Advocates: Lawmakers must tackle backlog of nursing home complaints

Iowa lawmakers are failing to tackle state oversight of nursing homes, seniors’ advocates say, despite a backlog of hundreds of uninvestigated complaints.

“Elected officials should shout from the rooftops their displeasure with the current situation,” said John Hale, an Iowa seniors consultant and advocate. “Yet they are not. Their silence either means they are completely comfortable with the status quo, or they didn’t know there was a problem. Either answer is unsatisfactory.

Dean Lerner, who headed the state agency that inspects Iowa retirement homes under Democratic Gov. Chet Culver, said Republican Gov. Kim Reynolds was partly to blame.

“It continues to baffle me how this Governor, his Republican House and Senate continue to knowingly ignore critical responsibilities to Iowa’s most vulnerable citizens, witness the damage done, and win re-election,” Lerner said. .

Two weeks ago, the Iowa Capital Dispatch reported that the Iowa Department of Inspections and Appeals had 410 outstanding complaints against Iowa retirement homes that are at least 30 days old. Of these, 201 complaints – almost half of the total number – were over 120 days old and 24 unresolved complaints were at least a year old.

Senator Zach Wahls, a Democrat from Coralville. (Photo courtesy of the Iowa Legislature)

In January 2020, Kimberly Jacob complained to the DIA about the care her grandmother, Connie Roundy, was receiving at a home in Woodbine. The DIA investigated the case in March 2021 – 14 months after the lawsuit was filed and six months after Roundy’s death.

Senator Zach Wahls of Coralville, Senate Minority Leader, said he was “pretty stunned” by the number of unresolved complaints to the DIA.

“The Governor’s disastrous management of our economy has compromised the ability of long-term care facilities to fully staff their buildings and has made it more difficult for the office of the Long-Term Care Ombudsman, or DIA, to conduct routine inspections,” he said. “Governor. Reynolds and the Iowa Republicans have made this crisis worse, not better, by refusing to prioritize funds for DIA inspectors or the office of the long-term care ombudsman and endorsing the shutdown of on-site visits by long-term care mediators.

Rep. Holly Brink, a Republican from Oskaloosa who chaired the House Government Oversight Committee this year, said Tuesday she was unaware of a backlog of complaints or of Capital Dispatch’s reporting. which was reprinted in the Des Moines Register, Cedar Rapids Gazette and Mason City Globe Gazette.

‘Nobody brought this to my attention,’ she said, adding that she had never looked at care home oversight in the past.

Rep. Holly Brink, a Republican from Oskaloosa. (Photo courtesy of the Iowa Legislature)

Brink said she can’t remember if she supported legislation this year that would have given the Iowa Office of the Long-Term Care Ombudsman $300,000 to hire additional staff to investigate complaints from nursing homes. treatment sent to this agency. The legislation was approved in the House, but as part of a much larger supply bill. He died in the Senate.

“Without seeing the exact legislation, I don’t think it’s fair for anyone to comment on that,” she said. “I just don’t think it’s fair for anyone to comment if they can’t remember all the exact details.”

House and Senate Republican leaders – including House Speaker Pat Grassley, House Majority Leader Matt Windschitl, Senate Speaker Jake Chapman, Senate Pro-Tem Speaker Brad Zaun and Chief of Senate Majority Jack Whitver — could not be reached for comment on Monday and Tuesday.

Siegrist: Backlog is ‘worrying’

Rep. Brent Siegrist, Republican for Council Bluffs and deputy House Majority Leader, said the backlog of complaints was “certainly concerning,” though he wasn’t sure what kind of action lawmakers might take. take next year.

“It’s definitely something that deserves some attention,” he said. “I think this article has probably made some people wonder what’s going on, so I guess it will get some attention.”

Rep. Brent Siegrist, a Republican from Council Bluffs. (Photo courtesy of the Iowa Legislature)

Asked if he thought House Republicans would be willing to hold government oversight committee hearings on the issue even if they paint the Reynolds administration badly, Siegrist said, “ I understand that concern, but I don’t know if that’s a fair assessment. I think these (decisions) are made on a case-by-case basis. And we will obviously have a new chairman of the oversight committee since Rep. Brink is not running for re-election. So that might change some things.

Rep. Mike Bergan, a Republican from Dorchester, said he’s unsure of lawmakers’ readiness to provide additional, ongoing funding for more nursing home inspectors or long-term care ombudspersons, but said lawmakers had provided new funds this year for inspections. department to keep abreast of complaint investigations over the next 18 months.

DIA officials said the COVID-19 pandemic was largely responsible for the backlog of uninvestigated complaints.

After the Centers for Medicare and Medicaid Services, or CMS, suspended state inspections of nursing homes to protect residents, it developed a COVID-19 “targeted infection control” process that ordered state agencies like the DIA to focus their inspections on infection prevention.

As a result, complaint investigations have been temporarily limited to those involving infection concerns and those involving allegations of immediate danger to the health and safety of residents. This, in turn, has led to a growing national backlog of uninvestigated complaints.

Currently, CMS requires state agencies to reduce their complaint backlogs by 60%. DIA inspectors are working through the backlog with federally certified contractors who have been hired to assist in this effort.

The backlog predates the pandemic

The DIA’s federal job performance reviews show that long before the pandemic hit, the state agency was struggling to meet federal standards for investigating complaints.

These reviews indicate that between September 2018 and September 2019, the DIA filed 971 complaints at nursing homes that the mental, physical or psychosocial state of residents was compromised. These cases were considered serious enough to require a “rapid response” from the DIA, which meant an on-site visit had to be conducted by state inspectors within 10 days.

The agency failed to meet this standard in 631 cases, or 65% of the time. In fact, 41 of those homes had still not been visited by an inspector at the time of the federal performance review, which ended in March 2020.

The previous year, DIA filed 1,041 nursing home complaints alleging harm. In 646 of these cases, or 62% of the time, the agency did not perform an inspection within the 10-day period. Six complaints dragged on for more than 130 days without any inspections taking place.

John Hale owns the Hale Group along with Terri Hale. (Photo courtesy of John and Terri Hale)

In 2017, the Inspector General of the U.S. Department of Health and Human Services studied states’ compliance with federally mandated time limits for investigating complaints. The study found that nearly a quarter of all states failed to meet performance thresholds for timely on-site investigations of high-priority complaints in each of the five years studied.

At that time, Iowa was one of four states that had failed to meet the standard in four out of five years.

“Investigations shouldn’t take 120 days,” Hale said. “What about investigations taking more than a year to complete? This, plain and simple, is a total failure of the government to protect the health and safety of the people of Iowa…Frankly, I am tired of witnessing and hearing stories of inadequate care in too many these establishments. Residents deserve better care. Taxpayers deserve better use of their money.

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