In 1987, the Nursing Home Reform Act (“NHRA”) was passed to ensure that residents of nursing homes would receive quality care at all times in order to achieve and maintain their “highest practicable” physical, mental and psychosocial well-being. With the law came significant challenges for nursing home owners to stay in compliance with the NHRA and state regulations regarding resident care, admission and reimbursement. For instance, nursing homes are subject to a certification process, which includes unannounced surveys such as resident interviews at irregular intervals at least once every 15 months. State authorities may also conduct more targeted surveys or investigations in response to complaints against nursing homes. If a survey or investigation reveals that a nursing home is out of compliance, the nursing home may be subject to penalties or other actions depending upon whether a deficiency subjects a resident to immediate jeopardy. The penalties or sanctions may also be different depending upon whether the deficiency that has been discovered is an isolated incident or part of a pattern or a widespread practice.
The complexity of the NHRA can lead to misunderstanding and miscommunications. Ever-changing state and federal regulations can add an extra burden for nursing home owners to stay in compliance. Owners must be vigilant and stay on top of new developments in multiple areas like the admission process, care planning, accommodating resident preferences, Medicare and Medicaid distinctions, reimbursement practices and transfer/discharge procedures. To help nursing home owners through the maze, PLDO Managing Partner Gary R. Pannone and health care attorney Jillian N. Jagling have co-authored an advisory, Challenges for Nursing Homes, that provides details of compliance issues faced by nursing homes. The article also includes an outline of “myth vs. reality” in this complex area of the law. If you have questions or would like more information, please contact attorneys Pannone or Jagling at 401-824-5100 or email [email protected] or [email protected]. We welcome your comments, questions and suggestions.