A recent government audit blames Medicare for failure to enforce a federal law that requires immediate notification of nursing home abuse and neglect to police.
Based on preliminary results from a large sample of cases over 33 states, the Office of Inspector General for Health and Human Services reported that while this is just early data, immediate action was required. The IOG investigates instances of waste, fraud and abuse within the health care system. This particular audit was part of a bigger investigation, which is ongoing, and additional results are expected in the coming months. The agency released an early alert memo regarding these initial findings, prompting the Senate Finance Committee to request additional information regarding elder abuse in nursing homes. Specifically, the committee chair has requested information on whether HHS intends to reevaluate its procedures to make sure nursing home abuse and nursing home neglect is not only identified but also reported.
It’s estimated approximately 1.4 million people live in nursing homes across the country. According tot he Florida Health Care Association, there are 683 licensed nursing homes in Florida and another 3,100 assisted living facilities. The IOG report revealed there were more than 130 cases wherein emergency room records showed possible abuse – physical abuse, sexual abuse or neglect. This was over the course of a two-year-period. Of those, 28 percent – more than 1 in 4 – had no record of any report being made to local law enforcement.
That means these cases are vastly under-reported. Of the cases that went unreported over the two year period (between 2015 and 2016), four out of five involved indications of possible sexual abuse or rape.
Federal law requires prompt reporting of nursing home abuse to proper law enforcement authorities. This statute has been on the books for more than five years. However, the inspector general’s findings suggest Medicare has failed to enforce this requirement. When a nursing home does not report issues of possible physical or sexual abuse to proper police authorities and other agencies (such as the state health department), the law allows for fines of up to $300,000. Incidents of a suspected crime are supposed to be reported within 24 hours, unless there is seriously bodily injury involved, in which case, reports must be made within two hours.
The inspector general’s office recommended Medicare administrators figure out a way to comb through computerized billing records in a systematic way to search for signs of possible nursing home abuse or neglect. These would include treatment for incidents such as falls, bed sores, malnutrition and other injuries that might indicate abuse or mistreatment.
Medicare officials responded that while it does require immediate reporting, those reports are to be made to state inspectors. Of the 100 or so cases in the sample that were eventually reported to police, the inspector general’s office investigators were unable to ascertain whether the federal mandate for “immediate” reporting was followed.
As our nursing home abuse attorneys in Orlando can explain, failure to immediately report such incidents results in a loss of key evidence, particularly in cases where there is suspected sexual assault. That is information that can be invaluable not only to the criminal case, but also to a civil claim for damages. Families with concerns should speak to an experienced attorney to learn more about their rights and how best to preserve and gather important evidence for a possible claim.
Call Freeman Injury Law — 1-800-561-7777 for a free appointment to discuss your rights. Now serving Orlando, West Palm Beach, Port St. Lucie and Fort Lauderdale.
Audit: Nursing-home abuse in Illinois, across U.S. going unreported, Aug. 30, 2017, Associated Press
More Blog Entries:
Florida Nursing Home Sued for Failing to Protect Patients Post-Hurricane Irma, Sept. 24, 2017, Orlando Nursing Home Abuse Lawyer Blog