Iowa Department of
Inspections & Appeals
“Protecting the Health and Safety
of Iowans”
Public Forums
January 5, 2009
Iowa Department of
Inspections & Appeals
Introductions
January 5, 2009
Iowa Department of
Inspections & Appeals
The Department is composed of four main divisions
and four attached units:
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Administration Division
Health Facilities Division
Administrative Hearings Division
Investigations Division
– Attached Units
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Child Advocacy Board
Employment Appeal Board
State Public Defender
State Racing and Gaming Commission
January 5, 2009
Health Facilities Division
The purpose of the Health Facilities Division
is to enhance the safety, security and
general welfare of the persons served in
licensed/certified facilities and programs.
Source: DOM FY 08 Financial Summary
January 5, 2009
Iowa Department of
Inspections & Appeals
State Licensed Health Care Facilities
Long-Term Care Facilities – 757 Facilities
– 409 Nursing Facilities
– 140 Intermediate Care Facilities
– 208 Residential Care Facilities
Adult Services Bureau – 311 Programs
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218 Assisted Living Programs
50 Assisted Living Dementia Specific Programs
36 Adult Day Services
7 Elder Group Homes
Hospitals – 123 Hospitals
– 40 Acute Care Hospitals
– 82 Critical Access Hospitals
– 1 Long-Term Acute Care Hospital
January 5, 2009
Iowa Department of
Inspections & Appeals
Funding Sources
$12,442,988,
84%
84 percent of the Division’s
funding comes from the
federal government –
Medicare and Medicaid
Funds
16 percent of the Division’s
funding comes from a
state appropriation
$2,412,647,
16%
January 5, 2009
Source: DOM FY 08 Financial Summary
Iowa Department of
Inspections & Appeals
Iowa Has Excellent
Nursing Facilities!
January 5, 2009
Iowa Department of
Inspections & Appeals
Iowa Nursing Homes Compared to
National Averages
2007 National
Average
Percentage of nursing homes cited for
Substandard Quality of Care
Percentage of nursing homes with
deficiencies
(11.6% of Iowa facilities are Deficiency-Free)
Average number of deficiencies per nursing
home
Percentage of nursing homes that had a
Federal penalty or other sanction effectuated
January 5, 2009
Iowa Department of
Inspections & Appeals
2007 Iowa
Average
6.1%
1.5%
91.9%
88.4%
(11th lowest in
the nation)
7.0
5.0
(12th lowest in
the nation)
18.1%
10.4%
Avg # of Deficiencies
Average # of Deficiencies per
Survey by Scope & Severity
4.5
4.2
3.9
3.6
3.3
3
2.7
2.4
2.1
1 .8
1 .5
1 .2
0.9
0.6
0.3
0
B
C
D
E
F
G
H
I
J
K
IA
0.34
0.25
3.09
1.8
0.25
0.15
0
0
0
0
KS
0.12
0.47
4.22
3.9
0.85
0.37
0.04
0
0.03
0.01
MO
0.09
0.15
4.33
2.74
0.46
0.25
0.01
0.01
0.04
0.01
NE
0.08
0.14
3.28
2.32
0.59
0.24
0.01
0
0
0.02
USA
0.43
0.3
3.79
1.88
0.32
0.21
0.02
0
0.03
0.03
Average # of Deficiencies per Survey by Scope & Severity – FY08
January 5, 2009
Iowa Department of
Inspections & Appeals
Percentage of Facilities with Remedy Effectuated by Fiscal Year
35.0%
30.0%
Iowa
25.0%
Kansas
20.0%
Missouri
15.0%
Nebraska
KCRO
10.0%
National
5.0%
0.0%
FY05 % of Total
Num ber of
Facilities w ith
FY06 % of Total
Num ber of
Facilities w ith
FY07 % of Total
Num ber of
Facilities w ith
FY08 % of Total
Num ber of
Facilities w ith
Iow a
11.8%
9.7%
10.4%
9.8%
Kansas
27.4%
29.2%
20.9%
13.4%
Missouri
9.8%
10.3%
14.0%
15.8%
Nebraska
7.7%
15.7%
17.1%
19.8%
KCRO
14.2%
15.2%
14.9%
14.0%
National
15.5%
17.9%
18.1%
17.1%
January 5, 2009
Iowa Department of
Inspections & Appeals
Deficiency-Free Facilities and Programs
In Iowa During SFY 2008
January 5, 2009
Iowa Department of
Inspections & Appeals
Deficiency-Free Facilities and
Programs In Your Area
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Windsor Manor, Vinton
Clarence Nursing Home, Clarence
Crestview Nursing & Rehab, West Branch
Valley View, North English
Jefferson Point, North Liberty
Anamosa Care Center, Anamosa
Woodland Park, Anamosa
Linn Manor Care Center, Marion
Winslow House Care Center, Marion
Cherry Ridge, Mount Vernon
Valley View Manor, Muscatine
January 5, 2009
Iowa Department of
Inspections & Appeals
Governor’s Award Winning
Facilities
January 5, 2009
Iowa Department of
Inspections & Appeals
Governor’s Award for Quality Care
• Awarded to nominated facilities that provide the
highest level of care to their residents.
• 38 awards have been presented to 34 facilities
across the state.
– Four facilities are repeat winners.
• Four facilities in east-central Iowa have been
award winners:
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Cedar Manor, Tipton (2001 and 2007)
Crestview Nursing & Rehab Center, West Branch (2006)
Linn Manor Care Center, Marion (2001)
United Presbyterian Home, Washington (2001 and 2003)
January 5, 2009
Iowa Department of
Inspections & Appeals
SFY 2008 Long-Term Care
State Enforcement Actions
5.5%
Repeat Offenders (42)
15.2%
79.3%
One-Time Offenders
(115)
No Citations/Fines (600)
Fines Collected From Nursing Facilities
FY 08: $180,585
Source: DIA Fining and Citation Data
January 5, 2009
Iowa Department of
Inspections & Appeals
SFY 2008 Assisted Living Programs
State Enforcement Actions
5.2%
8.6%
Multiple Enforcement
Actions (14)
Single Enforcement
Actions (23)
No Enforcement
Actions/Fines (231)
86.2%
Source: DIA Fining and Citation Data
January 5, 2009
Iowa Department of
Inspections & Appeals
Iowa’s Population is Changing
January 5, 2009
Iowa Department of
Inspections & Appeals
Iowa Demographics
Iowa’s % of Nursing Home Iowa’s % of US Population
Population
1.95%
1.0%
% of Iowans Over the Age
of 75
7.6%
% of Americans Over the
Age of 75
5.9%
Source: Kaiser State Health Facts, 2005 and 2000 US Census
January 5, 2009
Iowa Department of
Inspections & Appeals
The Changing Face of
Long-Term Care in Iowa
• Today’s seniors have more options than ever before
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Assisted Living Program
Elder Group Homes
Adult Day Care Services
Continuing Care Communities
Independent Living
Home and Community-Based Services to keep seniors in their
homes
• Nursing facility residents’ care needs are greater due to
acuity
January 5, 2009
Iowa Department of
Inspections & Appeals
Important Telephone Numbers
Health Facilities Division
Complaint Hotline
1-877-686-0027
Long-Term Care Ombudsman’s Office
1-800-532-3213
January 5, 2009
Iowa Department of
Inspections & Appeals
Contact Us
Iowa Department of Inspections
and Appeals
Health Facilities Division
Lucas State Office Building
321 East 12th Street
Des Moines, IA 50319-0083
(515) 281-4115
January 5, 2009
Iowa Department of
Inspections & Appeals
Internet Access to Information
https://dia-hfd.iowa.gov/DIA_HFD/Home.do
January 5, 2009
http://www.medicare.gov/NHCompare/
Iowa Department of
Inspections & Appeals
Questions?
January 5, 2009
Iowa Department of
Inspections & Appeals