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States Fail to Implement Risk Screenings in Medicaid Providers

A recent report from the Office of Inspector General revealed that despite the requirement that new and existing providers implement specified risk screenings in order to enroll in the federal Medicaid program. Since Medicaid funding pays for approximately 65% of all nursing home care in the United States, the stakes for being enrolled in this program are fairly high. Nonetheless, 37 of the 47 states examined in the report had not implemented the fingerprint-based criminal background checks that federal regulations require. In fact, over 25,000 providers enrolled without implementing the background checks between 2011 and 2014.

Risk screenings were not the only Medicaid regulations that providers did not comply with in several states. Some states admitted to failing to conduct regular required site visits, failing to meet deadlines for the mandatory revalidation process, and failing to report the proper ownership information. While the Centers for Medicare and Medicaid Services (CMS) have published suggestions for providers to implement background checks and comply with other regulations, there appear to be no repercussions for failing to meet federal requirements. Although CMS has admonished states for failing to report their providers who are having trouble complying with federal regulations. With respect to background checks, in particular, providers who fail to follow these rules could very well employ individuals who may have the propensity to abuse, neglect, or otherwise harm nursing home residents. Not only is this dangerous for residents, but it leaves these providers potentially civilly liable for the damages that occur as a result of their failure to comply with federal regulations.

Boller & Vaughan knows elder abuse law and has the experience to help you through any type of elder abuse claim. No matter what type of nursing home facility abuse or neglect is at issue in your case, we can help. All too often, residents and their families are reluctant to demand justice for situations that occurred in the resident’s care. In this situation, you can count on your Madison elderly abuse attorneys to guide you through every step of the legal proceedings related to your claim.