Should I Be Concerned about Trump Administration Easing Nursing Home Fines?

Jan 05, 2018

If you have a loved one in a nursing home, you may be asking – “Should I be concerned about the Trump Administration easing nursing home fines?” You may also be wondering how the scaling back of nursing home regulations could affect how real problems in nursing homes are managed.  With so many shifts, and a steady flood of nursing home abuse and neglect claims, there are many questions associated with the Trump Administration’s decision.

At Brown & Brothers, we understand that there are many reasons why you may be concerned about changing laws.  Nursing home abuse, neglect, bedsores, mental health, medications, and protecting the overall wellbeing of your loved ones may consistently weigh on your mind.  We are here to help.  Here is some helpful information about changing laws and what you can do to protect yours or your loved one’s legal rights.

Trump Administration Easing Nursing Home Fines

The Trump administration has been scaling back on numerous regulations, with one of the most recent being the use of fines as punishment against nursing homes that place residents in harm’s way, or directly harm residents.  Reducing fines against nursing homes comes after the nursing home industry complained that the Obama Administration focused “excessively” on finding wrongdoing, rather than offering solutions for nursing homes to improve.

Since 2013, four out of 10 nursing homes have received citations for at least one serious federal violation.  That accounts for approximately 6,500 facilities.  Two-thirds of these facilities were cited directly by Medicare for violations including:

  • Failure to protect residents from avoidable accidents
  • Neglect
  • Mistreatment
  • Improper bedsore management

Under the new regulations, nursing homes could avoid fines even for serious violations leading to injury or death.  It is further suggested that the maximum fine limits will also be reduced, further protecting nursing homes.

In recent years, nursing homes have amassed fines in excess of $100,000, but the average fine for a single facility was $33,453.  Over the past year, the way that fines are assessed and levied has changed to account for inflation not previously factored into the amounts.

New Regulations Cause Debate

The nursing home industry is in full support of the easing of fines saying that nursing homes have been spending too much time trying to comply with strict regulations, which interferes with their role as caregivers.  According to the Director of Clinical Standards and Quality at the Centers for Medicare and Medicaid Services (CMS), the time spent on compliance does not increase the quality of care provided.

Advocates for patient safety and rights, however, argue that reducing penalties only weakens patient safety measures.  An attorney for the Center for Medicare Advocacy stated that reduced penalties emasculates enforcement, which has been known to be weak already.  Advocates are concerned that previously made progress could be undone, and efforts to reduce errors in nursing homes could be damaged.

Nursing homes can be fined in different ways – a single fine for a particular violation, daily fines for continued violations, or denied payments for new patients admitted to the facility.  In recent months, CMS has discouraged state agencies from imposing daily fines, favoring a one-time fine.  CMS also discouraged facilities from penalizing facilities whose violations began prior to inspection.

What Reduced Penalties Means for Nursing Home Residents and Families

One of the most startling examples of how the reduced penalties could affect nursing home residents and families is that of a facility in Decatur, Illinois.  In September 2016, Lincoln Manor was cited $282,954 for failure to monitor and treat a patient whose pain-medication pump slipped and eventually protruded through her abdomen.  The patient died as a result.  The judge in that case ruled the fines were “modest” given the “appalling” care provided to the patient.  Had this case gone to court under the new guidelines, the one-time fine would have been, at maximum, $21,000 or less because penalties would not have been assessed on a daily basis.

Another factor that could affect nursing home residents and their families is the fact that the Trump Administration has exempted nursing homes violating eight safety rules from being penalized for 18 months.  During this 18 month period, nursing homes will be educated about specific new standards.

The eight violations included in the exemption include:

  • Baseline Care Plans
  • Behavioral Health Services
  • Sufficient/Competent Direct Care/Access Staff-Behavioral Health
  • Psychotropic Medications (PRN limitations)
  • Facility Assessment
  • Antibiotic Stewardship Program
  • Quality Assurance and Performance Improvement (QAPI) Program and Plan
  • Smoking Policies

Nursing homes are still required to abide by regulations, but will not be fined for violations during the 18 month period.

How to Protect Your Legal Rights

Many advocates for nursing home residents believe that strict regulations and steep fines were a means of penalizing nursing homes, but also putting attention on the heart of the issue of abuse and neglect.  With tens of thousands of lawsuits filed each year citing nursing home abuse and negligence, concerns about nursing homes and quality care are at an all time high.

Every year, thousands of nursing home residents become injured or die due to abuse or neglect.  Some of the most common factors contributing to these injuries and deaths include:

  • Improper monitoring and treatment of bedsores
  • Medication errors or improper use of medications
  • Inadequate staffing and training
  • Substandard facility maintenance, upkeep, or cleanliness

With laws changing, it is more important than ever that nursing home residents and their loved ones understand their legal rights and how changing laws could affect them.

To find out more about how to protect your legal rights, contact Brown & Brothers today.  Fill out our online form to schedule a no-obligation consultation.  Our attorneys are skilled in the areas of nursing home abuse, neglect, and medical malpractice.

 

Sources:

https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/Survey-and-Cert-Letter-18-04.pdf

https://www.beckershospitalreview.com/post-acute-care/cms-reduces-penalties-for-medical-errors-at-nursing-homes-5-things-to-know.html