The nursing home industry lobbied, and the Trump administration delivered. The industry asked the administration to ease up on penalties for facilities found to have endangered or injured residents, and that’s exactly it did.
A review of federal records conducted by Kaiser Health News found that “the average fine dropped to $28,405 under the current administration, down from $41,260 in 2016, President Obama’s final year in office.” Instead of fining facilities for each day they are in violation of health and safety rules as was done under Obama, the Trump administration is issuing just a single fine. That lessens the impact of the fine, and gives more incentive for nursing homes to allow bad practices to continue. Trump’s Centers for Medicare & Medicaid Services (CMS) has also granted an 18-month moratorium on penalties to care facilities for violations of eight new health and safety rules, and has revoked an Obama-era rule that barred facilities from forcing residents to submit to arbitration rather than going to court to settle disputes.
While Trump’s CMS is following an Obama-era policy that requires regulators to penalize a facility for every instance in which a resident is harmed, and those penalties have increased by 28 percent in frequency, the fines attached are much smaller. The total amount of penalties has fallen by 10 percent since 2016. On average, those fines are below $9,000. “These are multimillion-dollar businesses—$9,000 is nothing,” Toby Edelman, a senior policy attorney at the Center for Medicare Advocacy, told NPR. Fines are averaging 18 percent less under Trump than in the last year of Obama’s term. One example: A facility in New Mexico where workers weren’t properly disinfecting equipment got a one-time $20,965 fine, which would have been $54,600 in daily fines under previous rules.
“It’s not changing behavior [at nursing homes] in the way that we want,” Dr. Ashish Jha, a professor at the Harvard T.H. Chan School of Public Health, said. “For a small nursing home, it could be real money, but for bigger ones, it’s more likely a rounding error.” Those big nursing homes, the ones lobbying the administration, can write off the lower fines as just the cost of doing business—business that’s harmful to their residents.