It’s no secret that the Trump administration supports deregulation, and among the nursing home industry is among those affected. Nursing home owners wanted fines for health violations rolled back, and the administration acquiesced. During the Obama administration, nursing homes were fined for each day in which they were not compliant.
The Trump administration changed the way fines were calculated so that nursing homes are now issued a single fine for two-thirds of infractions, according to a report by NPR. While the average fine for a nursing home in violation was $41,260 in 2016, it is now down to just $28,405.
Less Incentive to Fix Problems
Significantly lower fines mean nursing homes are less likely to repair unsafe conditions – and that means it’s more likely that patients, staff, and visitors could get hurt. In addition, the Trump administration granted an 18-month moratorium on violation penalization for eight new regulations regarding health and safety.
Previously, nursing home facilities could not require patients to submit to arbitration when settling disputes. That law has been revoked, so issues must go before arbitrators rather than going to court.
Out of Control Fines
The nursing home industry saw the large fines imposed on facilities for non-compliance as “out of control.” They applaud the switch to per instance rather than per diem fines, not only because the penalties are smaller, but because fines are currently capped at $21,393 on either a per instance or daily basis.
If nursing homes pay the fine without contest, they receive a 35 percent break, so the maximum fine is $13,905. Currently, the average fine under the Trump administration is $9,000, a small amount for nursing homes owned by multimillion dollar businesses operating such facilities.
These relatively low fines are also in place for nursing homes with many violations, a situation known as immediate jeopardy. Immediate jeopardy exists, according to the Centers for Medicare & Medicaid Services (“CMS”) – the agency in charge of levying fines – when the situation is such that nursing home patients are in serious risk of harm.
For example, a nursing home in Mississippi ran out of medications but was fined just $13,627. A New Mexico nursing home had its fines reduced by more than half – from $54,600 to $20,065 – because workers were not properly disinfecting equipment and increasing the risk of spreading infectious diseases to a vulnerable population.
The Trump administration has issued fewer immediate jeopardy fines than in the past, and the number of such fines was an average of 18 percent lower than during the Obama administration.
Rules for immediate jeopardy fines have also changed. As of June 2018, inspectors were informed that immediate jeopardy fines were only issued to facilities if the violation resulted in death, or serious injury or impairment.
Penalties Too Low to Change Behavior
According to consumer rights organizations, the penalties for nursing home violations are now so low that they won’t change the behavior of unscrupulous nursing home operators. They contend a large fine can force a facility to make changes, while low fines are considered just part of the cost of doing business. For the 1.5 elderly and infirm people living in U.S. nursing homes, that cost of doing business affects not only their quality of life, but perhaps life itself.
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