Nursing Home Abuse Goes Unreported
Originally published by Reuters Health, March 4, 2002
WASHINGTON, DC (Reuters Health) — Some cases of physical and sexual abuse in American nursing homes are going unreported to police and regulatory authorities because of gaps in state and federal nursing home rules, according to a government report released Monday.
The report, issued by the federal General Accounting Office (GAO), also concluded that registries designed to prevent abusive workers from taking jobs in nursing homes are not keeping criminals out of nursing homes where vulnerable patients live.
In a study delivered to the US Senate, the watchdog agency called on federal healthcare authorities to do more to equalize how states handle alleged abuse at nursing homes.
GAO conducted a three-state review of 158 alleged cases of physical and sexual abuse by nursing home aides against residents. Nursing homes reported the alleged abuse to state law enforcement agencies within 2 days in less than half of the 111 incidents examined for reporting speed, according to the study.
Meanwhile, reporting speed varied widely among the three states studied. Alleged abuse incidents were reported the same day or the next day 60% of the time in Georgia, but only 40% of the time in Pennsylvania.
"These delays compromise the quality of available evidence and hinder investigations," the report stated.
Bruce Love, a resident of Mill Creek, California, said that severe physical abuse that resulted in his mother's death in September 1998 was never reported to authorities by the nursing home where it occurred. The offender, a nurses' aide at the Valley Skilled Nursing Home in Sacramento, also had also been previously fired from two other nursing homes for abuse but was still allowed to take a job caring for seniors.
"We entrusted my mother's care to institutions that failed us in every respect," said Love. His mother, Helen Love, died in surgery as doctors attempted to repair a broken neck suffered during an attack by the aide.
Federal law requires states to avoid hiring individuals convicted of abusing nursing home residents. But state registries designed to record instances of abuse by aides are inconsistently updated, GOA investigators said. Their report recommended that the Centers for Medicare and Medicaid Services (CMS) assess how states are using the registries and whether they are keeping offenders out of nursing homes.
Meanwhile, Congress is considering legislation that would create a centralized national registry of convicted nursing home workers and also require FBI criminal background checks for all potential employees who do not appear on the registry.
"There is a pervasive lack of coordination among all the agencies charged with responsibilities of protecting our seniors," said Sen. John Breaux (D-LA), a cosponsor of the legislation and the chair of the Senate Special Committee on Aging. The Committee heard testimony from investigators and relatives of abuse victims on the need for tighter protections for nursing home patients.
GAO's report also called on CMS to step up education efforts aimed at encouraging rapid reporting of abuse by nursing home employees. A plan to place educational posters in nursing homes throughout the country "has been under development for more than 3 years," according to the report.
CMS Chief Thomas A. Scully said in a statement that CMS is working to release the poster "as soon as possible." The agency is also planning to review state practices and federal rules regarding the employment of individuals convicted of abusing nursing home patients.
Dr. Charles Roadman, president of the American Health Care Association, a nursing home industry trade group, said his organization endorses the GAO recommendations. He stressed that 2.21% of approximately 17,000 nursing homes nationwide were cited for patient abuse in 2001 and that "the trend is downward" in the number of reported cases over the last 3 years.
The group is one of dozens of healthcare organizations looking for increased federal funding as Congress prepares to debate new Medicare and Medicaid reforms this year. Greater federal funding would allow nursing homes to increase their staffing numbers and standards, Dr. Roadman said.
