Cap on nursing home violation fines lifted, but will it help residents?
For the last several years, a penalty cap has allowed nursing homes failing to meet safety standards off without facing harsh enough penalties—but not anymore.
The Biden administration recently rolled back the nursing home penalty cap. That means the largest fine for a single violation is no longer around $22,000, but hundreds of thousands of dollars.
It's not clear whether the move will encourage better resident treatment.
Nursing home struggles
In 2017, the Trump administration took away the Centers for Medicare and Medicaid Services (CMS) discretion to fine substandard nursing home facilities for every day a violation is not properly addressed. The cap did not prevent large fines against nursing homes. Though, it did stunt them a bit. The CMS could still assess fines for multiple violations adding up to far more than $22,000.
In July, Biden restored the CMS' power to levy multiple-day fines.
The poor state of U.S. nursing homes was laid bare by COVID-19. The inability of long-term care facilities to protect residents from the virus launched hundreds of local and state investigations. People quickly discovered what health care professionals have known for years: nursing homes are understaffed, underfunded, and underappreciated
These shortfalls have had a traumatic impact on residents who are being abused and neglected in greater numbers as a result.
Nursing homes and assisted living facilities, many of which had already been struggling for years to meet standards and stay within budget, were walloped at the start of the pandemic. The virus tore through care facilities, killing many elderly and seriously ill residents in the process. About one-third of all Americans who have died from COVID-19 were nursing home residents. That's more than 200,000 deaths.
Now as the COVID-19 Delta variant spreads across the nation, people are once again concerned about whether nursing homes and assisted living facilities will be able to protect residents from the virus. Unsafe nursing homes will now be encouraged, again, to quickly fix violations or face daily fines. This may not result in better care for patients, however. The underlying problem at nursing home facilities is inadequate staffing brought on, for the most part, by a lack of revenue.
Nursing homes in Alabama
Alabama has about 230 nursing homes. A lot of the facilities in the Mobile area often perform well, but that's of little comfort when a family member is being abused or neglected. Elder abuse can happen anywhere — even at five-star nursing homes. It just takes one reckless employee to seriously injure, abuse, exploit, or kill a nursing home resident.
The CMS rates every nursing home and long-term care facility in the U.S. in a five-star system. The more stars a place gets, the better they are at meeting federal safety standards.
These standards require facilities to protect residents against:
- Avoidable accidents
- Preventable infection (for instance, bedsores that become infected and lead to sepsis)
There are about a dozen nursing homes within 25 miles of Mobile. Their level of federal safety compliance is varied. As of mid-August, there are four local nursing homes with a one- or two-star rating on Medicare.gov, meaning they are performing at a standard "below" or "much below" average. Three nursing homes are average, and 14 are either "above" or "much above" average.
As far as fines go, Alabama is home to one of the most heavily fined nursing homes in the country, according to a ProPublica analysis. Village at Cook Springs Skilled Nursing Facility in Pell City has been assessed $531,000 in fines over the last three years. The CMS is alleging two violations in 2021: the home failed to protect the identities and medical records of a few residents, and it did not immediately inform a resident, doctor, or family member about a significant injury or change in condition.
Will more fines help nursing home residents?
With the ability to fine for each day a nursing home does not address a violation, the CMS has a lot of power to enforce safety standards. Without this discretion, there is less incentive for a negligent nursing home to quickly improve.
Not everyone thinks fining nursing homes for every day they are unable to fix a problem is a good idea, however.
Nursing home associations say that hefty fines take money that could be used for patient care away from already struggling facilities. Indeed, many health care experts say that the federal policy to not fully reimburse centers for the cost of treating Medicare residents is choking the entire industry. Nursing homes can lose money by treating some Medicare patients, but under the law, they are barred from refusing admission based on insurance coverage.
Nursing home residents deserve dignity and respect
If you have a loved one you suspect is being abused or neglected at an Alabama nursing home, don't wait for the government to figure out what's going on so they can fine the facility into providing better care. You need to act immediately to protect the person you love from being mistreated.
At Braswell Murphy, LLC, in Mobile, our nursing home abuse and neglect attorneys fight for families throughout Alabama. We take charges of elder abuse seriously. We are aggressive in our pursuit of the truth and have a history of getting nursing home victims the compensation they need and deserve. In one case involving nursing home negligence, our law firm secured more than $1 million for a client whose parent died in a nursing home due to overmedication. We also won $175,000 for a client who was being verbally abused by nursing home staff.