Court affirms Ohio nursing home's pressure-ulcer penalty

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An Ohio nursing facility found to be out of compliance with Medicare quality-of-care regulations will still have to pay a $2,800 fine, according to a federal appeals court.

Sanctuary at Whispering Meadows failed to ensure that a resident did not develop avoidable pressure sores, according to an opinion from Judge Ronald Lee Gilman of the U.S. Court of Appeals for the Sixth Circuit. He affirmed the determination of the Departmental Appeals Board of the Department of Health and Human Services.

The Centers for Medicare & Medicaid Services imposed a civil monetary penalty on the facility, saying it was not in compliance with 42 C.F.R., which requires nursing facilities participating in Medicare to ensure that a resident who enters a facility does not develop pressure sores, unless they are clinically unavoidable.

An Ohio Department of Health survey concluded that one of the facility's patients had developed pressure sores after taking psychoactive drugs that decreased his mobility. Whispering Meadows appealed the CMS penalty to an administrative law judge, who similarly concluded the facility was not in compliance with Medicare quality-of-care regulations and that the penalty imposed was reasonable.

The facility attempted to show it was in compliance, but the judge ruled there was insufficient evidence that the pressure sores were clinically unavoidable. The HHS appeals board noted that the facility had not changed the resident's plan of care to account for the decrease in mobility until several weeks after the psychoactive drugs began.

A full version of the decision is available at http://www.ca6.uscourts.gov/opinions.pdf/05a0826n-06.pdf.