Iowa Nursing Homes Closures Accelerating; 696 Jobs Lost In Less Than a Year

The Iowa nursing home closings that began in 2022 are accelerating now—and they’re hitting small towns and rural communities the hardest.

Colonial Manors of Manilla, which closed in July 2021—loss of 34 jobs—was the only Iowa nursing home closure that year reported to Iowa Workforce Development.

But that began changing in July 2022, when the state reported eight facilities were shuttering that summer and fall.

That number is on track to at least double this year: Just four months in, seven facilities across Iowa have already closed their doors, laid off hundreds, and kicked out their residents.

From last July until now, at least 696 Iowans lost their jobs at nursing facilities around the state, while hundreds of families scrambled to get care for residents of those homes.

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Here are the nursing home closures reported to Iowa Workforce Development since 2022:

2022

• July 21: Touchstone Healthcare Community – Sioux City. Laid off: 70
• Aug. 15: Morningside Care Center – Ida Grove. Laid off: 23
• Aug. 20: Big Creek Nursing and Rehabilitation – Polk City. Laid off: 53
• Sept. 19: Sunnycrest Nursing Center – Dysart. Laid off: 33
• Sept. 28: Greene Medical Center Long Term Care – Jefferson. Laid off: 58
• Oct. 1: QHC Mitchellville (Mitchellville Care Center). Laid off: 8
• Nov. 4: Blessing Health Keokuk. Laid off: 151
• Nov. 19: The Evangelical Lutheran Good Samaritan Society – Postville. Laid off: 45

Total laid off: 441

2023 (as of April)

• Feb. 5: Country Winds Manor – Cresco. Laid off: 48
• Mar. 15: Humboldt Wellness and Rehabilitation – Humboldt. Laid off: 30
• Mar. 15: Madison Wellness and Rehabilitation – Winterset. Laid off: 43
• Mar. 15: Village Cottages Assisted Living – Fort Dodge. Laid off: 11
• Mar. 15: Webster Post Acute – Fort Dodge. Laid off: 51
• Mar. 15: Webster Post Acute – Winterset. Laid off: 26
• Apr. 15: Timber City Wellness and Rehabilitation – Maquoketa. Laid off: 53

Total laid off so far: 255

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Hidden problem

That number is almost certainly an undercount.

Even as Touchstone Healthcare in Sioux City was the first closure reported in July, Iowa Health Care CEO Brent Willett told Iowa Press it was one of “a dozen (nursing home) closures in the last seven months in Iowa.” (Companies only have to report closures to the state if they employ a certain number of workers.)

“They’re out of money,” Willett said.

And the problem is worse than just closures.

Willett said nearly half of Iowa facilities—”at least” 45% of its members—were “limiting or freezing admissions right now because of a lack of staff.” He estimated that thousands of Iowans needing care could be left without it in the coming months.

“It could not be a more profound challenge,” Willett said.

Workforce challenges

Attracting staff to the nursing field was an issue long before the pandemic, Iowa Caregivers Executive Director Di Findley said. But residents dying at higher rates since 2020 has meant a new challenge.

“It’s having a huge, devastating effect on the workforce,” Findley told Iowa Press last July. “They’re totally burned out.”

Willett agreed, saying he’s “never seen anything like what they’re going through now.”

“The real-world consequences of what we’re seeing is a limit on the access to long-term care throughout Iowa,” Willett said.

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Inflation up, reimbursement not

Because of the many residents who use Medicaid and Medicare to pay for care, nursing homes “don’t have the option of raising prices,” Willett said.

“Those rates are controlled by the federal and state government,” he said. “We do need a significant reinvestment in Medicare and Medicaid in this country, and in this state, to enable us to compete for the staff that we need.”

Profit over everything

But the elephant in the room: Many facilities are now owned by out-of-state conglomerates, including private equity investment firms, and 70% of the entire industry is now for-profit.

Private equity firms owned 11% of all nursing homes in the country as of June 2021.

A New York Times investigation from 2007 found that deaths skyrocket in facilities owned by private equity firms, prompting US Sen. Chuck Grassley to call out private equity companies. He did so again this March.

“Profits of investors cannot be put ahead of quality care,” he wrote last month, asking the Centers for Medicare and Medicaid Services to look into a rule requiring transparency on ownership of nursing homes.

by Amie Rivers
4/12/23

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