In June of 2021, the Centers for Medicare & Medicaid Services (CMS) revised its Trump-era position on how monetary penalties can be imposed on nursing homes that violate health and safety regulations. The change comes after more than 184,000 people died in long-term care facilities due to the COVID-19 pandemic. Patient safety in nursing homes has become a priority, leading to increased federal penalties for any violations.

Under the Trump administration, federal policy drastically limited the financial penalties that nursing homes faced for health and safety violations, even if the violations continued for months. The maximum one-time penalty a nursing home could face was $22,320, even if the violations continued for months.

The policy directed CMS regulators to shift away from fining a nursing home for each day it was out of compliance. Instead, the penalties were reduced to a single fine, thereby lowering penalty amounts from hundreds of thousands of dollars to a maximum of just over $22,000.

The Biden administration quietly changed the policy, once again allowing CMS to impose harsh penalties on nursing homes and long-term care facilities that violate health and safety regulations and place residents at unnecessary risk.

CMS Penalties Discourage Health and Safety Code Violations

CMS ensures that nursing homes provide a basic level of safety and quality to protect Medicare and Medicaid beneficiaries from abuse, neglect, exploitation, and inadequate care and supervision. Their primary enforcement mechanism is imposing fines on facilities that violate health and safety requirements. By returning to stiffer penalties for noncompliance, CMS will once again be able to incentivize nursing homes to correct problems before they become worse.

By limiting the financial penalties, a nursing home faced for repeated violations, regulators were limited in their ability to effectively enforce the Nursing Home Reform Act of 1987, which was enacted to maintain health and safety standards in nursing homes and long-term care facilities.

By limiting the financial penalties, a nursing home faced for repeated violations, regulators were limited in their ability to effectively enforce the Nursing Home Reform Act of 1987, which was enacted to maintain health and safety standards in nursing homes and long-term care facilities.

According to the U.S. Government Accountability Office, between 2013 and 2017, 82% of nursing homes were cited for infection protocol violations. Prior to the 2017 policy change, these facilities faced up to $20,965 per day. But by changing the policy, nursing homes were able to treat the fines as a “cost of doing business” rather than motivation to make changes or fix problems.

For example, according to an article in the New York Times, Washington-based Prestige Care experienced a COVID-19 outbreak that resulted in 52 residents and 43 employees being infected. Fifteen residents died. The nursing home had failed to meet infection control standards for more than a month. A cook who reported being symptomatic was told to come in and other employees, including a nurse and a nurse’s aide, kept working despite feeling sick. In March of 2021, the nursing home was fined $21,295 under the ‘per-instance’ penalty. If the facility had been penalized per day, it would have been fined more than $600,000.

Many of the nursing homes that are cited for health and safety protocol violations are repeat offenders. These violations often include failing to protect residents from avoidable accidents, neglect, mistreatment, and bedsores. By imposing larger fines, nursing homes will be more likely to comply with federal health and safety mandates.

COVID-19 Pandemic Exposed Inadequate Enforcement Mechanisms

The COVID-19 pandemic exposed the problems that came with a lack of adequate enforcement measures. Over 184,000 nursing home residents died due to the coronavirus, sometimes in facilities that had years of uncorrected infection control deficiencies because CMS lacked an adequate enforcement mechanism. By reversing the 2017 policy, nursing homes that violate health and safety protocols will face meaningful penalties that will incentivize them to correct problems before they become worse.

Nursing home industry trade groups, such as the American Health Care Association and the National Center for Assisted Living, claim that the changes will only take away resources that could be used to support and protect elderly residents.

But supporters of the change not that the previous policy was a slap on the wrist for nursing homes and did little to incentivize compliance.

The COVID-19 pandemic has been a visible and deadly way for people to see how nursing homes place profits over people. While the industry claims it did the best it could, additional accountability may have saved the lives of some of the people who were lost.

Robenalt Law Fights for Patient Safety in Nursing Homes

By returning to per-day penalties, CMS is once again putting teeth in the Nursing Home Reform Act of 1987. Nonetheless, nursing homes and long-term care facilities continue to place profits over people.

If someone you love was injured or died in a nursing home or long-term care facility, the nursing home neglect attorneys at Robenalt Law are here to help. We have the experience, resources, and expertise to investigate your claim and hold the negligent actors accountable.

We invited you to learn more about nursing home abuse and how we can help, to meet our attorneys, and to get answers to Frequently Asked Questions. Then contact us today to schedule a free, confidential consultation to discuss your case and how we can help.

Tom Robenalt started his litigation career representing doctors and hospitals at a large firm in Cleveland. For the past 25 years, he has used that experience to help victims and the families of those injured by negligent health care providers.