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April 11, 2016

DPH Strengthens Oversight of Long-Term Care Facilities

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As part of a recent initiative to address safety, quality and transparency issues in the long-term care industry in Massachusetts, the Department of Public Health (DPH) has notified nursing home administrators that beginning on April 11, 2016 it will be implementing certain changes specific to the licensure and survey processes for long-term care facilities.

Changes of Ownership

In an effort to obtain a more complete picture of nursing home owners and their vulnerabilities, DPH is revising the application for change of ownership of a long-term care facility to require real property owners of licensed long term care facilities to disclose certain information, including compliance and criminal history as well as financial capacity.

Imposition of Fines

Beginning on April 11, 2016, DPH will begin exercising its authority to impose fines on nursing home facilities that have violated state licensure regulations. Specifically, nursing homes that are cited for violating any provision of the Massachusetts long-term care regulations may be fined up to $50 for each deficiency—regardless of whether it is corrected before the follow-up or desk survey—and may continue to be fined an additional $50 per deficiency per day until the deficiencies are corrected.

If DPH plans to impose a fine, the facility will notified at the time the Statement of Deficiencies is released via EPOC. The total fine amount will be calculated once the nursing home has corrected all cited deficiencies, and provided in a final letter along with payment instructions and information regarding appeals. Unless the fine is appealed, the facility must remit payment in full within 30 days of the date of the final letter. Potential sanctions for failure to pay include license revocation, denial of a facility’s license renewal, or referral to the Office of the Attorney General.

According to DPH, the most common deficiencies cited between July 2013 and June 2015 included violations of regulations regarding (1) written documentation of staff qualifications and training, (2) resident centered environments in dementia special care units; (3) qualifications of and limitations on therapeutic activity directors, and the development of therapeutic activities programs in dementia special care units, (4) finishes, outdoor recreation space and noise control in dementia special care units; (5) emergency electrical systems, and (6) provision of a physical therapist and an occupational therapist for Level II care.

Although it was not specifically mentioned in the letter, facility administrators should note that DPH will be hiring additional staff to perform increased inspections of facilities.

About the Author

Crystal Bloom

Crystal Bloom is a partner and a senior healthcare regulatory attorney in Barrett & Singal's Health Law group. She provides state and federal regulatory guidance and corporate legal services to healthcare providers. You can find her on LinkedIn.

Law Clerk Alyson Visser contributed to this alert.

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