Lakeridge is an Ohio nursing home that participates in Medicare and Medicaid. When it was surveyed, it was found out of compliance with several provider requirements. It was fined a civil monetary penalty of $80,300. The fine was upheld and affirmed on appeal. Among the violations cited were “one violation of 42 C.F.R. § 483.25(h)(2), creating immediate jeopardy, and violations of 42 C.F.R. § 483.13, 483.25, 483.25(c), and 483.25(d)(2), not producing immediate jeopardy.” The most serious violation related to section 483.25(h)(2), which requires facilities to provide adequate supervision and assistance devices to prevent accidents. One of the facility’s arguments in response was that no actual harm resulted. The Court found that actual harm is not required for the nursing home to violate a provider agreement. The Court rejected the nursing home’s argument that the fine was excessive. Similarly, it rejected the argument that a fine cannot be imposed while the facility is implementing a plan of correction.

Note: Below, the ALJ determined that 42 C.F.R. § 483.25 was violated by not providing care consistent with that provided in the plan of care for each resident.