Trump administration caves to nursing home trade group

Move to weaken regulation comes after Star Tribune series on elder abuse.

December 30, 2017 at 12:03AM
Michael Hogue/Dallas Morning News/TNS ORG XMIT: 1021898
Michael Hogue/Dallas Morning News/TNS (The Minnesota Star Tribune)

The shocking assaults on Minnesota nursing home and assisted-living residents documented in the Star Tribune's recent "Left to Suffer" series inspired outrage across the state and vows from Gov. Mark Dayton and legislators to do better — much better.

To their credit, Minnesota legislators are calling for reforms and stronger oversight when they return to St. Paul in early February. But as they're weighing these improvements, federal regulators are frustratingly taking steps in the opposite direction — a situation that should alarm anyone with aging family members or friends.

The Trump administration's latest move to go easier on the nursing home industry as part of its regulatory rollbacks was detailed in a Dec. 24 New York Times story by Jordan Rau, a respected health care reporter. Unfortunately, it didn't get the attention that it should have because its publication came in the midst of last-minute preparations for the holiday.

According to Rau's story, the administration is "scaling back the use of fines against nursing homes that harm residents or place them in grave risk of injury." Levying these penalties may potentially be discouraged even in situations that led to a resident's death. Senior care advocates understandably decried the changes.

The American Health Care Association, an influential nursing home lobbying organization, had petitioned for the change, arguing that federal inspectors should focus more on helping facilities improve vs. finding violations. The group told President Donald Trump in a letter last month that it is "critical that we have relief."

It's hard to have much sympathy for this after the Star Tribune series. The stories detailed anguished families' struggles for accountability after sexual assaults and other disturbing abuse. Larger fines and making a public example out of facilities where serious harm has occurred are reasonable responses to prevent future harm.

While nursing home quality appears to be improving nationally, there's still a clear need for a heavier — not lighter — hand by federal officials, who share oversight with states. According to the Kaiser Family Foundation, 21 percent of nursing homes nationally had received a "deficiency for a serious quality violation" in 2015. That's an improvement from 26 percent a decade before, but still far too high, especially when this category includes infractions that led to actual harm or potential harm of residents.

The federal moves should give Minnesota policymakers even more impetus to strengthen state elder care protections. Minnesota's congressional delegation should also step up to stop further erosions of protections for vulnerable seniors.

The recent federal move to scale back fines is not helpful. Neither is another effort from the administration in 2016 — a proposal that would take away residents' rights to sue nursing homes. Any change to elder care safeguards should be driven by seniors, their families and medical experts — not simply enacted because the industry wants it.

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