From the U.S. Government Accountability Office, www.gao.gov Transcript for: Protecting Nursing Home Residents From Abuse Description: We look at the Centers for Medicare and Medicaid Services’ role in protecting nursing home residents from abuse. Related GAO Work: GAO-19-433: Nursing Homes: Improved Oversight Needed to Better Protect Residents from Abuse Released: July 2019 [ Background Music ] [ John Dicken: ] While abuse of nursing home residents were relatively rare, they have been increasing in recent years. [ Matt Oldham: ] Welcome to GAO's Watchdog Report, your source for news and information from the U.S. Government Accountability Office. I'm Matt Oldham. Around 1.4 million Americans live in nursing homes, and the Centers for Medicare and Medicaid Services is responsible for making sure nursing homes meet federal standards, including keeping residents safe from abuse. With me is John Dicken, a health care director at GAO. And he's here to talk about CMS's oversight role in nursing homes, and the abuse of elderly and disabled residents. Thanks for joining me, John. [ John Dicken: ] Thank you. Pleased to be here. [ Matt Oldham: ] So is this a large problem? [ John Dicken: ] It certainly is a significant concern. Now, while most nursing home residents are not victims of abuse, there certainly is a very disturbing when any physical sexual or verbal abuse does occur. And when we looked at data that's reported to the Centers for Medicare and Medicaid Services found in 2017, the most recent year with the full data, that there were 875 such instances where federal reporting and violations were reported by inspectors and nursing homes. Certainly that's very concerning for those residents who are a vulnerable population of elderly and disabled individuals, but may also understate the extent to which some of this occurs. That could be because there could be fear about reporting situations that may be abuse, both by the residents or by staff, as well as that some inspectors may cite other types of deficiencies, such as a fall or a resident altercation that doesn't specifically indicate that whether or not it was an abuse situation that led to that fall or that altercation. [ Matt Oldham: ] And what did you look at for this report? [ John Dicken: ] We looked at trends over the last five years on what has been reported, and the types of abuse that have been reported. We also looked at about 400 actual examples of nursing home abuse to get some real examples, and categorize the type of abuse that's occurring even beyond the data that's readily available to CMS. And we talked to a number of key experts, including visiting nursing homes, talking to groups that are adult protective services or law enforcement that also work with CMS in ensuring that nursing home residents are safe and free from abuse. [ Matt Oldham: ] Did you find that cases of abuse in nursing homes are trending downward or are they trending upward? [ John Dicken: ] Well, unfortunately we found that the reported instances are increasing that in that five year period they roughly doubled the number of abuse incidences that were reported to CMS. And even more concerning is not only are they doubling overall, but the most serious ones, the ones that really found actual harm to the residents would put them in immediate jeopardy of harm or even death had increased as a proportion of all of the abuse incidents. [ Background Music ] [ Matt Oldham: ] So it sounds like while CMS data shows that abuse citations in nursing homes number in the hundreds each year, that those numbers are rising, they've doubled in a five-year period. So John what can CMS do to address abuse in nursing homes? [ John Dicken: ] Right. We recommend that CMS require that state agencies provide more detailed data on the types of abuse that's occurring in nursing homes, whether it's physical or sexual or verbal, as well as who's the perpetrator for that abuse, whether it's staff or residents or other visitors to the nursing home. We believe that could help CMS better monitor the types of instances that are occurring to hopefully prevent and better target their prevention and correction efforts. We also recommended that there be more immediate referrals from the state agencies to law enforcement, so that whenever there is a suspicion by nursing home inspectors that there has been a crime that may have occurred, that there are referrals both to local law enforcement as well as to Medicaid Fraud Control Units where appropriate. [ Matt Oldham: ] So what would you say is the bottom line of this report? [ John Dicken: ] Well we certainly indicate that this is a serious concern, and that while abuse of nursing home residents were relatively rare, they have been increasing in recent years. And so that by recommendations that we made hope that it can better identify the particular types of abuse that are occurring, ensure that corrective actions are taken by CMS or by law enforcement or other groups, as well as to better protect vulnerable populations of elderly and disabled individuals. [ Matt Oldham: ] John Dicken was talking about a GAO report on CMS's mission to protect nursing home residents from abuse. Thank you for your time, John. [ John Dicken: ] Thank you. [ Background Music ] [ Matt Oldham: ] And thank you for listening to the Watchdog Report. To hear more podcasts, subscribe to us on Apple Podcasts. [ Background Music ] [ Matt Oldham: ] For more from the congressional watchdog, the U.S. Government Accountability Office, visit us at gao.gov.