According to the Associated Press, more than 1 in 4 cases of possible sexual and physical abuse against nursing home patients apparently went unreported to police, says a government audit that faults Medicare for failing to enforce a federal law requiring immediate notification.
The Inspector General of the U.S. Department of Health and Human Services issued an “early alert” on its findings from a large sampling of cases in 33 states. Investigators say Medicare needs to take corrective action right away.
“We hope that we can stop this from happening to anybody else,” said Curtis Roy, an audit manager with the inspector general’s office, which investigates fraud, waste and abuse in the health care system. The audit is part of a larger ongoing probe, and additional findings are expected, he said.
With some 1.4 million people living in U.S. nursing homes, quality is an ongoing concern. Despite greater awareness, egregious incidents still occur.
Auditors from the inspector general’s office identified 134 cases in which hospital emergency room records indicated possible sexual or physical abuse, or neglect, of nursing home residents. The incidents spanned a two-year period from 2015-2016.
Illinois had the largest number of incidents overall, with 17. It was followed by Michigan (13), Texas (9), and California (8). Indiana was 11th in the 33 state sample with 4 incidents. However, just one incident is too many.
The news was already bad for Indiana.
As the Northwest Indiana Times reported earlier this year, “Indiana ranks worst in nation for long-term care” for seniors and people with disabilities. Those findings were part of the Long-Term Services & Supports Scorecard, conducted in part by AARP earlier this year (2017).
The AP report continued. In 38 of the total cases (28 percent), investigators could find no evidence in hospital records that the incident had been reported to local law enforcement, despite a federal law requiring prompt reporting by nursing homes, as well as similar state and local requirements.
The federal statute has been on the books more than five years, but investigators found that Medicare has not enforced its requirement to report incidents to police and other agencies, or risk fines of up to $300,000.
Nursing home personnel must immediately report incidents that involve a suspected crime, within a two-hour window if there’s serious bodily injury. Otherwise, authorities must be notified within 24 hours.
Medicare “has inadequate procedures to ensure that incidents of potential abuse or neglect of Medicare beneficiaries residing in (nursing homes) are identified and reported,” the inspector general’s report said.
The agency said it has long required nursing homes to immediately report abuse and neglect to state officials, and it will have a formal response to the inspector general’s findings once the audit is complete.
The inspector general is urging Medicare to start systematically scouring computerized billing records for tell-tale signs of possible abuse of nursing home residents. Investigators used that approach to find the cases, matching emergency room and nursing home records.
Of the 38 unreported cases, 31 involved alleged or suspected rape or sexual abuse, or about 4 out of 5.
But even among the 96 cases that were ultimately reported to police, investigators were unable to tell if the federal requirement for “immediate” notification was followed.
The number of nursing home residents is expected to grow in coming years as more people live into their 80s and 90s. Medicaid is the main payer for long-term care, while Medicare covers doctors’ services and hospital care for elderly people and the disabled.
If you suspect abuse in a nursing home, you should:
- Report nursing home abuse immediately to the nursing home staff.
- If you suspect there is immediate danger, call 911.
- Make sure the suspected victim gets medical treatment immediately.
Another source for help is The Indiana Attorney General’s Patient Abuse and Neglect program. It was created to protect vulnerable Hoosiers—patients in nursing homes, homes for the disabled, assisted living residences, homes for the mentally ill and other residential care facilities.
Finally, call us Theodoros & Rooth. We have over 110 years of combined experience handling personal injury cases, including abuse of our seniors.
Our team of dedicated attorneys will investigate your situation and will take immediate and aggressive action if we determine there has been mistreatment.
Taking care of you and your family with respect, understanding, and compassion is part of what we do at Theodoros & Rooth.