Forty-nine Iowa nursing homes owe the taxpayers more than $10.7 million in fees, according to the Iowa Department of Health and Human Services. (Photo by Getty Images)
Forty-nine Iowa nursing homes owe the taxpayers more than $10.7 million in fees the state has so far failed to collect, according to newly released records.
One for-profit company based in West Des Moines operates 18 care facilities that collectively owe the state $3.6 million in unpaid fees. The company’s top two executives, meanwhile, have made $293,000 in political donations.
The state fees imposed on nursing homes, called Quality Assurance Assessment fees, are a mechanism that has been used since 2009 to artificially inflate the facilities’ cost of doing business.
The increased expense enables the facilities to draw down more money in Medicaid reimbursement for resident care. Often, the increased Medicaid payments more than offset the cost of the fees paid to the state, resulting in a net gain for the homes.
By law, the care facilities are supposed to use that additional money to increase the pay of their front-line caregivers — which is why the fees are called Quality Assurance Assessment fees. It’s a circular, but legal, method of increasing the revenue collected by nursing homes and has been approved by the federal government in Iowa and other states.