COVID-19 in Nursing Homes - Learn More.

Inspector General Finds Reporting Rates Lacking

The United States Department of Health and Human Service’s (HHS) Office of Inspector General (OIG) recently published a report detailing the rate that nursing home facilities themselves reported incidents of abuse or neglect during the year 2012. The report and its accompanying figures are jarring for anyone living in a nursing home or anyone who has loved ones residing in a nursing home.

The Latest Report

According to the OIG report, 53% of allegations and the findings of subsequent investigations into allegations were correctly reported in accordance with federal requirements. Federal law extends over nursing homes and other medical healthcare providers that accept federal money through insurance programs like Medicare and Medicaid, which are all administered by the Centers for Medicare and Medicaid Services (CMS). Nursing facilities certified by the CMS are required under law to report incidents of neglect and incidents of abuse against facility residents. This includes reporting even just plain allegations, as well as the reports and findings produced by investigations into any allegations. In addition to the 53% rate of correct reporting, it was found that approximately 76% of the nursing homes used internal policies based on those reporting requirements. Furthermore, 61% of nursing homes had documentation to show that they properly trained facility employees, as well as contractors, of those requirements to report abuse or neglect, as well as to file complaints in general. The 53% figure above about “correct reporting” is prescient in light of the fact that 85% of nursing homes reported at least a single claim to the OIG.

In addition to those statistics, the report broke down the different categories of the types of abuse or neglect that were reported. Abuse in general made up 50% of the claims, injuries resulting from “unknown” origins made up 20%, 15% was the taking of property (for example financial theft, theft of personal property, and other actions), neglect made up 12%, and general mistreatment made up 4%. The crucial statistic to make note of is how a whole fifth of the reports did not point to a known source of injury. Thus in addition to the general indications of underreporting and failure to correctly report in so many instances, there was a significant underreporting of the actual nature of the abuse, neglect or misdoing in that it could not be identified.

If anything, a positive to draw from this report is that we have an agency watchdog on the case looking into it. Hopefully these statistics will prompt the government to get involved with even more oversight than it already has through the Department of Health and Human Services and the Centers for Medicare and Medicaid Services, and that state agencies will do their part as well given that they bear the primary and central role in regulating public health and nursing homes within their states. Federal authority can only go so far legally and constitutionally.

For the part of HHS and CMS, priorities include improving the ease with which nursing homes, employees and residents can file reports, and providing greater guidance for how nursing homes can design better reporting policies, and for educating employees on the mandatory reporting of any “reasonable suspicion” of criminal activity, abuse or neglect. Hopefully all government agencies will improve oversight, and nursing homes will improve reporting activity.

See Other Blog Posts:

An Overview of the Regulation and Monitoring of Illinois Nursing Homes

The Worst Places in the Nation for Nursing Homes?

Lawyer Monthly - Legal Awards Winner
The National Trial Lawyers
Elder Care Matters Alliance
American Association for Justice
Fellow Litigation Counsel of America
Super Lawyers
Contact Information