We have gathered resources and talking points you can use if families have questions about the ongoing media coverage of the US Department of Health and Human Services Office of Inspector General (OIG) report on abuse reporting. We encourage you to reassure your residents and their families about the steps you are taking at your center to prevent abuse or report any allegations.

In addition, AHCA is working with media on their stories and has issued the following statement from Senior Vice President of Quality and Regulatory Affairs Dr. David Gifford:

“Abuse and neglect should never occur in any facility. Even one case is too many. While the OIG report shows only 0.4% of the 1.9 million residents in skilled nursing facilities who went to the emergency room experienced some type of abuse, more work is needed to reduce those reports to zero. We fully support more transparent reporting as the OIG suggests. The current CMS definition is of neglect is vague and creates confusion about what should be reported. The majority of the facilities contacted by the OIG for this report didn’t believe their situation met the CMS definition for reporting. We are ready to work with CMS, Congress and providers to bring more clarity to this definition, keep residents safe and improve the quality of care provided.”  

Reporting Requirements 

As a reminder, the Requirements of Participation (ROP) require that in response to allegations of abuse, facilities must report immediately, but not later than 2 hours after the allegation is made, to officials including the State Survey Agency and law enforcement authorities. For more details on the reporting requirements and related investigative obligations, see 42 CFR 483.12. You can use the Facility Reported Incident (FRI) form to make any such reports.

In addition to the ROP reporting requirements, health care providers also have a duty to check the List of Excluded Individuals and Entities (LEIE) database file to ensure excluded individuals are not working in their facilities. The updated files are posted on the Department of Health and Human Services Office of Inspector General website.  

Key Messages 

• The safety and well-being of the residents and patients in our skilled nursing care centers is our number one priority.
• Any person who commits this kind of heinous act should be penalized to the fullest extent of the law.
• While a single instance of a patient receiving substandard care is one too many, there are robust regulatory requirements and penalties in place to ensure patients are protected and corrective measures are implemented.
• Long Term Care Facilities are required to register to receive information regarding convicted sex offenders living in or near the facility, to determine whether potential residents are registered sex offenders, to inform residents of the existence and use of the Virginia Sex Offender Registry (the ”Registry”), and to assist residents in accessing the Registry.
• For nursing facilities, the CMS Requirements of Participation rules require that in response to allegations of abuse, facilities must report immediately, but not later than two hours after the allegation is made, to officials including the State Survey Agency and law enforcement authorities. 
• Health care providers also have a duty to check the U.S. DOJ OIG List of Excluded Individuals and Entities (LEIE) database file to ensure excluded individuals are not working in their facilities. 
• To satisfy employment background check requirements, Virginia Code requires that NFs and ALFs obtain the criminal history record report directly from the Virginia State Police Central Criminal Records Exchange.
• ALFs are prohibited from employing individuals convicted of specific barrier crimes (list published by the AG).

Additional Resources

• Template Letter for Family Members
• CMS Guidance on Reporting Requirements Found at 42 CFR 483.12
• Guidance on Abuse Reporting and Best Practices for Investigating Abuse
• LEIE Downloadable Database

If you have questions about the media coverage or need assistance responding to a media inquiry, contact Amy Hewett. If you have questions about the regulatory or reporting requirements related to allegations of abuse, please contact April Payne.