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CMS, Verma imposed few penalties at nursing homes despite promises of tough enforcement

The federal agency and its state partners, Verma said, would conduct a series of newly strengthened inspections to ensure 15,400 Medicare-certified nursing homes were heeding long-standing regulations meant to prevent the spread of communicable diseases. It was another key component of a national effort, launched in early March, to shore up safety protocols for the country’s most fragile residents during an unprecedented health emergency .

But the government inspectors deployed by CMS during the first six months of the crisis cleared nearly 8 in 10 nursing homes of any infection-control violations even as the deadliest pandemic to strike the United States in a century sickened and killed thousands, a Washington Post investigation found.

Those cleared included homes with mounting coronavirus outbreaks before or during the inspections, as well as those that saw cases and deaths spiral upward after inspectors reported no violations had been found, in some cases multiple times. All told, homes that received a clean bill of health earlier this year had about 290,000 coronavirus cases and 43,000 deaths among residents and staff, state and federal data shows.

That death toll constitutes roughly two-thirds of all covid-19 fatalities linked to nursing homes from March through August.

Patient watchdog groups acknowledge that not every outbreak could have been prevented, even with adequate infection-control practices in place. But as the pandemic raged, the number of homes flagged for infection-control violations remained about the same as last year.

The facilities that were cited for breakdowns often escaped significant penalties, The Post also found.

Inspectors reported violations at about 3,500 homes, ranging from dirty medical equipment to a lack of social distancing. Though federal law allows CMS to levy fines of roughly $22,000 for each day a serious violation lingers, most providers were fined little or nothing at all.

For failing to ensure staff members wore masks, Sterling Place in Baton Rouge, with more than 80 coronavirus cases and 15 deaths, was fined $3,250.

For failing to separate residents in a common area, Heritage Hall in Leesburg, Va., with more than 100 cases and about 18 deaths, was fined $5,000.

For failing to use protective gear, the Broomall Rehabilitation and Nursing Center in Pennsylvania, with more than 200 cases and about 50 deaths — among the highest nursing home death counts in the country — was fined $9,750.

Broomall spokesperson Annaliese Impink attributed the lapses to “covid fatigue” and said staff members are corrected when concerns crop up. Officials with Sterling Place and Heritage Hall did not return calls seeking comment. In its written response to the inspection, Heritage Hall said tables had been rearranged and a nursing supervisor would monitor for compliance. Heritage Hall went on to suffer a second deadly outbreak last month, state records show.

The inspections follow a three-year push at CMS to ease rules long considered burdensome to the nursing home industry, whose lobbyists and leaders include former politicians and government insiders. Even before the coronavirus crisis, the agency took steps to limit the use of some

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