State puts nursing homes on notice about increased fines

The $30,250 in fines that the Pennsylvania Department of Health slapped last month upon a Larimer nursing home could be just the beginning of increased penalties statewide for facilities found deficient by inspectors.

The department recently posted a website message advising the approximately 700 nursing homes of a change in enforcement policy likely to bring about increased fines. It emphasized that violators of regulations serious enough to merit a financial penalty in 2017 may have those “calculated on a per violation per day basis.”

Regulations already allowed the department to issue fines in that manner, but it has historically based penalties on a single instance rather than using a daily multiplier.

The Health Department’s press secretary, April Hutcheson, said Friday that the per-day fines are part of an overhaul of the nursing home enforcement process. She said more consistency among inspectors and more effective deterrents to violations were among department goals after its oversight was faulted in reports last year by both the state auditor general and a task force of outside experts. The auditor general noted that the state’s fines are among the lowest in the nation.

“In 2016, we took the most comprehensive look at the nursing home industry in almost a generation,” Ms. Hutcheson said.

“We took a look at how we were enforcing regulations and what the needs were, and based on all of them came up with new guidance because we are looking at improving nursing home care,” she said. “Our goal isn’t to issue civil penalties; our goal is to have nursing homes fix the deficiencies to make the situation better for the individuals living in the facilities.”

Even before this year’s change to potential daily fines, the department had been increasing penalties following a sharp drop-off during the Corbett administration’s 2011-14 tenure. In 2012, not a single fine and only two provisional licenses were issued to violators. In 2016, Ms. Hutcheson reported, there were 56 fines totaling $407,450 and 40 issuances of provisional licenses, which are designed to bring a facility under closer scrutiny.

The $30,250 in fines on Forbes Center for Rehabilitation and Healthcare for problems identified in July and November were higher than has been customary. The facility was fined $21,250 for failing to remedy 25 deficiencies cited in its annual inspection, Ms. Hutcheson said. An additional $9,000 fine, which also included a second provisional license, applied to a finding that Forbes failed to properly monitor a patient with a recent fall history before a fatal head injury occurred in an October fall.

Officials from Forbes, which is owned by CareRite Centers LLC of Englewood Cliffs, N.J., did not respond to a phone call seeking comment.

The department’s new emphasis has attracted the attention of the Pennsylvania Health Care Association, a trade association representing long-term care providers. The association has long maintained that the facilities are already hamstrung by the state’s level of Medicaid reimbursements for care of government-subsidized patients.

“PHCA continues to feel strongly that more stringent penalties do not alone improve care,” the association said in an emailed statement. “Taking financial resources away from the bedside does not improve resident care. In fact, it has the potential to make the situation worse than it was before the facility was sanctioned.”

Pennsylvania Health Secretary Karen Murphy stated a goal in October to review and update the state’s regulations and laws pertaining to nursing homes, including permissible fines. Ms. Hutcheson said that process has not yet begun, however.

Gary Rotstein: or 412-263-1255.


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