Iowa Nursing Home Among Nation’s Worst Cited for New Violations

A nursing home in Scott County, Iowa that is already on the list of the nation’s worst nursing homes, has been cited yet again. Already assessed with serious regulatory violations and fines of over $200,000 since 2022, The Ivy has been assessed with new regulatory violations.

Due to its lengthy and troubled history, The Ivy remains on a waiting list for the Centers for Medicare and Medicaid Services (CMS) Special Focus Facilities (SFF).

This article explains more about the SFF list, why The Ivy is among the nation’s worst and the newest violations assessed against the facility.

What Is the Special-Focus Facilities List?

Here are a few things to know about the Special-Focus Facilities List:

Purpose of the SFF List

The Special-Focus Facilities List is a program run by the Centers for Medicare and Medicaid Services (CMS). It is designed to help stimulate quality of care improvements at problematic nursing homes. Throughout the program, facilities have increased regulatory oversight.

Size and Distribution

The SFF list is limited, providing room for only 88 nursing facilities at a time. Each state typically gets one to two on the list. When a facility becomes eligible for this list, it is placed on a waiting list until a spot opens up. The average waiting time can be as long as four years.

Selection Criteria

Homes are not chosen based on a pattern of excellence. They are selected because they have a pattern of serious regulatory and quality issues over an extended period.

Oversight Process

Facilities on the list receive more frequent inspections. If they fail to improve, they may face termination from Medicare and Medicaid programs.

Program Limitations

Due to limited availability, not all poorly performing homes will have an opportunity to be added to the list. Many facilities, like The Ivy at Davenport, are deemed “eligible” for this list, but cannot be added because of the lack of available slots.

Duration and Outcomes

Once on the list, facilities may remain there for years. If they improve and “graduate” from the program, they can be removed from the list. If a facility fails to improve, it is terminated from Medicare/Medicaid participation.

Why This Is Significant

While the SFF is an important tool, its limited capacity means many facilities with serious issues may not receive that extra oversight.

What Is the Status of The Ivy at Davenport?

The Ivy has been eligible for inclusion on CMS’s Special-Focus Facilities list of the nation’s worst nursing home facilities for months. Due to its long history of poor performance, the Ivy remains eligible for the SFF, but it is still on the waiting list.

Prior Breaches at The Ivy

According to a recent article in the Iowa Dispatch, the troubles at The Ivy are not new. State regulators cited the home back in 2022 for 39 regulatory violations, an exceptionally high number. Those violations led to $85,318 in federal fines. The situation worsened in June 2023, when the facility was cited for a further 35 violations. Fines at that time resulted in federal fines that totaled $111,040. State officials reported alarming issues during the 2023 inspection, including:

• Medication errors, which can cause severe or fatal harm to residents
• Severe staffing shortages
• Lack of basic supplies, such as bed linens
• Unsanitary conditions that included rodent infestations
• Illicit drug use

New Violations Assessed in 2024

The most recent inspection occurred in early 2024. During this latest inspection, the state assessed the facility for 17 more violations. Proposed state fines against The Ivy totaled $40,500.

The trigger for the 2024 inspection was a serious incident involving a resident who wandered away from the home. This resident’s absence went undetected for an hour. Even then, staff failed to notify the police for an additional two hours. The resident was eventually found by a citizen 5.6 miles from the facility.

Other Serious Violations

Other violations noted in the recent inspection include:

• Failure to provide a safe environment
• Substandard quality of care
• Failure to prevent, diagnose or treat pressure sores
• Lack of proper physician assessments
• Incompetent nursing staff
• Poor infection control

Despite these issues, The Ivy continues to promote itself as a “premier health care center” that offers amenities like “gourmet meals and snacks” for residents.

The facility is partly owned by Ryan Coane, president and CEO of Ivy Healthcare Group, which also operates another problematic nursing home in Marion.

Iowa Nursing Homes Need More Oversight

The situation at The Ivy and other troubled Iowa nursing homes underscores the urgent need for improved oversight and stricter enforcement of regulations. It also highlights the limitations of the current SFF program. Serious problems at many severely underperforming nursing homes may be left unresolved for years. As the demand for nursing home care increases, addressing these issues becomes a crucial part of protecting the well-being and safety of our elderly population in the future.

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