CMS Could Use Medicare Data To Identify Instances of Potential Abuse or Neglect
Date
2019
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U.S. Department of Health and Human Services
Abstract
We identified 34,664 Medicare claims for our audit period that contained diagnosis codes indicating the treatment of injuries potentially caused by abuse or neglect of Medicare beneficiaries. We estimated 30,754 of these Medicare claims were supported by medical records that contained evidence of potential abuse or neglect. We further estimated that,of the claims in our population associated with incidents of potential abuse or neglect, 2,574 were allegedly perpetrated by a healthcare worker, 3,330 were related to incidents that occurred in a medical facility, and 9,294 were related to incidents that were not reported to law enforcement. (Author Text)
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Keywords
Administrative Data, Data Analysis, Intentional Injury, Elder Abuse, Elder Mistreatment, Older Adults, Abuse in Later Life, Elder Neglect, Medicare, Healthcare, Crime Reporting, Identifying Victims, Physical Assault, Sexual Abuse, Mandatory Reporting, Medical Records, Health Care Providers
Citation
Lamir, David; Roy, Curtis. (2019). CMS Could Use Medicare Data To Identify Instances of Potential Abuse or Neglect. U.S. Department of Health and Human Services, A-01-17-00513, 49 pgs.