Everyone agrees that abuse of any kind perpetrated on vulnerable elderly residents in care facilities is abhorrent. Yet a recent warning issued by the Office of the Inspector General in the Federal Department of Health and Human Services (HHS) charges that the process of preventing and reporting elder abuse is woefully inadequate at just about every level, from local nursing homes to state agencies to the officials in charge of Medicare and Medicaid administration.
The warning comes in a 14-page memorandum (you can access it here) sent just a few weeks ago from the HHS Inspector General to the leadership at the Centers for Medicare and Medicaid Services (CMS). Even in the light of the stilted bureaucratic language of such documents, the report is striking. “The purpose of this memorandum,” says the IG, “is to alert you to the preliminary results of our ongoing review of potential abuse or neglect of Medicare beneficiaries in skilled nursing facilities.” The bottom line, says the report: “The Centers for Medicare & Medicaid Services has inadequate procedures to ensure that incidents of potential abuse or neglect at skilled nursing facilities are identified and reported.”
According to an analysis about this disturbing finding from the watchdog group Center for Medicare Advocacy, the audit by HHS was part of an ongoing effort to better understand – and more effectively combat – elder abuse. Here’s how the Center for Medicare Advocacy describes these findings, which came after an OIG investigation of emergency room records for Medicare beneficiaries, a review of State Survey Agency reports, and interviews with officials from the Centers for Medicare and Medicaid Services. “The preliminary results are striking,” says the summary report. “Of the beneficiaries whose injuries may have been caused by abuse or neglect, a significant percentage (26 percent) may not have been reported to law enforcement by the hospitals, despite states’ mandatory reporting laws.” Nursing homes are also failing to comply with tougher rules about reporting elder abuse mandated by the Affordable Care Act.
In short, from top to bottom, says HHS, not enough is being done to protect seniors from physical and sexual abuse in the very places where they’re supposed to be safe: skilled nursing facilities.
According to the warning sent from HHS to the Centers for Medicare and Medicaid Services, the laws governing suspected abuse couldn’t be clearer. Skilled Nursing Facilities “must ensure that all alleged violations, such as mistreatment, neglect, or abuse (including injuries of unknown source)…are reported immediately to the administrator of the facility and to other officials, including the [State] Survey Agency,” says the HHS document. These allegations then must be investigated with results reported within five days. If the alleged violation is verified, says HHS, “appropriate corrective action must be taken.”
But it is clear from the findings in the HHS document that these policies are often being ignored or circumvented. HHS identified 134 suspicious incidents of probable elder abuse covering 33 states in the U.S. during 2015 and 2016. According to the Office of the Inspector General, “Many of the incidents of potential abuse or neglect that we identified may not have been reported to law enforcement.” The IG found that while 96 of the 134 incidents had been reported as required by law, “we found no evidence in the hospital records that the remaining 38 incidents (28 percent) were reported to local law enforcement despite State mandatory reporting laws requiring the hospitals’ medical staff to do so.”
The conclusion was stark. HHS found that procedures put in place by Medicare and Medicaid officials to prevent elder abuse are inadequate. Health and Human Services officials reported “significant concerns that incidents of potential abuse or neglect at Skilled Nursing Facilities have gone unreported.” The only way to combat elder abuse, the HHS report inferred, is for all agencies to meet their responsibilities, including residents, families, nursing home staff, state agencies and the federal officials in charge. The report suggests that some of the links in the chain of reporting and prevention appear to be broken.
We echo the words of the Center for Medicare Advocacy, a long-time advocate for the rights of nursing home residents. They “urge [the Center for Medicare and Medicaid Services] to take strong enforcement action.” They add that “Medicare beneficiaries in nursing facilities deserve to live with dignity and in safety. Elder abuse devastates the lives of its victims and must be reported appropriately.”
So what can you as a family member of a nursing home resident do? We suggest two things. First, says AgingOption’s Rajiv Nagaich, don’t be naïve. “Looking to the government for a good fix to the problem of elder abuse is foolish,” says Rajiv. “Government officials have already acknowledged that their systems are broken! We strongly advise our clients and radio listeners to use their own resources to ensure future security safety and happiness. Get a care manager in place and let him or her guide you. Seniors and their families need to take this problem seriously and plan with care!”
Our second piece of advice is, don’t be uninformed: elder abuse, while statistically rare, is still too frequent, and can tragically go unreported. Be on the alert for any signs that something is amiss with your loved one. Be observant and ask questions. You might also want to review this list of abuse prevention tips from a website called Elder Protection Center. As a caring loved one, family member or friend, you may be the first line of defense against abuse – and if you see something, for heaven’s sake say something, to nursing home staff, administrators, and (if necessary) law enforcement.
Elder abuse in nursing homes is not only a medical and family issue, it can also be a housing issue, since failing to plan ahead may force a senior into a substandard institutional facility. The best way to ensure that you’re able to live the life you want as you age, on your terms, is by starting right now to prepare an AgingOptions LifePlan – a retirement plan that blends housing, family, financial, legal and medical aspects of retirement together into one seamless blueprint. Why not take the time to learn more, without cost or obligation? Come to a free AgingOptions LifePlanning Seminar where you’ll get your questions answered concerning this revolutionary approach to retirement planning. For all the details plus convenient online registration, click here, or call us during the week and we’ll be glad to assist you.