In December 2017, President Trump, standing proudly beside several massive stacks of papers that represented the federal government’s expansive regulatory regime, boasted that his administration had removed more than 22 times as many regulations as it had added. He punctuated his point by literally cutting some red tape to a smattering of applause. Hokey as that was, Trump’s deregulation message has been core to his political agenda. What are we deregulating? How are we doing it? Doesn’t matter. Just cut, cut, cut!
But those reams of paper contain essential protections for vulnerable Americans. Among them: regulations designed to protect residents at nursing homes.
Nursing homes are highly regulated under federal law, but for decades, those rules were poorly enforced and few administrations made them a priority. President Barack Obama attempted to change that late in his tenure by crafting policies to put pressure on poorly managed facilities. In 2014, he issued policy guidelines that urged regulators to issue daily fines against nursing homes for infractions until those violations were remedied. By 2016, that approach applied to two-thirds of cases. He also issued a rule that would have barred facilities from requiring that disputes with residents be settled in private arbitrations that limit the companies’ public exposure and allow the residences to resolve complaints in venues over which they have more control.