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As the Delta variant raises new concerns about the safety of the nation’s nursing homes, the Biden administration has quietly reversed a controversial Trump policy that limits fines imposed on facilities that endanger or injure residents.

deaths in nursing homes climax has fallen since the introduction of Covid-19 vaccines at the end of last year. account for them About one-third of the total death toll of the US pandemic.

But advocates and some officials say understaffed, protective equipment shortages and poor infection control remain a concern in the country’s 14,000 skilled care facilities.

While 81 percent of nursing home residents are vaccinated, only 58 percent of workers are vaccinated. federal dataincreased risk, epidemics even among fully vaccinated elderly residents.

While the delta variant is driving the recent increase in cases, there are signs of a creeping increase in infections in nursing homes. especially among workers. The Centers for Disease Control and Prevention also search Source of outbreaks in Colorado nursing homes where low vaccination rates may occur.

NS Policy supporting lower penalties adopted in 2017 He’s prompted regulators at the Centers for Medicare and Medicaid Services by the Trump administration to stop fining a nursing home for every day it doesn’t meet federal standards. The relaxed policy reduced multiple penalties to a single fine, effectively reducing the amounts from hundreds of thousands of dollars to a maximum of $22,000.

The change sought by the nursing home industry, a powerful lobby, was part of the Trump administration’s rollback of government regulation in many business sectors.

“It’s the most obvious change the Trump administration has made,” said Toby Edelman, a senior policy attorney at the Center for Medicare Advocacy. “That’s a much, much lower penalty.”

Many of the nursing homes cited due to inadequate infection controls fail to protect their residents from preventable accidents, neglect, mistreatment and bedsores, repeat offenders. Ms Edelman said larger fines act as a deterrent and are more likely to signal strong enforcement of the rules.

With little fanfare, the Biden administration revoked earlier guidance on Centers for Medicare and Medicaid Services. Web site It said in early July that it had decided that “the organization should now retain its discretion to impose a daily penalty where appropriate to address certain circumstances of prior non-compliance.” Under the new policy, regulators can impose penalties per day or per sample.

Consumer groups challenged the policy in a federal lawsuit in January, arguing that weakening sanctions put residents at greater risk. The AARP Foundation, which opened the case with the firm of Constantine Cannon, applauded the Biden administration’s decision. Medicare officials citing the case declined to comment.

The main industry trade group, the American Health Care Association and the National Center for Assisted Living, said in a statement that the daily fines “only took valuable resources from an already underfunded industry, at an unprecedented time, especially in lactation.” Houses need all kinds of support to protect their occupants.”

But critics of Trump’s policy say it offers just a slap on the wrist for nursing homes, even those at greatest risk of harming patients and workers. A year ago, a nursing home in Washington State, the Prestige Post-Acute and Rehabilitation Center in Kittitas in Ellensburg, experienced a major outbreak in which 52 residents and 43 employees were infected. questionnaire Made for Medicare. Fifteen residents died.

According to the survey, the facility has failed to meet infection control standards for more than a month and inadequately vetted employees who fell ill and potentially infected. A cook who reported to his immediate supervisor that he was symptomatic was told to keep coming in, while other staff members, including the nurse and assistant, continued to work despite feeling sick. Employees described indiscriminate screening attempts.

Federal regulators fined Prestige a total of $21,295 in March 2021 using the “per sample” penalty system. The nursing home could have been fined more than $600,000 if it had been fined daily.

Maureen McKinney’s husband, known as Buck, was one of the residents at the home who died of the virus in July 2020. “I was just horrified,” he said when he learned of the fine.

McKinney said she forced state regulators to investigate after witnessing test delays and failures to isolate those who were sick, including when her husband’s roommate fell ill. “I decided to be ruthless about it,” he said.

Prestige Care, which is headquartered in Vancouver, Wash., and operates facilities in the western United States, said it “trusts regulators to determine and enforce penalties appropriately for cases of citations, and we work with them to resolve issues.” They’re quoting.”

“Losing members of our community is difficult under any circumstance, and the Covid-19 pandemic has magnified our deep grief over patients lost to the virus.”

The policy became the norm when the Trump administration prompted regulators to fine nursing homes on a case-by-case basis, says Kelly Bagby, senior attorney for the AARP Foundation. Lower fines were even imposed where residents were deemed “immediate danger” at risk of serious harm, such as at the Washington State facility.

“The corrosive effect of this change must be underlined,” said Ms. Bagby.