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New report details low staffing, high turnover in Iowa nursing homes

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May 4th, 2024 by Ric Hanson

(Iowa Capital Dispatch) – More than 43% of all Iowa nursing homes do not meet upcoming federal mandates on staffing levels, a new national report shows. According to the Iowa Capital Dispatch, the report also indicates 21 Iowa care facilities each cycled through three to five nursing home administrators during 2023. Using newly published data collected by the federal government, a nonprofit advocacy group called the Long-Term Care Community Coalition issued a detailed report this week outlining the staffing levels at every Medicare-certified nursing home in the nation during the fourth quarter of 2023.

The report compares actual staffing levels with the Biden administration’s new rule mandating specific staffing levels in Medicare-certified nursing homes. That rule requires the presence of a registered nurse 24 hours per day, seven days a week in all facilities, as well as 3.48 hours per day, per resident of total nursing-staff time. The rule will be phased in over the next five years and includes exemptions and waivers for facilities in rural areas that are making a good-faith effort to meet the new mandates.

The coalition’s report shows that 6 in 10 of all U.S. nursing homes would have met the new nurse-staffing standard of 3.48 hours in the fourth quarter of 2023. Iowa homes fell below the national average, with 56.5% of them meeting the new standard.

The report indicates the Iowa homes with the lowest nurse staffing levels in the fourth quarter of 2023 were Arbor Springs of West Des Moines, Midlands Living Center of Council Bluffs, Linn Haven Rehab & Health Care of New Hampton, Pleasant Acres Care Center of Hull, Northbrook Healthcare and Rehabilitation Center of Cedar Rapids, Crest Haven Care Centre of Creston and Aspire of Perry. All reported less than 2.5 hours of total nursing care per resident, per day, according to the report.

A separate set of data published by the Centers for Medicare and Medicaid Services indicates that 14% of Iowa’s 422 nursing facilities were cited for insufficient staffing in fiscal year 2023. That’s more than double the national average, which was 5.9%.

The report also highlights a problem in many nursing homes nationwide: high staff turnover, which disrupts continuity of care and leads to errors by workers who aren’t familiar with residents’ needs.  The Iowa homes with the highest rate of nursing-staff turnover, ranging from 85% to 100%, were Risen Son Christian Village of Council Bluffs, Sunrise Retirement Community of Sioux City, Wesley Acres of Des Moines, Arbor Springs of West Des Moines, Dunlap Specialty Care, Azria Health Park Place of Des Moines, Sunny Knoll Care Centre of Rockwell City, and Montezuma Specialty Care.

The report also identifies the Iowa nursing homes that had the highest number of administrators who left employment with the facility during 2023. The Elmwood Care Centre of Onawa and Heritage Specialty Care of Cedar Rapids, are each reported to have had five administrators who left the facility in 2023. Azria Health Park Place of Des Moines, Sunny Knoll Care Centre of Rockwell City, Crest Haven Care Centre of Creston, Cedar Falls Health Care Center, Premier Estates of Muscatine, Westwood Specialty Care of Sioux City, Casa De Paz Health Care Center of Sioux City, Wesley Park Centre of Newton, and Garden View Care Center of Shenandoah each are reported to have had four administrators leave during the year. Ten other Iowa nursing homes had three administrators leave during the year.