Trump implemented a policy to limit financial penalties for nursing home violations for the last four years. These violations include abuse and neglect that caused repeated harms and injuries. The policy restricted monetary fines for violations to a maximum one-time amount of $22,320 — even if the violation had continued for months. This is not an incentive the facility to fix known problems.
Meanwhile, the U.S. Department of Health and Human Services Office of Inspector General reported that out of 15,295 nursing homes nationally, 10,913, or 71%, have gone at least 16 months without a standard survey inspection. Comprehensive nursing home inspections — standard surveys — are CMS’s main tool to ensure that nursing homes meet the minimum standards necessary for the safety and wellbeing of residents.
The arbitrary policy of “per-instance” penalties stopped per-day fines involving past and ongoing dangerous practices and noncompliance. These per-day fines deterred misconduct and promoted remediation. Fortunately, the Administration reversed six months after AARP Foundation filed suit to end the practice.
Nearly a third of the more than 600,000 U.S. COVID-19 deaths have been in nursing homes, assisted living facilities and other long-term care settings. According to the U.S. Government Accountability Office, 82 percent of surveyed nursing homes between 2013 and 2017 were cited for infection protocol violations.