“Together these changes gut enforcement,” said Toby Edelman, a senior lawyer at the Center for Medicare Advocacy, a nonprofit legal assistance group for the elderly. “They are a gift to the industry.”
The administration’s moves came after intense lobbying by the nursing home industry, including by the firm run by Brian Ballard, Mr. Trump’s friend and a fund-raiser. Parlaying his personal connections to Mr. Trump, Mr. Ballard has become one of the most powerful lobbyists in Washington, with the most clients of any registered lobbyist last year, according to an analysis by the Center for Responsive Politics. His firm has lobbied on behalf of nursing homes in his home state, Florida, for years, according to public records. (He was also a lobbyist for Mr. Trump’s Florida golf course, the Doral.)
After Mr. Trump was elected, Mr. Ballard was retained by a leading trade group for the nursing home industry, the American Health Care Association. His firm, Ballard Partners, has earned $930,000 in lobbying fees from the group since Mr. Trump took office, records show.
Ms. Verma, who emphasized that she didn’t even know Mr. Ballard, said she didn’t like to hear from lobbyists. “I tell folks I am not going to meet with D.C. insiders,” she said. “I want to meet with people on the front lines.”
A spokeswoman for the nursing home trade group said that loosening the requirement to have an infections specialist on staff would allow facilities to “provide greater flexibility to meet” to thwart infections.
In November, Mr. Trump was honored by a group of nursing home operators at a fund-raising event at a packed ballroom at the InterContinental hotel in Midtown Manhattan. The event drummed up more than $3 million for his re-election campaign through a political action committee called America First Action.
Flanked by two American flags onstage, Mr. Trump singled out one of the executives, Eliezer Scheiner, who donated $750,000, the most of any attendee.