Hospices should be required to report all instances of abuse and neglect, even if the perpetrator was not an employee, the U.S. Government Accountability Office (GAO) has recommended.
The U.S. Centers for Medicare & Medicaid Services (CMS) requires operators to report incidents of patient abuse and neglect that involve their staff. If the agency follows the GAO’s recommendation, they would also have to notify survey agencies when others, like family members or caregivers, become abusive or neglectful. This would bring the hospice rules in line with those used in long term care.
“Strengthening hospice reporting requirements to align with the requirements for nursing homes and hospitals providing extended care will provide CMS with the information necessary to ensure that hospice care providers are taking appropriate steps within the scope of their authority to protect vulnerable individuals,” GAO indicated in a report.
CMS has yet to agree with the recommendation, which GAO released today.
About 10% of seniors age 60 or older who live at home experience neglect or exploitation, according to the U.S. Centers for Disease Control & Prevention (CDC).
More than 643,000 older adults received emergency department treatment for nonfatal assaults and more than 19,000 homicides occurred among that population, CDC indicated.
Prevalent types of abuse include physical, sexual, emotional or psychological, financial and neglect, defined by CDC as failure to meet a person’s basic needs like food, water and shelter, among others.
Most of these acts are committed by others in an older adult’s household, according to GAO.
“GAO’s common-sense recommendation that hospice requirements be brought in sync with the requirements applicable to nursing homes and hospitals providing extended care is one that should be implemented with all due speed,” Theresa Forster, vice president for hospice policy for the National Association for Home Care & Hospice (NAHC), told Hospice News.
NAHC also called on the U.S. Department of Health & Human Services (HHS) to implement 2019 recommendations from its own Office of the Inspector General (OIG) that hospices be required to develop written plans, policies and procedures for investigating and reporting suspicions of abuse, neglect, and other harm, Forster said.
GAO determined that under current rules abuse reports from hospices may be less complete or timely than those from nursing homes and hospitals.
“Immediately reporting all allegations to survey agencies before providers conduct investigations is important because the agencies use abuse and neglect allegations to inform decisions about the need to conduct their own unannounced on-site investigations of hospice providers,” GAO said in its report. “These investigations can ensure, for example, that the hospice has worked within the scope of its authority to protect individuals receiving care.”
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