John and Terri Hale own The Hale Group, an Ankeny-based advocacy firm working for better lives for all Iowans. Contact them at terriandjohnhale@gmail.com. An earlier version of this commentary appeared in the Des Moines Register and Cedar Rapids Gazette.

Twenty-seven years ago, the Quad-City Times published a six-part series on neglect and abuse in nursing homes. The articles told the stories of residents whose physical and mental health needs were not met, who were subjected to verbal or physical abuse by staff or other residents, and had been injured or had died.

The stories were tragedies. And sadly, tragic stories still regularly appear in Iowa Capital Dispatch and other Iowa media written by Clark Kauffman—the same journalist who authored the stories in 1996.

For more than 27 years, horrific stories of neglect and abuse have stemmed from far too many nursing facilities that have employed too few workers; failed to adequately compensate, train, and respect workers; routinely accepted exceptionally high levels of employee turnover; lobbied elected officials to increase annual appropriations of tax dollars but to also minimize oversight of their efforts; avoided criminal prosecution for their misdeeds; and have put the desire for profit ahead of the needs of the Iowans they exist to serve.

In 27 years, little has changed. At too many facilities, neglect, abuse and dehumanization of older Iowans continue.

Mary Weaver writes a regular column for the Jefferson Herald and Greene County News online, where this commentary first appeared. She is a former registered nurse and former public health nurse administrator, who currently chairs the Iowa Democratic Party’s Women’s Caucus. Mary resides on a farm near Rippey.

I am saddened, as well as shocked by the horror stories erupting statewide about the deplorable, life-threatening situations occurring in Iowa nursing homes. Stories of gangrene resulting in amputations, a story of a person choking in their own saliva, a story of a person freezing in the winter of 2023 when the alarm door triggered was never given a response.

In complete transparency regarding this subject, in part of my former work life, I was a surveyor for the Iowa Department of Inspections and Appeals. That involved inspecting State Certified Home Care agencies as well as nursing homes.

The long-term care or nursing home survey team consisted of three or four people, and the team was usually in a facility for three or four days. Policies were reviewed, charts were audited, comparing orders written to implementation, interviews with residents were conducted, the ombudsman assigned to the facility was visited, staffing ratios for Registered Nurses and Certified Nurses Aids were reviewed using established formulas. Temperature checks of food served were done at mealtime.

It took one day for the team to write the report of the findings, usually a Friday, and the following Monday we were sent to the next facility. Facilities were visited once each year, but unannounced, and if a complaint was received regarding a facility, it was immediately visited.

Kurt Meyer writes a weekly column for the Nora Springs – Rockford Register and the Substack newsletter Showing Up, where this essay first appeared. He serves as chair of the executive committee (the equivalent of board chair) of Americans for Democratic Action, America’s most experienced liberal organization.

The financial services company “Bankrate” recently named Iowa the best state to retire in. I admit to being a bit surprised. The company scored 50 states on five metrics: affordability (40 percent), health care cost and quality (20 percent), a vague category entitled “community wellbeing” (25 percent), weather (10 percent), and crime rate (5 percent). Iowa dislodged Florida from last year’s highest ranking; Florida fell to #8.

Rounding out the top five are Delaware, West Virginia, Missouri, and Mississippi. Without intending to sound harsh, these states don’t strike me as being exactly heaven on earth. But then, I guess we all can make our own assessment of what constitutes the good life. Mine is below.

John and Terri Hale own The Hale Group, an Ankeny-based advocacy firm working for better lives for all Iowans. Contact them at terriandjohnhale@gmail.com.

A crisis ignored eventually leads to catastrophe. That’s what we’re witnessing in long-term care services. 

As far back as 1990, the U.S. Bipartisan Commission on Comprehensive Health Care described as a “crisis” the challenges the nation faced in providing long-term care services to people with disabilities and older citizens.

That commission also used phrases like an “urgent need for action” and “current conditions that are unconscionable” when urging Congress to act on recommendations that would ensure all Americans have access to high-quality, affordable long-term care services in the setting they prefer.

Tony Leys is Rural Editor/Correspondent for Kaiser Health News, where this story was first published. Follow him on Twitter @TonyLeys.

KNOXVILLE, Iowa ― Bette Helm was glad to have someone to talk with about her insomnia.

Helm lives in a nursing home in this central Iowa town of about 7,500 people, where mental health services are sparse. On a recent morning, she had an appointment with a psychiatric nurse practitioner about 800 miles away in Austin, Texas. They spoke via video, with Helm using an iPad she held on her lap while sitting in her bed.

Video visits are an increasingly common way for residents of small-town nursing homes to receive mental health care. Patients don’t have to travel to a clinic. They don’t even have to get cleaned up and leave their bedrooms, which can be daunting for people with depression or anxiety. Online care providers face fewer appointment cancellations, and they often can work from home. While use of some other telehealth services may dwindle as the COVID-19 pandemic winds down, providers predict demand for remote mental health services will continue to increase in rural nursing homes.

Sixth in a series interpreting the results of Iowa’s 2022 state and federal elections. This post has been updated to include numbers from the Iowa Secretary of State’s revised statewide statistical report, issued on January 27.

The Iowa Secretary of State’s office recently published the statewide statistical report on the 2022 general election. Republicans enacted many new barriers to early voting in 2021, which meant that compared to previous elections, Iowans had fewer days to request absentee ballots, fewer days to vote early by any means, and less time to return absentee ballots to county auditors. It was also much harder for Iowans to deliver another person’s completed absentee ballot, and each county could have only one drop box.

As expected, fewer Iowans voted early. The decline wasn’t spread evenly across the electorate.

Steve Corbin is emeritus professor of marketing at the University of Northern Iowa and a freelance writer who receives no remuneration, funding, or endorsement from any for-profit business, nonprofit organization, political action committee, or political party.      

Thankfully we are nearly six weeks past the 2022 midterm election. I can hear many voters exuding a sigh of relief and shouting, after $17 billion was spent on disinformation, misinformation, and the occasional truthful political ad, “yes, finally, the election is over.”

Normal life is back, and we’ve jumped right into the holiday season. Let’s ponder how to make this year’s holiday season better than we’ve experienced heretofore.

State Representative John Wills bragged in a recent Facebook post that he had reassured an elderly housebound voter, who was worried about getting an absentee ballot. The third-ranking Iowa House Republican told the story to show the “mantra that Republicans are trying to prevent people who don’t think like us from voting is false.”

More than a dozen Iowa Republican lawmakers and legislative candidates liked Wills’ self-congratulatory post.

There was just one problem: thanks to changes Wills and his colleagues enacted in 2021, the deadline for that woman to request an absentee ballot had already passed.

Randy Evans can be reached at DMRevans2810@gmail.com.

People in the health care field have worked their tails off since the COVID-19 pandemic hit Iowa with a vengeance in 2020.

Doctors, nurses, and all manner of technicians and support staff have performed heroically under circumstances that often were trying.

But the death this year of a patient at a Centerville care center has struck a chord with many Iowans — and not just because COVID claimed another life. The reaction has ranged from sadness to anger because the person’s treatment was unprofessional, uncaring and incompetent, if not bordering on criminal.

New restrictions on absentee voting prevented hundreds of Iowans from having their ballots counted in the June 7 primary election, Bleeding Heartland’s review of data from county auditors shows.

About 150 ballots that would have been valid under previous Iowa law were not counted due to a bill Republican legislators and Governor Kim Reynolds enacted in 2021, which required all absentee ballots to arrive at county auditors’ offices by 8:00 pm on election day. The majority of Iowans whose ballots arrived too late (despite being mailed before the election) were trying to vote in the Republican primary.

Hundreds more Iowans would have been able to vote by mail prior to the 2021 changes, but missed the new deadline for submitting an absentee ballot request form. More than half of them did not manage to cast a ballot another way in the June 7 election.

The new deadlines will trip up many more Iowans for the November election, when turnout will likely be about three times the level seen in this year’s primary, and more “snowbirds” attempt to vote by mail in Iowa from other states.

Iowa’s June 7 primary election will be the first conducted under restrictions on absentee voting that Republicans enacted in 2021.

Two changes in particular greatly increase the risk that Iowans attempting to vote by mail will not have their ballots counted. First, all ballots must arrive at the county auditor’s office by 8:00 pm on election day. Late-arriving ballots will not be counted, regardless of any postmark. So at this writing, it’s far too late to safely put a ballot in the mail.

Second, Republicans made it much harder for voters to have someone else hand-deliver their completed absentee ballot.

If you have an ballot sitting at home, do not mail it on Monday. Here are your best options for making sure your vote will be counted.

Early voting for Iowa’s June 7 primary begins on May 18. Democrats have one contested race for a federal office (Abby Finkenauer, Mike Franken, and Glenn Hurst are running for U.S. Senate) and one for a statewide office (Joel Miller and Eric Van Lancker are running for secretary of state). There are also many competitive primaries for Iowa House or Senate seats.

Turnout for this year’s primary will likely be much lower this year than in 2020, when Secretary of State Paul Pate sent every active registered voter an absentee ballot request form. In addition, a law Republicans enacted last year shortened Iowa’s early voting window from 29 days to 20 days and made it harder to return a completed ballot in time to have the vote counted.

Even so, more than 100,000 Democrats will likely participate in the June 7 election. I analyzed statistics and results from the last three cycles for clues on who Iowa Democratic primary voters are and where most of them live.

Charles Bruner: Taxes, inflation, and essential services … there’s an obvious solution for Democrats.

President Joe Biden and Democrats in Congress have done much to support essential workers and provide economic help to working and retired Americans during the height of the COVID-19 pandemic. Several of those actions were designed to become permanent: improvements to the child tax credit, investments in child care, and expansion of home and community based services and the direct care workforce.

Established in the American Rescue Plan Act through a process known as reconciliation (which requires only a simple majority vote and therefore could be enacted without Republican support), these policies have proved both popular and effective.

Approximately 290,000 Iowans living in some 141,000 households will receive less food assistance beginning in April, due to Governor Kim Reynolds’ decision to declare the COVID-19 state of emergency over.

Leaders of area food pantries are expecting a surge in demand, as Iowans’ Supplemental Nutrition Assistance Program (SNAP) benefits will drop by at least $95 per household, and in some cases by more than 90 percent.

According to the Iowa Hunger Coalition, “The average SNAP benefit for individuals will drop from $2.65 per meal to an estimated $1.52 per meal. Total SNAP benefits issued in the state of Iowa will decrease by an estimated $29.5 million,” a 42.6 percent reduction.

Iowa Alliance for Retired Americans President Mike McCarthy (retired AFSCME), Vice President Kay Pence (retired CWA), Secretary Jan Corderman (retired AFSCME), and Treasurer Ken Sagar (retired IBEW and Iowa AFL-CIO President Emeritus) co-authored this commentary.

Years of cuts to the Social Security Administration’s (SSA) funding have caused reductions in service. Since 2010, SSA’s national 1-800 number staff shrank by 12 percent even as call volume grew 6 percent. As those staffing cuts started to go into effect, about 10,000 Baby Boomers started reaching retirement age every day. That trend is expected to continue until 2030.

Not everyone retires when they first become eligible, but the COVID-19 pandemic pushed many seniors into retirement earlier than they planned. Compounding those problems, the pandemic forced local Social Security offices across the country to stop in-person appointments.

Kay Pence is Vice President of the Iowa Alliance for Retired Americans. -promoted by Laura Belin

U.S. Senator Joni Ernst is no longer working for Iowans. She is working at the behest of President Donald Trump, no matter what he says or does. She has become a puppet to Trump no matter how low he sinks, voting with the president more than 91 percent of the time and following his lead to attack our healthcare and defund Social Security.

The Iowa Alliance for Retired Americans recently invited Ernst and her Democratic challenger Theresa Greenfield to virtual forums celebrating the anniversaries of Medicare and Social Security. I was not surprised when Ernst failed to show up for either forum, because she has such a dismal record on both issues.  

More Iowans than ever participated in the 2020 primary, and the event changed some features of the Iowa electorate. For the first time in at least 20 years, people who choose not to affiliate with any party don’t comprise a plurality of registered voters. Democrats and Republicans both outnumber no-party voters now.

In other ways, the 529,586 Iowans who cast ballots in the June 2 election resembled past primary voters. For instance, nearly three-quarters of them were at least 50 years old, while about 13 percent were under age 35. Those proportions by age group are remarkably close to corresponding figures from the 2018 primary, when only 288,749 Iowans voted.

Follow me after the jump for a closer look at this year’s expanded voter universe by party, gender, and age.

Mike McCarthy is president of the Iowa Alliance for Retired Americans. -promoted by Laura Belin

President Lyndon Johnson signed the Older Americans Act into law on July 14, 1965. It responded to the need for community services, evidence-based health promotion, disease prevention programs, civic engagement, and elder justice for senior citizens. America’s seniors require a similar response to the COVID-19 pandemic.

The Iowa Alliance for Retired Americans believes that seniors must have relevant and accurate information about preventing and treating the coronavirus. Seniors and retirees are becoming more desperate looking for security and a cure. We should be able to trust President Donald Trump’s pronouncements. However, he repeatedly shows us that we cannot believe his statements.

Amy Ward: “We heard that Jay’s passing was peaceful and that two nurses held his hands, but oh, how we hungered to make sure the last words he heard were from those who really loved and knew him.” -promoted by Laura Belin

In early February, our family watched the news about the novel coronavirus. We hoped, as I imagine others did, that our family would somehow remain untouched by the pandemic. That was not to be our fate.

Many of the most powerful COVID-era images that I have seen were taken from New York City or Los Angeles: stark cityscapes that seem far away and nearly foreign. In May, we buried my father-in-law Jay at a peaceful suburban cemetery – not in a big city, but in our verdant hometown of Des Moines, Iowa.

Dr. Glenn Hurst: The nursing homes know that if they accept one COVID-19 patient in their facility, they will likely be sending ten new patients to either the hospital or the coroner. -promoted by Laura Belin

As we look to reopen the U.S. economy, many questions arise regarding whose interests the economy serves. In the health care sector, the answer is large health systems, often at the expense of some of the most vulnerable populations in our state. Their vertical integration of the profitable components of health care provision, hospitals, surgery centers, rehab and physicians, and the casting off of components such as nursing care and hospice have acutely left the older generation at grave risk.

Today’s crisis illustrates the problem. The continued outbreak of novel coronavirus (COVID-19) cases in Iowa nursing homes should be shocking. The response to calls for assistance to protect these patients should be met with the same distress.

“I do want to encourage every Iowan to go to TestIowa.com and take the assessment,” Governor Kim Reynolds said as she rolled out a program to increase the state’s coronavirus testing capacity during an April 21 news conference. The governor announced the following day that more than 80,000 Iowans had completed an initial assessment during the first 24 hours the website was online.

However, the online survey at the new site is not accessible to all Iowans in high-risk groups for COVID-19 infections and complications. Representatives of the governor’s office and Iowa Department of Public Health did not respond to Bleeding Heartland’s repeated questions about barriers to taking the survey.

Ira Lacher reflects on the unprecedented crisis we are facing. -promoted by Laura Belin

What will we have learned after this has ended?

How will America and Americans be different?

How will America and Americans be better?

What kind of nation will America be in the year 1 A.C. (after COVID-19) that we were not in the year 1 B.C. (before COVID-19)?

The Iowa Democratic Party has approved a plan to replace the “virtual caucus” recently nixed by the Democratic National Committee.

But while a news release hailed the proposal to “increase participation and make the caucuses more accessible for Iowans who have traditionally been unable to attend their in-person precinct caucus,” many Democrats won’t be able to use satellite caucuses.

Bill Witt represented part of Black Hawk County in the Iowa House for ten years and is a well-known advocate for improving health care services and environmental causes. -promoted by Laura Belin

While the big political noise machines have traded barrages in a host of high-profile battles over border security, student debt, the Affordable Care Act, Afghanistan, and more, U.S. Senator Amy Klobuchar has quietly, and with her customary adroitness, slipped around the flanks of the clanking, clattering behemoths and planted her standard on strategic, long-term high ground: the security and health of America’s seniors.

Fourteenth in a series interpreting the results of Iowa’s 2018 state and federal elections.

The November election was the first since Republicans shortened our state’s early voting window. Proponents of the 2017 law, best known for requiring voter ID, never made a case for limiting early voting. Nor did they produce evidence of any problems caused by allowing Iowans to cast ballots 40 days before elections. (County auditors needed to have ballots ready anyway, since federal law requires them to send overseas military ballots 45 days in advance.)

The power play was inspired by a simple fact: Iowa Democrats rely more on early voting than do Republicans. Switching from 40 days to 29 gave Democratic volunteers two fewer weekends to “chase” absentee ballots.

Now that the statewide statistical report on the 2018 general election is available, we can see how early voting played out in a compressed time frame. Bleeding Heartland previously discussed notable findings on turnout rates for Iowans of different political affiliations, age groups, and gender.

This afternoon’s public hearing at the Iowa Secretary of State’s office probably will not lead to any substantial revisions in the administrative rules proposed to implement Iowa’s new election law. While the bill was working its way through the legislature, neither Secretary of State Paul Pate nor Republican lawmakers acknowledged research from other states, indicating voter ID and signature verification requirements would suppress voting by some eligible citizens, especially in certain groups.

Nevertheless, the record from today’s hearing could become important in potential future court rulings on the law.

Gerry Hebert, one of the country’s top experts on voting rights law, told an audience in Des Moines last week that testimony at public hearings has sometimes been useful in litigation on other states’ voting restrictions. Speaking to Bleeding Heartland after that event, Hebert offered more specific suggestions on questions that would be helpful for citizens to ask today.

Iowans have a chance this Monday to weigh in on rules that will make it harder for some citizens to register to vote or cast a ballot, starting next year.

Iowa’s Long-Term Care Ombudsman has “eliminated virtually all staff visits” to our state’s 850 nursing homes and assisted-living facilities, Clark Kauffman reported for the Des Moines Register on August 23. A large reduction in state funding led to the policy change, announced last month. Republican legislators passed the health and human services budget on party-line Iowa House and Senate votes. Governor Terry Branstad approved the cuts in his final batch of bill signings.

Reducing oversight of nursing homes has long been a goal for Branstad, whose Department of Inspections and Appeals didn’t even fill all the nursing home inspector positions funded by state lawmakers. Iowa already ranked last among the 50 states in terms of ombudsman visits to nursing homes at least once per quarter, according to 2015 statistics cited by Kauffman.

Ending on-site visits by ombudsmen will put approximately 53,000 Iowans at greater risk of receiving substandard care.

This Sunday’s Des Moines Register carried another front-page story by Tony Leys about the substandard treatment some patients have received since being transferred from the now-closed state mental health facility in Clarinda. Leys reported last month that eight former Clarinda patients were sent to nursing homes “rated ‘below average’ or ‘much below average’ on a federal registry,” and that two of the patients “died shortly after their transfers.”

“Transfer trauma” can endanger a frail person’s health even if the new facility offers excellent care. Unfortunately, the Perry Health Care Center’s handling of three former Clarinda patients left much to be desired, according to an Iowa Department of Inspections and Appeals report cited at length by Leys. Failure to monitor and care appropriately for one man led to severe dehydration and breathing problems, and eventually his hospitalization. The man died two weeks later. Staff carelessness caused a shower accident that broke a woman’s leg. A third woman did not receive a blood-clot prevention medication for six days in a row. Click through for many more depressing details. The whole 28-page inspector’s report is embedded at the bottom of the page. The company that owns the nursing home rejects the inspector’s findings and will appeal the fines, its manager told the Register.

From where I’m sitting, the nursing home is fortunate to face only $13,500 in fines for the long list of documented problems. I’m shocked that failure to administer a medication for six days, or to inform the prescribing physician that the patient had not received the drug, resulted in only a $500 fine (pages 24 and 25 of the report). Failing “to provide adequate supervision when transferring a resident from a shower chair,” leading to a broken leg, resulted in only a $5,000 fine (pages 16 to 23).  

Most stunning: the nursing home will receive only an $8,000 fine for repeated staff failures to properly assess or treat a man who was becoming lethargic and dehydrated. Nor did staff always provide supplemental oxygen as indicated when the man’s saturation levels dropped below 90 percent. The brother of the (now dead) man told Leys that a doctor at Mercy Medical Center “said she’d never seen a person so dehydrated in her life.”

Eight years ago, an Iowa nursing home received state and federal fines totaling $112,650 for failing to change a woman’s wound dressing for 25 days, resulting in gangrene and amputation of the affected leg. A settlement later reduced that fine to $75,397.

I don’t know how much discretion state inspectors have in assessing penalties. Iowa nursing homes can’t be fined at all for some of the most common health and safety violations, under a law Governor Chet Culver signed in 2009. The Iowa House and Senate had unanimously approved that bill, ignoring concerns raised by some advocacy groups, the Iowa Department of Elder Affairs, and the Iowa Department of Inspections and Appeals.

Leys reported that the woman who failed to receive her anti-clotting meds has moved “a more highly rated nursing home near Bloomfield, which specializes in treating elderly people with mental illnesses.” The woman whose leg was broken would like to move from the Perry facility but has no place to go.

What’s on your mind, Bleeding Heartland readers? This is an open thread: all topics welcome.

Ryan Foley’s August 3 story for the Associated Press was disturbing on several levels. A “Serious Mismanagement Report” described a “decade of dysfunction” at the Effigy Mounds National Monument in northeast Iowa. Between 1999 and 2010, “78 construction projects costing a total of $3.4 million were approved there in violation of federal laws meant to protect archaeological resources and historic sites.” Also troubling: National Park Service officials have suppressed the report’s publication and recently denied that it existed. They have commissioned another team to write a separate (less critical) review of Effigy Mounds operations. National Park Service deputy regional director Patricia Trap delivered some unintentional comedy when she said, “I’m not denying some serious mismanagement […] But also there were actions taken along the way that were actually appropriate management.” I’m so relieved to know that Effigy Mounds officials handled some matters appropriately in addition to the seventy-eight projects that failed to comply with federal law.

Iowa Public Radio’s Morning Edition with Clay Masters interviewed Foley about the mismanagement and next steps at Effigy Mounds. Click through for the audio and transcript.

The Des Moines Register published a front-page piece by Grant Rodgers on August 5 about the “uncertain future” for Iowa’s regional drug courts. Those courts steer defendants into treatment rather than prison, turning lives around at lower cost than incarceration. “Yet despite their popularity among prosecutors, judges and community leaders, several Iowa drug courts have experienced sluggish legislative funding – so much so that they now are in jeopardy,” Rodgers reports. What a classic case of penny-wise and pound-foolish budgeting by state legislators who brag to their constituents about fiscal responsibility. With an ending balance (surplus) of at least $300 million expected for Iowa’s budget in the 2016 fiscal year, it’s ridiculous that the drug court in Council Bluffs will shut down on October 1, with courts in Burlington and Ottumwa “at risk of closing” later this year.

The front page of today’s Sunday Des Moines Register features a depressing must-read by Tony Leys about former residents of the now-closed Iowa Mental Health Institute at Clarinda, which “cared for some of the frailest and most complicated psychiatric patients in the state.” Of the eighteen people who lived in the Clarinda facility earlier this year, eight

were transferred to four traditional nursing homes, all of which are rated “below average” or “much below average” on a federal registry. The four facilities are in the bottom 29 percent of Iowa nursing homes for overall quality, according to the Medicare registry. Two of those eight patients died shortly after their transfers.

I’ve enclosed excerpts from all of the above stories after the jump, but I recommend clicking through to read the articles in their entirety.

The nursing home industry already had too much political power in Iowa before Terry Branstad returned to the governor’s office. Since late 2010, Branstad has repeatedly demonstrated that he prefers a more lax inspection regime for residential care facilities, with fewer nursing home inspectors than state lawmakers are willing to fund.

But Branstad may have hit a new low this month, according to a story by Clark Kauffman in Monday’s Des Moines Register. Kauffman has reported extensively on substandard care in Iowa nursing homes. Following up on this year’s winners of the “Governor’s Award for Quality Care in Health Care Facilities,” Kauffman learned that one of the three honored facilities “was cited by inspectors seven weeks earlier for widespread unsanitary conditions and failure to meet residents’ nutritional needs.”

At this writing, I could not find the July 9 press release announcing the awards on the governor’s official news feed. I found it on the Department of Inspections and Appeals website and posted the full text after the jump.

I also enclosed excerpts from Kauffman’s report, but you should click through to read every disgusting detail about the Woodland Terrace in Waverly (Bremer County). I challenge Branstad or Lieutenant Governor Kim Reynolds to move any of their own beloved relatives to a home with such low standards of hygiene. It’s bad enough that Woodland Terrace wasn’t fined after the conditions inspectors found when they visited in May. To honor that facility is outrageous.

Regarding the other two award-winners, Kauffman noted that Prairie View Home in Sanborn did not have any violations during its most recent inspection, but Friendship Haven in Fort Dodge was cited in late 2013 “for failure to provide adequate incontinence care for residents; failure to adequately treat bedsores; and failure to keep food at the proper temperature before serving.”

The year’s not even half over, but I doubt any public figure will surpass the brazen chutzpah former Vice President Dick Cheney displayed in television appearances on two consecutive days this week. Cheney asserted that former Secretary of State Hillary Clinton should be “held accountable” for the terror attack in Benghazi, and that President Barack Obama has abused executive power. Look who’s talking! The guy who never faced any consequences for his central role in leading the country into war on false pretenses. The Iraq war killed nearly 4,500 U.S. military personnel in the theater, contributed to hundreds of veteran suicides in the past decade, and left thousands of Americans with life-altering physical injuries or PTSD (not to mention the hundreds of thousands of Iraqi casualties).  I don’t know why anyone would listen to anything Cheney has to say about anything, particularly about being held accountable.

A remarkable example of home-grown chutzpah came from Jerry Rhoads, who recently filed for bankruptcy protection for himself and two Iowa nursing homes he owns. One of the homes is on the federal government’s list of most troubled care facilities, according to Clark Kauffman’s piece in the Sunday Des Moines Register. But to hear Rhoads tell it, he’s an innocent victim of over-zealous inspectors:

“I don’t think I’m the bad guy,” Rhoads said Wednesday [May 14]. “I believe this is criminal, the way we have been treated. They have fined us over $100,000, and we lost another $1 million because of the hold they placed on new Medicaid admissions.” […]

“We’re not bad people, but the state has treated us like criminals.”

No, if the state were treating you like criminals, you’d be facing criminal charges and not just civil fines for substandard care that may have led to several deaths. After the jump I’ve posted some of the shocking details from Kauffman’s article.

Iowa has some outstanding nursing homes and skilled care facilities, but I would still recommend keeping a close eye on any loved ones receiving long-term care, given our state’s weak enforcement of violations and limited capacity for inspections.  

Happy St. Patrick’s Day to Bleeding Heartland readers who celebrate the occasion. This is an open thread; all topics are welcome. For a laugh, enjoy The Onion’s recent write-up of Iowa fashion week: “The big themes this season are ‘roomy,’ ‘loose,’ and ‘comfortable.'”

After the jump I’ve posted a few links about health and happiness, including details from Gallup’s 2012 report on well-being in the United States. Iowa ranked ninth on the “Gallup-Healthways Well-Being Index” but was not one of the “elite five states” that have shown consistently high levels of resident well-being over five years.

This week New Jersey’s Chris Christie became the eighth Republican governor to recognize that only a chump would turn down 100 percent federal funding to provide Medicaid coverage to low-income constituents. But Governor Terry Branstad doubled down on his determination not to allow Medicaid to expand in Iowa.

While some advocates are hoping Republican legislators will help pass a Medicaid expansion bill by a veto-proof majority, that scenario appears extremely unlikely. A prolonged standoff between Branstad and Iowa Senate Democrats seems unavoidable.

Thank Gannett for small favors: the successive rounds of newsroom layoffs at the Des Moines Register have spared Clark Kauffman. He’s been tenacious in covering flawed oversight of Iowa’s nursing homes. On Thursday, Kauffman reported on a recent act by Governor Terry Branstad that worries national advocates for senior citizens.

Remember when Republicans were saying that Washington was going to pull the plug on grandma? Little did we know, they were on to something.

The newly released Republican budget does indeed threaten grandma – by dismantling Medicare and ending the guaranteed health care that so many seniors' lives depend on.

If House Republicans and Budget Chairman Paul Ryan get their way, they would privatize Medicare – getting rid of the government guarantee that makes the program accessible for all elderly Americans. Under this “brave” and “courageous” Republican plan, seniors would get a voucher to purchase insurance on the private market. This may sound like a reasonable plan until you consider that privatizing Medicare would cost seniors significantly more, almost doubling their out-of-pocket costs to more than $12,000 a year and leaving many unable to afford health care at all.

When Governor Chet Culver took final action on the last two dozen bills from the 2009 legislative session, my biggest disappointment was his decision to sign Senate File 433, a bill that “eliminates a broad range of fines against Iowa nursing homes that fail to meet minimum health and safety standards.”

Governors rarely veto bills that pass out of the state legislature unanimously, as this one did. However, when Culver didn’t sign Senate File 433 right away, I hoped he was seriously considering the advice of the Iowa Department of Elder Affairs and the Iowa Department of Inspections and Appeals. Both of those state agencies opposed the bill.

Instead of listening to the public officials who have the most in-depth knowledge of nursing home regulations and violations, Culver sided with a corporate interest group:

Former state legislator John Tapscott, who now advocates for Iowa seniors, said the new law is an example of what the nursing home industry can buy with its campaign contributions.

“It only proves that our legislative leaders and governor are willing to sell out the most vulnerable of our citizens – the sick and elderly residing in nursing homes – for a few thousand campaign dollars,” he said.

Click “there’s more” to read about the substance of this bill and the winning strategy of the Iowa Health Care Association, which represents nursing homes. I couldn’t have written this post without an outstanding series of reports by Clark Kauffman of the Des Moines Register last November (see also here and here).