Abuse and neglect in nursing facilities unreported

Not throwing rocks at nursing facilities - more interested in the methods the OIG used to identify "potential neglect or abuse that was not reported" and applying them to other provider types... (Article summary from Hospice News Today, 6/13/19.)

Watchdog—Abuse and neglect in nursing facilities unreported
Associated Press/Washington Post
June 12, 2019

Nursing facilities have failed to report thousands of serious cases of potential neglect and abuse of seniors on Medicare even though itʼs a federal requirement for them to do so, according to a watchdog report released Wednesday that calls for a new focus on protecting frail patients. Auditors with the Health and Human Services inspector generalʼs office drilled down on episodes serious enough that the patient was taken straight from a nursing facility to a hospital emergency room. Scouring Medicare billing records, they estimated that in 2016 about 6,600 cases reflected potential neglect or abuse that was not reported as required. Nearly 6,200 patients were affected. “Mandatory reporting is not always happening, and beneficiaries deserve to be better protected,” said Gloria Jarmon, head of the inspector generalʼs audit division. Overall, unreported cases worked out to 18% of about 37,600 episodes in which a Medicare beneficiary was taken to the emergency room from a nursing facility in circumstances that raised red flags. … CMS officially agreed with the inspector generalʼs recommendations, including clearer guidance to nursing facilities about what kinds of episodes must be reported, improved training for facility staff, and requirements that state nursing home inspectors record and track possible problems as well as incidents reported to law enforcement. … The American Health Care Association, which represents the nursing home industry, said in a statement from its vice president for quality, David Gifford, that it would “fully support more transparent reporting.” The group said Medicareʼs current definition of neglect “is vague and creates confusion about what should be reported.” … Separately, the report also flagged potential problems with state nursing home inspectors reporting documented cases of abuse or neglect to local law enforcement.