFSCME Council 61 President Danny Homan sent an email Nov. 25 to Linda Miller, director of the Iowa Department on Aging, which oversees the ombudsman’s office, about employees’ concerns that the program may not be meeting requirements of the federal Older American Act.

Homan forwarded Miller a letter a local ombudsman had written July 19 to State Ombudsman Cynthia Pederson. Among the concerns raised are a 2017 budget cut that virtually eliminated travel for the local ombudsmen, who investigate reports of abuse and neglect at over 800 nursing homes and assisted living facilities in Iowa.

“Not all concerns can be investigated over the phone or through the use of technology,” the letter states. “Getting LLTCOs (local long-term care ombudsmen) into facilities is essential to identifying and adequately investigating complaints brought by and on behalf of residents and tenants in Iowa’s long-term care facilities.”


Homan removed the employee’s name from the letter before providing it to advocates to protect the woman from possible retribution, he told The Gazette. The Gazette has filed a records request with Miller to get an unredacted copy of the letter, but had not yet received it Monday evening.

Other concerns raised in the July 19 letter were Pederson’s lack of responsiveness when local ombudsmen have questions and her decisions to not ask for more money from the state to restore ombudsman travel.

The state ombudsman’s office budget decreased from nearly $1.6 million in fiscal 2016 to $1.26 million in fiscal 2019, and the office is down from 14.4 full-time equivalent positions in 2016 to 9.6 in 2019.

Homan said Miller has agreed to have a meeting with him about the concerns, but one hasn’t been scheduled yet.

Buchanan recently wrote a letter to the Commission on Aging, the policymaking board for the Aging Department, to share concerns about possible outsourcing and the ombudsman office’s decision to change in-person volunteer training to online training.

The volunteer ombudsman program, started in 2012, had about 150 volunteers at its peak, doing regular visits to nursing homes and assisted care facilities around the state. Now the program has about 50 volunteers.

Gov. Kim Reynolds’ staff has heard complaints about the State Ombudsman, spokesman Pat Garrett confirmed Monday. Complainants have been referred to Pederson, he said.

Pederson and Miller did not reply Monday to emails from The Gazette.

The ombudsman’s office this fall issued a request for proposals for a public agency or nonprofit organization to take over six local long-term care ombudsman positions around Iowa. Office leaders have said decentralizing local investigators would maintain quality while potentially save money.


Responses to that request were due last week. Miller and Pederson did not respond Monday to requests for more information about the complaints or about responses to the request.

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