Editors’ Note: This story has been updated with comments from the National Association of Health Care Assistants.

Sexual assaults of nursing home residents by facility employees are “widespread” but “little-discussed,” according to an investigation published Wednesday by CNN.

The report’s authors conducted surveys of state health departments, reviewed cases and interviewed experts in an attempt to shed light on sexual assaults that occur in long-term care facilities.

“Despite the litany of abuses detailed in government reports, there is no comprehensive, national data on how many cases of sexual abuse have been reported in facilities housing the elderly,” the report’s authors wrote.

The incidents outlined in the CNN report “must never happen again,” LeadingAge said in a statement to McKnight’s, adding that “no older adult should be fearful of moving to a nursing home or be subjected to any kind of abuse while living in one.”

The American Health Care Association and the National Center for Assisted Living concurred, calling the cases “deeply troubling.”

“Any person who commits these heinous acts should be penalized to the fullest extent of the law,” the group said in a statement to McKnight’s. “The safety and well-being of residents and patients is a number one priority for all of our member centers and communities.”

The National Association of Health Care Assistants also released a statement saying it was “saddened and sickened by the CNN investigative report,” and that it would be “taking immediate action to provide additional CNA education on identifying and reporting signs of sexual abuse.”

In the end, CNN’s analysis of nursing home inspection and citation reports found more than 1,000 facilities had been cited for “somehow mishandling or failing to prevent alleged cases of sexual assault at their facilities in recent years.”

More cases may have gone unreported or overlooked, the investigation argues, due to the “scenes of chaos” — such as residents “running wildly up and down halls” or “pulling out knives and other weapons” — described in non-sexual abuse related nursing home reports.

“In cases reviewed by CNN, victims and their families were failed at every stage. Nursing homes were slow to investigate and report allegations because of a reluctance to believe the accusations — or a desire to hide them,” the report reads. “And because of the high bar set for substantiating abuse, state regulators failed to flag patterns of repeated allegations against a single caregiver.”

Among the cases detailed in the investigation is the that of George Sumo Kpingbah, a former aide at a Minnesota nursing home who was sentenced to eight years in prison last year for raping an 83-year-old resident with dementia.

The facility declined to comment for CNN‘s report, but noted that it cooperated with authorities during the investigation and that “the care and well-being of all of our residents and patients is our primary focus.”

Another facility contacted by CNN noted that they “weren’t prepared for anything of this nature” when they handled a similar case.

CNN’s report also includes a list of five things that “need to change” in nursing facilities to protect residents from sexual assaults, including more intense investigations into claims of assault, preserving evidence and training staff on the signs of abuse.

AHCA, LeadingAge and NAHCA all stated that they support policies and regulations to combat cases of sexual abuse in nursing facilities.

“LeadingAge has strongly supported the Elder Justice Act and other measures requiring prompt reporting to the police of any suspicion that a crime has been committed against a resident,” the group said. “The law also set up a mechanism for tracking and reporting of resident abuse at the federal level.”

AHCA/NCAL said it’s working to support regulations and laws that “seek to prevent such abhorrent behavior,” such as employee background checks.

“We continue to work with members of Congress and CMS on ensuring national background checks are fully implemented and on the development of a national abuse registry that can be accessed by all post-acute and long term care providers,” AHCA said. “We also stand with the millions of staff who are committed and passionate about providing high quality care for those they serve every day.” 

Click here to read the full CNN investigation.