Information and Insight for Injured Iowans

Things seem pretty bad at Muscatine’s Riverbend Nursing and Rehabilitation Center. A recent state inspection found no medical director on staff, no contract with anyone to handle medical emergencies and no registered nurse on duty. Employees hadn’t been tested for tuberculosis. Toilets were dirty and leaking. There were dead crickets, a grimy dining room and broken washing machines.    

Earlier this year, the federal government withdrew its Medicare certification - a move that resulted in dozens of residents leaving. The recent inspection found more than 25 violations. Iowa’s long-term care ombudsman Jeanne Yordi said there has been a “total system failure” at the facility.

So what does a “total system failure” cost an Iowa nursing home in state fines?

One hundred bucks. Only one offense, the failure to check backgrounds of employees, earned the home a fine. A follow-up inspection is pending, according to David Werning, spokesman for the Iowa Department of Inspections and Appeals, which regulates nursing homes.

Then there’s USA Healthcare of Urbandale, where residents have been choked, punched, kicked and slapped by other residents who suffer from dementia. One man broke the clavicle of a fellow resident by tipping over that person’s wheelchair. He hit residents and staff with broken coat hangers and tried to stab someone with a fork. This home, which hasn’t met minimum health and safety standards, is being fined a grand total of $400. In 2004, the same home was fined $2,500 for violating the same regulations.

Four hundred dollars isn’t even a slap on the wrist, especially for a home collecting thousands of dollars a day to care for 150 residents.

Ridiculously low fines send a message that Iowa doesn’t take seriously the care of its most vulnerable people.

Unfortunately, that might be true.

The state has failed to implement reforms previously called for by the Register and patient advocates. As an example, it has not set defined staff-to-patient ratios, instead opting to follow the vague federal requirement of “sufficient” staffing.

Iowa has too few Inspections and Appeals staff to inspect nursing homes and respond to the hundreds of complaints it receives each week. Though the agency has added some investigators through additional federal dollars in recent years, the department will ask the Legislature in fiscal year ‘08 for six more full-time investigators. The Legislature should approve the funds.

Lawmakers also should increase the financial penalties for nursing-home violations, and state inspectors should slap violators with the harshest penalties possible. And finally, criminal charges - a rare occurrence now - should be pursued whenever appropriate.

It should be acknowledged that most Iowa nursing homes provide quality care. But some don’t. A message needs to be sent to all home operators and workers that this state expects the best care for our parents, grandparents and other loved ones. It’s not acceptable if they’re eating their lunches in filth or being cared for by workers who haven’t had basic health screenings.

Failing to provide the cleanest, safest conditions should earn a fine that actually stings.