Eye on Oversight – Abuse & Neglect of Medicare Beneficiaries


Residents of Skilled Nursing Facilities and
other Medicare beneficiaries may become victims of abuse and neglect. Identifying and reporting such instances of
abuse and neglect is crucial to the well-being of this population, and the subject of two
reports just released by the HHS Office of Inspector General. Here is Assistant Regional Inspector General
Curtis Roy, who will explain the focus of these reports. “The first report dealt with Medicare beneficiaries
as a whole during the period from 2015 through 2017, and what we found is quite a number
of incidents of potential abuse and neglect were not reported to law enforcement authorities
as they should have been. And in the second report that dealt with Medicare
beneficiaries who were residing at skilled nursing facilities and subsequently treated
for injuries in emergency rooms, that many of these incidents were not reported to the
appropriate state regulatory authorities.” “Both reports we’ve noted that people
who are required to report these incidents have not reported them or are not reporting
them.” OIG recommends that CMS use Medicare claims
data to identify instances of abuse and neglect. OIG also recommends that CMS clarify what
is a reportable incident, and work with state agencies to train skilled nursing facility
staff on how to report incidents. “If the families of beneficiaries suspect
abuse and neglect they should contact local law enforcement, certainly, as well as the
nursing home administrators to make sure that they are aware of what’s going on as well.”

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