AARP Hearing Center
The Trump administration’s decision to alter the way it punishes nursing homes has resulted in lower fines against many facilities found to have endangered or injured residents.
The average fine dropped to $28,405 under the current administration, down from $41,260 in 2016, President Barack Obama’s final year in office, federal records show.
The decrease in fines is one of the starkest examples of how the Trump administration is rolling back Obama’s aggressive regulation of health care services in response to industry prodding.
Encouraged by the nursing home industry, the Trump administration switched from fining nursing homes for each day they were out of compliance — as the Obama administration typically did — to issuing a single fine for two-thirds of infractions, the records show.
That reduces the penalties, giving nursing homes less incentive to fix faulty and dangerous practices before someone gets hurt, critics say.
“It’s not changing behavior [at nursing homes] in the way that we want,” said Ashish Jha, M.D., a professor at the Harvard T.H. Chan School of Public Health.
The federal Centers for Medicare & Medicaid Services (CMS), however, said it has revised multiple rules governing fines under both administrations to make its punishments fairer, more consistent and better tailored to prod homes to improve care.
“We are continuing to analyze the impact of these combined events to determine if other actions are necessary,” the CMS said in a statement.
Since President Donald Trump took office, the administration has heeded multiple nursing home complaints about zealous oversight. It granted facilities an 18-month moratorium from being penalized for violating eight new health and safety rules. It also revoked an Obama-era rule barring homes from preemptively requiring residents to submit to arbitration to settle disputes, rather than go to court.
The slide in fines occurred even as the CMS issued financial penalties 28 percent more frequently than it did under Obama. That’s due to a policy begun near the end of Obama’s term that required regulators to punish a facility every time a resident was harmed, instead of leaving it to their discretion.
