"The Senior Care Resource Network"

Skilled or unskilled nursing: Feds ramp up investigations, prosecutions

Skilled or unskilled nursing: Feds ramp up investigations, prosecutions

              January 23, 2013
Thomas S. Brown
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“The lack of supervision and monitoring of the residents is a serious safety concern.” 

“Due to the facility’s inadequate documentation, the team could not determine if the resident was receiving the appropriate nursing care to meet her healthcare needs.” 

“Areas of concern included decomposing walls at the floor level, uneven floor surfaces, peeling paint throughout the facility, non-functioning water fountains and heavily soiled floors, baseboards and doors.” 

“In summary, systemic problems with the provision of medical care and services, with extreme polypharmacy and the unwarranted prescription of psychoactive agents without adequate indications or consent, create a risk of possible substantial harm to every resident of the facility.[1]

The above comments are from a series of memoranda prepared by the Operation Guardians inspection team, an investigative arm of the Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse, after conducting recent random inspections of SNFs in California. The inspections are part of an increased focus by the Attorney General’s office on the conditions in SNFs throughout the state of California and mirror the trend of enforcement and prosecution against those in the healthcare industry across the country[2].

The descriptions are chilling and convey a growing concern among law enforcement agencies throughout the country—that those facilities and the owners, operators and administrators responsible for providing care to our elderly and infirm residents are failing to meet a basic standard of care. The result of this failure can have severe civil and criminal consequences.

The Centers for Medicare & Medicaid Services (CMS) in the past few years has published a list of underperforming nursing homes throughout the nation. These facilities are subjected to increased visits from CMS survey teams under the Special Focus Facility (SFF). The teams conduct thorough inspections of nursing homes and monitor their compliance progress. Those facilities found to be non-compliant with CMS’ federal standards are listed on CMS’ website.


Almost every state has a similar program to that of the CMS survey teams and an example of this nationwide increased level of inspection and enforcement is readily apparent in California. The Operation Guardians (OG) is a multi-agency task force established in 2000 to conduct unannounced, on-site inspections of California’s SNFs. The task force comprises state regulatory and law enforcement officials such as district attorneys, city attorneys and geriatric care specialists, including physicians.


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