Earlier this month, the U.S. Senate Committee on Finance held a hearing to discuss reports of abuse and neglect in some nursing homes across the country. The Committee also discussed how to protect these patients from abuse.

This hearing was held only weeks after a health care facility in Arizona discovered that one of their patients, a 29-year-old women in a vegetative state, had been raped. The pregnancy was discovered when the woman went into labor. In January, a 36-year-old nurse was arrested on suspicion of sexually assaulting and impregnating the woman.

In September of last year, the U.S. House Committee on Energy and Commerce held a subcommittee hearing on nursing homes. The Committee specifically examined “federal efforts to ensure quality of care and resident safety in nursing homes.”

The day before the Senate hearing was held, the Centers for Medicare and Medicaid Services (CMS) announced that they would be making updates in April to the online tools available to consumers to research nursing home quality. These tools are the Nursing Home Compare database, which allows users to compare nursing homes based on various criteria, and the Five-Star Quality Rating System, which rates nursing homes based on inspections, staffing, and quality measures.

CMS also issued new guidance that “clarifies what information is needed to identify immediate jeopardy cases across all healthcare provider types, which we believe will result in quickly identifying and ultimately preventing” situations such as abuse or neglect cases.

Both CMS and their rating system have been criticized in the past and present. One woman who testified at the Senate hearing, Patricia Blank, described how her mother was a victim of neglect at her nursing home and died as a result. In spite of this, the facility where she resided and died had “received the highest possible ranking from CMS for quality of resident care, though it had been fined for physical and verbal abuse a year before [the victim’s] death.”

“How a place with the highest possible rating could yield such a tragic incident is just outrageous,” Iowa Senator Chuck Grassley said in a news release on Tuesday. “Things need to change, both for the standards at care facilities and for how CMS rates them.”

According to Senator Grassley, two government watchdog groups are currently working on reports for Congress regarding CMS and nursing home abuse, which are the Inspector General of Health and Human Services and the Government Accountability Office. In the news release, Grassley indicated that he planned to “convene another hearing on this topic after these agencies release their reports.”

Anyone, whether it be a nurse, family member, or facility resident, can report nursing home abuse or neglect to CMS through state groups or a state’s long-term care ombudsman program, whose information can be found through the Medicare website. If abuse is reported, state officials typically conduct these investigations on behalf of CMS, which regulates the more than 15,000 facilities that receive government reimbursements that pay for many residents’ care.

If abuse or neglect is found in a nursing home, that facility will face penalties that range from monetary penalties to termination from the Medicare and Medicaid program.

States conduct standard survey inspections of nursing homes, which are unannounced visits which examine the facilities along various staffing and quality measures. State health agencies and the federal government use the information gleaned from these surveys to the rate the facilities.

Despite the wide ranging examples of abuse and neglect detailed in government reports, there is no comprehensive national data to be found listing how many cases of sexual abuse have been reported in facilities housing the elderly.

In 2017, CNN published an exclusive investigation into U.S. nursing homes, examining federal inspection reports filed from 2013 to 2016. The results were fairly staggering.

CNN discovered that more than 1,000 nursing homes across the country have been cited for somehow mishandling or failing to prevent alleged cases of sexual abuse, including rape and assault, at their facilities in that 3-year period.

This CNN investigation examined inspection reports filed between 2013 and 2016, before CMS made revisions related to how the organization surveys and inspects long-terms care facilities.

“When American families consider where their loved ones can get the care they need, they should be able to rely on CMS information,” said Senator Grassley in his news release. “That’s clearly not the case right now.”