Reporting gaps exposed for abuse allegations at Medicare/Medicaid certified hospices

WASHINGTON, D.C. — A new watchdog report is exposing reporting gaps for abuse and neglect allegations at Medicare and Medicaid certified hospices.

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The report from the U.S. Government Accountability Office (GAO) points to two issues.

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First, it said these hospices are only required to report abuse or neglect allegations to the state if the alleged perpetrator is affiliated with the hospice, meaning it does not apply if the suspect is a caregiver or a family member.

Secondly, the report said if the case does involve a person affiliated with the hospice, the hospices are only required to report it after the hospice completes an internal investigation, which can take up to five days.

It points out this is different from nursing homes and hospitals, which are required to report all abuse or neglect allegations immediately and regardless of whether it is directly involved with a hospice staffer.

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“As a result of these gaps, hospice care providers’ reporting may be less complete or timely than that of nursing homes and hospitals providing extended care,” the report said.

In response to the findings, the Department of Health and Human Services (HHS) pointed to the complexities in the process.

“Abuse and neglect should never be tolerated,” HHS said in its response.

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But the Department goes on to say that state requirements determine reporting rules, saying: “additional reporting requirements may create confusion for both individuals required to report as well as the hospice programs and the state agencies and officials responsible for taking action and investigating allegations of abuse and neglect.”

HHS did say it is reviewing its reporting guidance.

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