NCPA - National Center for Policy Analysis

Nursing Home Appeals Bog Down

January 18, 1999

Three years ago, when federal regulators started slapping much higher fines on nursing homes violating health and safety rules, a backlog of appeals began to build at the Department of Health and Human Services. Today, the cases are overwhelming the staff assigned to deal with them.

  • At the agency, the Departmental Appeals Board had before it 670 cases last year -- of which only 22 were resolved.
  • The new fines range as high as $10,000 for each day a home is out of compliance, with some of the totals reaching $600,000 -- compared to the old norm of $100.
  • While many owners hit with small sums chose to pay the penalties, others facing big fines are opting for judicial hearings -- driving up the case load.
  • It costs a nursing home about $10,000 to appeal a fine.

The appeals board has only three administrative-law judges and new cases aren't even getting on the calendar, experts report. Fines that are meant to compel compliance can't even be collected, they say.

In Texas, for example, more than $18 million in fines have been levied against several hundred nursing-home owners in the past several years. But just $1.9 million has been collected, since many cases remain on appeal.

Source: Michael Moss, "Appeals Mire Collection of Nursing-Home Fines," Wall Street Journal, January 18, 1999.


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