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Fines against nursing homes have notably decreased

A change in how U.S. nursing homes are regulated has lowered the amount of fines they pay for violations. Overall, the government has cut fines by about 40 percent.

The administration says the new system is fairer to the nursing home industry. Critics say that lower fines mean less incentive to comply with patient safety laws. That lax policy could put nursing home residents at acute risk for injury, illness, abuse or neglect.


Nursing homes paid higher fines under the prior administration

Federal records show that a change in procedure under the Trump administration has substantially reduced the level of fines levied against nursing homes. The current level of fines for nursing home violations is down about 40 percent since the end of the Obama administration.

In the final year of Obama's term, the average nursing home fine was about $41,000. In the current term, the average fine dropped to about $28,000.

The industry lobbied for a different system

The Trump administration did not simply slash fines, per se. At the request of the industry, the Centers for Medicare and Medicaid Services changed the method for fining nursing homes. Under the Obama administration rules, facilities were fined per day until the violation was resolved. Under the new rules, facilities are fined once per instance, no matter how long the violation persists. While the number of instances actually increased under the new system, the result is that the average fines are far lower.

What does it mean for your loved one in a nursing home?

Under the new rules, elder care facilities have less incentive to comply with regulations:

  • Larger nursing home chains are able to absorb the reduced fines.
  • Since the fines are one-time instead of per-day, there is less urgency to address issues.

This dynamic puts patients at greater risk for elder abuse and neglect. Substandard care and substandard conditions increase the likelihood of falls, abuse, bed sores, medication errors and a whole host of dangers. As an example, one nursing home was fined for running out of patient medications. Other nursing homes have been fined for short staffing, sloppy sterilization of medical equipment, unsanitary practices in their kitchens, or failure to investigate a sexual assault. 


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