The Iowa agency plans to release more data on nursing home inspections

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 health care facility inspectors have met the federal mandate for nursing home inspections for federal fiscal year 2024. While the inspection materials were still being uploaded to federal databases, a department spokesperson said website of health institutions ccontains updated information about the inspection frequency of a long-term care facility. Iowa has about 400 nursing homes.

Federal regulations require nursing homes to be inspected at least once every 15.9 months. A review of inspection reports compiled by the department and provided to The Gazette shows that all nursing homes in Iowa have been inspected at least once in the past 16 months.

In an effort to control the spread of COVID-19, Medicare and Medicaid halted most nursing home investigations in March 2020, resulting in a backlog of complaint and recertification investigations that needed to be investigated nationwide.

The Inspections Department has pushed back on a report from State Auditor Rob Sand released last month claiming the state lags behind the federal requirement and fails to conduct timely nursing home inspections. The report states that Iowa also lags behind neighboring states in the frequency of inspections and licensing of nursing home staff that impact the quality of nursing care.

Iowa Department of Inspections, Appeals and Licensing Director Larry Johnson alleges that Sand, a Democrat, relied on outdated figures and inaccurate federal performance measures, “which could have been avoided if the accounting firm had engaged with DIAL before the inaccurate report came out.”

“In keeping with DIAL’s mission to be transparent and provide accurate and updated information to the public, the inspection histories of all long-term care facilities are available” on the 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 continue to meet CMS performance guidelines for federal fiscal year 2025.”

The Court used publicly available data from the Centers for Medicare and Medicaid Services. The dataset used in the report has been updated as of June 1.

Sand’s office said in a statement to The Gazette that the latest figures cited by the department show short-term improvements in the frequency of inspections.

“We welcome this,” the Court said, adding: “We cannot ignore the fact that during the last three inspections, based on CMS data as of September 1, 2024, 77 percent of Iowa nursing homes had at least one gap larger than the federal mandate of 15.9 months. Additionally, 21 percent of Iowa nursing homes had multiple instances of inspection gaps longer than 15.9 months during the last three inspections. DIAL may meet the federal minimum standard today, but that hasn’t been the case for quite some time, and the most vulnerable Iowans deserve better than the bare minimum.

The Court also noted that the Centers for Medicare and Medicaid Services has not yet released data on inspection rates for the 2024 federal fiscal year.

“We will continue to monitor the CMS data and hope to see further progress,” Sand’s office said.

The department said it plans to provide more information and materials on the nursing home inspection process, and will release quarterly updates on its progress on recertification investigations and how it is meeting federal guidelines. The department has done that too has created a new podcast to answer questions about his 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 detailed information for nursing homes and other healthcare facilities regulated by the department can be found on the website website.

ccomments: (319) 398-8499; [email protected]