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Amid close to 46,000 resident deaths, nursing homes face more than $15 million in fines

The fines are being criticized by nursing homes and advocacy groups like LeadingAge, which says the industry faces unprecedented financial strain.

The Centers for Medicare and Medicaid Services is issuing more than $15 million in fines to nursing homes during the COVID-19 pandemic for noncompliance with infection-control requirements and failure to report infection data. 

The monetary civil penalties have gone to more than 3,400 nursing homes.

Since March 4, CMS and state survey agencies have completed over 15,000 nursing home inspections, and covered 99.2% of facilities, as a way to make sure residents are being safely cared for during the pandemic. As a result, more than 180 immediate-jeopardy-level violations have been imposed, tripling the rate of these deficiencies from 2019 and totaling $10 million. 

A facility receives an immediate-jeopardy fine when it causes or is likely to cause serious injury, harm, impairment or death to a resident, according to CMS. On average, one of these fines equals $55,000. 

Under CMS and the Centers for Disease Control and Prevention's COVID-19 reporting system, Medicare and Medicaid certified nursing homes are required to report COVID-19 cases and deaths to the CDC. As of August 3, over 90% of nursing homes have followed protocol and reported data, according to CMS.

However, for the facilities that have not reported data or have lapsed, CMS has cited more than 3,300 deficiencies to the policy and fined more than $5.5 million in monetary civil penalties.


As of August 2, there have been nearly 46,000 reported resident deaths in nursing homes from COVID-19, according to CMS.

CMS oversees nursing homes to ensure they provide safe and effective care. The responsibility to keep residents safe and healthy has become especially important during the pandemic, CMS said.

But the fines have received criticism from both nursing homes and nursing home advocacy groups such as LeadingAge. The organization says that the industry is already facing unprecedented financial strain and fines are not the answer to better care. 

Instead, stakeholders are asking for more funds from the government to provide better care through testing and personal protective equipment. 


Older adults are at a higher risk of becoming seriously ill from COVID-19, according to the CDC. In fact, the CDC reported that 80% of reported COVID-19 deaths have been in adults over the age of 65. 

Throughout the course of the pandemic, CMS has issued record numbers of new protocols for nursing homes. In the last six months, it has released 18 sets of guidance, compared to nine in the entirety of 2019.

Actions include the allocation of Coronavirus Aid, Relief, and Economic Security Act funds based on performance metrics; requirements to inform residents, their families, and representatives of COVID-19 cases in facilities; and prioritized inspections to allow inspectors to focus on the most serious health and safety threats like infectious diseases and abuse. 


"The Trump Administration is taking aggressive enforcement action against Medicare and Medicaid certified nursing homes that fail to implement proper infection control practices," said CMS Administrator Seema Verma. "Now more than ever, nursing homes must be vigilant in adhering to federal guidelines related to infection control to prevent the spread of infectious disease, including COVID-19. We will continue to hold nursing homes accountable and work with state and local leaders to protect the vulnerable population residing in America's nursing homes."

"The priority of LeadingAge's mission-driven members is to ensure the health, safety and highest quality of life possible for older adults," said Katie Smith Sloan, the president and CEO of LeadingAge. "Providers have been on the front line, under mortal threat from this pandemic for over six months – fighting for adequate personal protective equipment, access and funding for rapid-response testing, and other life-saving supplies and support. When we know that community spread is a leading source of infection in long-term care, and members are paying tens of thousands of dollars – millions, in some cases – for PPE, tests, and other pandemic-related expenses, fines are not the answer. We need help and collaboration from CMS. A punitive approach is unsustainable."

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