Advocates decry rollback in reforms to protect the elderly

Attorneys general from around the U.S., including New York state, have issued an official complaint against federal actions that would delay the enforcement of protections for Medicare and Medicaid beneficiaries who receive care in skilled-nursing facilities.

According to information from the office of New York Attorney General Barbara D. Underwood, the decision by the U.S. Department of Health and Human Services and its Centers for Medicare and Medicaid Services (CSM) would roll back reforms put in place two years ago to improve the safety and well-being of nursing home residents to protect them from abuse, neglect and exploitation. CMS was to revisit requirements in June that were deemed to be burdensome for facilities, according to Underwood’s office.

“Gutting these essential protections would threaten the health and safety of the many New Yorkers who rely on nursing home care,” Underwood said in a statement. “My office will continue to prosecute those who victimize vulnerable nursing home residents.”

Along with New York, the states whose attorneys general also have signed the complaint represent California (which led the initiative), Connecticut, Hawaii, Illinois, Iowa, Maryland, Massachusetts, Minnesota, Mississippi, Oregon, Pennsylvania, Rhode Island, Vermont, Virginia, Washington and the District of Columbia.

In the letter to U.S. Health and Human Services and CMS (, the coalition of attorneys general said rolling back protections would threaten the mental and physical safety of senior residents in nursing homes, as well as create additional challenges for New York’s Medicaid Fraud Control Unit (MFCU). The second phase of the protections was to begin last November, but CMS delayed by 18 months the implementation of certain penalties for violating the protections, as well as lowered the frequency and amount of penalties for past violations, the letter states. Civil monetary penalties, which are included in the delayed implementation phase, are an essential tool to ensure nursing facilities comply with care standards and protect their residents, according to the coalition’s letter.

“MFCU recovers taxpayer money and protects vulnerable nursing homes residents and New York taxpayers by holding criminals and other violators of New York laws accountable,” according to the letter. “MFCU also works with whistleblowers and law enforcement agencies to investigate and prosecute fraud perpetrated on the Medicare and Medicaid program at large. In essence, a rollback of these important and much needed long-term care regulations will result in greater challenges for holding criminals and other violators accountable.”

The issue of delaying enforcement is a polarizing one, but there are a lot of unknowns right now, Michael E. McRae, president and chief executive officer for St. Ann’s Community, wrote in an e-mail to El Mensajero Católico.

“Everyone wants seniors in skilled nursing facilities to be protected,” he said. “What I can say is that regardless of the outcome, our standards at St. Ann’s Community will remain high. We do not tolerate abuse of our residents in any form and we expect that they will be treated with respect and dignity at all times.”

In a speech last October (, the administrator of HHS, Seema Verma, said: “Regulations have their place and are important to ensuring quality, integrity and safety in our health care system. But, if rules are misguided, outdated or are too complex, they can have a suffocating effect on health-care delivery by shifting the focus of providers away from the patient and toward unnecessary paperwork, and ultimately increase the cost of care.”

Justice in Aging, however, said the administration’s actions are bad news for nursing home residents, their family and friends, and for anyone who cares about older Americans, according to a statement from the national nonprofit group, which advocates for senior citizens (

“(Nursing home) residents benefit from early care planning and antibiotic standards, but CMS created an 18-month moratorium on money penalties for violations of these requirements,” the organization stated. “A new regulation requires nursing homes to notify a local ombudsman whenever they move to evict a resident, but now CMS has requested comments on how they might eliminate that requirement.”

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