WASHINGTON – Nursing facilities have failed to report thousands of serious cases of potential neglect and abuse of seniors on Medicare even though it's 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 general's office drilled down on episodes serious enough that the patient was taken straight from a nursing facility to an 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 general's 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.
Responding to the report, Administrator Seema Verma said the Centers for Medicare and Medicaid Services is already moving to improve supervision of nursing homes in critical areas such as abuse and neglect and care for patients with dementia.