Following Request from Bipartisan Lawmakers, Independent Watchdog Reveals Increase of Abuse in Nursing Homes, Need for Improved Oversight

Press Release

Today, U.S. Senators Rob Portman (R-OH) and Tom Carper (D-DE), Chairman and Ranking Member of the Permanent Subcommittee on Investigations (PSI), along with Chuck Grassley (R-IA) and Ron Wyden (D-OR), Chairman and Ranking Member of the Senate Committee on Finance, released the findings of a new U.S. Government Accountability Office (GAO) report that assessed incidents of abuse of nursing home residents across the country.

The report, which was requested by the bipartisan group of senators, reveals that abuse in nursing homes across the country has more than doubled between 2013 and 2017. Physical and mental/verbal abuse occurred most often in nursing homes, followed by sexual abuse, and staff were more often the perpetrators of the abuse deficiencies cited. GAO also found gaps in processes managed by the Centers for Medicare and Medicaid Services (CMS). The report shows that CMS -- the agency responsible for ensuring nursing homes meet federal quality standards, including that residents are free from abuse -- cannot readily access information on abuse or perpetrator type in its data and, therefore, lacks key information critical to taking appropriate actions.

The senators will discuss the findings of the GAO study at today's Senate Finance Committee hearing with Department of Health and Human Services (HHS) and GAO officials.

"We should all be concerned that the number of abuses more than doubled in just four years from 2013 to 2017," said Senator Portman. "When we entrust our loved ones to long-term care, we expect them to be safe from harm. It is highly concerning that the agency charged with overseeing the safety of this vulnerable population does not have access to the basic information it needs to carry out this mandate. This report underscores the need to fully implement the recommendations outlined in the report."

"Nearly 1.5 million elderly Americans are in the care of nursing homes across this country. Those individuals are our mothers, our fathers, our grandparents, our friends, and they deserve the utmost care and respect as they live out their final years. It's the familiarity and personal connection that so many of us have with nursing homes that makes the findings in this report so alarming and unacceptable. It is clear that Congress must do more oversight to ensure the most vulnerable among us -- many of whom are living with diminished mental capacities or physical disabilities -- are treated with dignity," said Senator Carper. "Not only have abusive incidents doubled in recent years, but GAO has found that CMS -- the agency charged with ensuring that these facilities meet federal quality standards -- often cannot access information about abusive incidents after they occur and, therefore, cannot take the necessary steps to remedy the situation. We simply can and must do better than this. We all want our loved ones to receive the quality of care and attention they deserve from professionals in whom we place our trust. That's why I will continue working to make sure the recommendations drawn out in this report are met by the agencies responsible for these abuse deficiencies."

"The results of this report are disturbing, to say the least," said Senator Grassley. "There is no excuse for the ongoing abuse and neglect happening at nursing homes throughout the country. CMS needs to ramp up its oversight efforts and fix the problems identified by the Government Accountability Office. Nearly everyone has a loved one who is either in a nursing home or may be in the coming years. Serious reforms are necessary in order to provide a safe and loving environment for our nation's seniors."

"This new report documents the fact that vulnerable seniors -- people living in nursing homes specifically because they cannot care for themselves -- are exposed to unforgivable treatment," Senator Wyden said. "Incidents of physical, verbal, mental and sexual abuse are on the rise. This cannot go on. Seniors and their families have a right to know which homes are safe and which homes are not."

The report's findings include:

Incidents of abuse more than doubled in nursing homes from 2013 through 2017. Physical and mental/verbal abuse by staff were the most commons forms.
Key challenges for abuse investigations include underreporting of abuse, cognitive impairment of victims, lack of nursing home cooperation, and lack of agency coordination.
CMS's ability to ensure abuse-free facilities may be limited by gaps in oversight and lack of information on abuse/ perpetrator that may not be readily available.
Gaps in CMS processes that can result in delayed and missed referrals of abuse.