Press Release  AG Healey Opposes Federal Rollback of Consumer and Safety Protections for Nursing Home Residents

Boston — Attorney General Maura Healey today joined a coalition of 17 attorneys general in submitting comments to the U.S. Department of Health and Human Services and the Centers for Medicare and Medicaid Services (“CMS”) opposing the rollback of regulations intended to protect nursing home residents and those receiving care in skilled nursing facilities. 

“All nursing home residents deserve to live in a safe and healthy environment in which they are treated with dignity and respect,” said AG Healey. “These rules were put in place to protect seniors and those with disabilities from facing abuse, neglect and exploitation and should not be weakened by industry lobbyists.” 

Today’s letter from the attorneys general addresses CMS’s rollback and delay in implementation of rules enacted in 2016 for nursing homes that participate in Medicare and Medicaid. The 2016 overhaul was the first major revision of federal nursing home facility regulations since the regulations were issued more than 25 years ago. 

Among the 2016 reforms were provisions to increase infection control, improve training for staff, and provide protections against abuse, neglect, and exploitation of nursing home residents. The components of these regulations were originally scheduled to take effect in three phases, beginning on November 28, 2016 (Phase I), to reduce the burden on nursing facilities implementing the reforms. 

Since 2017, CMS has issued guidance in the form of regulatory memoranda that make it more difficult for federal inspectors and regulators to fine or deny reimbursement to nursing homes that don’t meet quality and safety standards, in effect rolling back the protections imposed in the 2016 revisions. 

The second phase of the revised regulations took effect on November 28, 2017, but just days before the Phase II revisions were to be implemented, CMS imposed an 18-month moratorium on certain enforcement remedies for a number of the Phase II regulations.

In their letter, the attorneys general note that CMS’s actions weaken existing protections and roll back critical reforms. CMS’s actions to reduce civil monetary penalties that may be imposed on facilities that violate the regulations also deprive regulators of an important tool to encourage compliance or punish wrongdoing. The letter asserts that “with fewer safeguards to protect them, nursing home patients will be subject to diminished standards of care and will be more vulnerable to abuse, neglect, and exploitation.”

In August 2017, AG Healey and 16 other state Attorneys General submitted comments to CMS urging that it maintain its 2016 rule prohibiting pre-dispute arbitration clauses in nursing home and other long term care contracts, which had been challenged by the long term care industry. Under the Trump administration, CMS ultimately reversed its position and rescinded the prohibition on pre-dispute arbitration agreements in long term care contracts. 

The following states signed today’s letter: California, Connecticut, District of Columbia, Hawaii, Illinois, Iowa, Maryland, Massachusetts, Minnesota, Mississippi, New York, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, and Washington.

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