10th Circuit Court of Appeals Upholds Civil Monetary Penalties Issued to New Mexico Nursing Home

In February, the Federal 10th Circuit Court of Appeals upheld a decision to impose fines against a 67-bed nursing home in New Mexico. The nursing home was issued the fines by the Centers for Medicare and Medicaid Services (CMS), and upheld by an administrative law judge and the Departmental Appeals Board (DAB). The fines are formally known as Civil Monetary Penalties, or CMPs, which are issued for non compliance. The 10th Circuit case, Sunshine Haven Nursing Operations v. U.S. Dept. of Health and Human Services, et al., provides assurance to the public that neglect and abuse in nursing homes are duly accounted for with appropriate punishment.

Nursing home abuse and neglect unfortunately occurs with increasing regularity in New Mexico and across the United States. Nursing homes uphold a great responsibility to take care of the state’s elderly and the loved ones of New Mexico’s citizens. While this responsibility is often a thankless task, each nursing home is still obliged to follow the state and federal regulations in place. These safety laws and regulations require nursing homes to provide safe environment for their residents, and that residents receive the amount of care that is needed. When a nursing home fails to uphold their duty to provide a safe environment and medical care as prescribed by statute and regulation, and the failure results in injury, the nursing home can be held liable under civil law.

Nursing home abuse and neglect unfortunately occurs with increasing regularity in New Mexico and across the United States. Nursing homes uphold a great responsibility to take care of the state’s elderly and the loved ones of New Mexico’s citizens. While this responsibility is often a thankless task, each nursing home is still obliged to follow the state and federal regulations in place. These safety laws and regulations require nursing homes to provide safe environment for their residents, and that residents receive the amount of care that is needed. When a nursing home fails to uphold their duty to provide a safe environment and medical care as prescribed by statute and regulation, and the failure results in injury, the nursing home can be held liable under civil law.

The nursing home in the case above was issued four CMPs based on two surveys conducted in February and April of 2009. These surveys were amongst several conducted by the New Mexico Department of Health, after CMS was notified about a complaint that a resident wasn’t bathed often enough. Four separate fines were issued – two $5000.00 fines from the February survey and two $2000.00 fines from the April survey. The first set of fines was issued based on the nursing home’s failure to take reasonable steps to prevent abusive acts, regardless of the source. The nursing home had a resident who physically assaulted a neighboring resident he was dating, then sexually assaulted another resident following that instance. The assaulting resident then had contact with the first resident despite deliberate efforts to keep them separated. In both instances, the nursing home put a plan in place to monitor the assaulting resident’s whereabouts, but the ALJ found that the attempts to monitor were ineffective at actually preventing further abuse or protecting the other residents. The DAB and Court of Appeals agreed, upholding the fines imposed.

The second set of fines was issued after it was learned that a resident was not provided with a medical assessment within 35 hours after initially complaining about an ankle injury, and that no investigation was performed until the 2nd report of the injury, violating their own policies of investigating any unexplained injury. The Court of Appeals again agreed with the prior rulings, which found that the nursing home failed to make a good faith attempt to identify and correct deficiencies. Ultimately, the Court of Appeals denied the petition regarding the four CMPs and affirmed the findings of the prior rulings.