Nursing Homes Des Moines Iowa – At ManorCare in West Des Moines, there are six infections related to the latest outbreak. According to federal officials, only 61% of workers there are fully immunized and four residents of the home have died from Covid-19. (Photo: Clark Kaufman/Iowa Capital Dispatch)
The number of COVID-19 infections in Iowa nursing homes doubled last week to 821.
Nursing Homes Des Moines Iowa
The Iowa Department of Public Health said this week that as of Jan. 18, 63 Iowa nursing homes — about 15% of all nursing facilities in the state — are in states of emergency. These 64 strikes have so far affected 821 workers and residents.
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The data shows that in the past week, the number of nursing home outbreaks in Iowa increased by 52%, from 41 to 63, and the number of infections increased by 117%, from 378 to 821.
By comparison, only two Iowa nursing homes were in a state of emergency at one point last summer. However, the current numbers are well below the levels seen in November 2020, when 4,327 infections were linked to 119 outbreaks in Iowa nursing homes.
The largest nursing home exits in Iowa are at the Iowa Veterans Home and the state’s Kahl Nursing Home of Scott County. The two centers have 55 infections related to the current outbreak.
This is the seventh disaster at the Iowa Veterans Home, more than any other nursing facility in Iowa. Six previous outbreaks have resulted in at least 212 infections in homes in Marshall County.
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While 96% of residents at the Iowa Veterans Home are fully immunized, about 25% of staff have declined vaccinations, according to data from the Centers for Medicare and Medicaid Services.
A home for veterans is not the only care facility in Iowa with a current, active outbreak where less than 75% of its staff are fully vaccinated. At ManorCare in West Des Moines, there are six infections related to the latest outbreak. According to CMS, only 61% of workers there are fully vaccinated and four residents of the home have died from Covid-19.
The biggest problem areas for nursing home infections remain in Linn County and Black Hawk County. Linn County has six buildings under a state of emergency, the same number as a week ago. Black Hawk County has eight buildings in a state of emergency, compared to five a week ago.
The Iowa Department of Public Health defines a nursing home environment as a facility with three or more active infections among staff and/or residents. The department says it does not track or report outbreaks or infections at state-licensed medical facilities.
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Nationally, Iowa has one of the highest vaccination rates among nursing home residents, with 93% of all residents fully vaccinated. Only seven other states have higher vaccination acceptance rates among nursing home residents. However, only 78% of nursing home workers in Iowa are fully vaccinated. There are only 16 other states with lower vaccination acceptance rates among nursing home workers.
Since the outbreak began, 13,679 Iowa nursing home residents have contracted COVID-19, and 2,633 of them have died.
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Associate Editor Clark Kaufman has worked as an investigative reporter and editorial writer for two of Iowa’s largest newspapers, the Des Moines Register and the Quad-City Times, for the past 30 years. He has received numerous state and national awards for reporting and editorial writing. Arbor Court in Mount Pleasant, considered among the worst nursing homes in the country, is going to court to increase the money it collects from taxpayers through Medicaid. (Image via Google Earth)
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An Iowa nursing home ranked as the nation’s worst is taking the state to court to increase the money it collects from taxpayers through Medicaid.
Arbor Court Health Care is subject to a decision by the Iowa Department of Health and Human Services that it collects for the care of Medicaid residents at Arbor Court Nursing Home in Mount Pleasant.
As of October 2020, the company owned and operated a 62-bed home, which is now on the Centers for Medicaid and Medicare Services list of specially designated facilities with a history of poor care. In the past 20 months, Arbor Court has been cited by inspectors for 46 code violations and five fines for deficiencies that have resulted in the deaths of at least two residents.
Arbor Court’s request for a judicial review of the money Iowa nursing homes collect from Medicaid, which is largely based on self-reported expenses for the past month. Iowa DHHS has long had an informal policy that accepts requests from new owners of care facilities to report expenses only for a short period of time after the ownership change, except for expenses calculated and reported by previous owners. This process, called “short-term reporting,” usually means the new owners collect more cash.
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Because Arbor Court’s initial short-term report covered the same three-month period as the traditional cost reporting method, the company sought permission to file a short-term report with the Iowa DHHS.
However, in June 2021, Governor Kim Reynolds signed legislation that changed the traditional method of reporting expenses. The new law requires states to use data older than 2018, calculate the standard Medicaid payment rate and pay more for benefits based on inflation.
The move was an effort to ensure nursing homes continue to receive increased Medicaid payments in 2020 even as their costs decrease due to the impact of COVID-19 on staffing levels.
After signing the law, Iowa DHHS notified nursing facilities that they could expect “an increase in (their) nursing facility fees” based on cost reports covering the 2018 calendar year.
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But for Arbor Court, the law had a negative impact. DHHS ignored the housing cost report for the last three months of 2020 and instead relied on data from 2018, which is before the change in ownership.
According to the Arbor Health Court, the effect of the Iowa law change was immediate. The Mount Pleasant home saw its Medicaid reimbursement rate drop by $400,000 in 2021 — to the point where owners are reportedly paying $70 to $80 less per day, per resident, than actual self-reported costs.
The Arbor court objected, but DHHS officials responded that a request to submit a “short-term report” would generally be considered because the deadline for such a request had passed.
The Arbor court appealed, and after a hearing on the argument, Administrative Law Judge Jonathan Gallagher upheld the state’s decision.
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Ironically, it was DHHS’s decision to violate its own regulations and allow nursing homes to submit “abbreviated reports” that contributed to Gallagher’s decision in favor of the agency.
DHHS, Gallagher said, was “operating outside of its own rules” by developing internal practices that allowed nursing facility owners to use short-term reporting processes to increase their revenue.
“The upshot of this process is that policies that affect the public must generally be incorporated into agency regulations,” Gallagher said in his decision.
Because no policy or regulation required DHHS to grant such a summary hearing, Gallagher said, DHHS’s refusal to allow Arbor Court to use that process did not violate Arbor Court’s rights.
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For its part, DHHS acknowledged in the appeals process that it created what it called an “imperfectly executed” exception to its written policies.
According to federal statistics, Arbor Court Healthcare is owned by Judah Bienstock of MGM Healthcare, a St. Louis company. Louis that operates seven nursing homes in Iowa and 18 facilities in Missouri and Oklahoma.
Earlier this year, Arbor Court received a one-star rating from CMS for both health inspection results and quality of care measures. Currently, it has no CMS rating because of what the federal agency calls “a history of serious quality problems.”
CMS has punished the home six times in the past three years. As of November 2020, these fines totaled $275,604.
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Last December, the home was cited for the death of a resident after the woman was given antibiotics and blood thinners that were prohibited. The woman was taken to the hospital where she was diagnosed with stomach bleeding and died.
In January 2022, the state filed a lawsuit in Arbor Court after the home’s resident, Donna Lee Huffaker, was killed by a piece of machinery that kept her in bed and left.
Our stories may be republished online or in print under a Creative Commons CC BY-NC-ND 4.0 license. We request that you modify or shorten the style a little, provide the correct link and link to our website. AP and Getty images are not reproduced. Please see our instructions for printing
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