The U.S. Government Accountability Office (GAO) analyzed data from the Centers for Medicare & Medicaid Services (CMS) and found that abuse deficiencies cited in nursing homes doubled from 430 to 875 between 2013 and 2017. Mental and physical abuse was the most common, while sexual abuse was the third most common form of abuse.

The GAO found that a lack of nursing home abuse oversight allows for repeated offenses and less protection for residents. Gaps were found in the CMS process due to state agencies referring to complaints under federal law. CMS was found to not properly report abuse cases to law enforcement because proper oversight is not conducted.

CMS has also failed to provide guidance on what nursing homes should include on self-reported abuse incidents when reporting to state survey agencies. Facility-reported incidents often lack vital information to make the investigation a priority, according to state survey agencies. The lack of information additionally leads to the state agency not responding to complaints as quickly due to needing more information about the incident.

GAO officials conducted the study to have better insight into the safety of 1.4 million nursing home residents in the United States. Nursing home residents are a vulnerable population which is either disabled, elderly or both. CMS is responsible for defining standards for nursing homes to meet to be able to participate in Medicare and Medicaid programs.

CMS's policies were reviewed by the GAO, and officials at CMS and state agencies in five states were interviewed as part of the report. 

GAO officials have concluded that CMS needs to do more to protect nursing home residents and makes six recommendations to help residents. State officials should, according to the recommendations, submit abuse data and perpetrator type information, refer any suspicion of a crime to law enforcement and additionally provide guidance to nursing homes for self-reporting incidents.

Data from November from state adult protective services (APS) found that more than 142,000 cases of intervention occurred in elder abuse cases.

There are an estimated 5 million cases of elder abuse each year, with as many as 24.3% of nursing home residents facing at least one form of physical abuse each year. Another study concluded that just 1 in 14 incidents were formally reported to officials. Abuse of various forms occurs to a minimum of 1 to 2 million people per year, but with less than a tenth of the cases reported properly, this figure can be drastically higher than reported.