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Justice in Aging Timeline

Published on September 2nd, 2018

A top elder rights legal group, Justice in Aging, has released a timeline of events in which the Centers for Medicare and Medicaid Services (CMS) have cut nursing homes a break by eliminating or easing restrictions that protect nursing home residents.

CMS is the federal agency tasked with the oversight and regulation of over 15,600 nursing homes in the United States. Their safety rules dictate how nursing homes operate and the group’s inspections and surveys may lead to fines and punishments that are intended to spur change and compliance. The number of incidents of neglect are still at an all-time high.  The rules, regulations, and laws need to be strengthened, with harsher punishments that send a message that improper treatment of the elderly is unacceptable.

CMS Easing Nursing Home Regulations
Below are some of the most notable rule changes and reversals by CMS from December 2016-June 2018, as detailed by Justice in Aging:

  • Removed ban on arbitration agreements in nursing home contracts after industry lobbyists pushed back.
    • Arbitration agreements force residents or their loved ones to settle grievances out of court, without legal representation, typically to the detriment of the injured party.
    • Arbitration agreements are now allowed to be used as a condition of admission to nursing homes.
  • Granted nursing homes an 18 month ‘grace period’ free of fines and penalties before new safety rules must to be followed.
    • New regulations went into effect in November 2017 but after complaints from nursing homes, CMS has given them 18 months to become compliant.
    • Some of these new regulations are:
      • Creation of a Baseline Care Plan for each resident within 48 hours of admission.
      • Facility Assessment requirement that forces a nursing home to consistently evaluate the needs of residents and what’s needed to meet those needs.
  • Reduced nursing home fines for past violations.
    • For past incidents, went from per-day fines to per-instance fines.
    • Even if an incident lasted for days, weeks, or months, a nursing home now only pays 1 fine.
  • Relaxed fines for Immediate Jeopardy citations.
    • Allowing CMS’ regional offices to determine whether to assess fines for Immediate Jeopardy violations that didn’t actually cause harm or death vs. past rule that required a fine for these violations.
    • Advised CMS regional offices to consider the severity of incident, the odds that it was a one-off mistake, and if the act of neglect or abuse was intentional.
Joe Pioletti
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