An audit released Monday shows the state has made "substantial improvements" in efforts to inspect nursing homes and now meets federal requirements, state Auditor Rob Sand said. This requirement was set by the Centers for Medicare and Medicaid Services (CMS), the federal entity that pays for states to inspect nursing homes for compliance with federal regulations. Sand: Care facilities still struggle with nursing staff levels"More people can get more inspections done. An Iowa Capital Dispatch review of 2025 federal data found 15% of Iowa nursing homes were cited for insufficient staffing. There are also 17 fewer nursing homes in the state as well as roughly 2,000 fewer beds available for residents in Iowa compared to 2024.