The nursing home industry, which is already awash in claims of supposed health violations and abuse, might soon be subject to even more claims — only now, they won't face the same harsh penalties as they have in the past. A new policy from the Trump administration will roll back fines against nursing homes cited for mistreatment or neglect. While the nursing home industry and the American Health Care Association are largely in favor of the move (they requested the change in 2016), others worry that the mistreatment of nursing home patients, or spread of infection, could now go unpunished.
The new guidelines could seriously affect nursing home residents' living conditions. For one, they could discourage regulators from levying fines in some cases, and could result in lower fines in others. Under Obama-era policies, two-thirds of the homes cited for serious violations were fined. The New York Times reports that the easing of the regulations means that citations that previously resulted in fines (such as “failing to protect residents from avoidable accidents, neglect, mistreatment and bedsores," according to the Times) will now see reduced penalties, or none at all.
One example offered by the Times is an instance in which a nursing home failed to properly monitor a patient's wound, which led to a pain medication pump protruding from the patient's abdomen before she died. That nursing home was fined $282,954 under Obama's rules. Under Trump's new guidelines, the same home would be fined less than $21,000.
Still, those in favor of the new guidelines say the nursing home industry is unfairly penalized and too highly regulated, forcing doctors and caretakers to focus more on regulations, rather than forming relationships with patients. In a December 2016 letter to Trump, Mark Parkinson, CEO of the American Health Care Association, called assisted living "the most regulated profession in the country," adding that it places an undue burden on providers. Patient advocates, however, say the rollback puts nursing home residents at an even greater risk of harm, injury, or death.
The news of the rollbacks comes just months after the Trump administration offered a different blow to nursing home residents. In August, reports surfaced that the new administration was planning to place a different Obama-era nursing home regulation on the chopping block. The Trump administration proposed to replace a rule that would've made it easier for nursing home residents to sue for negligence.
The news was certainly timely. In the aftermath of Hurricane Irma, 14 Florida nursing home residents died and more than 100 were hospitalized after a facility failed to evacuate residents after losing air conditioning. In the wake of that and a similar incident in Texas during Hurricane Harvey, 46 members of Congress called on Centers for Medicare and Medicaid Services Administrator Seema Verma to maintain current protections for elderly Americans against abuse in nursing homes.
In a letter, the Congress members said the Florida and Texas incidents underscored "the need for [CMS] to reconsider upending the legal protections of those who have worked and saved for their entire lives to retire with dignity."
"This is a time when we should be protecting our nation’s seniors, not rolling back their fundamental right to hold wrongdoers accountable for neglect and abuse," the letter continued.
According to an investigation by the Los Angeles Times, some 74 percent of nursing homes were cited for lapses in infection control over the span of four years. And while repeat citations were found to be fairly common, fines were not. In fact, just 1 of the 75 homes found to be deficient actually received a high-level citation and financial penalty. Now, that number could drop even lower.