Articles Posted in Legislation

nrusing home reform

Senate Hearing Regarding U.S. Nursing Homes Called Attention to Unfixed Issues and Reform 

An estimated 1.5 million individuals receive care from nursing homes nationwide each day, many of whom are living with serious physical and cognitive impairments, leaving them frail and remarkably vulnerable to abuse and neglect injustices. On July 23, 2019, members of the Senate Finance Committee Hearing once again heard pleas from elder community leaders about the constant struggles of Americans dependent on Centers for Medicare & Medicaid Services

(CMS) regulated skilled nursing facilities face each day. These guests discussed the continual lack of follow thru to require facilities to improve, a disregard to follow federal regulation by U.S. nursing home administrators, and ongoing failures to meet minimum care standards.

elderly medical care

National Survey Evidence Shows Behavioral Health Services Inadequate in Most U.S. Nursing Homes

Researchers at the University of Rochester School of Medicine started surveying randomly selected skilled nursing facilities in 2017, asking questions about the types of behavioral health issues residents have, available behavioral health services, quality, satisfaction, staffing, staff education, turnover and service barriers. Now complete, the results of the study were published in the Journal of the American Geriatrics Society on June 5, 2019 and show that mental health disorders can affect up to 90 percent of nursing home residents in as many as a third of the nation’s nursing homes and community-based care facilities.

In this first review of its kind, researchers measured four different outcomes:

nursing home reform

Latest Senate Hearing Shows CMS Can Do More to Protect Nursing Home Residents

On Wednesday, March 6, 2019 another government session, this time led by the US Senate Committee on Finance, was held to discuss several disturbing reports of nursing home abuse and neglect and the lack of preventative measures and faulty reporting system used by the Centers for Medicare and Medicaid Services (CMS) to create environments for quality resident care. The hearing was led by Chairman, Chuck Grassley (R – IA) and Ranking Member, Ron Wyden (D – OR) with special panelist testimony delivered by family members of residents fallen victim to nursing home abuse or neglect.

A Minnesota woman heartbreakingly remembered her mother, an Alzheimer’s patient who was raped by care staff. During the hearing she said, “My final memories of my mother’s life now include watching her bang uncontrollably on her private parts for days after the rape, with tears rolling down her eyes, apparently trying to tell me what had been done to her but unable to speak due to her disease.” A woman from Iowa shared her family’s concern after their mother died in a nursing home ranked with the highest possible quality of resident care scores from CMS even though the organization had been seriously fined for physical and verbal abuse. The elderly woman was allegedly left in severe pain and may have been dehydrated days before her nursing home death.

“Frail and vulnerable people are harmed when nursing homes fail to meet our standards. And I don’t think any of us wants to wait until the next natural disaster or other disaster exposes some kind of a deficiency that kills dozens of people.”

                                                 -Rep. Diana DeGette (D-CO)

On Thursday, the House Subcommittee on Oversight and Investigations held a hearing to address substandard care and recent findings of abuse and neglect in U.S. nursing homes.

nursing home reform delay

Impact of Centers for Medicare & Medicaid Services (CMS) Decision to Delay Enforcement of Protections For Nursing Home Residents

On May 30 several State Attorneys General, including Illinois Attorney General Lisa Madigan, sent a joint complaint to Alex M. Azar II, Secretary of the U.S. Department of Health and Human Services and Seema Verma, Administrator Centers for Medicare & Medicaid Services and expressed extreme concern over the Centers for Medicare & Medicaid Services (CMS) actions to slow regulatory enforcements that support the safety and wellbeing for Medicare and Medicaid beneficiaries who receive care in nursing homes and long-term care facilities. In the letter, the Attorneys General are holding CMS responsible for not pushing forward a 2016 series of skilled nursing facility reforms that were set to move out in three future stages. The current administration’s delay will bring major challenges in holding facilities accountable for providing appropriate resident care and well-being.

“We write this letter to express our concern and to alert the Centers for Medicare & Medicaid Services (CMS) about the substantial and foreseeable detriment of CMS’ actions to delay enforcement of protections for Medicare and Medicaid beneficiaries who receive care in skilled nursing facilities (SNFs). The recent CMS guidance significantly decreases the protections in SNFs by rolling back reforms to improve the safety and wellbeing of nursing home residents. If allowed to proceed, recent regulatory changes will not only threaten the mental and physical security of some of the most vulnerable residents of our states, but also potentially create additional challenges for MFCU investigation and prosecution of grievances, violations, and crimes occurring in SNFs. We therefore urge you not to lower the level of regulatory oversight.”

In the second part of our look back at the transformative and impactful 1987 Nursing Home Reform Act, we explore some other major aspects of the legislation in addition to the core rights of residents and responsibilities of facilities to ensure those rights are respected. The 1987 Nursing Home Reform Act was a part of the broader Omnibus Budget Reconciliation Act of that year. In going beyond the initial 1965 legislation that created Medicare and Medicaid, the 1987 Act laid out a series of principles that re-defined what it meant to provide care to the elderly and infirmed at nursing homes and long-term care facilities. In addition to the minimum standards of care that would give rise to later legislation at the federal and state levels, and the modern notions of a residents’ bill of rights, the Act also laid out the foundation of an enforcement network that, while still improving today, has evolved and become more robust over time relative to its nascent stages two decades ago.
Continue reading ›

Current nursing homes laws and regulations on the federal level as well as the state level owe their genesis to the immensely important foundational laws that preceded them. The current laws and regulations continue to evolve and improve over time thanks to advocacy by watchdog and public interest groups, as well as other interested parties that fight for nursing home residents every day in legislatures, court rooms, and media. One tremendous law at the root of decades of efforts was passed by the United States Congress and signed into law by President Ronald Reagan in 1987.

It was called the federal Nursing Home Reform Act, which was part of the broader Omnibus Budget Reconciliation Act of 1987. The 1987 Act brought with it many vital reforms steeped in the overall principle that nursing home residents are entitled to their own bill of rights that requires them to receive a certain level of dignified and quality care such that they can enjoy a quality of life at the home. This also marked a significant moment in that the federal government took on a substantially greater role in governing nursing home care for the first time since Medicare and Medicaid were created by federal law in 1965, more than twenty years earlier.
Continue reading ›

As the members of the baby boomer generation age and will undoubtedly create an increasing demand for health care, including at nursing homes and long-term care facilities, state governments and the federal government appear to be looking for ways to help regulate nursing homes and ensure more protection and safety for facility residents. This is especially important where so many nursing home owners are so focused on their bottom line that they are willing to cut overhead, which includes keeping staff at disturbingly low levels in order to save money, all the while overtaxing the existing aides with too much work. Such scenarios unfortunately can lead to abuse and neglect against patients, which also can occur even at seemingly normally staffed nursing homes.

As part of increased oversight, the federal government has given its review and rating process for nursing homes more teeth, and states in general have sought to find ways to strengthen regulations and come down harder on offending facilities or individual aides and staffers. Illinois’ push toward allowing nursing home residents to keep cameras in their rooms to surveil what goes on is one such example of trying to better protect residents. For months, Texas, which is also one of the worst states for nursing home quality care in the country, there has been a push to enact a bill that would make it much easier to close a nursing home if it is found to have multiple violations of the law or regulations. This is called the “Three Strikes Rule” bill.

The Details of the Law
Continue reading ›

In the world of medical care and specifically nursing homes and long-term care facilities, the authority and resources of the federal and state governments to inspect and evaluate nursing home performance, quality of care, staffing levels, and overall compliance with relevant law and regulations, is paramount.

This keeps nursing homes honest, pushes them to hire and train staff appropriately, and to ensure that abuse is eliminated and that residents get the proper attention and treatment rather than have their health and lives risked by neglect. In recent news, and as we’ve discussed in this space numerous times in recent months, the federal government’s rating system was found to have been faulty, limited, and relied on unverified self-reported data from nursing homes when ranking them and evaluating them for consumers. Investigations and inspections are thus all vital parts of this effort, and the federal and certain state governments have ramped up efforts to meet this oversight obligation.

New Proposed Nursing Home Law
Continue reading ›

We previously covered the goal of a Taxes lawmaker to institute a three-strikes rule that would require a nursing home or long-term care facility to shut down after it has at least three health or safety violations as determined by the state’s Department of Aging and Disability Services. State Senator Charles Schwertner from Georgetown, Texas has worked to gain support for this initiative, and recently proposed a bill that, if gathering enough legislative support and the signature of new Governor Greg Abbott, would require the Department of Aging and Disability Services to revoke the license of any facility that has three strikes. These violations or “strikes” would have to fall on separate days, and would be considered over the course of a 24 month time period, thus all three strikes would have to fall in the span of two years.

Understanding the Law

This bill was prompted by findings at certain nursing homes that failed to operate up to standards. One home, for example, lost its license as well as federal funding (presumably through Medicare and/or Medicaid) because it had a whopping “70 deficiencies” which included lack of cleanliness, as well as poor food quality, among other things. A local affiliate also conducted an independent investigation in which it discovered how Texas did not do what it was supposed to in “thousands of cases,” and that the state failed “to report allegations of abuse, neglect and exploitation to law enforcement within 24 hours . . . in more than 1,500 instances.”
Continue reading ›

Lawyer Monthly - Legal Awards Winner
The National Trial Lawyers
Elder Care Matters Alliance
American Association for Justice
Fellow Litigation Counsel of America
Super Lawyers