Tuesday, February 11, 2020

More elder abuse cases being reported in RI, statistics show


Elder abuse is happening at an alarming rate across the country, including in Southern New England.

An estimated one in 10 older adults are victims of elder abuse. Some of the cases are physical or sexual in nature, while others are emotional involving abandonment, neglect and self-neglect.

According to the Rhode Island Office of Healthy Aging (formerly the Division of Elderly Affairs), there were 1,377 confirmed cases of elder abuse in 2017, which is 444 cases more than just five years earlier. Some of the cases have happened in state-run facilities, such as nursing homes and adult day care centers.

I pulled records from the Center for Medicare and Medicaid Services to get a better idea of what’s happening at nursing homes in Rhode Island.

The Nursing Home Comparison Tool has ranked 23 of Rhode Island's 79 nursing homes as “below average” or “much below average” based on quality of care, staffing and health inspections. The reasons behind those ratings are detailed in reports filled out by the facilities.

In one case, a staff member "threatened to hit a resident” and was “throwing air punches” at the resident. In a separate case, a nurse directed other staff members not to help a resident who was locked in her room, calling out for help, because she was upset the resident threw pills at her. Another nursing home was cited after a CNA failed to tend to a resident who activated their call light, because that CNA was “on a coffee break” for 20 minutes.

Those instances just scratch the surface of what we found.

Attorney Anthony Leone has prosecuted dozens of legal cases against local nursing homes, ranging from neglect to abuse.

“We’ve seen cases where folks haven’t seen medication for almost a year. We’ve also seen cases where a clear medication error led to serious harm," Leone said.

He said many of these cases are the result of low staffing levels.

"There are a whole variety of injuries we see Some of the most common include high-pressure injuries, falls that result in fractures hip fractures, medication errors, infections that are not timely diagnosed or are not timely treated. Those are probably the most common types of cases that we see," he said.

There are no minimum requirements for staffing levels at nursing homes in Rhode Island, but the state does require a registered nurse to be in the facility 24 hours a day, seven days a week.

NBC 10 News found several cases in local nursing homes where residents fell because no one was around to help them get up or suffered skin wounds after they were left lying in one position for too long.

Leone said abuse and neglect complaints are reported to the state Department of Health, which will then conduct an unannounced visit to investigate.

If a deficiency is found during an inspection or complaint investigation, the facility is required to develop a plan of correction. The state will then monitor that plan to make sure any issues have been corrected within a certain time frame.

Depending on the case, the attorney general's office may also get involved.

NBC 10 News found that over the past two years, the attorney general's Medicaid Fraud Control Unit has investigated 20 accusations of patient abuse in state health care facilities, including nursing homes and adult day care centers.

The office’s Elder Abuse Unit investigated 73 abuse incidents in that same time period, cases that aren’t exclusive to nursing homes.

Rhode Island also has an ombudsman program that addresses complaints in the state’s long-term care system. The most recent statistics show the ombudsman verified 200 of the 416 complaints about nursing homes in 2017, and 41 of 78 complaints from assisted-living facilities.

Special Assistant Attorney General Molly Kapstein Cote told me the number of cases that haven't been reported or investigated is likely much higher than that.

“It’s underreported for a variety of pretty serious and sad reasons," Kapstein Cote said.

Kapstein Cote said elder abuse isn't just happening in nursing homes. Oftentimes, it happens under the victim's own roof by someone they know and trust, making many victims reluctant to come forward.

"Oftentimes victims rely on their caretaker, who may also be their perpetrator for help with everything throughout the day, from assistance with personal needs to getting food and transportation. They’re terrified that if they turn that person in, they’ll have no other person to take care of them and make sure they can function throughout the day," Kapstein Cote said.

That's why she wants to remind the public that Rhode Island is a mandatory reporting state. That means if you suspect abuse is happening, you're legally obligated to report it regardless of whether you're a stranger, a family member or even the victim.

According to state law, failure to report abuse of a person 60 or older can result in a fine of up to $1,000.

Kapstein Cote said the state can only stop elderly abuse if it knows when it’s happening.

"It’s happening much more than we realize, and we need to encourage older adults to not be scared or embarrassed. We want them to come forward and know that we’re here," Kapstein Cote said.

Elder abuse and self-neglect can be reported 24 hours a day by calling the Office of Healthy Aging at 401-462-0555.

Reports can be filed anonymously.

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More elder abuse cases being reported in RI, statistics show

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