AARP is urging the Centers for Medicare & Medicaid Services (CMS) to strengthen its enforcement of the quality standards put in place to protect the 1.3 million Americans who live in nursing homes.
In a letter to CMS, which oversees nursing homes, AARP notes there are dangerous conditions at nursing homes across the country and cites a report last year by the inspector general at the Department of Health and Human Services (HHS) that found that complaints to states about nursing homes jumped by one-third between 2011 and 2015.
“These findings coincide with a disturbing trend of CMS actions to undermine federal oversight and enforcement of nursing home quality standards,” the letter, from Joyce A. Rogers, AARP’s senior vice president of government affairs, states.
For example, last November, CMS stopped using for 18 months a number of the enforcement remedies it has to address certain violations, including financial penalties and the termination of eligibility for Medicaid and Medicare funding. At the time of that announcement, CMS said it would emphasize education, rather than impose such penalties.
This weakening of enforcement represents a sharp departure in policy for CMS, which in 2016 issued regulations that included improved protections against abuse, neglect, exploitation and evictions.
AARP said any weakening of the federal regulations would lead to situations that would have a negative effect on safety for nursing home residents. For example, in some cases a state might opt to defer to the federal government for penalizing a nursing home violation, because the federal penalties would be greater than the state’s. But if federal enforcement of those penalties is weakened, the health and safety of nursing home residents are jeopardized.
AARP also underscored its strong opposition to a rule that CMS proposed last year to end the ban on binding pre-dispute arbitration agreements in nursing home admission contracts. “Pre-dispute binding arbitration is not appropriate where abuse and neglect are at issue,” AARP said, adding it is “alarmed that the provisions of the proposed rule would very likely have dangerous and harmful impacts on nursing home residents.”
AARP’s letter comes as the agency prepares to issue a proposed rule that could eliminate regulations it calls “unnecessary, obsolete or excessively burdensome on facilities.” Based on that characterization, AARP is concerned that the rule might weaken or dismantle important protections for current and future nursing home residents.