This is what budget cuts can look like
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Rod Roberts, director of the Iowa Department of Inspections and Appeals, is ultimately responsible for oversight of about 700 nursing homes and assisted living centers. Weeks into the job he chose to eliminate the positions of 10 nursing home inspectors and two part-time attorneys who prosecuted nursing home abuse.
The cuts made a small dent in state spending, but result in the loss of hundreds of thousands of federal dollars that paid the bulk of those salaries. Worse, they reduce oversight of homes responsible for the most vulnerable Iowans.
The cuts made a small dent in state spending, but result in the loss of hundreds of thousands of federal dollars that paid the bulk of those salaries. Worse, they reduce oversight of homes responsible for the most vulnerable Iowans.
Now state lawmakers - including those part of a unanimous vote to confirm Roberts - seem to be paying attention. A Senate budget subcommittee approved a plan to allow Iowa to rehire the 10 inspectors. Senate Democrats agreed to use money from the state's Medicaid Fraud Account to pay for all the eliminated positions - something Roberts should have pushed harder to do in the first place.
The Legislature should follow through and restore these positions. There is no more important job in state government than protecting vulnerable people.
The Legislature should follow through and restore these positions. There is no more important job in state government than protecting vulnerable people.
But even restoring the positions doesn't ensure good oversight.
State inspectors need to be encouraged - by leaders - to conduct rigorous and thorough inspections. And to cite facilities when there is wrongdoing. The message from the current governor: concern that state inspectors have been too tough on facilities.
Not anymore, said Thomas Slater, a West Des Moines attorney who has represented many seniors living in facilities. He said the "changing of the guard" with Roberts is painfully apparent already. One of his clients developed a "horrendous ulcer" on her leg after sitting for days in a wheelchair. "It looks just like raw flesh from the ankle to the knee," he said.
State inspectors need to be encouraged - by leaders - to conduct rigorous and thorough inspections. And to cite facilities when there is wrongdoing. The message from the current governor: concern that state inspectors have been too tough on facilities.
Not anymore, said Thomas Slater, a West Des Moines attorney who has represented many seniors living in facilities. He said the "changing of the guard" with Roberts is painfully apparent already. One of his clients developed a "horrendous ulcer" on her leg after sitting for days in a wheelchair. "It looks just like raw flesh from the ankle to the knee," he said.
For years, the woman's daughter had checked on her every day. Then her daughter died. That means state inspectors are even more important to ensure good care. So the family filed a complaint a few weeks ago about the ulcer.
"It was given such short shrift compared to before. It would have been met with at least a fine," Slater said. But it was "not substantiated."
The attorney calls what's going on at DIA "mind boggling."
On Wednesday, the Register interviewed the family of another Iowan, Polly Stevens. She is 84 and has dementia. Earlier this month her adult children filed a complaint with the state about the home where her mother lives. State workers said there were too few inspectors to immediately address the complaint. When we asked about this, the agency said it could take 30 to 45 days to get a report about the investigation. Stevens' son and daughter moved Polly to another home.
"It was given such short shrift compared to before. It would have been met with at least a fine," Slater said. But it was "not substantiated."
The attorney calls what's going on at DIA "mind boggling."
On Wednesday, the Register interviewed the family of another Iowan, Polly Stevens. She is 84 and has dementia. Earlier this month her adult children filed a complaint with the state about the home where her mother lives. State workers said there were too few inspectors to immediately address the complaint. When we asked about this, the agency said it could take 30 to 45 days to get a report about the investigation. Stevens' son and daughter moved Polly to another home.
These are the kinds of stories Iowans are telling this newspaper about DIA. And that was just this week.
So while lawmakers should ensure adequate funding for this agency, Iowans should also recognize oversight isn't just about money. It's also about leadership having the right philosophy.
Maybe Gov. Terry Branstad and Roberts should spend more time in nursing homes to hone that philosophy. When we interviewed Roberts last week, he had not yet observed any part of a nursing home inspection.
So while lawmakers should ensure adequate funding for this agency, Iowans should also recognize oversight isn't just about money. It's also about leadership having the right philosophy.
Maybe Gov. Terry Branstad and Roberts should spend more time in nursing homes to hone that philosophy. When we interviewed Roberts last week, he had not yet observed any part of a nursing home inspection.
"When somebody is in a nursing home, they are so vulnerable. They are so fragile. For lack of a better word, they are helpless," retired state inspector Tom Lee told the Register.
Perhaps the current administration doesn't understand that.
Perhaps the current administration doesn't understand that.
