Iowa’s state auditors have alleged that nursing home inspections are not being conducted as frequently as required by federal regulators, but the industry’s biggest advocates and the state’s own inspection agency say that’s untrue.
Iowa State Auditor Rob Sund announced the findings at a press conference on Monday, alleging that facilities were going 17.1 months between inspections on average, exceeding the federally mandated average of 12.9 months. Sund said his analysis was based on data from the Centers for Medicare and Medicaid Services.
His report found that 85% of the state’s nursing homes had gone more than 15.9 months between tests, and he argued that Iowa is lagging behind neighboring states in how often it tests nursing homes and how many qualified nursing home staff it has.
But a spokesperson for the state Department of Inspection, Appeals and Licensing told local media that Sandoz’s analysis used “outdated and inaccurate data and inaccurate performance measures.” In a statement, the department said the state “conducts nursing home inspections in a timely manner and meets federal requirements,” and cited the average inspection gap statewide as 12.75 months.
The department said as of Monday, 99% of the province’s nursing homes were within the federally mandated 15.9-month inspection period, with the remaining 1% on track to be completed by the end of the month.
Nationwide, some states are on hold for nearly three years, though recent efforts have improved the situation in some states.
Iowa Healthcare Association President and CEO Brent Willett told McKnight’s Long-Term Care News on Tuesday that although the results of the Sandoz audit were widely reported in mainstream media locally and nationally, it’s not reflective of the frequency of nursing home recertification inspections.
Data from the CMS Quality, Certification and Monitoring Report shows that just 6.8 percent of the state’s 403 nursing homes hadn’t been inspected in the past 15 months, a quarter of the national average of 25.7 percent, Willett noted.
Additionally, Willett said, providers have said the inspection process has been more efficient and timely this year after disruptions caused by the pandemic. He added that Sand’s audit also cited a previous report that misleadingly claims Iowa is 47th in the nation in inspector-to-facility ratios. The state’s Department of Inspection, Appeals and Licensing organizes compliance enforcement teams by setting, meaning that teams in the long-term care department only inspect nursing homes, while other states assign teams to multiple facility types. These teams can inspect more facilities than teams assigned to multiple types of facilities, making comparisons between Iowa and other states invalid.
“This difference in systematic methodology makes the investigator-to-facility ratio statistically useless,” Willett added.
