nursing home ratings: bonita springs nursing home ratings

A. FEDERAL NURSING HOME LEGISLATION--NURSING HOME REFORM ACT OF 1987Nursing homes receiving federal funds through Medicare and Medicaid must comply with federal laws requiring nursing homes to provide high quality care to residents.(20) Responding to the widespread nursing home abuse in the mid-to-late 1970s,(21) Congress enacted the Nursing Home Reform Act (NHRA) to reform the nursing home industry.(22) Included in the Omnibus Budget Reconciliation Act of 1987, this legislation specifies that nursing homes seeking reimbursement from Medicare and Medicaid must "care for residents in such a manner and in such an environment as will promote maintenance or enhancement of the quality of life of each resident"(23) and "attain or maintain the highest practicable physical, mental and psychosocial well-being of each resident in accordance with a written plan of care...."(24) Promulgated under NHRA, the "Requirements for Long Term Care Facilities"(25) regulation governs the operations of nursing homes with Medicaid patients and mandates residents'' rights and facility duties.(26)

In 1995, HCFA released regulations ("1995 regulations") outlining significant enforcement remedies for surveyors.(38) This allowed the federal government to penalize nursing homes in several other ways. Some of the current remedies now available include: levying hefty fines ranging from $50 per day to $10,000 per day;(39) denying payment for new admissions(40) or all payments;(41) closure of facility and/or transfer of residents;(42) and termination of the provider agreement.(43)

The tensions between government standards, agency oversight and state reimbursement exposes the industry to private litigation. When agency oversight and enforcement of government standards proves ineffective or inefficient, society turns to the legal system for a remedy,(9) but unrestrained private litigation is easily abused against nursing home providers. Although punitive damages are certainly warranted in cases of egregious abuse and neglect, excessive and frivolous residents'' rights suits driven by plaintiffs'' attorneys can bankrupt providers already struggling to operate on inadequate Medicaid reimbursement.(10) Suspending the discussion of Medicaid reimbursement, both legislative reform and strong state agency action are necessary to reform this vital industry and to save it from potentially devastating litigation. The industry needs efficient and consistent regulatory oversight and application, while being afforded some limits to currently unlimited legal liability.

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