Categorized | Features, Pushback

A ‘Very Dangerous Time’ For Nursing Home Residents

Coronavirus, nursing home

The new regulations on nursing facilities were the first update to the requirements in 25 years.

By Al Norman

The Trump administration’s Centers for Medicare and Medicaid Services (CMS) announced in December that it will give nursing facilities across the nation another year and a half to comply with new regulations that were written by the Obama administration, which seek to improve the quality of care and safety at nursing homes.

The new regulations on nursing facilities were the first update to the requirements in 25 years.

Facility owners were pleased, because they told federal regulators that they needed more time to implement the new policies. But elder advocates charged that CMS was favoring the nursing facility industry over its residents. CMS said it would give  facilities the extension of time before enforcement of many of the new nursing home regulations begin. Nursing facilities were supposed to be in compliance with the new regulations by Nov. 28, 2017.

The moratorium means that facilities will not face financial penalties, payment denials or termination from Medicare if they don’t comply with certain requirements in the new rules.

For example, facilities will not face fines for having inadequate staff on-site, including staff qualified to handle mental health issues. New rules that ensure appropriate prescribing of psychotropic medications are also now on hold.

CMS justified its delay by saying it needs to educate nursing facility staff and federal surveyors to make sure they all understand the health and safety expectations that must be met. A facility will still be cited for deficiencies — but they will not be subject to actual money fines.

The nursing facility industry wanted the rules frozen completely, so they could be rewritten to remove administrative burdens. But patient advocates, like the Center for Medicare Advocacy, said the moratorium simply delayed quality improvement and safety at facilities.

The new regulations:

? Allow residents to choose their roommates, and have the right “to receive visitors of his or her choosing at the time of his or her choosing,’’ as long as it doesn’t impose on another resident’s rights.

? Require nursing facilities to have a staff person to handle complaints and follow a strengthened grievance process, with decisions in writing.

? Prohibit facilities from discharging residents for nonpayment if they have applied for Medicaid or other insurance, or are appealing a claim denial.

? Allow residents who want to return to a  facility from a hospital stay to appeal a nursing facility denial, and have the right to return to their same room, if it is available.

? Prohibit nursing facilities from hiring any licensed professional who has received a disciplinary action because of abuse, neglect, mistreatment or financial exploitation of residents.

? Require nursing facilities to have enough skilled and competent staff to meet residents’ needs. There are specific training requirements for caring for residents with dementia and for preventing elder abuse.

The moratorium on these changes “directly threaten the health, safety and well-being of nursing home residents,” said a spokesman for the Center for Medicare Advocacy. The CMS announcement of an 18-month moratorium is just the latest assault on the enforcement system. This is a very dangerous time for residents.”

Al Norman worked in the Massachusetts home care network for 37 years. He can be reached at: or at 413-834-4284.


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