DES MOINES, Iowa (IOWA CAPITAL DISPATCH) – The federal government’s most recent assessment of health-facility inspections indicates Iowa has failed to meet three key standards.

The new report from the Centers for Medicare & Medicaid Services indicates the state-run inspection agencies that oversee nursing homes and hospitals around the nation fielded more than 107,000 complaints about health care facilities last year. That’s a 31% increase from 2019, which officials say may have contributed to 38 states failing to meet all of the federal performance standards.

Each year, CMS assesses the performance of the state agencies tasked with enforcing federal regulations concerning health care facilities. The latest data shows that last year, only 14 of the 52 agencies met all of the acceptable thresholds for the annual recertification of nursing homes, according to the CMS State Performance Standards System Findings published last week.

CMS’ report indicates the Iowa Department of Inspections, Appeals and Licensing met most of the federal standards related to the inspection process in 2024, but failed to meet the standards in three areas:

— Off-hour inspections at the worst nursing homes: Under CMS guidelines, state agencies are to inspect the worst care facilities in their jurisdiction — the federally designated “special-focus facilities” that have recurring, serious deficiencies in resident care — during off hours to guard against homes altering their routine in anticipation of what should be a surprise visit by inspectors.

— Immediate jeopardy in acute-care settings: To accurately record the seriousness of deficiencies that can cause actual injury or death to residents in acute and continuing-care settings, inspectors must use a CMS-prescribed “immediate jeopardy template” in at least 80% of all cases where immediate jeopardy is cited. The template is used to document the evidence of each issue that places patients at risk.

— Emergency Medical Treatment & Labor Act violations in acute-care settings: State inspection agencies must initiate, on a timely basis, the intake and investigation of at least 95% of EMTALA immediate-jeopardy complaints tied to acute and continuing-care providers. EMTALA violations often relate to emergency-room patients being discharged without first being stabilized.

The Iowa Capital Dispatch asked the Iowa Department of Inspections, Appeals and Licensing on Tuesday for its perspective on the CMS report. As of Wednesday afternoon, the agency had not commented on the report.