Each year, about 380,000 residents are killed by infections, according to the Medicare agency. Failure to prevent them is also the leading cause of citations that state inspectors bring against nursing homes. The Trump administration has been working to weaken safety standards governing America’s nursing homes, including rules meant to curb deadly infections among elderly residents.
Last July, the federal Centers for Medicare and Medicaid Services, or CMS, planned to weaken rules that required every nursing home to employ at least one specialist in preventing infections. The proposed rules eliminate the requirement to have even a part-time infection specialist on staff. Instead, the Trump administration would require that anti-infection specialists spend “sufficient time at the facility” which is not defined.
The push followed a spate of lobbying and campaign contributions by people in the nursing-home industry especially Brian Ballard, a Trump ally, according to public records and interviews. As soon as Trump was elected, Ballard was hired by the nursing home industry lobbyists, the American Health Care Association. His firm, Ballard Partners, has earned $930,000 in lobbying fees from the group since Trump took office, records show.
Based on his financial and personal connections to Trump, Ballard is now one of the most powerful lobbyists in Washington, with the most clients of any registered lobbyist last year, according to an analysis by the Center for Responsive Politics. His firm has lobbied on behalf of nursing homes in his home state, Florida, for years, according to public records. (He was also a lobbyist for Trump’s Florida golf course, the Doral.)
The administration’s reckless and dangerous decisions were caused after intense lobbying by the nursing home industry, including by the firm run by Brian Ballard, Trump’s friend and a fundraiser.
The main federal regulator overseeing nursing homes proposed the rule changes last summer, before the coronavirus pandemic highlighted the vulnerability of nursing homes to fast-spreading diseases.
Infection-prevention specialists are supposed to ensure that employees at nursing homes properly wash their hands and follow other safety protocols. They are widely considered the front line for stopping infections, among the leading causes of deaths in nursing homes.
Attorneys general in 20 states have called the proposed rules a threat to “the mental and physical security of some of the most vulnerable residents of our states.”
“It adds up to less time, less infection control,” said Anthony Chicotel, a staff lawyer for California Advocates for Nursing Home Reform. He said the proposed change was “alarming.”