Question

It comes as no surprise that care in nursing homes has its issues. Some problems include:

• There is urine and/or feces on the bathroom floors of several incontinent patients.
• Less than 40% of staff and 70% of residents received an influenza vaccine this year.
• Medication patches ordered “discontinued” for a resident were found on the resident’s shoulder one day after the discontinuation order was placed in chart.
• Four activities scheduled on the Recreation Calendar were cancelled within your first week without notice, leaving residents sitting in front of the television in the activity room.

What does oversight entities, such as the CMS, TJC, and state health departments, inspecting nursing home facility would react to problems is nursing home facilities? What penalties might they impose and what would the impact of the penalty/penalties be on nursing homes having problems? How could they be helpful in improving quality?

Answer 1

Nursing homes have a duty to provide a safe environment and adequate, compassionate care for their residents.The Centers for Medicare & Medicaid Services (CMS) is tasked with regulatory oversight, inspecting nursing homes across the country and levying fines on those facilities that are out of compliance with established standards. Fines and correction enforcement can cost care facilities thousands of dollars, with the average fine—for endangering residents or causing injury—around $28,000 per infraction.Non-compliance with standards, especially willfully neglecting to correct known hazards and practices in violation with those standards, can result in other exposures.

As detailed above, non-compliance fines can drive up overhead costs for long-term care facilities. In order to avoid fines, there are several steps nursing homes can take:

• First and foremost, it is imperative that nursing home facilities understand the regulations and standards they must adhere to
• It is critical that any non-compliance issues be corrected immediately. The sooner the deficiencies are corrected, the less likely that fines will accrue.
• Home facilities should implement regular internal inspection and practices reviews to ensure that the facilities are fulfilling their duties to residents in a safe manner.