On October 23, 2019, the Centers for Medicare and Medicaid Services (CMS) added a new abuse icon to its Nursing Home Compare website. The icon’s purpose is to alert the public to nursing homes that have been cited for an abuse violation in the past year or over each of the past two years, depending on the level of harm. The abuse icon looks like this.

Initially, 56 of California’s 1193 Medicare and/or Medi-Cal certified nursing facilities – about 5 percent – have the abuse icon. Although it is good that CMS is alerting the public about abuse findings at these facilities, consumers should be aware that nursing homes without an abuse icon might also have histories of abuse.

Why might nursing homes with histories of abuse not have the abuse icon displayed on Nursing Home Compare? Here are some of the major reasons:

• The abuse occurred before the lookback period CMS is using to flag facilities. For example, this appears to be the case at Riverside Heights Healthcare Center, a nursing home that was cited twice in May 2018 after a helpless female resident was sexually assaulted by male residents on two different occasions in December 2017.
• The abuse has not yet been investigated. The California Department of Public Health (CDPH) has an enormous backlog of open complaints and facility reports of abuse – over 17,000 cases – some of which were reported years ago.
• The abuse was reported but not substantiated by CDPH. Due to the poor quality of its investigations, CDPH fails to substantiate or cite the vast majority of reported abuse cases.
• Most abuse of nursing home residents is never reported or investigated, especially serious cases of abuse such as sexual crimes.

Consumers using Nursing Home Compare should consider these limitations.

Despite the limitations, CANHR and other advocacy organizations for nursing home residents supported CMS’s plan to add the abuse icon. The nursing home industry, meanwhile, is fighting to hide findings of abuse, with both the non-profit and for-profit trade associations seeking to stop or neuter the public warning.