After increased regulation under the Obama administration, President Trump has whittled away at federal regulations targeting nursing homes and meant to prevent nursing home abuse across the country. At the same time, the country’s aging population is putting more senior citizens in nursing homes. According to research by Morningstar, by 2020, a full 40 percent of all deaths will occur in a nursing home. Elder care advocates worry about an increasing number of Americans being allowed into a decreasingly regulated nursing home system.
According to elder care advocates, their worry is not misplaced. Between 2013 and 2018, almost four out of every 10 nursing homes in the country received a citation for a “serious violation” that could endanger nursing home residents. Under previous administrations, these violations would typically come levied with a serious fine – hopefully high enough to deter future behavior. Under the Trump administration, however, the amount of these fines has been significantly reduced through new guidelines issued in December 2017. In an example cited by the Kaiser Foundation, a nursing home was fined $300,000 in 2013 after a nursing home resident died because the staff failed to effectively monitor and treat a wound. Under the new guidelines, the maximum fine the nursing home could receive is $21,000.
In addition to issuing new guidelines on fines, the Trump administration has also overturned the previous administration’s controversial ban on “mandatory arbitration clauses.” These clauses became standard fare over the past few decades for any applicant seeking entry into a nursing home in America. In simplest terms, the clause forces an elderly resident to file all of their legal grievances against the nursing home through a private company – instead of through the court system. Typically, these “alternative forms of dispute resolution” also bind both the nursing home resident and the facility to confidentiality. Advocates of banning these mandatory clauses say they force patients into private companies that act more favorably towards the nursing home and their secrecy prevents cases of egregious abuse from becoming public knowledge.
With the federal government rolling back restrictions on nursing homes, elder care advocates hope that states will lead the charge in supplanting and increasing protections for these vulnerable citizens. In New York, the New York State Assembly Committees on Health and Aging will hold hearings in September to discuss improving nursing home quality and enforcement. Given the federal administration’s recent approach, the hearings in Albany will be important in protecting New York’s senior citizens.