Normally, people who write laws want the rest of us to follow those laws. However, when enforcing a statute costs a corporate interest group more money, prepare to hear some whining about government officials doing their jobs. So it was last week, when the Iowa Legislature’s Administrative Rules Review Committee unanimously approved rules formulated by Iowa Department of Inspections and Appeals.

The rules expand the number of hospital workers who are considered mandatory reporters of abuse to include food service workers and housekeeping staff, and define “gross negligence” as a form of abuse.

Lobbyists for Iowa’s hospitals and nursing homes attended Tuesday’s meeting and argued against approval. They said the state inspectors’ definition of gross negligence would result in too many caregivers being branded as abusers. They argued that gross negligence requires a willful, deliberate effort to harm a patient. […]

Representatives of Iowa AARP, the Governor’s Developmental Disability Council and Iowa Protection and Advocacy argued that industry proposals would weaken protection for seniors.

Rep. Bruce Hunter, a Des Moines Democrat who managed legislation related to the proposed rules, addressed the committee and said the industry’s proposed definition of gross negligence was unworkable.

“It would make it very, very difficult, if not impossible, to prosecute somebody in a nursing home or a hospital,” he said. “Yes, we want to make prosecution difficult because dependent-adult abuse is a serious charge, but we don’t want to make it impossible.”

Democratic State Representative Marcella Frevert

expressed dismay that regulators seemed to have regressed from “educational and helpful” enforcement to a “gotcha mentality” of penalizing violators.

Frevert joined the rest of the committee in approving the inspections department’s proposals, but said the full Legislature should consider revisiting the issue in 2010. “So, this isn’t over,” she said.

Here’s an idea: let’s stop issuing tickets for speeding and running red lights in favor of more “educational and helpful” enforcement of traffic laws.

Seriously, those talking points about the “gotcha” mentality of nursing home regulators sound familiar. That’s because legislators from both parties have made the same points in the past. By an amazing coincidence, those legislators have taken expenses-paid trips to Washington courtesy of the Iowa Healthcare Association, which represents nursing homes.

This issue bears watching during the 2010 legislative session, because nursing home operators know their way around the capitol and are good at getting what they want. Legislators could do this group a favor by relaxing the rules on “gross negligence” in nursing homes, and it wouldn’t cost an extra dollar from the general fund.  

The Des Moines Register’s Clark Kauffman reported Monday on some outside-the-box thinking by an assisted living center in Dubuque that has been fined repeatedly for providing inadequate care. I wouldn’t be happy if one of my loved ones were among the center’s 116 residents.

More details are after the jump.

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).