Changes in the Nursing Home Industry Could Put Millions of Lives at Risk

If your loved one is being cared for in a nursing home facility, you’ll want to pay close attention to recent changes made by The Trump Administration. The implementation of fines against nursing home facilities that have been accused of neglect or wrongdoing, should be scaled back, according to The Trump Administration. This announcement comes as part of a broad relaxation of various regulations. Such a change in the penalty protocols made by Medicare was requested by the nursing home industry and their main trade group The American Health Care Association. The group has made several complaints since 2013 alleging that federal inspectors, under President Barack Obama, focused more on “catching the wrongdoing” rather than encouraging these facilities to make improvements.

Mark Parkinson, president of the AHCA, wrote a letter to Trump in 2016 and asked him for relief. Between 2013 and 2016, approximately 6,500 nursing homes, or 4 in 10, were cited for at least one serious violation. Of those, Medicare allocated fines of around $33,000 to two thirds of these facilities. Citations and violations included the failure to protect residents from accidents that could be avoided, mistreatment, abuse, and neglect.

According to the recent guidelines laid out by the administration, regulators are discouraged from fining facilities, even when a death was the result. When a fine is levied, it is suspected that it will be much lower than the previous fines.

Dr. Katie Goodrich, director of clinical standards and quality at the Centers for Medicare and Medicaid Services, says providers were most concerned about unnecessary regulation. She is quoted as saying “Rather than spending quality time with their patients, the 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,”

Advocates and nursing home lawyers say decreasing these penalties could put vulnerable, elderly people at risk. Concerns of patients being taken advantage of or further neglected are also prevalent amongst those against the new changes. Senior attorney at the Center for Medicare Advocacy, Toby Edleman, says “They’ve pretty much emasculated enforcement, which was already weak,”

These changes have been slowly enforced throughout 2017. In October, the Centers for Medicare and Medicaid Services sent out a memo to regional offices which discouraged them from imposing fines – including serious violations, if the violation was a “one time mistake”. Multiple repeat violations or intentional neglect of the safety and wellbeing of patients could still merit fines and citations.

In July the same center asked directors of state agencies to avoid issuing daily fines for any violation that happened before an inspection. Rather, a one time fine would be sufficient. Medicare implements various ways to penalize nursing homes. These include daily fines, one time fines for specific violations, or payment denial for any new admissions.

David Gifford, explains that the daily fines were meant to force the nursing home into making a fast solution to the problem, but such fines were “pointless” when levied against past errors that were fixed by the time of the inspection.

These new changes could also imply that nursing homes will not have to pay more than the current maximum of $20,965 per fines. This is true even when a death occurs. In September 2016, Decatur, IL nursing home, Lincoln Manor, was faulted for negligence by inspectors. They had been accused of failing to monitor and treat a patient’s wound which resulted in an implanted pain-medication pump to slip through a ruptured suture leading to a severe protrusion from the abdomen. The patient did not survive her injuries. Lincoln Manor was fined almost $300,000. A judge was noted as saying that the penalties were “quite modest” given the “appalling” care. The facility closed one year later and could not be contacted for comment.

In November, the Trump administration exempted nursing homes that were in violation of new safety rules from any penalties for 18 months. These rules must be implemented over the course of this time and include the need to reduce an overuse of psychotropic medications and allow patients to have better access to psychiatrists.

Another alarming change is one that requires patients to submit to arbitration or mediation to settle any kind of dispute rather than taking a case to trial. Further changes are expected to be put into place over the coming year. Non profit organizations and advocacy groups for elderly patients continue to voice their concerns and fears about the future of these men and women.

Do you believe your loved one has been abused or neglected in a nursing home?

If you suspect your loved one has been abused or neglected physically, psychologically, or financially, we want to hear from you. Call The Higgins Firm at +1 615-353-0930.



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