Federal, state and local authorities will collaborate in 10 new regional task forces across the country to toughen enforcement against nursing homes accused of providing grossly substandard care to patients and residents, the the U.S. Justice Department announced Wednesday.
“We expect to share information and concerns much more quickly and to take action in a more coordinated and timely manner,” Benjamin Mizer, principal deputy assistant attorney general, said in a call with reporters Wednesday.
Industry group the American Health Care Association, however, criticized the announcement.
“We support any effort to improve overall care and weed out bad actors, but today’s announcement mistakenly conveys that quality is on the decline,” said association CEO Mark Parkinson in a statement. “It is a smokescreen aimed at finding cost cutting measures that would threaten life-improving post-acute and long term care services for millions of seniors.”
The Elder Justice Task Forces will include representatives from U.S. attorneys' offices, state Medicaid Fraud Control Units, state and local prosecutors' offices, HHS, state Adult Protective Service agencies, Long-Term Care Ombudsman programs and law enforcement.
The task forces will be located in the Northern District of California, Northern District of Georgia, District of Kansas, Western District of Kentucky, Northern District of Iowa, District of Maryland, Southern District of Ohio, Eastern District of Pennsylvania, Middle District of Tennessee and the Western District of Washington. These locations were chosen because of their expertise, and the department wants to build on that. Whether the task forces will lead to an increased number of investigations into nursing homes remains to be seen, Mizer said.
Mizer cited the 2014 Extendicare Health Care Services case as an example of what can be accomplished through similar collaboration. In that False Claims Act case, long-term-care provider Extendicare and its subsidiary, Progressive Step Corp., settled with the federal government and eight states for $38 million over allegations that it didn't have enough nurses to care for patients, didn't provide adequate catheter care to residents and didn't follow appropriate protocols to prevent pressure ulcers and falls. Some patients had to have limbs amputated as a result of the poor care, the government alleged.
Delaware-based Extendicare also entered into a five-year agreement that required it to hire an independent quality monitor to oversee the quality of its skilled-nursing care. The company did not admit wrongdoing as part of the settlement.
The Justice Department worked closely with other agencies and state governments in that case, Mizer said. The new task forces will “build and expand on this model of federal-state cooperation,” he said.
An HHS Office of Inspector General study (PDF) found that about one-third of skilled-nursing facility residents experienced harmful events during their stays in 2011, and 59% of those incidents are preventable.
The task forces could be helpful in ensuring nursing home patients and residents get adequate levels of care, said Martin Kardon, a partner at Kanter, Bernstein & Kardon in Philadelphia and chair of the nursing home litigation group at the American Association for Justice, which represents plaintiff attorneys.
Nursing homes are regulated by state agencies, which often face tight state budgets. “If there's not enough money in the budget for this particular thing, then supervision and oversight could falter,” said Kardon, who represents families of nursing home residents. “It's a good thing that you have the resources of the federal government involved in it.”
Kardon added that nursing home owners sometimes skim off money, provide poor care, then shut down the facility and open new ones. These operators rarely face criminal prosecution. “It's a great idea to have sort of an overarching nationwide system to scrutinize the repeat offenders,” he said.
Becky Kurtz, director of the Office of Long-Term Care Ombudsman with the federal Administration on Community Living, also praised the new joint effort during a call Wednesday with reporters. “Older adults and people with disabilities should be able to live the lives they want,” she said. “Everyone has a basic right to live with dignity, free from abuse.”