Nearly four years after 16-year-old Iowa teen Natalie Finn’s starvation death, a 160-page report published Monday blasted the state Department of Human Services (DHS) for failing to investigate more than a dozen complaints of child abuse at her adopted home after she left the foster care system.

Finn weighed only 81 pounds when first responders came to the home of her adoptive parents in Des Moines in October 2016. She died hours later at the hospital. Her adoptive mother, Nicole Finn, was sentenced to life in prison for first-degree murder in 2018. Her adoptive father pleaded guilty to assault and injury, KCRG reported.

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According to a 160-page report published by the Iowa Office of Ombudsman Monday, 14 child abuse reports were received by Iowa's DHS about Finn and other children in the home from neighbors, daycare workers, school staff and others concerned for their safety.

DHS failed to retain records of the reports of abuse over the years – given the first three came between 2005 and 2009 – which hindered child welfare workers' ability to detect patterns of mistreatment early on, the ombudsman report argued, according to the Des Moines Register.

“DHS’s records for those three reports were scant or nonexistent, due to the agency’s policies for maintaining child-abuse records. The lack of any meaningful records prevented the ombudsman from reaching conclusions on the appropriateness of DHS’s responses to those three abuse reports,” it said.

The state DHS fired social worker Amy Sacco and her supervisor in 2017 after Finn’s case gained national media attention, the Register reported.

Four out of five of the child abuse reports about the Finn children made from November 2015 to May 2016 were rejected by DHS intake staff and never assigned to field agents for investigation.

State Ombudsman Kristie Hirschman’s report said increased call volume at the DHS call centers is straining staff. The number of call intake workers has not increased since 2011 due to a lack of funding.

“Although DHS received funding for the current fiscal year to hire additional field staff, I believe employees remain overworked, especially those in the intake unit,” Hirschman said in the report. “I am seriously concerned that the recent budget increase is insufficient, especially in light of the increasing numbers of abuse reports and investigations since Natalie’s death.”

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Hirschman’s office also pointed out that the Child Fatality Review Committee, which was established by the Iowa state legislature following the 2000 child abuse death of 2-year-old Shelby Duis, has not convened since it was founded.

“We will learn from this and improve the safety net DHS provides to Iowa’s children,” DHS Director Kelly Garcia wrote in response to the report. “Some of the work to improve the Department’s response began immediately, but a large part of the Department’s ongoing efforts will focus on finding better ways to support our team so they can better support the families we serve.”