What happens when a nursing home is cited by state or federal regulators for quality of care problems? Most assume that the regulators will ensure that that negligent facility will be forced to improve or face closure. And in theory that is how the regulators are set to work. While the specific procedure depends on the state in question, most regulators will conduct investigations into practices and protocols at a nursing home during routine inspections or following a particular incident. Following those inspections, the facility may face financial penalties and is often forced to make changes and show improvement. Regulators will often conduct follow-up visits to ensure changes have actually been made.
In some cases, the facility may have committed so many egregious offenses or continually fail to improve, that more drastic actions are taken. This may result in the facility losing its ability to participate in Medicare and Medicaid programs (a death knell for many facilities which cannot financially survive otherwise). Alternatively, a state may deny the facility the ability to receive the proper licensing to legally operate. In those instances, the facility may be closed.
For example, SF Gate reported last week on a nursing home that is slated to close following the end of a two year legal battle with state and federal regulatory officials.
According to the report, the particular facility in question was cited for over 40 violations during inspections in 2010 and 2011. Many of those violations were of the most serious kind-related to problems like failure to prevent elder abuse, medication problems, allowing bed sores to fester, failure to prevent falls, and more. All of this resulted in the officials deciding to stop Medicare and Medicaid payments.
In an effort to drag out the enforcement of the penalty-which would make the home impossible to operate financially-the nursing homes filed a federal lawsuit. This move temporarily allowed the home to stay open while the legal battle dragged on. Eventually the case was thrown out by a federal judge. It was only then that the nursing home acted to fix the matter.
The result is that residents were moved to other facilities and the home itself was sold to another nursing home operator. The facility in question was owned by one large company that owns several nursing homes. The deal also involved the transfer of ownership of six other nursing home and assisted living facilities in the area.
Proper Oversight is Helpful, But Lacking
This particular case is a good example of how regulation plays out in these nursing home cases. For one thing, the facilities often do everything in their power to avoid being held accountable following citations. In this case they went so far as to file suit in order to delay the enforcement of the penalty. As a result, the home stayed open for nearly two years after the first attempt to pull the facility from participation in federal programs.
Then, even after the legal challenge dissolved, the proximate result was simply to transfer ownership to another. While this may be a good thing, if the new owner provides superior care, it is by no means a guarantee that life for residents will actually be better. It is not uncommon for ownership transfers to result in little to no improvements in actual care.
The bottom line is that while regulatory oversight is a good thing, regulators often have their hands tied when it comes to quickly and efficiently ensuring improvements are made to help residents.
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