OIG: More than 25% of alleged abuse incidents at nursing homes go unreported

A "significant percentage" of potential elder abuse and neglect incidents may go unreported, according to a recent audit by HHS' Office of Inspector General.

For the audit, the OIG analyzed emergency room records for 134 Medicare beneficiaries as well as Survey Agency reports for skilled nursing facilities and the Medicare exclusion database. Additionally, the OIG interviewed CMS officials.

The OIG said its preliminary findings show a "significant percentage" of potential abuse or neglect incidents from January 1, 2015, through December 31, 2016, involving the studied Medicare beneficiaries may have gone unreported to law enforcement. Overall, the OIG found 72 percent of the incidents were reported and "no evidence" that the other 28 percent were reported.

OIG said it "determined CMS has inadequate procedures to ensure that incidents of potential abuse or neglect of Medicare beneficiaries residing in SNFs are identified and reported."

The OIG suggested CMS take immediate action, such as "implement[ing] procedures to compare Medicare claims for emergency room treatment with claims for SNF services to identify incidents of potential abuse or neglect of Medicare beneficiaries residing in SNFs."

The OIG said it will make formal recommendations once it is finished with the audit.

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