The Trump administration has been busy this year and has taken a particular focus on nursing homes. Throughout the year, the administration has been redefining the relationship between care providers, patients, and regulatory bodies.
In June of last year, the Centers for Medicare and Medicaid Services dropped a short-lived rule that prevented long-term care facilities from demanding that patients go through arbitration rather than pursue other options should problems arise.
In November, the administration suspended enforcement on a series of new safety regulations, giving long-term care facilities 18 more months to operate without penalty. Now, however, they are rethinking the fine structure itself.
A Shift in Power
"It is critical that we have relief," the New York Times reports Mark Parkinson, president of the American Health Care Association, wrote to then President-Elect Trump in 2016. The organization, which serves the interests of long-term care facilities, has been appealing to the Trump administration that Obama-era regulations, including an inflation-based increase in fines, were harming their business and preventing them from offering adequate care.
In summarizing the concerns that the Centers for Medicare and Medicaid Services were receiving, the agency's director of clinical standards and quality, Dr. Kate Goodrich, said in a statement, "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."
The response by the administration has now been to relax fines in general. Regulators are now being discouraged from levying fines in a number of circumstances, even if known problems resulted in a patient's death. Further advice from the administration is to prefer one-time fines, with a relatively small upper limit, over per-day fines which are designed to encourage a fast response from facilities. And while the nursing homes claim that the intent is to free up time to provide better care, advocates for patient safety are concerned that this new direction taken by the administration will threaten the people who rely on long-term care facilities.
Suspending safety regulations, removing patient options to hold their facilities accountable, and taking the teeth out of regulatory enforcement ensure that the power is shifting in favor of the companies that own nursing homes and away from patients and those who protect them.
As these regulations change, it is also deeply important that patients and their families understand what legal standards the nursing homes are being held to and what options they have when things go wrong. If you are looking into nursing homes, or have concerns about one housing a family member, contact an experienced nursing home lawyer who can walk you through your rights and help you fight if needed.