Industry Responds to Democrats’ Call for Skilled Nursing Scrutiny

In a Valentine’s Day letter to top health officials, a group of influential Senate Democrats asked the Centers for Medicare & Medicaid Services (CMS) to reconsider certain rollbacks of nursing home regulations.

In response, a leading industry group on Wednesday wrote back to the senators to clarify and rebut some of their points.

“We think the letter may reflect some misunderstandings and misinterpretations of CMS’s guidance,” LeadingAge president and CEO Katie Smith Sloan wrote in the organization’s letter, addressed to the 12 Senate Democrats who signed the original note.


“In reality, nothing in the three CMS memos changes the requirement that nursing homes comply with federal regulations and correct deficiencies. The memos do not weaken enforcement of this requirement,” Sloan continued.

The group of lawmakers — which included former presidential candidate Sen. Bernie Sanders of Vermont, an independent who caucuses with the Democrats, and Sen. Elizabeth Warren of Massachusetts — took issue with multiple CMS memos changing the agency’s guidance on rule enforcement.

“The need to guarantee that the nursing home industry remains safe and sustainable for patients grows more urgent each day,” the senators wrote.


In particular, the senators were concerned about the delay of civil monetary penalties (CMPs) for infractions related to Phase II of the new Requirements for Participation (RoPs). But Sloan emphasized in her response letter that the delays apply only to new requirements, and that the implementation of the updated rules could prove difficult for operators.

“The new requirements involve significant changes in nursing home operations and training of nursing home staff,” Sloan wrote. “State survey agencies and their staff also had a steep learning curve on the new requirements.”

Sloan, who leads the group that represents an array of non-profit long-term care providers across the country, clarified that CMS can still issue directed plans of correction during the moratorium period, while CMPs will continue to be levied for violations unrelated to the most recent RoP update.

“LeadingAge understands and appreciates your concern on behalf of nursing home residents and their families,” Sloan concludes. “We have additional proposals for improving the federal-state nursing home oversight system, and would like to have the opportunity to work with you and your staff on these initiatives.”

Written by Alex Spanko

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