(Des Moines, Iowa) – More than 50 privately owned Iowa nursing homes have agreed to reimburse taxpayers for $13.9 million in unpaid fees owed to the state. In August, Iowa Capital Dispatch reported that records obtained though the state’s Open Records Act showed that 49 Iowa nursing homes owed the state more than $10.7 million in fees the state had so far failed to collect. At the time, the Iowa Department of Health and Human Services said it had entered into payment plans with many of the care facilities.

In response to a subsequent request for the amortization schedules that detail the schedule of payments for individual homes, DHHS recently turned over records pertaining to 52 care facilities, indicating a few facilities that hadn’t agreed to payment plans in August have since been added to the list. The newly disclosed documents show that:

— The payment plans total $13.9 million: The 52 nursing homes are in the midst of reimbursing the state for $13,914,672 in unpaid fees, with many of the monthly payments having been initiated in April of this year. Most of the agreements call for the companies to have their debt paid off by September 2025.

— Two homes owed $1.3 million each: Two of the nursing homes that accrued a large amount of debt are owned by one for-profit company called Pacifica Health Services. That company operates the Carlisle Center for Wellness and Rehabilitation, and the Fleur Heights Center for Wellness and Rehabilitation in Des Moines.

— One chain owed $4 million: The nursing home chain that accrued the largest debt is Accura Healthcare, which operates 19 care facilities in Iowa that are now on payment plans totaling $4,073,725. The chain has been hit with more than $1.1 million in fines for quality-of-care violations, and regulators have suspended Medicaid payments to various Accura facilities at least 11 times. In a written statement, the company said Friday that it is “fully committed to fulfilling its repayment obligations.”

— Some homes charged interest: DHHS is characterizing some of the financial arrangements with nursing homes as the repayment of “loans,” rather than the collection of unpaid fees. In some cases, the documents show, the state is charging the facilities interest, but in other cases the payment plans speak only to the amount of principal that will be paid, with no mention of interest.

— Debtors include closed facilities: Two now-shuttered care facilities — the Donnellson Health Care Center and Fremont County’s Tabor Manor – owe the state close to $1.3 million. The state appears to have no payment plan in place for Tabor Manor, which is currently in bankruptcy and owes the state roughly $1.1 million, but it does have a payment plan that calls for the Donnellson home to make an escalating series of payments through September 2025 to pay $282,265 it owes the state.

— Million-dollar balloon payments: Many of the facilities that owe the state hundreds of thousands of dollars will pay a relatively small amount toward their debt until 2025, when balloon payments of $400,000 or more will come due.

Among the care facilities on a payment plan, is:

Accura Healthcare of Carroll: This facility agreed to make an escalating series of 18 monthly payments, beginning in April 2024, to repay $345,222 that is owed. The plan includes a balloon payment of $309,222 to be made in September 2025.

Accura Healthcare of Shenandoah: In April 2024, this facility agreed to repay the state $62,274 by making 18 monthly payments of $3,460.

Accura Healthcare of Stanton: This facility has agreed to make a series of 18 monthly payments, beginning in April 2024, to repay $31,478 that is owed.

Crest Haven Care Center, Creston: This home agreed to repay the state $24,660 by making 12 monthly payments of roughly $2,055 each, beginning in April 2024. This facility is owned or operated by Trillium Healthcare Group.

Denison Care Center: This home agreed to repay the state $30,480 by making 12 monthly payments of roughly $2,540 each, beginning in April 2024. This facility is owned or operated by Trillium Healthcare Group.

Garden View Care Center, Shenandoah: This home agreed to repay the state $231,639 by making 12 monthly payments of roughly $19,303 each, beginning in April 2024. This facility is owned or operated by Trillium Healthcare Group.

Lenox Care Center: This home agreed to repay the state $30,754 by making 12 monthly payments of roughly $1,729 each, beginning in April 2024. This facility is owned or operated by Trillium Healthcare Group.