*This post is written in honor of my grandpa, Ronald Ray Baumann (April 16, 1930—October 31, 2023) who passed away in part due to nursing home negligence and mistreatment. 


Lex 2

United States citizens are regularly denied healthcare because of the cost to go to the doctor.[1] Other developed countries—including Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United Kingdom—provide their citizens with universal, affordable healthcare[2]… why can’t the U.S.? 

Unfortunately, the United States does not view healthcare as a right despite many scholars advocating for it to be. While scholars advocate for a single-payer system to give everyone regardless of socioeconomic status access to healthcare, the healthcare industry itself actively opposes a single-payer system because “[t]he health insurance industry already spends tens of millions of dollars on lobby, political campaign donations, and public relations.”[3] The average American struggles to pay for healthcare, while the “seven largest health insurance companies in our country made over $69 [billion] in profits last year.”[4]

Quality of healthcare for the elderly has been an issue since the 1970s due to lack of regulations.[5] The most common abuse reported in nursing homes is physical abuse, and 95% of respondents in a study of over 2000 nursing home residents reported either experiencing neglect by staff or witnessing another resident be neglected.[6]

Nursing homes within the state of Iowa seem to follow this trend. As of November 29, 2023, four nursing homes in Iowa were added to the “federal list of the nation’s worst care facilities.”[7] These nursing homes include: (1) Embassy Rehab and Care Center (Sergeant Bluff), (2) Harmony (West Des Moines), (3) The Ivy (Davenport), and (4) Westwood Specialty Care (Sioux City).[8] These four facilities accompany six other facilities within the state of Iowa on the list.

Each “care” facility has its own horrifically unique regulatory issues. At Westwood, for example, employees neglected to complete assessments and interventions for five residents resulting “in a death and several hospitalizations and visits to an emergency room for treatment.”[9] Similarly, the Harmony facility ignored a patient’s complaints until she was screaming in pain—so loud that residents from down the hall could hear her cries.[10] Sadly, this patient passed away after two surgeries resulting from the neglect. The Ivy failed to properly clean their facility, resulting in a “220-page report documenting 35 state and federal violations…”[11] Embassy Rehab received the most federal violation citations (40) for both failing inspections and quality measures.[12]

Because of cases like these, Iowa Senate Democrats have been advocating for investigation of nursing home abuse in the state.[13] Despite various complaints from constituents—some complaining of their loved ones waiting hours to use the restroom and irregular bathing, for example—Republican congress members refuse to address the issue. Specifically, Senate Amy Sinclair (R) has stated “she ‘will not be scheduling a Government Oversight meeting on [nursing home abuse and neglect] because it would distract staff from performing their important work monitoring these facilities.”[14]

The current federal law is failing the aging population. The current requirements for nursing homes are established under 42 U.S.C.A. §1396(r).[15] Among other things, the nursing home must provide services that meet professional standards of quality.[16] In terms of residents’ rights, each resident has the right to “reside and receive services with reasonable accommodation of individual needs and preferences…”[17] The number of Iowans alone submitting nursing home complaints reinforces the failure to implement regulations that protect the elderly.

In light of these horrors, the state of Iowa—along with the federal government—must realign its priorities to ensure healthcare as a human right by prioritizing accessibility and quality over the profit of health insurers and pharmaceutical companies. 

[1] Press Release, New International Study: U.S. Health System Ranks Last Among 11 Countries; Many Americans Struggle to Afford Care as Income Inequality Widens, The Commonwealth Fund (Aug. 4, 2021), https://www.commonwealthfund.org/press-release/2021/new-international-study-us-health-system-ranks-last-among-11-countries-many [https://perma.cc/X7ME-8GUN]. “50% of lower-income U.S. adults reported that costs prevented them from getting needed healthcare, compared to 27% of higher-income adults.” Id. 

[2] Id. 

[3] Fran Quigley, Seize the Moment: The Opportunity to Realize the Human Right to Healthcare in the United States, 17 Ind. Health L. Rev. 53, 55 (2020).

[4] Bernie Sanders, Opinion, It’s Time to Guarantee Healthcare to All Americans as a Human Right, The Guardian (May 18, 2023), https://www.theguardian.com/commentisfree/2023/may/18/healthcare-us-human-right-medicare-for-all-bernie-sanders [https://perma.cc/UW5L-AWGR].

[5] Karan Patel et al., Elder Abuse: A Comprehensive Overview and Physician Associated Challenges, 13 Cureus (2021), DOI: 10.7759/cureus.14375.

[6] Id. 

[7] Clark Kauffman, Four Iowa Care Facilities Added to Federal Watchlist of Nursing Homes, Iowa Capital Dispatch (Nov. 29, 2023, 3:42PM), https://iowacapitaldispatch.com/2023/11/29/four-iowa-care-facilities-added-to-federal-watchlist-of-nursing-homes/ [https://perma.cc/VK6C-DPB6].

[8] Id. 

[9] Id.

[10] Id.

[11] Id. See also Clark Kauffman, Feds Prompt State Regulators to Increase Fines Against Davenport Nursing Home, Iowa Capital Dispatch (June 28, 2023, 4:42PM), https://iowacapitaldispatch.com/2023/06/28/feds-prompt-state-regulators-to-increase-fines-against-davenport-nursing-home/ [https://perma.cc/L4ZP-T5NU].

[12] Id.

[13] O. Kay Henderson, Senate Democrats Call for Investigation of Iowa Nursing Home Abuse, Neglect Cases, Radio Iowa (Dec. 14, 2023), https://www.radioiowa.com/2023/12/14/senate-democrats-call-for-investigation-of-iowa-nursing-home-abuse-neglect-cases/ [https://perma.cc/V69P-4WE2].

[14] Id.

[15] Requirements for Nursing Facilities, 42 U.S.C.A § 1396(r) (2021).

[16] Id. § 1396(r)(F)(4)(A).

[17] Id. § 1396(r)(G)(c)(A)(v).

Friday, February 16, 2024