Crisis: Long term care facilities
~a column by Mary Weaver
I was alarmed this week when my longtime friend who resides in a nursing home in eastern Iowa called and told me there were no nurse’s aides at the facility. There was an older (above age 80) registered nurse and an LPN to care for 32 residents. My friend is frail and needs assistance with activities such as bathing and walking to the bathroom, but she is of a very sound mind. She is allowed three showers per week and reimburses the facility $,7000 per month. When she turns her call light on to request assistance to the bathroom, it is not unusual for the wait time to be 45-60 minutes.
The facility where she resides and the other long term care facility in the town were purchased June 1 by a company in New Jersey. She was hoping the change of ownership would bring additional staff, but sadly that has not been the case.
In Iowa the current charge for private pay residents is $7,350 per month/$253 per day but Medicaid reimbursement rate averaged $6,180 /$215 per month in 2022. The Medicaid program pays for the care of more than half of Iowa nursing home residents.
Thirteen of the 15 facilities that closed in Iowa last year were in rural communities. Greene Countians experienced the need to transfer residents to other facilities when the long term care facility was shuttered at the Greene County Medical Center.
Care is lacking for Iowan’s seniors. We have read about a resident leaving a facility and freezing to death this past winter, gangrene of the lower extremities, a resident with a tracheostomy not cleared of secretions resulting in death. According to ProPublica, of Iowa’s 409 nursing homes, about 32 percent of them have been cited for violations serious enough to jeopardize the health and safety of the residents.
We often read the violations are referred to the Centers for Medicare and Medicaid, CMS, regarding the subsequent fines to the faculties. Many times, the fines seem to be only a tap on the wrist to the facility. The Iowa Department of Inspection and Appeals allows public access regarding the documentation of the health facility inspections. It would be wise to check the website prior to entering a loved family member or friend into a facility.
IOWA CAPITAL DISPATCH reported that death-related violations were cited in facilities in Coralville, Pleasantville, and Sioux City. The violations in Sioux City resulted in the death of four patients.
Iowa nursing homes were allocated an additional $15 million to increase the Medicaid reimbursement rate beginning July 1. The funds will be on top of an expected federal match of $27 million, creating a $42 million total increase in funds for long term care facilities in the state, according to the Iowa Health Care Association.
Some legislators encouraged strings to be attached to the funding, providing assurance the funds would be used for improved reimbursement for staff and not more profit for the owners. The reasoning is that adding staff will improve the quality of resident care. Unfortunately, no strings were attached to the enacted legislation.
Every week I urge you to contact Representative Carter Nordman, and Senator Jesse Green. This problem is serious, and for many of us care in a long-term facility is looming in our future.
Mary Weaver writes her views from her rural Rippey home. She is chair of the Democratic women’s caucus.
