Nursing home abuse not reported, prosecuted promptly, GAO says


WASHINGTON - Physical and sexual abuse of nursing home residents is not being promptly reported to local authorities and is rarely prosecuted, federal investigators say.

In a new study, the General Accounting Office, an investigative arm of Congress, says, "Nursing home residents have suffered serious injuries or, in some cases, have died as a result of abuse."

Safeguards are clearly inadequate, the report says, because more than 30 percent of the nation's nursing homes have been cited by state inspectors for violations that harmed residents or placed them in immediate jeopardy.

The accounting office conducted an 18-month investigation and plans to present its findings tomorrow at a hearing of the Senate Special Committee on Aging, headed by Sen. John B. Breaux, a Louisiana Democrat.

The report says workers who abuse patients in one state can often be hired by "unsuspecting nursing homes" in other states because the states do not exchange information, and there is no national list of workers who have abused patients.

The inspector general of the Department of Health and Human Services recommended such a national registry in 1998. Medicare officials are still studying the feasibility of the idea, the report said.

About 1.6 million people live in 17,000 nursing homes nationwide. Medicaid and Medicare help pay for three-fourths of the patients and spent $58 billion for their care last year.

The GAO found that "alleged physical and sexual abuse of nursing home residents is frequently not reported in a timely manner" and that "few allegations of abuse are ultimately prosecuted."

Even when charges are brought, some frail and elderly victims die before a trial can be held, the report said.

The federal investigators said they had found several reasons for the delays:

Patients and their relatives are often reluctant to report abuse, because the patients fear retribution and the relatives fear the patients will be told to leave.

Nursing home managers are reluctant to report abuse because they fear it will cause "adverse publicity," or state regulators will impose fines and other penalties.

Nursing home employees "fear losing their jobs or recrimination from co-workers" if they report abuse.

In some states and at some nursing homes, it is difficult to learn the correct telephone number for reporting abuse.

Nursing homes rarely incur penalties for failing to report abuse, the report said.

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