Many skilled nursing facilities failed to report abuse or neglect incidents to their surveyors, the Office of Inspector General says.
There were likely 7,831 high-risk hospital ER Medicare claims for beneficiaries residing at SNFs that resulted from incidents of potential abuse or neglect during 2016, according to the OIG. Investigators came to this conclusion by examining 256 high-risk hospital ER Medicare claims from eight states.
Of the 51 claims studied that were associated with incidents of potential abuse or neglect, the agency determined that 42 facilities did not report the incident to the survey agencies. With 35 SNFs, respondents said they did not feel the incidents met a reporting threshold.
“We have to get to the root cause of any finding,” Assistant Regional Inspector General Curtis Roy told McKnight’s. The OIG recommended the Centers for Medicare & Medicaid Services work with states to better identify what needs to be reported.
“For those who did respond, there seems to be some general confusion regarding what is and what isn’t reportable,” Roy said. “Clarify the guidance — it really gets back to that.”
