January 5, 2009 Iowa Department ofInspections & Appeals

Iowa Department of Inspections & Appeals

Public Forums

“Protecting the Health and Safety of Iowans”

Introductions

Iowa Department ofInspections & Appeals

January 5, 2009

January 5, 2009

The Department is composed of four main divisions and four attached units:

– Administration Division– Health Facilities Division– Administrative Hearings Division– Investigations Division

– Attached Units• Child Advocacy Board• Employment Appeal Board• State Public Defender• State Racing and Gaming Commission

January 5, 2009 Iowa Department ofInspections & Appeals

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 ofInspections & 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– 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 ofInspections & Appeals

Funding Sources

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

Source: DOM FY 08 Financial Summary

$2,412,647, 16%

$12,442,988, 84%

Iowa Has Excellent Nursing Facilities!

Iowa Department ofInspections & Appeals

January 5, 2009

Iowa Nursing Homes Compared toNational Averages

2007 National Average

2007 Iowa Average

Percentage of nursing homes cited for Substandard Quality of Care

6.1% 1.5%

Percentage of nursing homes with deficiencies

(11.6% of Iowa facilities are Deficiency-Free)

91.9% 88.4%(11th lowest in

the nation)

Average number of deficiencies per nursing home

7.0 5.0(12th lowest in

the nation)

Percentage of nursing homes that had a Federal penalty or other sanction effectuated

18.1% 10.4%

Iowa Department ofInspections & Appeals

January 5, 2009

Average # of Deficiencies per Survey by Scope & Severity

00.30.60.91.21.51.82.12.42.73

3.33.63.94.24.5

Avg #

of D

efi

cien

cies

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

B C D E F G H I J K

Average # of Deficiencies per Survey by Scope & Severity – FY08

Iowa Department ofInspections & Appeals

January 5, 2009

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

Iowa

Kansas

Missouri

Nebraska

KCRO

National

Iowa 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%

FY05 % of Total Number of

Facilities with

FY06 % of Total Number of

Facilities with

FY07 % of Total Number of

Facilities with

FY08 % of Total Number of

Facilities with

Percentage of Facilities with Remedy Effectuated by Fiscal Year

Iowa Department ofInspections & Appeals

January 5, 2009

Deficiency-Free Facilities and ProgramsIn Iowa During SFY 2008

January 5, 2009 Iowa Department ofInspections & Appeals

Deficiency-Free Facilities and Programs In Your Area

• 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

Iowa Department ofInspections & Appeals

January 5, 2009

Governor’s Award Winning Facilities

Iowa Department ofInspections & Appeals

January 5, 2009

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:– 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)

Iowa Department ofInspections & Appeals

January 5, 2009

SFY 2008 Long-Term CareState Enforcement Actions

5.5%

79.3%

15.2%

Repeat Offenders (42)

One-Time Offenders(115)

No Citations/Fines (600)

January 5, 2009 Iowa Department ofInspections & Appeals

Source: DIA Fining and Citation Data

Fines Collected From Nursing Facilities FY 08: $180,585

SFY 2008 Assisted Living ProgramsState Enforcement Actions

8.6%

5.2%

86.2%

Multiple EnforcementActions (14)

Single EnforcementActions (23)

No EnforcementActions/Fines (231)

Source: DIA Fining and Citation Data

January 5, 2009 Iowa Department ofInspections & Appeals

Iowa’s Population is Changing

Iowa Department ofInspections & Appeals

January 5, 2009

January 5, 2009 Iowa Department ofInspections & Appeals

Iowa Demographics

Iowa’s % of Nursing Home Population

Iowa’s % of US Population

1.95% 1.0%

% of Iowans Over the Age of 75

% of Americans Over the Age of 75

7.6% 5.9%

Source: Kaiser State Health Facts, 2005 and 2000 US Census

The Changing Face of Long-Term Care in Iowa

• Today’s seniors have more options than ever before– 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

Iowa Department ofInspections & Appeals

January 5, 2009

Important Telephone Numbers

Health Facilities Division

Complaint Hotline1-877-686-0027

Long-Term Care Ombudsman’s Office1-800-532-3213

Iowa Department ofInspections & Appeals

January 5, 2009

Iowa Department ofInspections & Appeals

January 5, 2009

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

Internet Access to Informationhttps://dia-hfd.iowa.gov/DIA_HFD/Home.do http://www.medicare.gov/NHCompare/

Iowa Department ofInspections & Appeals

January 5, 2009

Questions?

Iowa Department ofInspections & Appeals

January 5, 2009