CMA study highlights serious health and safety issues in nursing homes
Nursing home decisions issued by theDepartment of Health and Human Services’ Departmental Appeals Board(DAB) in 2007 highlight serious failures in care that cause residentsto suffer unnecessary pain, injury, trauma, and death. “Despite theserious deficiencies reflected by these cases, the federal enforcementresponse is usually modest, at best,” said Toby S. Edelman, SeniorPolicy Attorney with the Center for Medicare Advocacy and author of thejust-released report, Nursing Home Decisions of the Department of Health and Human Services’ Departmental Appeals Board, 2007,an analysis of nursing home enforcement decisions issued by theDAB. “The federal government imposes only minor fines for thesedeficiencies,” she continued, citing a case where a trivial $4050 finewas imposed when a resident strangled to death on her bedrail, afterhaving fallen out of bed numerous times and been found caught by thebedrail in the same way a week before.
The Center for Medicare Advocacy’s study of the 85 decisions is thefirst study ever made of the administrative appeals filed by nursinghomes when federal remedies are actually imposed against them for poorcare. “The study shows not only that the problems in care are seriousand that penalties are modest, but also that facilities choose toappeal these enforcement actions through the administrative appealsprocess. Almost always, the facilities lose their cases,” Edelmansaid. The government won 66 of the 71 cases that reached the merits ofthe appeals – a 93% success rate.
The Center for Medicare Advocacy recommends that the regulatory system,unchanged for more than a decade, be updated. The Center calls for astronger and faster enforcement response to the serious noncompliancethat these cases reflect. The federal enforcement system should imposelarger fines for facilities’ failure to provide residents with the carethey need, not just for failing to correct problems, and it shouldinclude a broader array of federal remedies to impose againstfacilities that harm residents.