As the number of older Americans (age 65 and older) continues to grow at an unprecedented rate, the issue of elder abuse and neglect also continues to make headline news across the country. Experts have long claimed that it is difficult to accurately gauge the prevalence of elder abuse because a significant percentage of the abuse is not reported by victims. A recently released government report, however, is also pointing the finger at hospitals and nursing homes for failing to report possible incidences of physical and sexual abuse. Moreover, the State of Illinois took the number one spot for unreported instances of suspected elder abuse.
Health and Human Services Audit
The Health and Human Services inspector general’s office was issuing an “early alert” based on its conclusion after a federal audit that more than one in four cases of possible sexual and physical abuse against nursing home patients apparently went unreported to police. The agency faults Medicare for failing to enforce a federal law requiring immediate notification. The audit included a large sampling of cases in 33 states. Illinois had the largest number of incidents overall with 17, followed by Michigan (13), Texas (9), and California (8).
The HHS office has urged Medicare to take corrective action immediately. “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 healthcare system. The audit is part of a larger ongoing probe with additional findings expected.
Using investigative data analysis techniques, auditors from the inspector general’s office identified 134 cases, spanning a two-year period from 2015-2016, in which hospital emergency room records indicated possible sexual or physical abuse, or neglect, of nursing home residents. 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. “Based on the records we had available to us, we could not determine that they had been reported to law enforcement,” said Roy.
The Federal Reporting Requirement
The federal statute has been on the books more than five years and requires nursing home personnel to report incidents that involve a suspected crime within 24 hours or within two hours if serious bodily injury is involved. The statute imposes a fine of up to $300,000 for non-compliance. Investigators, however, found that Medicare has not enforced the law. 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.
In a statement, the Centers for Medicare and Medicaid Services said “nursing home resident safety is our priority and primary focus,” and it is committed “to ensure these vulnerable people are properly cared for, and that all viable or alleged instances involving abuse or neglect are fully investigated and resolved.” 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.
Elder Sexual Abuse – A Case Study
What many may find particularly shocking is that of the 38 unreported cases, 31 involved alleged or suspected rape or sexual abuse, or about 4 out of 5. It also appears that 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. For example, in one case classified as “reported to law enforcement,” an elderly woman with verbal and mobility limitations was taken to the emergency room after she was allegedly sexually assaulted by a male resident of the same nursing home. The report said two silver-dollar-sized bruises were noted on her right breast. Nursing home staff had helped the woman bathe and change clothes after the incident, in clear violation of the two-hour reporting requirement. “These actions could have destroyed any evidence that may have been detected using the rape kit,” said the report. Instead of reporting the alleged abuse right away as required, the nursing home contacted the woman’s family the following day. The victim’s family then called the police which finally triggered an investigation. Incredulously, the nursing home told police “we were required to report it but that we were doing our own internal investigation and did not need (police) to make a site visit…no one was interested in pressing charges.”
Contact the Illinois Elder Law Attorneys
If you have questions or concerns regarding elder abuse or neglect in the State of Illinois, contact the experienced Illinois elder law attorneys at Hedeker Law, Ltd. by calling (847) 913-5415 to schedule an appointment.