Putting Hard-Earned Improvements in Nursing Homes at Risk

Elderly sitting on a bench

We are witnessing unprecedented rollbacks in regulations that were established to protect our nation’s Elders. In October 2016, CMS issued a final rule, “Medicare and Medicaid Programs; Reform of Requirements for Long-Term Care Facilities” that contained several important updates to OBRA 1987—the first significant set of rules in 30 years. One important new rule was the ban on facilities requiring pre-arbitration agreements as a condition of admission. This protection was rolled back in a September 2019 rule—now facilities are able to ask residents to enter into pre-arbitration agreements, although not as a condition of admission. Another significant setback is related to enforcement of the rules governing facilities. OBRA 1987 established Civil Money Penalties to impose monetary sanctions against nursing homes for non-compliance.

In 2017, CMS granted the industry a moratorium on fines for non-compliance and reduced the penalty amounts. CMS’ proposed 2019 rule, “Medicare & Medicaid Programs; Requirements for Long-Term Care Facilities: Regulatory Provisions to Promote Efficiency and Transparency” will even further erode Elder protections gained under OBRA 1987 and the 2016 final rule. The following is a letter sent by the Claude Pepper Center to CMS and an issue brief detailing what will be lost in response to the 2019 proposed rule.

Issue Briefs:


Letter to CMS:

Important Links: