In what appears to be the first civil COVID-19 related resolution of its kind - the US Attorney’s Office of Northern Iowa (DOJ) entered into a settlement with the Care Initiatives in Dubuque for $214,200 for alleged deficiencies in COVID-19 safety protocols.

While the settlement amount is small, the Care Initiatives matter serves as a concrete reminder that the government is scrutinizing the adequacy of COVID-19 safety protocols in the context of federal reimbursement—even with respect to the early days of the pandemic.

Keep that bit in mind.

I want to make clear Pedati isn’t the problem. She absolutely was in the early stages of the pandemic.

But what she didn’t say matters tremendously. no one knew there was an outbreak - at the Iowa Veterans Home - a breakthrough infection to boot - at the State Veterans Hospital in Des Moines.

This is a 1:30 minute audio clip. Key takeaway: IVH had a breakthrough COVID19 outbreak and the federal Vets Administration in Des Moines wasn’t told.

ME:

I called the state Veterans Hospital [in Des Moines] to ask them about crossover and what kind of oversight they had and about regulatory crossover [between a state facility IVH and the federal VHA] And I said I was just calling because of the outbreak. And this again was last month [JUNE 2021] at Iowa Veterans Home.

And he - the Des Moines VA spokesman - just stopped. And it was silent for a minute. And he said, “I had no idea there was an outbreak at the Veterans Home.”

** pause **

“[VA Spox] because we see patients from the Veterans Home.”

PEDATI:

No, that's, you know that that's helpful.

ME:

Well, but the thing is it's a state run home is what I'm saying. And again, those were breakthrough infections. You see where where this is problematic is that there's a public facing issue. And then there's the behind the scenes issue of what's really going on with a pandemic in Iowa.

This is where my conversation with a CMS - Centers for Medicare and Medicaid - came in. I asked a specific question about reporting requirements and federal oversight at state veterans homes.

AK:

I understand there is new HHS guidance in a recent rule for state-owned veterans homes bound by states that require them to report COVID cases directly to the CDC. Who has the ultimate authority over civilian and veteran nursing homes when it comes to legal actions if they don’t comply about reporting COVID data?

CMS:

CMS only has authority on facilities that are certified as meeting CMS’ federal requirements for long-term care facilities. Some veterans homes meet these requirements…..[IVH IS A CMS CERTIFIED FACILITY]

Facilities that are certified by CMS are required to report resident and staff COVID-19 vaccination information weekly. Facilities that do not comply with the COVID-19 vaccination reporting requirement are fined for each week they fail to report.

Anyone can call CMS, HHS, etc. with concerns. I suggest literally everyone does. Here’s the regional contact information from the national CMS website.

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