Late last year, the federal government announced that it is reducing the use of fines against nursing homes where residents suffered harm or faced the serious risk of injury. Guidelines put in place by the previous administration, intended to sanction nursing home neglect and abuse, were reversed. Under the new guidelines, regulators are discouraged from imposing fines in some situations. These will even include times where there is a resident death.
Almost 6,500 nursing homes, or four out of every 10, were cited at least once for a serious violation since 2013. Medicare fined two-thirds of those facilities. Failure to protect residents from avoidable accidents, neglect, mistreatment and bedsores were among the most common violations.
The average fine was $33,453 in recent years, although 531 nursing homes had cumulative federal fines exceeding $100,000. Congress raised these fines in 2016 to account for several years of inflation.
These new rules slowly took effect over 2017. In July, the Centers for Medicare and Medicaid Services discouraged directors of state agencies from issuing daily fines for violations that started before inspection and to issue one-time fines instead.
In October, CMS persuaded its regional offices from imposing fines for a single error, even if it was a serious health violation. However, it said that fines should be levied for intentional disregard of health or safety and systemic errors.
Under this new policy, nursing homes could be protected from fines exceeding the single violation fine of $20,965, even for serious mistakes. Advocates for nursing home residents say these changes could diminish efforts at deterring wrongdoing and reduce enforcement which was already weak.
Other enforcement was reduced last year. CMS, in June, revoked a government policy that prohibited nursing homes from requiring residents to participate in mediation instead of going to court.
In November, nursing homes who violated eight new safety rules were exempted from penalties for 18 months, but still must follow these requirements. These rules were designed to reduce the overuse of psychotropic drugs and ensure that every facility is prepared to assist residents with serious psychological problems.
Lower federal enforcement may lead to greater personal injury for residents. When a facility does not provide a reasonable standard of care, residents and their families should seek legal assistance to help assure that violations are corrected and that they can seek compensation.
Source: CNNMoney, “Trump administration eases penalties against negligent nursing homes,” Jordan Rau, Jan. 3, 2018