Pennsylvania has seen a significant increase in the deaths of older adults following abuse or neglect complaints in recent years, with the numbers soaring during the COVID-19 pandemic. State data reveals a shocking rise in deaths from 120 reported in 2017 to nearly 1,400 in 2022, a more than tenfold increase. The reasons behind this surge in deaths are complex, with various factors potentially contributing to the alarming statistics.

Officials from Pennsylvania's Department of Aging and county-level agencies suggest that the growing population of people aged 65 and older, along with an increase in complaints and the devastating impact of the pandemic on older adults, may have played a role. However, some county agencies refused to provide any explanations, while others cited errors in data entry procedures or cases remaining open for longer periods.

The increase in deaths occurred as agencies across Pennsylvania and the nation struggled to retain caseworkers during the pandemic and manage their caseloads. The Department of Aging claims that there is no data to support a link between the lack of caseworkers and the rise in deaths. They argue that the data may be misleading since the deaths may not be directly related to the original abuse or neglect complaint. The department does not track causes of death, and county-level agencies are not required to provide that information to the state.

Former employees of the Department of Aging and county officials suggest that improvements in data collection and recording practices may have contributed to the increase in reported deaths. However, it remains unclear to what extent this factor influenced Pennsylvania's significant rise, as similar jurisdictions did not experience such a steep increase. The National Adult Protective Services Association has not heard of any similar spikes in deaths among state programs investigating abuse and neglect complaints.

While the broader death rate of older adults did not increase as steeply during the pandemic, rising from 4% in 2018 to 4.5% in 2021, Pennsylvania's data shows a dramatic surge in the closure of neglect or abuse cases due to death. In 2017, caseworkers reported closing 120 cases, but this number steadily rose each year, reaching 1,389 in 2022 - a more than 10-fold increase in just five years.

The number of complaints received by caseworkers also increased, but at a much smaller proportion compared to the rise in deaths. State data indicates a 55% increase in complaints over the same period. In the first six months of 2023, there were 528 deaths reported, suggesting that the pace of cases closed due to death has slightly slowed but remains significantly higher than in 2020.

The Department of Aging does not disclose the details of case investigations or any shortcomings found during inspections of county-level agencies. These agencies, which may be county-run or nonprofits, handle elder abuse or neglect reports under state contracts. They employ caseworkers to investigate complaints and coordinate with healthcare providers, service providers, and law enforcement when necessary. Most calls involve individuals living alone or with family members or caregivers, and poverty is often a contributing factor.

The release of the deaths data followed a request from The Associated Press under Pennsylvania's open records law. The request was prompted by internal emails, also obtained through an open records request, which revealed concerns among state protective services staff about how Philadelphia's agency handled cases in 2021. However, the Department of Aging refused to disclose the outcomes of these cases when questioned by a state lawmaker.

During the pandemic, Pennsylvania experienced delays in closing cases, as caseworkers faced higher caseloads and often exceeded state regulations. The shortage of caseworkers became so severe that then-Governor Tom Wolf's administration deployed state employees to handle investigations for Philadelphia's agency in 2021. The nonprofit Philadelphia Corporation for Aging reported four cases closed due to death in 2017, which rose to 220 in 2020, 472 in 2021, and dropped to 295 in 2022.

Bob Burns, the director of Dauphin County's Area Agency on Aging, believes that the increase in deaths is not surprising considering the devastating impact of the pandemic. He suggests that the shortage of caseworkers leads to higher caseloads, as it takes longer to close cases. However, counties have started using experienced caseworkers upfront to promptly investigate complaints and assess the urgency of each situation.

Jason Kavulich, the secretary for the Department of Aging, highlighted the challenges faced by county-level agencies, including inadequate staffing, high turnover rates, and training issues. These issues have been a concern even before the pandemic, with a 2018 report from the state's Office of Inspector General criticizing the handling of abuse and neglect reports by the state and counties. The report identified failures to investigate complaints within required timelines and insufficient staffing in the Department of Aging's monitoring office.

While other states have also reported significant increases in deaths following abuse or neglect complaints, Pennsylvania's rise has been disproportionately higher. Similar-sized states like Illinois and Michigan saw triple increases during the pandemic, whereas Pennsylvania experienced a more than tenfold surge.