Chuck Grassley

United States Senator from Iowa





Grassley Receives Response from CMS on Iowa Nursing Home Death

Sep 07, 2018

WASHINGTON – U.S. Sen. Chuck Grassley of Iowa received a response from Centers for Medicare and Medicaid Services (CMS) Administrator Seema Verma regarding his July 27 letter seeking more information into what happened in the case of an elderly Iowa woman who passed away seemingly due to lapses in care by staff at the Timely Mission Nursing Home in Buffalo Center, Iowa.

In her letter, Administrator Verma notes that “Timely Mission has had 19 complaint investigations conducted over the past 5 years” and that it “has come back into substantial compliance with program requirements following each of these surveys.”

“I appreciate Administrator Verma’s response to my letter on this issue. I’m also encouraged by the investigations by the Centers for Medicare and Medicaid Services when questions of abuse and neglect of seniors arise,” Grassley said. “But specifically regarding Timely Mission Nursing Home, I’m concerned about its compliance history and the sheer number of complaint investigations. The reported events are extremely troubling and call into question Timely Mission’s ability to make lasting changes so that the recurring problems stop. Patient care must be the number one focus at all times and I will continue to press for more information on this case and others like it.”

Grassley has been an advocate for seniors throughout his time in Congress, particularly through his oversight work. In 2017, Grassley pressed CMS for answers on why it failed to ensure that nursing home abuse and neglect cases are reported to law enforcement as required, as well as its lack of urgency in responding to an early alert from the agency watchdog on the problem. Grassley also called on Snapchat and other social media companies to explore how they could stop users from posting humiliating and demeaning photos of vulnerable individuals after reports surfaced of nursing home workers in at least 18 facilities taking unauthorized photos of elderly residents.

Also last year, Grassley introduced the Elder Abuse Prevention and Prosecution Act, which became law. The law enhances enforcement against perpetrators of crimes targeting senior citizens. Specifically, it increases training for federal investigators and prosecutors and calls for the designation of at least one prosecutor in each federal judicial district who will be tasked with handling cases of elder abuse. It also ensures that the Federal Trade Commission’s Bureau of Consumer Protection and the Department of Justice will both have an elder justice coordinator and increases penalties for perpetrators.

Text of the letter is available here and below.

The Honorable Charles Grassley

United States Senate

Washington, DC 20510

Dear Senator Grassley:

Thank you for your letter regarding the survey conducted on June 6, 2018 at Timely Mission Nursing Home in Buffalo Center, Iowa. As you are aware, the Iowa Department of Inspections and Appeals (IDIA) identified serious concerns with the quality of care provided by this facility. These concerns were determined to pose an immediate jeopardy to the health and safety of residents in the facility. Prior to the conclusion of the survey, Timely Mission implemented a removal plan to address the immediate threat to resident health and safety. A revisit survey conducted on July 11, 2018 found that the provider had returned to substantial compliance with CMS’ program requirements.

IDIA informed CMS of these survey findings on June 29, 2018, and transferred this case to the CMS Regional Office (RO) for determination of the appropriate enforcement remedy. The fine that is discussed in the link to the news article you provided was an independent fine imposed by the state. Holding the fine in suspension was an action the state took, and was not directed by CMS.

In determining the appropriate enforcement action for a nursing home, CMS imposes a remedy designed to promote on-going compliance with Medicare program requirement that is specific for a given facility. CMS makes this determination by evaluating the severity of findings, the facility’s history of non-compliance and related past enforcement actions, as well as the financial situation of the provider. In response to the findings of this case, CMS imposed a Civil Money Penalty (CMP) of $77,462 on August 3, 2018.

With respect to the facility’s compliance history, Timely Mission has had 19 complaint investigations conducted over the past 5 years. The facility has come back into substantial compliance with program requirements following each of these surveys. A complaint survey conducted on September 1, 2017, identified a situation of Immediate Jeopardy related to the reporting and investigating of abuse for which a CMP of $57,960.50 was imposed. All other complaint surveys of this facility over the past 5 years either did not result in deficiencies or resulted in low level deficiencies that did not require enforcement action from CMS. As you requested, a list of all complaints, survey findings and enforcement actions taken on Timely Mission over the last 5 years is enclosed.

Thank you again for your letter. CMS shares your concern for the health and safety of nursing home residents and we appreciate the opportunity to demonstrate that we take our role in protecting this vulnerable population seriously. Please let us know if there is additional information you would like or if there are further questions we could address.


Seema Verma