If you reside in a nursing home and are not getting needed care, you might be afraid to complain. You don’t want to offend or anger the people who feed and bathe you. You don’t want to be labeled uncooperative and discharged.
Your family members may have the same fears.
So you are reluctant to contact the Iowa Department of Inspections and Appeals. That agency may be perceived as too harsh because it has the power to sanction and fine facilities. Instead you turn to the Office of the State Long-Term Care Ombudsman. It is viewed as more of a mediator and doesn’t have regulatory authority.
The stated mission of the ombudsman’s office is to “protect the health, safety and welfare” of Iowans living in more than 800 long-term care facilities, including nursing homes and assisted living facilities. The office is supposed to provide this protection by investigating complaints, seeking resolutions to problems and advocating for the most vulnerable people in our state.
Its failure in recent years to fulfill that mission is stunning. Unfortunately, it’s getting worse.
The office’s newly released annual report is yet another reminder it is time for Ombudsman Cynthia Pederson to either step up and do her job or step aside. Iowa needs a leader who is willing to stand up for Iowans. Pederson is not that person.
The latest report, which covers a 12-month period that ended Sept. 30, is a mere eight pages. It lacks detail about the work performed by the office compared to annual reports filed in previous years. What it contains shows a significant decline in “program activities” of all kinds.
In 2016, under different leadership, the office participated 99 times in periodic nursing home inspections handled by the Iowa Department of Inspections and Appeals. After Pederson took the helm, that number fell to 94 in 2018 and 46 last year.
In 2016, office staff visited nursing home residents on issues not related to complaints more than 4,300 times. In 2018, the number of visits fell to 2,177. Last year they made those visits only 1,602 times.
Then there are the visits related to complaints, which fell from 636 in 2016 to 470 in 2018 to 163 last year.
The office provided a mere three training sessions for nursing home employees last year — one tenth of what it provided only a few years ago.
According to an Iowa Capital Dispatch review of data from the National Ombudsman Reporting System, Iowa ranks last in on-site visits made to care facilities. Our ombudsman’s office visited only 10% of the state’s facilities in 2018, compared with the national average of 72%.
“The bottom line — the office is failing to do its job,” said John Hale, a consultant and advocate for older Iowans. Those who use the office’s services “are often poorly served because of staff reductions, a shortage of volunteers, and a policy to limit travel of staff.”
The long-term care ombudsman should be yelling from the rooftops, demanding that lawmakers increase funding to her office.
Yet Pederson has failed to do that. In 2018, she submitted a zero-growth budget to the governor and failed to register support for legislation that could provide money to her office. Last legislative session, she indicated she was “undecided” on Senate File 2278, which would have, among other things, provided new money to hire additional staff.
Lobbyists from numerous organizations formally supported the bill. But Pederson, a registered lobbyist, is apparently not interested in staffing her own office or ensuring that seniors are treated well.
Neither is the GOP-controlled Legislature. Neither is Gov. Kim Reynolds who fails to demand more rigorous oversight of facilities caring for vulnerable people.
Do they not understand government is responsible for doing what it can to take care of people who cannot take care of themselves?
The ombudsman’s office should be “the ears and eyes of the state and provide public oversight about what’s going on in facilities,” said Hale.
That isn’t happening under Pederson.
Ideally, she would be replaced by someone who will proactively attract needed volunteers and raise awareness about problems, including too few staff in nursing homes and involuntary discharges.
Fragile Iowans deserve better. Their families deserve better. We need an ombudsman who will actually stick her neck out to protect people.