Law360 had an interesting article about the Trump Administration decision to ignore requests for public information about nursing homes.  At least four lawsuits have been filed in federal courts since early April accusing CMS of wrongly impeding access to various records. The allegations include improper redactions and charging of excessive fees in violation of the Freedom of Information Act.

Abuse and neglect in the nation’s 16,000 nursing homes is a widely recognized problem. Two years ago, the U.S. Department of Justice launched 10 task forces targeting “grossly substandard care” in nursing homes. Last year, a federal watchdog urged CMS to take “immediate action” to address the underreporting of physical and sexual abuse in the nation’s nursing homes.

“The Trump administration is hindering plaintiffs attorneys who investigate abuse and neglect of seniors by heavily redacting nursing home records and charging tens of thousands of dollars to produce such records, according to interviews, government correspondence and newly filed lawsuits.”

This is clearly a decision to help the nursing home industry cover up neglect and avoid accountability.   Some of the recent litigation brought by plaintiffs attorneys is aimed at gathering evidence of the administration’s motivations. In a lawsuit filed last month, two plaintiffs attorneys — Ernest Tosh of Tosh Law Firm PLLC and David Marks of Marks Balette Giessel & Young PLLC — sought any communications between CMS and third parties concerning the disclosure of nursing home records.  The attorneys want those communications in order to determine “whether CMS’ reversal of its prior policy regarding disclosure … resulted from, or was influenced by, pressure from nursing home industry representatives or others acting at their behest,” according to the suit.

Another lawsuit that Tosh and Marks filed last month accuses CMS of excessively redacting nursing home records. According to the suit, the federal agency in July 2017 demanded $9,000 to produce records, and so Tosh requested a sample of the records to ensure that they would be worth the money.

“The redactions included in the sample provided to Tosh indicate that any records [CMS] does eventually produce will be unlawfully redacted and functionally useless,” the lawsuit says.

Steele’s lawsuit is aimed at forcing CMS to certify its own estimates of appropriate staffing levels in nursing homes. CMS employees usually cannot be subpoenaed to testify about the accuracy of those estimates, and so certifications are essential to using the estimates as evidence that nursing homes were understaffed when patients suffered harm.

“It’s literally the only way we can use this in court cases,” Steele said.  “I think there absolutely was some sort of directive that came down … to cut off the spigot of data,” Steele said. “Because this data’s getting used effectively to hold these nursing homes responsible for the way that they’re treating their residents.”

The cases are Johnson v. Centers for Medicare & Medicaid Services, case number 2:18-cv-00590, in the U.S. District Court for the Western District of Washington, The Steele Law Firm LLC v. U.S. Department of Health and Human Services et al., case number 4:18-cv-00275, in the U.S. District Court for the Western District of Missouri, and Tosh et al. v. U.S. Centers for Medicare & Medicaid Services et al., case numbers 1:18-cv-00915and 1:18-cv-00949, in the U.S. District Court for the District of Columbia.


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