During the last four years, the federal Centers for Medicare & Medicaid Services restricted financial penalties for some nursing home violations to a maximum one-time fine of $22,320 even if the violation was ongoing for months. On July 19th, however, the federal government reversed this policy and is again allowing the imposition of daily fines for nursing home abuse and other safety violations.
More lenient policy
The federal government weakened its enforcement policy in 2017. Before that change, fines of up to $20,965 per day were imposed for the most serious nursing home violations.
This relaxation impacted over 15,000 nursing homes in this country regulated by CMS. The agency is tasked with assuring that these facilities meet a level and safety and quality of care to protect Medicare and Medicaid beneficiaries from abuse, neglect, exploitation or inadequate care and supervision.
Data from the U.S. Government Accountability Office indicates that 82 percent of surveyed nursing homes between 2013 and 2017 received citations for violations of infection protocols. However, the now rescinded policy prevented state agencies that monitored these facilities from recommending daily fines for previous non-compliance regardless of the duration of their offense.
The AARP criticized this policy because it did not provide incentives for improving facilities. The AARP equated it with allowing violators to treat noncompliance as a mere cost of doing business. It filed a lawsuit against the CMS concerning the reduced penalties two years after requesting it to reimpose the daily penalties.
The lower penalties reduced enforcement of the Nursing Home Reform Act of 1987, according to the lawsuit’s plaintiffs. That law began recognition of the need to uphold health and safety in long-term health care facilities.
In its announcement reinstating daily fines, CMS said that that the agency should keep its discretion to impose daily fines, when appropriate, to address specific non-compliance situations. It declared that nursing homes have the primary responsibility for their residents’ health and safety.
A nursing home trade organization, The American Health Care Association/National Center for Assisted Living, said that per diem penalties take away resources from an underfunded industry especially during an unprecedented time.
Stronger enforcement will hopefully improve care and deter abuse and neglect. But understaffing and other problems may continue to persist. Attorneys can assist families to seek compensation and protect their loved ones.