Unreported Nursing Home Abuse and Neglect

Date: June 18, 2019

Nursing Home Abuse is One the Rise

Cases of neglect and abuse in nursing homes are required by the federal government to be reported when involving senior citizens receiving Medicare. In a report issued on June 12, 2019, auditors from the Health and Human Services Inspector General’s Office estimated that approximately 6,600 cases of potential neglect or abuse were not reported to state inspection agencies in 2016. Investigators found this information by looking at Medicare billing codes where previous investigations linked to potential abuse or neglect. Approximately 37,600 cases where a Medicare beneficiary was taken from a nursing to an emergency room showed circumstances raising red flags, including fractures, head injuries, shock, foreign objects swallowed, and gangrene (not including other more common problems). Alarmingly, an estimated 18% of these cases went unreported. Investigators then asked state inspectors which of the incidents of these cases should have been reported, and came up with the 6,600 based on the expert opinions of the state inspectors. Nursing homes receive significant fines from the Centers for Medicare and Medicaid when they are found to have not reported incidents of abuse and mistreatment.

How Many Cases of Nursing Home Neglect Go Unreported?

Investigators believe many cases may go unreported because elderly citizens may feel too vulnerable in reporting incidents of abuse or neglect to their families, friends, and law enforcement. In other cases, the neglect or abuse may be not be totally clear when patients have other underlying medical conditions. For example, a 65-year-old nursing home patient arrived in critical condition at an emergency room where she was delirious, struggling to breathe, and suffering kidney failure. The report of this incident stated that a nurse miscopied a doctor’s orders and dosed the patient with much more pain medication than necessary. The patient returned to the nursing home following treatment, while the nurse received remedial training, but the incident went unreported. This incident represents a substantial problem today where patients are sent back to the same facility where they were possibly abused and neglected. Without any incident reports to inspection agencies, the government is not be able to ensure corrections in the facility that would meet their standards to qualify for receiving patients’ Medicare. Gloria Jarmon, head of the inspector general’s audit division, believes the problem lies not only with nursing homes, but also with state inspectors. In a statement following the report, Jarmon remarked that state inspectors were found to have failed to report incidents to local law enforcements, as required, in the states where the investigation occurred. Jarmon then noted that state inspectors of nursing homes who participated in the study appeared to be confused about when they were required to report incidents to local law enforcement.

Will Elder Abuse Ever Be Resolved?

The Inspector General’s Office has made recommendations to the Centers for Medicare and Medicaid Services to combat the problem of unreported incidents of abuse and neglect. These recommendations include making clearer guidelines for state inspectors on what constitutes, and when a potential case of abuse or neglect must be reported. The American Health Care Association represents the nursing home industry, and a statement released by a vice president for quality points out that Medicare’s current definition for neglect is “vague and creates confusion about what should be reported.” The statement also indicated the Association would “fully support more transparent reporting.” Until clearer standards for reporting are set forth, and hopefully understood and followed from the nursing homes, to the inspection agencies, to local law enforcement, to federal agencies overseeing patients receiving Medicare and Medicaid, abuse and neglect may occur in nursing homes without being discovered.

Contact Our Nursing Home Abuse Lawyers

Are your loved ones being properly cared for? If they are not, and there are concerns of potential abuse or neglect in their facilities, please reach out to us at DLP. We are experienced in nursing home abuse cases, and work tirelessly to ensure nursing home patients are receiving the proper care they deserve, and the proper compensation for any prior or ongoing abuse or neglect they have been victims of.

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Sean McDonough
Upon graduation from law school, he entered the private practice of law with Dougherty, Leventhal & Price. He has been a partner with the firm since 1993. Over the years, Sean has concentrated his practice in the areas of personal injury litigation; he has also represented governmental entities and officials in federal civil rights and employment lawsuits. Sean also works on many of DLP's Nursing Home Abuse cases.