One glance at the headlines this week, and it’s easy for anyone working in skilled nursing to feel as though you’re at the stake. Again.

Monday, I brought you the news that the feds appear intent on charging facilities (and possibly leaders of those facilities) with False Claims Act violations when their employees divert controlled substances for their own use.   

Today, my colleague Josh Henreckson shares with us a Medicaid Fraud Unit’s push to hold nursing home leaders criminally culpable of felonies in abuse cases that happen under their watch in Delaware facilities.

In both cases, law enforcement appears to be infringing on the compliance and corrections roles long carved out for regulators.

The threat, to both “bad actors” and well-meaning providers who get caught up in the rush to accuse, is only going to grow if the government has its way. The Biden administration has been relentless in the attention it has paid to healthcare, and long-term care in particular, over the last two years.

Last month, the DOJ filled a full, two-day summit with tips on strengthening investigations into elder abuse and fraud, including oversight of nursing homes. On Tuesday, we got our first soundbites from that event when the department posted a video of a session titled, “Identifying and Investigating Abuse Occurring in Long-Term Care Facilities.”

Although the department acknowledged in its session description that nursing homes are already regulated by federal and state agencies, officials also clearly want local and state law enforcement agencies to join them on their anti-nursing home crusade.

“A nursing home can be, with the right facts and circumstance, a crime scene,” Susan Lynch, senior counsel for the Justice Department’s Elder Justice unit, told attendees. “We need you, law enforcement, to partner with us, the Department of Justice, states, EMS, ombudsmen, to really bring to justice those nursing homes and their owners who are providing grossly substandard care to residents.”

That video landed along with a Tuesday announcement calling for information that could help the Justice Department, Health and Human Services and the Federal Trade Commission  “accurately understand the modern market realities of the healthcare industry and forcefully enforce the law against unlawful deals.”

That itself was layered on top of a previous White House announcement regarding a cross-government public inquiry “into corporate greed in healthcare” that added high-ranking healthcare attorneys at those same three federal agencies with healthcare oversight. Not to mention the Justice Department has said it planned to add 75 more attorneys this year to nine “strike forces” tasked with rooting out healthcare fraud.

As I’ve written before and see even more clearly now: These efforts reinvigorate the federal government’s investigative powers and provide fresh resources to take civil and criminal cases against healthcare providers — both businesses and individuals — to court.

And yet.

Many of the high-profile federal cases that come down to individual nursing homes or chains have not landed the way the government might have liked. Take the ongoing case against the former head of Skyline Healthcare. A man accused of pilfering nearly $39 million and failing to pay the workers charged with caring for residents in dozens of facilities has negotiated a plea deal in which he would spend a year in prison and pay just $5 million in restitution.

There are plenty of folks in the trenches of nursing homes who see Skyline as triggering the enforcement efforts that have rained down on them since 2021. Their good efforts and high-quality care are being besmirched by broad-stroke insinuations that every operator is working the way Skyline apparently did.

If what’s happening in such cases is truly criminal, if patient lives are at risk, why then the apparent easy out for this bad actor? Will others in this who have gotten into the long-term care business for the wrong reasons be encouraged to continue their “profiteering” by such questionable terms?

Instead of ensuring that a punishment fits a specific crime, the Skyline case seems to indicate that the Justice Department and its partners in the nursing home witch hunt are content to punish an entire class for the sins of the trouble-makers among them.

Sink or swim, reputations will be torched and care will suffer as the feds continue their vilification of the whole.

Kimberly Marselas is senior editor of McKnight’s Long-Term Care News.

Opinions expressed in McKnight’s Long-Term Care News columns are not necessarily those of McKnight’s.