Letter to Eric Hargan, Acting Secretary of Health and Human Services and Gene Dodaro, Comptroller General - Klobuchar Urges U.S. Department of Health and Human Services to Take Action to Address Elder Abuse in Nursing Homes and Assisted-Living Facilities and Requests GAO Report to Examine Additional Solutions

Letter

Dear Acting Secretary Hargan,

I write to urge the Department of Health and Human Services (HHS) to take additional actions to prevent and more effectively respond to elder abuse in nursing homes and assisted-living facilities.

A recent report revealed troubling accounts of physical and sexual abuse of senior citizens in Minnesota nursing homes and assisted-living facilities. Many of these incidents were either insufficiently investigated or not investigated at all. The report noted that in 2016, 97 percent of the more than 25,000 allegations of neglect, physical abuse, unexplained serious injury, and theft in state-licensed facilities for seniors in Minnesota were never investigated.

The report also discussed how the facilities systematically failed to notify the families and guardians of victims when incidents occurred -- which prevented family members from advocating on behalf of their loved ones, removing them from dangerous situations, or otherwise ensuring they received the treatment and assistance they needed.

In one disturbing incident, a 78-year-old Minnesotan in a senior home was sexually assaulted by a nurse's aide. Despite an eyewitness account, the facility waited two hours to report the assault to law enforcement, allowed the aide to leave the scene to go home for the night, failed to notify the victim's family of the assault, and compromised critical evidence. This is just one example of a problem affecting seniors across the country.

The preliminary conclusions of an ongoing national review by the HHS Office of Inspector General (OIG) have also found "inadequate procedures" at the Centers for Medicare and Medicaid Services (CMS) for identifying and reporting potential incidents of abuse or neglect in nursing home facilities. OIG has recommended that CMS take immediate action to strengthen its procedures and the enforcement of existing requirements.

To identify additional measures that HHS can take to prevent and more effectively respond to elder abuse in nursing homes and assisted-living facilities, I respectfully request responses to the following questions:

How do HHS and its component agencies plan to ensure that allegations of neglect, physical abuse, unexplained serious injury, theft, and other mistreatment are immediately reported to law enforcement?

How do HHS and its component agencies plan to ensure all of these allegations are investigated in a timely manner? What do HHS and its component agencies consider to be an acceptable time period for completing these investigations?

How do HHS and its component agencies plan to ensure that family members or guardians of victims of elder abuse are notified when these incidents occur and are kept informed of the progress of administrative or criminal investigations?

What are the differences under federal law between assisted-living facilities and nursing homes regarding these forms of abuse or mistreatment?

Are there any federal legislative changes necessary to ensure HHS and its component agencies are able to take action and implement effective safeguards to protect seniors from this type of abuse or mistreatment?

Thank you for your prompt attention to this critical issue.

Sincerely,

Dear Mr. Dodaro,

I write to urge the Government Accountability Office (GAO) to examine what additional actions the federal government can take to prevent and more effectively respond to elder abuse in nursing homes and assisted-living facilities.

A recent report revealed troubling accounts of physical and sexual abuse of senior citizens in Minnesota nursing homes and assisted-living facilities. Many of these incidents were either insufficiently investigated or not investigated at all. The report noted that in 2016, 97 percent of the more than 25,000 allegations of neglect, physical abuse, unexplained serious injury, and theft in state-licensed facilities for seniors in Minnesota were never investigated.

The report also discussed how the facilities systematically failed to notify the families and guardians of victims when incidents occurred, which prevented family members from advocating on behalf of their loved ones, removing them from dangerous situations, or otherwise ensuring they received the treatment and assistance they needed.

In one disturbing incident, a 78-year-old Minnesotan in a senior home was sexually assaulted by a nurse's aide. Despite an eyewitness account, the facility waited two hours to report the assault to law enforcement, allowed the aide to leave the scene to go home for the night, failed to notify the victim's family of the assault, and compromised critical evidence. This is just one example of a problem affecting seniors across the country.

The preliminary conclusions of an ongoing national review by the HHS Office of Inspector General (OIG) have also found "inadequate procedures" at the Centers for Medicare and Medicaid Services (CMS) for identifying and reporting potential incidents of abuse or neglect in nursing home facilities. OIG has recommended that CMS take immediate action to strengthen its procedures and the enforcement of existing requirements.

To identify additional measures that the federal government can take to prevent and more effectively respond to elder abuse in nursing homes and assisted-living facilities, I respectfully request GAO examine the following questions:

How do HHS and its component agencies ensure that allegations of neglect, physical abuse, unexplained serious injury, theft, and other mistreatment are immediately reported to law enforcement?

How do HHS and its component agencies ensure all of these allegations are investigated in a timely manner?

What do HHS and its component agencies consider to be an acceptable time period for completing these investigations?

How do HHS and its component agencies ensure that family members or guardians of victims of elder abuse are notified when these incidents occur and are kept informed of the progress of administrative or criminal investigations?

What are the differences under federal law between assisted-living facilities and nursing homes regarding these forms of abuse or mistreatment?

What changes to current practices at HHS and its component agencies would GAO recommend to ensure that agencies are able to take action and implement safeguards to protect seniors from this type of abuse or mistreatment?

Are there any federal legislative changes necessary to ensure HHS and its component agencies are able to take action and implement effective safeguards to protect seniors from this type of abuse or mistreatment?
Thank you for your prompt attention to this critical issue.

Sincerely,

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