Experts and consumer advocates are concerned that reduced federal oversight and enforcement of regulations of nursing homes will remove incentives for facilities to improve the care patients receive. Nursing homes nationwide are monitored by the Centers for Medicare and Medicaid Services. Advocates, experts, and concerned legislators worked for years to secure new protections for residents of nursing homes. The year 2016 brought national long-term care regulatory reform.
The new safety rules to improve the quality of care included increased oversight in infection control, added training for staff and protections against abuse, neglect and exploitation. But those regulations, some of which were due to be implemented in November 2017, were halted by the Trump administration. The nursing home industry provided millions in campaign donations in the 2016 campaign.
In May, 18 Attorney Generals condemned the reduction of oversight and patient protections. The letter, addressed to the U.S. Department of Health and Human Services, cited a 2017 report from the inspector general that found the Center of Medicare and Medicaid Services has “inadequate procedures to identity and report incidents of abuse and neglect.” Patients need more protection, not less, the letter said.
An estimated 22 percent of Medicare beneficiaries experienced adverse events — including infections, pressure ulcers and medication-induced bleeding — during stays at skilled nursing facilities, a report said. Nearly 70 percent of these adverse events were preventable or could have been avoided if the facilities had provided better care, according to the letter, and over half of residents harmed needed hospital care.
A combination of low pay, inadequate training, and the difficulty of the job due to short-staffing contributes to poor turnover rates. The federal government did a study back in 2001 that found that, more than likely, it takes more than four hours of direct care per resident per day just to prevent harm.
“There are a lot of nursing homes that are even worse off for staffing in the state,” she said. “If there is not enough staffing, no matter how good they are, they can’t do the job they’re there to do.”