Fine tuning.

HCFA ups fines for serious incidents

A MOVE BY HCFA TO IMPOSE TOUGHER FINES on nursing homes with problems has drawn retorts from provider organizations and a reminder from a consumer group that penalties are effective only if they are enforced.

HCFA issued a new regulation in March that enables states, which inspect nursing homes, to recommend fines up to $10,000 for incidents that threatens residents' health and safety. Existing rules link fines directly to the number of days that nursing homes fail to comply with federal requirements.

HCFA says the new action ensures that regulators do not have to wait until a violation is fixed to assess a penalty. In addition, nursing homes will not have an opportunity to avoid such fines by fixing the violations that led to their imposition. Nursing homes will continue to have the right to appeal.

"Imposing additional fines will do nothing to evolve the system to where it needs to be, which is a regulatory system that encourages good behavior rather than continuing to come up with ways to beat up the industry," says Dan Springer, a spokesperson for Ft. Smith, Arkansas-based Beverly Enterprises, the largest nursing home chain. "We still are operating under a system that seeks and finds problems where sometimes they don't even exist."

The American Association of Homes and Services for the Aging said in a written statement that it agrees that "the current system of penalizing poor-performing nursing homes is not working." Instead, AAHSA declared "Federal and state inspections should target poor-performing homes, and we should shut down the really bad facilities."

Tougher fines are "essential" but must be coupled with measures "to see that a fine actually sticks once it's levied," contends the National Citizens' Coalition for Nursing Home Reform in a written statement.