President Donald Trump

Nursing facilities have seen their fines drop by about 31% during the Trump administration, according to a Kaiser Health News analysis, released on Friday.

At the urging of industry grade groups, the administration has moved away from penalizing providers for each day out of compliance with a regulation. Instead, facilities are issued a single fine for two-thirds of infractions. Since that shift, the average fine dropped from $41,260 during President Obama’s last year in office to $28,405 in 2017.

Nursing home trade groups told KHN that they “don’t feel they’ve been given a reprieve,” while consumer advocates claim penalties may be reaching levels too low to incite change.

“Fines need to be large enough to change facility behavior,” said Robyn Grant, director of public policy and advocacy at the National Consumer Voice for Quality Long-Term Care, a nonprofit based in Washington. “When that’s not the case and the fine is inconsequential, care generally doesn’t improve.”

The report notes other examples of allegedly preferential treatment for nursing homes under the Trump administration, including an 18-month moratorium on imposing monetary fines for some violations. Trump officials have also revoked an Obama rule that barred nursing homes from requiring residents to sign pre-dispute arbitration agreements.

Investigators have actually fined nursing homes about 28% more frequently under Trump, but larger fines have become less common, the report noted.

American Health Care Association spokeswoman Beth Martino told KHN the group believes the feds have “returned to a method of applying fines in a way that incentivizes solving problems” rather than penalizing “facilities that are trying to do the right thing.” LeadingAge’s Barbara Gay added that nursing homes “don’t’ feel they’ve been given a reprieve.” CMS said it has looked to make penalties fairer and more consistent, and it will continue to “analyze the impact of these combined events to determine if other actions are necessary.”