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The federal government is handing out fines to nursing homes as never before, thanks to a favorable U.S. Supreme Court ruling last February. In that ruling, the court held that nursing homes must exhaust their appeals to Medicare before they can contest their fines in the courts. As a result, the Health Care Financing Administration has been fining substandard nursing homes at five times previous rates. Where only 199 such fines were doled out in 1996, 1,000 fines were issued for substandard care through November 2000. As part of the government''s nationwide crackdown on nursing homes, the Justice Department for the first time is suing deficient nursing homes under the federal False Claims Act. Two such lawsuits against Philadelphia homes have resulted in settlements of $80,000 each, plus an agreement that increases federal monitoring of the sites. A third nursing home settled with the government for $60,000, with an additional $100,000 promised for building and equipment improvements over the next two years. Congressional investigators say that staff shortages are to blame for deficiencies that have harmed nursing home residents. Indeed, according to the Department of Health and Human Services more than half the nation''s nursing homes have dangerously low staffing levels. A spokesperson for the American Health Care Association, which represents more than 12,000 of the nation''s 17,000 nursing homes, blames the government itself for creating this crisis. The spokesperson told The New York Times that "Medicaid does not pay enough for us to hire the staff and provide care in compliance with federal regulations."
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