“Rather than spending quality time with their patients, the (nursing home) providers are spending time complying with regulations that get in the way of caring for their patients and doesn’t increase the quality of care they provide”, says Dr. Kate Goodrich, director of clinical standards and quality at the Centers for Medicare & Medicaid Services (CMS). This must be why the Trump administration is scaling back the use of fines against nursing homes that harm residents or place them in grave risk of injury.
Since 2013, nearly 6,500 nursing homes — 4 of every 10 — have been cited at least once for a serious violation, federal records show. Medicare has fined two-thirds of those homes. Common citations include failing to protect residents from avoidable accidents, neglect, mistreatment and bedsores. The new guidelines discourage regulators from levying fines in some situations, even when they have resulted in a resident’s death. “They’ve pretty much emasculated enforcement, which was already weak,” said Toby Edelman, a senior attorney at the Center for Medicare Advocacy.
Dr. David Gifford, the American Health Care Association’s senior vice president for quality, said daily fines were intended to prompt quick remedies but were pointless when applied to past errors that had already been fixed by the time inspectors discovered them. “What was happening is you were seeing massive fines accumulating because they were applying them on a per-day basis retrospectively,” Gifford said.
Rodney Whitlock, a health policy consultant and former Republican Senate staffer, said health inspectors “are out there looking for opportunities to show that the nursing homes are not living up to some extremely tight standards.” He said while the motivation for tough regulation was understandable, “the fines don’t make it easier to hire people and doesn’t make it easier to stay in business.”
Trump Administration Relaxes Financial Penalties Against Nursing Homes, Kaiser Health News, Jordan Rau, December 31, 2017