An advancing Iowa bill could lead to fewer on-site complaint surveys and more collaborative training programs between nursing homes and state regulators.
Currently, the Iowa Department of Inspections, Appeals & Licensing is required to make on-site inspections following all nursing home complaints unless they are determined to be without merit in an initial review. The new bill would give state regulators more discretion in cases where surveys can be conducted remotely or where a repeat complaint is made about the same issue multiple times within three months.
Passed Feb. 26, House File 2585 is the latest effort from the Republican-controlled House to address nursing home care quality complaints by increasing cooperation with the long-term care sector, rather than tightening regulatory oversight.
The bill’s detractors in the Iowa House expressed concerns, particularly with the portion of the bill allowing discretion about repeated complaints within 90 days.
“If there are repeated mistakes, that’s a sign that something is wrong,” said Representative Megan Srinivas (D-Des Moines). “We don’t just turn our back. But this bill says, ‘Oh, if there’s more than one mistake, we can turn our back. We don’t need to identify a pattern.’”
Providers on board
The bill is not a reduction in legitimate oversight — but rather a streamlining of processes — said Brent Willett, president and CEO of the Iowa Health Care Association.
“We don’t view the bill as necessarily seeking a reduction of the number of inspections,” he told McKnight’s last week, “but instead seeking to allow the department the latitude to deploy technology and critical thinking to increase efficiencies in the survey process.”
Willett noted that the state would simply have added discretion to perform complaint surveys remotely, speeding up the process and freeing up valuable time for regulators and providers alike. He emphasized that all necessary investigations would still happen, as required by federal law.
While reducing the time state surveyors would have to spend on in-person investigations, the bill also would mandate twice-yearly training sessions in which the inspections agency would discuss at least three of the most common citations leveled against nursing homes each year. The regulator would have to develop new processes to identify these top complaints and the patterns and outcomes surrounding them.
Willett’s association also supports this provision, citing several ways in which the meetings could improve awareness of key challenges and foster collaboration between providers and regulators.
“Joint trainings would improve relationships, promote consistency in regulatory expectations, and identify trending areas of concern so that providers can better equip their staff to pro-actively review quality improvement efforts and protocols to ensure ongoing compliance,” Willett said.
