On October 5, 2018, the Centers for Medicare/Medicaid Services (CMS) announced that it will soon promulgate new regulations aimed at increasing the oversight of health care and other services provided to senior citizens and the elderly. CMS hopes the new regulations will ensure that appropriate care occurs, decrease elderly abuse and other illegal activities against seniors, and prevent crimes against residents from going unreported.
The new regulations are expected to affect post-acute care settings, long-term care facilities, and nursing homes. CMS was prompted to take action following a recent Department of Health and Human Services’ (HHS) report finding that CMS has not done enough to prevent abuse or neglect and to ensure that reasonable suspicion of abuse or neglect was reported promptly to law enforcement.
Health care facilities that violate the regulations will face serious consequences including the imposition of civil monetary penalties of up to $200,000. Additionally, violators can be subject to a two-year exclusion from the benefits of federal health programs. Facilities will also be disciplined by CMS if they retaliate against individuals who report violations. These significant penalties should motivate senior living facilities to plan for compliance to the new regulations now rather than waiting.
Fortunately, senior living facilities can take preparatory actions now to help decrease the likelihood of violating CMS’s new regulations. Studies show that elderly abuse/neglect is more prevalent and unreported in facilities that lack abuse and neglect prevention policies. Effective policies should inform staff on recognizing signs of abuse/neglect; detail procedures for reporting abuse/neglect allegations; and provide assurance that staff will not be punished for reporting. Policies should also address avoiding the isolation of elders (or allowing them to isolate themselves). Isolation causes depression, sadness and loneliness, which in turn increase the likelihood of neglect or abuse.
Staff training is a powerful tool as well. Employees must be educated/trained to respond appropriately to difficult situations, such as dealing with physically combative residents, which situations have the potential to trigger abuse. Appropriate training provides staff with conflict resolution and coping skills. Resident training and education should not be overlooked. Facilities should counsel elderly residents about the dangers of solicitations from internet email (and via the telephone). Numerous “phishing” and other scams have been reported which deprived seniors of vast sums of money. Those types of cyber-crimes are a form of illegal activity that would need to be reported to law enforcement under the new regulations’ broad reporting requirements.