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DOJ’s National Nursing Home Initiative Targets “Grossly Substandard Care”

May 11, 2020

In the face of “once-in-a-lifetime” disasters like the 2008 recession, the 2010 BP oil spill, and now the CoVid-19 pandemic, the Department of Justice (DOJ) increases scrutiny, and makes extra efforts to show the American public that the government will not abide misconduct or those who take advantage of those disasters.   This is especially true when federal dollars are being loaned: with federal funding comes federal scrutiny.

One of the areas of specific focus for DOJ is nursing home abuse.  Announced in early March of this year, even before the country was rocked by a pandemic, the Nursing Home Initiative targets what DOJ has termed “grossly substandard care” of those citizens most vulnerable to abuse.  We expect that scrutiny to increase greatly now that it has been shown that one of the groups most susceptible to the deadly effects of CoVid-19 is the elderly.

“The HHS Office of Inspector General (OIG) continues to pursue nursing home operators who provide potentially harmful care to residents who are often unable to protect themselves,” said Chief Counsel to the Inspector General Gregory Demske of HHS.  “Creating this [National Nursing Home] Initiative sends a message to those in charge of caring for these beneficiaries that grossly substandard care will not be tolerated.”

DOJ considers several factors in identifying the most problematic nursing homes, including:

  • failing to provide adequate staff to care for their residents,
  • failing to adhere to basic protocols of hygiene and infection control,
  • failing to provide residents with enough food to eat,
  • withholding pain medication, or
  • using physical or chemical restraints to restrain or otherwise sedate residents.

Nursing homes that provide “grossly substandard care” also force vulnerable elderly residents who cannot leave the facilities to live in conditions where, for example, there are leaks in the roofs, mold is growing, and rodents are living in residents’ rooms.

One of the best ways to combat allegations of “grossly substandard care” is to carefully and accurately document all steps taken to assure proper care for residents and to assure accurate billing.  This includes in some cases documenting not just what was done, but why it was done as well.  Taking the time for proper documentation is a valuable step in avoiding and, if necessary, disproving allegations of fraud and neglect in the months and years to come.

If you have any questions or need legal support, please contact:

Richard Davis at 205-868-6044 or

Reed Bates: 205-868-6080 or

Jay Ezelle at 205-868-6025 or

Stephen Still at 205-868-6085 or


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