Nursing Home Regulations Flashcards
Sunshine Haven Nursing Operations v. US Dep’t of Health & Human Services
Rule:
A healthcare facility may be penalized for failure to comply with federal regulations if the facility does not demonstrate by a preponderance of the evidence that it substantially complied with the regulations.
Facts:
-CMS IMPOSED HARSH SANCTIONS FOR FAILURE TO GIVE BATHS, USE RESTRAINTS APPROPRIATELY, USE PROPER BODY
TRANSFER TECHNIQUES, AND HAVE PROPER FIRE PROTECTION
-CT AFFIRMS PENALTIES & DISMISSES CASE W/ PREJUDICE
-D HAS BURDEN OF PERSUASION; this means that D has to prove, by a preponderance of evidence, that they are more likely not guilty than not. Unusually high standard in this case.
CMS =
Centers for Medicare & Medicaid Services
CMS -> Internal Appeal -> Court
Discounts (self reporting for instance by nursing homes)
-50% DISCOUNT ON FINES FOR SELF REPORTING, CORRECTING &
WAIVING HEARING
-35% DISCOUNT JUST FOR WAIVING RIGHT TO HEARING
Should CMS be more aggressive in enforcement?
-Well, penalties need to be paid, and that payment would likely come from funds the nursing homes would use for the patients. It would perpetuate a potential cycle of violations since nursing homes still need revenue to improve quality of facilities. And if a facility closes down due to a penalty, then what do you do with all of the residents? What if the nursing home is the only one available in the area (rural are for instance)?
