HHS Joins CFPB to Protect Nursing Home Residents and Their Caregivers From Illegal Debt Collection Practices

In joint letter with CFPB, HHS urges nursing homes and debt collectors to ban requiring caregivers to bear responsibility for cost of resident care

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), stepped up efforts to protect nursing home residents and their caregivers from illegal methods of securing payment for care. CMS, in partnership with the Consumer Financial Protection Bureau (CFPB), sent a joint letter to retirement homes and their debt collectors urging them to review their debt collection practices and ensure they comply with Federal law that prohibits nursing homes from requiring family members or caregivers to guarantee payment for a resident’s stay in a nursing home.

The letter was prompted by concerns that some nursing facilities have tried to circumvent this ban by creating admission contracts that attempt to hold third parties liable for a resident’s debt. However, CFPB and CMS point out that contract terms that conflict with the federal ban are unenforceable.

The letter represents the latest efforts by HHS to build on the Biden-Harris administration’s commitment to ensuring older Americans and people with disabilities receive the care they need. With his State of the Union address earlier this year, President Biden announced a series of reforms improve the safety and quality of care in nursing homes, hold nursing homes accountable for the care they provide, and make the quality of care and ownership of facilities more transparent so residents and potential caregivers can take informed decisions about care.

“A carer making difficult decisions about the future of their loved one should have the peace of mind knowing that nursing homes will not unlawfully force a family to take responsibility for medical debt,” said the secretary of the HHS, Xavier Becerra. “We expect care homes to act responsibly and obey the law. HHS continues to follow through on President Biden’s commitment to improve the safety and quality of retirement homes. »

“Nursing home residents and their families have the right to be free from harassment and financial pressure from facilities,” said CMS Administrator Chiquita Brooks-LaSure. “CMS supports the CFPB’s goal of ensuring that nursing home debt collection practices comply with federal law. The Bureau’s action complements the important work that CMS and our partners are doing to support the Biden-Harris administration’s initiative to improve the safety and quality of care in our nation’s nursing homes.

CMS enforces the Nursing Home Reform Act of 1987, which prohibits nursing homes participating in Medicaid or Medicare from requiring a third party such as a family member or caregiver to personally guarantee the payment of a resident’s living expenses as a condition of admission (or expedited admission), or as a condition of continued stay at the facility. The CFPB enforces federal laws governing debt collection and credit reporting that protect caregivers from illegal practices by debt collectors who wrongly attempt to hold caregivers accountable for the costs of their loved one’s care and who report inaccurate information. on caregivers to credit bureaus. With this action and others, HHS and the CFPB are working together to ensure that the approximately 48 million guardians in the United States are not subjected to coercive tactics and illegal practices by debt collectors. .

In addition to today’s letter, HHS has heeded President Biden’s call to action to improve home nursing care for older Americans and people with disabilities by:

  • CMS has launched the public consultation process and research study that will inform the future development of the staffing requirements rules, with a commitment to publish the proposed minimum staffing rule by spring 2023.
  • CMS has launched the public consultation process that will inform the future development of rules to incentivize better staffing, namely measures on staffing levels and staff turnover for the purchase program based on the value of Medicare skilled nursing facilities.
  • CMS released data publicly — for the first time — on mergers, acquisitions, consolidations, and ownership changes for Medicare-enrolled hospitals and nursing homes.
  • CMS released a proposal that would require retirement home owners to be fingerprinted for federal background checks to address oversight reports of abuse and fraud to Medicare by retirement home owners.
  • CMS has taken steps to improve Care Compare, the nursing home comparison site, by better integrating verifiable information on staffing levels into the 5-star rating system.
  • CMS has updated its guidance to care home inspectors, including requiring infection control specialists to be on-site (not off-site consultants).
  • CMS released a newsletter detailing steps states can take using existing Medicaid authorities to improve health outcomes for nursing home residents and improve staff salaries, training and retention efforts.

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