Iowa Sen. Presses CMS Over Abuse Protections for Skilled Nursing Residents

Sen. Chuck Grassley, an Iowa Republican, joined a growing chorus by questioning whether the Centers for Medicare & Medicaid Services (CMS) is doing enough to protect skilled nursing residents from abuse.

In a letter penned last Friday, Grassley pressed CMS on “why it has failed to ensure that nursing home abuse and neglect cases are reported to law enforcement, as required.” Grassley’s letter came just days after a Department of Health and Human Services (HHS) “early alert” report found that abuses at skilled nursing facilities frequently go unreported.

That report, overseen by HHS’s Office of the Inspector General (OIG), looked at the emergency room records for 134 Medicare beneficiaries in 33 states with any of 12 diagnoses that could signal abuse or neglect. Just 72% of those incidents were reported to local law enforcement.


Three such incidents occurred in Iowa, only one of which was reported to local authorities. All three incidents involved possible sexual assault.

“These early findings are extremely troubling and call into question why, for so many years, CMS has failed to take proper steps to ensure that SNFs followed the law and protected patients,” Grassley wrote in his letter to CMS Administrator Seema Verma. “Our nation’s most vulnerable people must be protected, not ignored.”

Specifically, Grassley asked what actions HHS has taken to enforce section 1150B of the Social Security Act, which stipulates that SNFs that receive at least $10,000 in federal funds annually must report suspected crimes to local law enforcement. HHS called out this lack of rule application in its preliminary report, though CMS responded by claiming it was never granted authority to oversee 1150B.


Grassley also asked when HHS will delegate responsibility to enforce 1150B; why it took CMS six years to update the abuse-reporting requirements mandated under the Social Security Act on March 23, 2011; why CMS failed to match emergency room Medicaid claims to identify potential cases of neglect; and why CMS is waiting to take OIG’s recommendations until after OIG finalizes its review.

Written by Tim Regan

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