美国国家公共电台 NPR Health Workers Still Aren't Alerting Police About Likely Elder Abuse, Reports Find（在线收听）

RACHEL MARTIN, HOST:

It can be hard to quantify the problem of elder abuse. Experts believe many cases go unreported. And this morning their belief is confirmed by two new government studies. Those found in many cases of abuse or neglect severe enough to require medical attention, the incidents were not reported to enforcement agencies as required by law. We've gotten more now from NPR's Ina Jaffe.

INA JAFFE, BYLINE: One of the studies focuses on the possible abuse of nursing home residents who end up in emergency rooms. It looked at claims sent to Medicare for treatment of head injuries, body bruises, bedsores - all diagnoses that might indicate physical or sexual abuse or severe neglect. Gloria Jarmon is the deputy inspector general in charge of audits for the Department of Health and Human Services. She says her team found that, in 2016, nursing homes failed to report nearly 1 in 5 of these potential abuse cases to the state inspection agencies charged with investigating them. That's even though the law requires them to do so.

GLORIA JARMON: Some of the cases we saw, you know, a person's treated in an emergency room, they're sent back to the same facility where they were potentially abused and neglected.

JAFFE: But the failure to report possible cases of elder abuse is not just on the nursing homes. Jarmon says in five states where nursing home inspectors did investigate and substantiate cases of abuse...

JARMON: Ninety-seven percent of those had not been reported to local law enforcement. That's required.

JAFFE: Nursing home inspectors who participated in the study appear to be confused on when they were required to refer cases to law enforcement. One agency said that it only contacted the police for what it called the most serious abuse cases. But elder abuse occurs in many settings not just nursing homes. The second report released this morning, also from Health and Human Services, looked at 18 months of Medicare claims, beginning in 2015. The study projected that out of more than 30,000 potential cases of elder abuse and neglect, health care providers failed to report nearly a third of them to law enforcement or adult protective services, even though the law requires them to do that.

JARMON: It's very important that the first person who notices these - this potential abuse and neglect reports it because then it can begin the investigative process to determine if abuse or neglect occurred. And, you know, if it's not reported, it can't be tracked.

JAFFE: The report says that Medicare could do a better job of tracking the data it has on hand. It recommends that the Centers for Medicare and Medicaid Services, which oversee the health care program for older Americans, should periodically examine claims for treatment and look for diagnoses that suggest possible abuse or neglect and where and when those cases occur.

JARMON: You have to be able to get data to see how bad the problem is. And then when you see how bad a problem is, you need to make sure that everybody who can take action has it.

JAFFE: But the Centers for Medicare and Medicaid Services rejected most of the report's recommendations. The agency declined our request for an interview. But in a written response, it argued that it can take up to a year for Medicare claims to be filed, so analyzing them would not be a timely enough way to identify and respond to cases of elder abuse and neglect.

Ina Jaffe, NPR News.

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