California Did Not Ensure That Nursing Facilities Always Reported Incidents of Potential Abuse or Neglect of Medicaid Beneficiaries and Did Not Always Prioritize Allegations Properly

This audit report is one in a series of OIG reports addressing the identification, reporting, and investigation of incidents of potential abuse and neglect of our Nation’s most vulnerable populations, including Medicaid beneficiaries in nursing facilities. Nursing facility residents are at an increased risk of abuse or neglect when health care professionals and caregivers fail to report incidents of potential abuse or neglect or when allegations of abuse or neglect are not acted upon in a timely manner.Our objectives were to determine whether California: (1) ensured that nursing facilities reported incidents of potential abuse or neglect of Medicaid beneficiaries transferred from nursing facilities to hospital emergency departments and (2) complied with Federal requirements for recording, prioritizing, and investigating allegations of abuse or neglect.