Crime and Safety:
Seniors > Medicaid Fraud & Elderly Abuse > What is Abuse and Neglect?
MEDICAID PATIENT ABUSE OR NEGLECT
Physical abuse or neglect is any action or failure to act that causes unreasonable suffering, misery, injury or harm to a resident of a health care facility licensed by the Office of Long Term Care or to a resident of the state-owned Benton Services Center or any one of the six state-owned Human Development Centers. It includes anything from striking or sexually assaulting a patient to withholding necessary and adequate food, physical care or medical attention. Financial abuse includes the misuse of a resident’s trust funds to pay for nursing home services already being paid for by the Medicaid program or for uses of a patient’s funds not authorized by either the resident or the resident’s guardian, trustee, administrator, etc.
It is a sad fact that some Medicaid patients, especially the elderly, are physically and sexually abused or neglected by health care workers. In many cases, an abused person is totally dependent on the abuser and is afraid or physically unable to complain.
These are some of the warning signs of physical abuse, sexual abuse and criminal neglect:
- cuts, black eyes, bruises and burns, especially when the caregiver cannot adequately explain how they occurred (burns or bruises in an unusual pattern may indicate the use of cigarettes, instruments, or similar items)
- patient’s fear of being alone with caregivers
- reports of physical abuse, such as:
- striking a resident
- hitting a resident
- kicking a resident
- punching a resident
- throwing an object at a resident
- spitting at a resident
- burning a resident
- pulling on a part of the resident’s body
- any form of retaliation for a resident’s behavior
- inappropriate touching of a resident’s body, including touching that is not in the usual
- course of treatment or care
- inappropriately kissing a resident
Unjustified physical contact involves, but is not limited to:
- excessive force in the course of a prescribed treatment or therapy
- unnecessary physical contact when providing care, comfort or assistance to the resident
- retaliation against the resident
- physical signs of sexually transmitted diseases or of injury to genital areas
- difficulty sitting or walking
Drug diversion is another form of abuse, since it deprives the patient of proper medication. It may also defraud the Medicaid program.
Drug diversion includes:
- a health care worker throwing away a patient’s medication, selling it or using it himself/herself
- a doctor selling prescriptions
- a nurse ordering medication for patients without a doctor’s approval
Neglect is the failure of an individual or facility to provide treatment or services necessary to maintain the health or safety of a resident.
Neglect includes, but is not limited to:
- failing to provide medical, dental, nursing, physical therapy, pharmacy, psychological, speech or other treatments or services
- failing to carry out care plans or specific treatments
- failing to provide for the dietary requirements of a resident
- failing to provide safety measures
