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Over 25% of serious abuse cases occurring in nursing homes are not being reported to law enforcement. The Office of Inspector General, which is part of the U. S. Department of Health & Human Services, issued an alert about this last Monday.

Despite state and federal law demanding that serious nursing home incidents involving abuse must be reported to the police, many cases never were.

Governmental investigators are doing an extensive ongoing review of reports of abuse and neglect occurring in nursing homes but are issuing the alert now because immediate action is required due to the seriousness of the cases they’ve found so far.

The abuse cases are so severe that the victims were sent to the emergency room. The alert cited an example of a woman who was terribly bruised from a sexual assault that occurred in her nursing home room, yet this was not reported to law enforcement.

Federal law requires that such an assault be reported to law enforcement within two hours of the crime being discovered. But that wasn’t done according to Curtis Roy, the Department of Health & Human Services’ assistant regional inspector general.

“Instead, they cleaned the victim up and this actually destroyed crucial evidence that the police could have relied on while investigating this crime.”

The nursing home did tell the family that their loved one had been sexually assaulted the previous day. The family then went to police to file a report on the crime. Even after the crime had been reported, the nursing home attempted to conceal the crime, according to Roy.

“They actually contacted the police department trying to persuade them that no investigation was necessary and attempted to dissuade them from coming out to the nursing home to look into the incident,” said Roy.

Examining records pulled from 2015 and 2016, Roy and his investigative team discovered 134 incidents of residents in nursing homes being abused so severely that they needed to go to the emergency room. The overwhelming majority of these incidents were sexual assaults.

“There is absolutely no excuse for allowing someone to suffer this degree of torture, never ever,” says Roy.

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The abuse cases occurred in 33 different states, with Illinois having the most incidents, which numbered 17. Investigators found that in 72% of the cases law enforcement did get a report within the required two hours. But, that leaves 28% unreported. Investigators made the decision to report every single one of these 134 cases of abuse to the police. Roy said, “We were so worried that we would rather over-report than risk the chance that a single case would remain unreported.”

The Inspector General’s alert says nursing home regulators, who are the Centers for Medicare and Medicaid Services (CMS), must do a better job of tracking these abuse cases. They said that CMS should do exactly what Curtis Roy’s team did: look at Medicare claims submitted by residents of nursing homes and cross-reference their emergency room claims. This way the investigators could see whether a Medicare recipient had filed a claim for emergency room care during the same time they were filing a claim for nursing home care. If so, the investigators could look at the emergency room diagnosis and determine whether the patient appeared to be a crime victim, as would be the case if the diagnosis indicated a physical and/or sexual assault.

The alert emphasized that in 2011 federal law regarding the issue of nursing home abuse was strengthened. The law now requires that anyone who even suspects that a resident in a nursing home had been abused to the extent that it caused them to suffer serious bodily injury are required to report these suspicions to the police within no more than two hours. If they suspect a nursing home resident has been abused, but not to the extent of serious bodily injury, they have up to 24 hours to report the abuse to law enforcement. 

Failure to make the required abuse report to law enforcement within the specified time period can result in fines being imposed of up to $300,000.

However, CMS never received specific instructions from the Secretary of Health & Human Services to exercise the authority to carry out the penalties and collect the fines. According to the alert, CMS only this year started to seek the authority to enforce the law. There was no one from CMS who would agree to be interviewed for this article. 

Obviously, the 134 incidents of severe nursing home abuse discovered by the investigators represent just a tiny percentage of the 1.4 million currently residing in the country’s nursing homes. But, according to Curtis Roy, these cases are likely to be just the tip of the ice burg, since his investigators were only able to pinpoint abuse victims who were sent for emergency room care. “This is the absolute worst possible thing,” he said. “I don’t believe for a second that anyone could possibly think this is anywhere near being acceptable.”

“We must do a whole lot better,” says Roy, at “ridding our healthcare system of any form of abuse, no matter how minor.”

One fact that investigators were not able to find out is whether or not any of the nursing homes where incidents of abuse occurred were ever fined or penalized in some way for ignoring the law in not reporting these incidents and in some cases, trying to cover up the evidence. That information will likely be covered in the Inspector General’s complete report, which should be released next year. 

(Source: NPR)

Published on behalf of O'Connor, Runckel & O'Malley LLP

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