Iowa’s state auditor claims inspections of nursing homes are not taking place as frequently as required by federal regulators — a charge the sector’s largest advocate and the state’s own inspection agency say is not true.
Iowa State Auditor Rob Sand unveiled his findings at a press conference Monday, alleging that the average gap between facility inspections is 17.1 months, which is above the federally required average gap of 12.9 months. Sand said he based his analysis on data from the Centers for Medicare & Medicaid Services.
His report claims that 85% of the state’s nursing homes experienced a gap of more than 15.9 months between inspections. In addition, he claims Iowa lags neighboring states in nursing home inspection frequency and licensed staff levels at nursing homes.
A state Department of Inspections, Appeals and Licensing spokesperson, however, told local media that Sand’s analysis uses “outdated and/or incorrect data and inaccurate performance measurements.” The department’s statement said the state “is conducting timely nursing home inspections and will meet the federal requirements” and that the statewide average inspection gap is 12.75 months.
As of Monday, the department said that 99% of nursing homes there fall within the federally required 15.9-month inspection gap with the remaining 1% scheduled to be completed by the end of the month.
Nationally, several states have closer to a three-year delay, though recent efforts have improved conditions for some.
Brent Willett, president and CEO of the Iowa Health Care Association, told McKnight’s Long-Term Care News Tuesday that even though Sand’s alleged audit findings were played big in the local and national mainstream media, they are not reflective of nursing home recertification survey frequency.
Data from the CMS Quality, Certification & Oversight Reports shows that only 6.8% of the state’s 403 nursing homes have not received a survey in the last 15 months. That’s one-fourth of the national average of 25.7%, Willett pointed out.
In addition, providers say the survey process has become more efficient and timely this year after a pandemic-induced pause, Willett said. He added that Sand’s audit also cites a previous report that misleadingly claims that Iowa is 47th in the nation for surveyor-to-facility ratio. The state’s Department of Inspections, Appeals and Licensing organizes compliance enforcement teams by setting, meaning that teams in the long-term care division will only survey nursing homes while other states assign teams to multiple facility types. Those teams can survey more facilities than teams assigned to multiple types of facilities, negating comparisons between Iowa and other states.
“This difference between organizational methodology renders the surveyor-to-facility ratio statistically useless,” Willett added.
