Storm Lake Times Pilot

Editorial: Another rural nursing home closes



Pleasant View Home in Albert City is the latest rural Iowa nursing home to close. Fifteen closed in Iowa last year, 12 of them rural, including Newell’s Good Samaritan. Before that, it was North Lake Manor in Storm Lake. It’s shocking to see longstanding operations, many run by non-profits like Good Sam that offered high-quality care, close their doors.

Pleasant View cited the worker shortage. Nursing homes are begging for certified nursing assistants, registered nurses and support staff. Northwest Iowa facilities are offering CNAs starting pay of $21 per hour and still can’t recruit enough to support their licensed number of beds. Empty beds mean less revenue.

The problem is compounded in Iowa where Medicaid payments were handed over to private insurance-industry administrators. Health care providers of all sorts got lower payments as the insurance companies had to make their own profit. Gov. Reynolds claims to have saved a lot of money on the backs of places like North Lake Manor. The Pocahontas hospital has to hold patients for rehab care because they can’t find a care facility bed for them. They used to go to Newell.

This while Baby Boomers age into the system looking for a place to call home when their needs overwhelm family abilities to provide care. We can’t even wait to die out here anymore — you have to go to the city for that.

Medicaid should pay nursing homes a rate that can sustain a level of care that Pleasant View or Good Sam provided. It did not, obviously. It is not because of mismanagement — these places ran soundly for generations. It’s because of changes in state policy and the economy.

Iowa should have been cranking up nursing education a long time ago. Anybody could see the Boomer crisis coming. It doesn’t take long to certify a nursing assistant, if the state would try. Increasing tuition at the University of Iowa on health care and science students is not helping matters. We can address a health worker shortage by putting money into it. It really is pretty simple.

We have instead put tax cuts above elderly care — $2 billion could go a long way toward LPN scholarships and higher reimbursement rates for in-home care. As always, it’s a matter of priorities. Elderly care clearly is not on the Iowa agenda.

Instead, Gov. Reynolds introduced a 44-page health care bill that does very little for Pleasant View Home. It would do some good things, like providing a special designation for critical rural hospitals (many of which are on the brink of closing because of, yes, lower Medicaid reimbursement rates).

The bill also would provide funding for “pregnancy resource centers,” would cap medical malpractice damages, and provide for easier access to birth control. Many of these proposals are controversial even with the Republican legislative caucus. It is hard to tell how it will turn out.

It is replete with half-measures that do not adequately deal with the challenging demographics of an aging, declining population with fewer resources in rural Iowa — and that’s the lion’s share of the state.

Rural areas voted for Republican solutions to critical problems like nursing home access and quality of life. What they get are caps on medical malpractice, and an education allowance for K-12 that starves rural districts. And a tax cut that goes mainly to the wealthiest.

You would think that the legislature would take action when Pleasant View and Good Sam are shutting down. We hear little to nothing. We hope there is something in the works.

THE GOVERNOR also proposes to streamline state government with a 1,500-page bill. It has a lot of ideas that make sense on their face: turning over the schools for the blind and deaf from the Board of Regents to the Department of Education; putting workers compensation under the Department of Inspection and Appeals; placing Cultural Affairs under the auspices of the Economic Development Authority, and so on. Nothing appears to be a huge issue, but we have not combed the pages. It’s good to have an occasional pruning and reorganization as government builds and spreads.

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