The nation’s largest nursing home company has agreed to resolve allegations that 12 of its facilities turned away prospective residents because they were prescribed buprenorphine or methadone to treat opioid use disorder. 

The U.S. Attorney’s Offices for the Districts of Massachusetts and Rhode Island and the Department of Health and Human Services announced the agreement with Genesis HealthCare Inc. regarding denied admissions in violation of the Americans with Disabilities Act, the Rehabilitation Act and the Patient Protection and Affordable Care Act.

Individuals receiving medication to treat OUD are generally considered disabled under federal civil rights laws. The complainants were seeking admission for health issues unrelated to their dependency, but they also needed continuing drug treatment.

To end the case, Genesis will adopt a non-discrimination policy and provide training on the ADA and opioid use disorder to admissions personnel. The company also will pay a civil penalty of $60,000, of which $50,000 will be suspended and forgiven if designated facilities comply with the agreement.

“There was no admission of wrongdoing by the centers, nor did the government provide clinical or any other information in support of the allegations,” Lori Mayer, a Genesis spokeswoman told McKnight’s Long-Term Care News on Monday. “To avoid the expense of litigation, however, the centers nevertheless agreed to clarify their admission policies to ensure full compliance with the ADA in connection with medication-assisted treatment for opioid use disorders. The updated policy confirms that admission decisions must ensure the safety of all residents in accordance with ADA law, consistent with Genesis policy.”

Skilled nursing providers previously have argued that accepting patients on medically assisted addiction treatment requires specialized training and staff, things that not all facilities can provide. 

Long-term care pharmacists, likewise, have explained that turning away such patients may be necessary “given some of the administrative and regulatory hurdles that exist.” Pharmacists are responsible for ensuring appropriate stewardship of controlled medications such as methadone, but few skilled nursing facilities have full-time, on-site pharmacy providers.

Still, prosecutors have been increasingly targeting skilled nursing facilities that don’t accept patients requiring buprenorphine or methadone. Genesis is the fourth skilled nursing provider the U.S. Attorney’s Office for the District of Massachusetts has settled with for denying admission to patients receiving OUD treatment, citing ADA violations.

“The ADA is the law of the land, and the ADA makes it illegal to discriminate against people with disabilities — including Opioid Use Disorder,” Acting U.S. Attorney Nathaniel R. Mendell said in a statement Monday. “All providers must comply with the ADA, and we are happy to vindicate the rights of those in recovery by protecting their fair access to necessary treatment.”

“We appreciate Genesis’s cooperation in modifying its policies for compliance with the ADA, and we encourage other skilled nursing facilities to proactively do the same,” added Richard Myrus, acting U.S. Attorney for the District of Rhode Island.