Agency Won’t Disclose Payment Status of $5.7 Million in Iowa Nursing Home Fines

Published by editor on Thu, 05/02/2024 - 9:58am

By:

Clark Kauffman

Iowa Capital Dispatch

Last year, the federal government imposed 244 fines totaling $5.7 million against Iowa nursing homes, but it won’t say which of those fines remains unpaid.

Federal data show that just five of Iowa’s 422 care facilities accounted for more than $1 million in regulatory fines imposed in fiscal year 2023. Three of those homes – Lantern Park Specialty Care of Coralville, Arbor Court of Mount Pleasant, and Genesis Senior Living of Des Moines – each were fined more than $200,000.

The fines represent penalties imposed by the Centers for Medicare and Medicaid Services, and typically stem from quality-of-care violations reported by state inspectors. Although CMS publicly reports the fines imposed against all Medicare-certified nursing facilities, the agency does not disclose whether such fines have actually been paid.

In response to a recent Iowa Capital Dispatch inquiry about the payment status of 28 fines CMS imposed this year against two Iowa nursing homes, an agency spokesperson declined to provide the information and explained that “CMS does not publish the status of any nursing home payments for imposed fines.” No reason was given for the refusal.

“There is so much secrecy surrounding this whole regulatory process,” said Toby Edelman, senior policy attorney for the Center for Medicare Advocacy. “This is public information. Who are they hiding this information from? Who are they protecting by not saying which fines aren’t paid? The public has a right to know what is going on.”

According to the CMS data, the Iowa nursing homes that in fiscal year 2023 compiled the highest level of federal fines were:

Lantern Park Specialty Care, Coralville – CMS levied two penalties against this 90-bed facility, totaling $227,587.75. In 2023, state inspectors cited this home for failing to suction a resident’s airway, resulting in multiple hospitalizations. Six weeks later, the home was cited for violations that contributed to a resident’s death from an infection.

Arbor Court, Mount Pleasant – CMS levied four penalties against this 62-bed facility, totaling $222,888.87. Since 2022, the home has been cited for at least two resident deaths. In one case, a woman was given an antibiotic and an anticoagulant medication that were contraindicated, resulting in a fatal gastrointestinal bleed, according to state records. In another case, state inspectors reported, a resident fell to her death from a mechanical device that was being used to transfer her in and out of bed.

Genesis Senior Living, Des Moines – CMS levied two penalties against this 80-bed facility, totaling $211,367. Between 2021 and 2023, 22 months passed between this facility’s “annual” state inspections. By the time inspectors visited in September 2023, 34 complaints had triggered several investigations. The home was cited for repeatedly failing to administer residents’ pain medications for prolonged periods of time. The home had previously been cited for open sores on a resident’s legs that were dripping with fluid and filled with maggots.

Pine Acres Rehabilitation and Care Center, West Moines – CMS imposed one penalty of $189,685 against this 140-bed facility. On the morning of Sept. 12, 2023, a 70-year-old resident of the home was rushed to a hospital where her leg was amputated after she was diagnosed with blood poisoning, septic shock, a serious bone infection and gangrene. Pine Acres’ primary owner, New York investor Akiko Ike, has ties to other nursing home owners who currently stand accused of defrauding the government, according to CMS.

Cedar Falls Health Care Center, Cedar Falls – CMS imposed two penalties against this 82-bed facility, totaling $186,965. In 2023, the home was cited for failing to protect residents from physical abuse and ignoring a resident’s high blood pressure. The man was eventually admitted to a hospital where he suffered a stroke caused by dangerously high blood pressure, according to state records. Doctors reported removing “18 pounds of fluid” from the man’s swollen body using diuretics.

Aspire of Gowrie, Gowrie – CMS imposed two penalties against this 46-bed facility, totaling $170,678.30. Since October 2022, the home has been cited by the state for at least 116 quality-of-care violations and been the focus of 26 complaints. On four occasions it has been cited for failing to provide a safe environment for residents. The violations were tied to a failure to protect residents from sexual abuse; squirting glue, rather than eye drops, into a resident’s eye; inoperable door alarms to prevent residents from wandering away; and a choking death that occurred in January of this year.

Other Iowa facilities that were fined more than $100,000 in 2023 were Garden View Care Center in Shenandoah, which was fined $163,034; Crown Pointe Estates in Sioux Center, which was fined $161,905; Ivy at Davenport in Scott County, which was fined $111,039; Maple Crest Manor in Fayette, which was fined $107,7468; and Heritage Specialty Care in Cedar Rapids, which was fined $105,645.

CMS changed policy on disclosing fines

Two of the Iowa care facilities that racked up the highest number of federal penalties in the current fiscal year, without regard to the total dollar amounts, are Valley View Community and Lakeside Lutheran Home. So far this year, each of the homes has been fined $97,073 for 14 violations — all of which are tied to a failure to submit weekly COVID-19 data reports to the Center for Disease Control and Prevention.

The data reported by CMS makes it difficult to identify the Iowa nursing home chains that have the worst record of compliance with regulations. Facilities that are clearly part of a multifacility chain, operating under common ownership, are incorrectly reported as having no affiliation with any chains.

For example, two of the most heavily fined care facilities in Iowa, Lantern Park Specialty Care and Heritage Specialty Care, are part of a 44-facility chain run by Care Initiatives of West Des Moines. CMS. However, reports state that neither facility has any affiliation with a nursing home chain.

In June 2021, the Iowa Capital Dispatch reported that CMS was only informing the public of the fines it had imposed against care facilities if and when the owners chose to pay those fines. Unpaid fines were not being reported at all by CMS.

That policy led to situations such as the Dubuque Specialty Care nursing home being fined $84,825, with CMS reporting to the public several months later that no fines had been imposed. At the time, an agency spokesman said that because the facility had not paid anything toward the fine, CMS policy was to report to the public that no fine had been imposed.

By the end of the year, CMS had reversed that policy and was reporting fines within 90 days of when they were incurred, rather than when they were paid. However, the agency also stopped disclosing whether the fines were paid, stating only that “this information is not generally publicly available.”