In September 2016, the Centers for Medicare & Medicaid Services (CMS) released new Requirements for Participation, which are requirements that apply to skilled nursing facilities (SNF) and nursing facilities (NF) with Medicare and Medicaid-eligible residents. The new requirements included a three-phase implementation timeline.
Phase 1 went into effect in November 2016 and Phase 2 took effect one year later. However, because of significant efforts by the American Health Care Association and other industry lobbying groups, Phase 2 implementation has been delayed for a second time, according to The New York Times.
CMS announced the initial delay last June, extending the timeframe for imposing penalties by one year. In November, when Phase 2 went into effect, the moratorium on the penalties portion was extended by an additional six months for an 18-month delay.
Provider Magazine, an industry publication, celebrated the delay as a win for the industry. It explained that while providers must be in compliance with Phase 2 rules, they will not suffer any penalties, such as fines, denial of payment, or termination of participation, for violating certain health and safety requirements in Phase 2.
The policy change is essentially a blank check from the federal government to nursing homes and other long-term care facilities. If these facilities attempt to comply with the requirements, they likely will not be held accountable for at least 18 months, regardless of the severity of the infraction. CMS says that systemic errors and intentional action or disregard for residents’ health and safety should still merit fines, yet the shift in policy discourages regulators from fining facilities in certain situations even if the incident causes a resident’s death.
At a time when serious health and safety violations at nursing homes and other long-term care facilities seem to be on the rise, it is disconcerting that federal regulators would bend to the wishes of an industry responsible for the reprehensible behavior.
The New York Times reports that since 2013, four of every 10 facilities have received at least one serious violation citation and two-thirds of those cited were fined. Failing to protect residents from avoidable accidents, neglect, mistreatment and bedsores are among the commonly cited violations. Advocates for nursing home residents say the policy change weakens a valuable tool to ensure patient safety and reverses the progress of deterring wrongdoing.
If you need more information on nursing home litigation contact Chris Boutwell at 800-898-2034 or by email at Chris.Boutwell@beasleyallen.com. Chris handles nursing home litigation for our firm, and he will be glad to talk with you.
Centers for Medicare & Medicaid Services
New York Times