Unlicensed care facility continues to operate one year after deadline passes
The Sutton Senior Home in Des Moines. (Photo by Clark Kauffman/Iowa Capital Dispatch)
One year after state officials told the owner of an unlicensed care facility to relocate her elderly residents for their own safety, the home continues to do business on Des Moines’ southwest side.
In November 2020, the Iowa Department of Inspections and Appeals gave the owner of Sutton Senior Home a deadline of Dec . 1, 2020, to submit a plan to relocate tenants of the home, which is located just off Park Avenue in Des Moines. Since then, the state has initiated and then suspended court action against the owner while pursuing settlement negotiations that have yet to be completed.
In May of this year, the state officials took the owner, Anne Porter of Ankeny, to court, seeking a judicial order that would force the home to cease operations as an unlicensed health care facility. As an alternative, the state asked the court to grant a writ-of-removal order against the residents of the home, which would have required the owner to “re-home” the tenants elsewhere.
In July, those court proceedings were put on hold when it was determined the state had yet to exhaust all administrative remedies in the matter, a necessary step before the court could hear the case.
A hearing before an administrative law judge was held in August, at which point the two sides agreed to a 90-day delay while they pursued settlement negotiations. Another hearing was held Nov. 22, with both parties indicating settlement talks were ongoing.
Anagha Dixit, the assistant attorney general who is handling the case for the state, told Administrative Law Judge Emily Kimes-Schwiesow at last month’s hearing that she expects an agreement of some kind will be finalized within the next three weeks.
“We have been working fairly diligently toward getting a settlement together,” Dixit told the judge. “There were a number of issues we had to go back and forth on multiple times, so, kind of hammering out the details has taken up most of the time.”
State records indicate the home has been admitting tenants since 2017, with residents paying up to $9,500 per month for their care.
The single-family house, which was home to five tenants earlier this year, appears to have been generating up to $46,800 per month in revenue. The Iowa Department of Inspections and Appeals and the City of Des Moines have alleged that DIA inspectors visited the house in the fall of 2020 and reviewed the level of care needed by the six people then living there.
DIA concluded the house was functioning as either a residential care facility or an assisted living program, both of which would require state licensure or certification.
DIA has alleged Porter is circumventing state laws requiring licensure and inspection of care facilities by using one corporate entity to provide housing, as a landlord normally would, and another company that she owns, A-Plus Home Care Services, provides health care for residents.
In responding to those allegations, Porter’s attorneys have stated in court that by delivering housing and health care through two “separate and distinct legal entities,” Porter need not be licensed.
Porter, who is a state-licensed registered nurse, is merely a “residential landlord in the business of leasing rooms to tenants,” according to filings by her attorneys. They acknowledge that the residents of the home are all elderly individuals “who need varying amounts” of care.
According to DIA, one of the tenants at the home last fall was 77 years old and had moved into the house in November 2017, paying $2,100 per month in rent, A-Plus $5,800 per month for health care. The woman required 24-hour supervision for her safety, was diagnosed with Alzheimer’s disease and glaucoma, and had issues with anxiety, paranoia, confusion and wandering. Other residents of the home were in a similar situation, according to the state.
Porter has declined to comment on the case. On her website, she says she has been a registered nurse for more than 40 years and holds a master’s degree in health care administration.
The outcome of the Sutton case could have major implications for nursing facility regulation in Iowa. If the court rules that a company can bypass state licensing and inspections by having separate corporate entities handle the housing and the health care, other providers might take that same path.
In 2009, Dubuque Retirement Community, then home to 116 seniors, attempted to avoid state oversight and regulation after being repeatedly penalized by inspectors for poor-quality care. The owners of the facility announced plans to give up their state license as an assisted living center so the property could operate as an apartment complex subject only to landlord-tenant laws, while health care services were delivered by a wholly owned subsidiary that functioned as a home health agency.
The company indicated that by separating the housing component from the health care services, it would be able to provide the same care to the same seniors in the same building, but without a license and all of the attendant regulations and inspections.
The Dubuque facility is now a fully licensed assisted living center operating under new ownership.
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