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Regulatory enforcement is lacking

Published on September 22nd, 2009

The DesMoines Register had an article about the outrageous delays in disciplinary actions in Iowa.  I am sure it has something to do with all the political campaign contributions given by the nursing home industry to Iowa politicians. The state board that disciplines Iowa’s nursing home administrators hasn’t issued any sanctions in two years and isn’t reviewing the state’s own care facility inspection reports.  The Board is made up of industry lobbyists and insiders, and doesn’t even have the requisite number of citizen representatives.  Of the two most recent citizen representatives, one is a former hospital lobbyist with a poor record of attendance at board meetings, and the other resigned in protest last year after complaining that she had been marginalized by the board.

The chairman is a former nursing home administrator who recently resigned from a Waterloo care facility for "confidential personnel reason". He admits that some cases of abuse and neglect aren’t being reviewed by the board.  The records show that the board doesn’t act even when the state’s own regulators have alleged criminal wrongdoing.

The board is meant to protect the 24,000 residents of Iowa nursing homes. The board licenses and reviews the conduct of facility administrators who are ultimately responsible for meeting the needs of the residents. However, since 2001, the Board of Nursing Home Administrators has disciplined only nine of Iowa’s 750 licensed administrators. In some cases, the discipline had no real effect, because the administrators were already retired from the profession or in prison.

Board records show how lengthy the delays can be:

– In January 2001, nursing home administrator Randy Downey was convicted of assault and jailed for physically attacking his wife in a care facility in front of the residents. Three years passed before the board took action by placing Downey’s license on probation and imposing a $250 fine.

– In July 2003, Kenneth Opp was sentenced to prison for embezzling $400,000 from The Abbey, a Des Moines care facility. It wasn’t until October 2004 that the board revoked his administrator’s license.

– In 1999, Stanley Schryba was accused of sexually harassing a co-worker. In late 2003, the case was disposed of when Schryba agreed to refrain from renewing his license once it had expired. By that time, he had already moved from Iowa and retired.

Other cases that have resulted in no action by the board:

– In 2002, the administrator at Mapleleaf Health Care Center in Mount Pleasant failed to tell the state that a resident had been found dead with his or her head wedged between the mattress and side rail of a bed.

– In 2003, the administrator at Van Buren Good Samaritan Home in Keosauqua allegedly concealed information about a resident who died there after choking on a hot dog while left unattended in the dining room. Inspectors alleged the administrator failed to report the choking episode to the resident’s physician and family, and falsely told the home’s own medical director the resident had suffered a seizure.

– In 2004, the administrator at Davenport’s Meadow Lawn Nursing Home was fired for transferring three residents to other care facilities simply because they "annoyed" her. The owner had allegedly ordered the administrator to apologize to the residents and tried to have them moved back to Meadow Lawn.

– In 2004, the administrator of the Stacyville Community Nursing Home was fired after she allegedly put a friend on the payroll, then routed more than $12,000 from a fund used for nursing services into a bank account she maintained with that friend.

– In 2007, ManorCare nursing home in West Des Moines was fined $12,500, and the federal government temporarily cut off Medicaid and Medicare funding for the home. One of the most serious allegations was tied to "resident dumping" – the practice of forcing out elderly residents once their savings are depleted and Medicaid begins paying for their care. The administrator allegedly told inspectors, "I don’t want to fill up 120 beds with Medicaid long-term-care residents."
 

Joe Pioletti
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