Some Iowa Nursing Homes Wait Up to 41 Months for Annual Inspections

It is taking far too long for nursing homes in Iowa to undergo annual inspections. Some facilities wait up to 41 months between inspections.

Federal regulations say Medicaid-certified nursing homes must receive annual inspections within a maximum interval of 15.9 months. The average timeline for nursing homes in the state should be 12.9 months.

Despite these clear guidelines, Iowa’s state agency tasked with these inspections has consistently failed to hit these benchmarks from October of 2022 to September of 2023. This conclusion was reached after an analysis of state records and published reports by Iowa Capital Dispatch.

Northcrest Community in Ames waited 41 months between annual inspections. While this is an extreme example, more than 150 care facilities across the state have waited 16 months or longer for their annual inspections. These delays are particularly alarming because many facilities have been cited for violations while waiting for an inspection.

For example, Genesis Senior Living faced a significant delay of 22 months between annual inspections. In those 22 months, the facility was cited for 45 violations. There were 34 complaints that led to several investigations and an additional 32 violations, along with proposed fines of $25,250.

The Iowa Department of Inspections, Appeals and Licensing (DIAL), which is responsible for annual inspections, has acknowledged the delays. DIAL has said coordination with the federal Centers for Medicare and Medicaid Services is a factor in scheduling re-certification surveys. DIAL has said it wants to catch up on all recertifications in the next federal fiscal year.

Enforcement of the 16-month standard for inspections was relaxed in the 2023 fiscal year, with a temporary goal to reduce the backlog of overdue inspections by 50 percent. DIAL claims to have hit that target.

Prior to the pandemic, which led to a temporary suspension of certain standards, DIAL had not met the federal 12.9-month average inspection cycle since October 2017. Despite efforts to address the backlog, including nearing full staffing levels and utilizing contracted inspectors, the challenge persists.