GAO Report Urges CMS to Improve Oversight of Nursing Homes to Address Growing Number of Abuse Citations
The U.S. Government Accountability Office issued a report in June 2019 urging the Centers for Medicare & Medicaid Services (CMS) to improve its oversight of nursing homes due to the increasing number of abuse citations being issued by state survey agents.
According to the report, abuse in nursing homes is underreported; however, the report noted that from 2013 to 2017, the number of citations issued by state survey agents more than doubled, with the largest increase involving the most severe cases.
The report identified gaps in CMS oversight that may limit the ability of CMS to ensure that nursing homes meet federal requirements for residents to be free from abuse.
Specifically, the report found that CMS: (1) cannot readily access data on the type of abuse or type of perpetrator, (2) has not provided guidance on what information nursing homes should include in facility-reported incidents, and (3) has numerous gaps in its referral process that can result in delayed and missed referrals to law enforcement.
Compliance Perspective
Failure by a nursing home to report incidents involving abuse, including the identification of the suspected perpetrator; to preserve evidence, e.g., when sexual assault occurs; and to report incidents in a timely manner to the police and other authorities, may result in state survey agents issuing citations and indicate provision of substandard quality of care, in violation of state and federal regulations.
Discussion Points:
- Review policies and procedures regarding the protocol for reporting incidents of suspected abuse.
- Train staff regarding the protocols to use in reporting and investigating incidents of abuse, with special emphasis on identifying the perpetrator, preserving evidence, and notifying police and other authorities in a timely manner.
- Periodically audit to determine if reported incidents of abuse followed compliance protocols.
