Center for Medicare Advocacy Report Says HHS Weak on
Enforcing Nursing Home Errors
Analysis of 2007 decisions by appeals board calls for
stricter oversight
June 3, 2008 – A recently released review of
nursing home decisions made in 2007 by the Department of Health and
Human Services' Departmental Appeals Board (DAB) highlights serious
failures in care that cause residents to suffer unnecessary pain,
injury, trauma, and death, according to the Center for Medicare
Advocacy, publisher of the report.
"Despite the serious deficiencies reflected by
these cases, the federal enforcement response is usually modest, at
best," said Toby S. Edelman, Senior Policy Attorney with the Center for
Medicare Advocacy and author of the report released in May,
Nursing Home Decisions of the Department of Health and Human Services'
Departmental Appeals Board, 2007, an analysis of nursing home
enforcement decisions issued by the DAB.
"The federal government imposes only minor fines
for these deficiencies," she continued, citing a case where a trivial
$4050 fine was imposed when a resident strangled to death on her
bedrail, after having fallen out of bed numerous times and been found
caught by the bedrail in the same way a week before.
The Center for Medicare Advocacy says its study of
the 85 decisions is the first ever made of the administrative appeals
filed by nursing homes when federal remedies are actually imposed
against them for poor care.
"The study shows not only that the problems in care
are serious and that penalties are modest, but also that facilities
choose to appeal these enforcement actions through the administrative
appeals process. Almost always, the facilities lose their cases,"
Edelman said.
The government won 66 of the 71 cases that reached
the merits of the appeals - a 93% success rate.
The Center for Medicare Advocacy recommends that
the regulatory system, unchanged for more than a decade, be updated.
The Center calls for a stronger and faster
enforcement response to the serious noncompliance that these cases
reflect. The federal enforcement system should impose larger fines for
facilities' failure to provide residents with the care they need, not
just for failing to correct problems, and it should include a broader
array of federal remedies to impose against facilities that harm
residents.
In addition, said Edelman, "more public information
is needed about the survey and enforcement systems and about the appeals
process."
Medicare's informational website, Nursing Home
Compare, does not describe the facts supporting deficiencies and
contains no information about enforcement actions. "Consumers need
information about surveys and enforcement to help them choose facilities
and to monitor the care their loved ones receive."
June 3, 2008 – A recently released review of
nursing home decisions made in 2007 by the Department of Health and
Human Services' Departmental Appeals Board (DAB) highlights serious
failures in care that cause residents to suffer unnecessary pain,
injury, trauma, and death, according to the Center for Medicare
Advocacy, publisher of the report.