Close up image of a caretaker helping older woman walk

Sen. Charles Grassley (R-IA) is upset with the way some Iowa nursing facilities are receiving performance-pay bonuses and has said he will ask federal regulators to explain them. Grassley’s request could lead to scrutiny of practices in other states that use similar systems.

Some $8 million in taxpayer funding is currently paid in bonuses to some of Iowa’s worst nursing homes, Grassley noted in response to a Des Moines Register article. The newspaper revealed Sunday that among the state’s facilities collecting bonus pay based on “accountability measures,” 16 potentially face fines for resident abuse or neglect — and two of them are on the Special Focus Facility list, which is reserved for the “worst of the worst” facilities in the nation.

“I’ll be asking CMS about what it’s approving when states present plans like this one and others,” Grassley said.

More than 80% of 428 Iowa nursing homes in the program will receive bonuses this year, averaging just under $20,000 each.