The U.S. Senate Committee on Finance held a hearing to examine the “devastating” nursing home abuse that’s becoming increasingly common in the United States.

Maya Fischer, daughter of a nursing home resident, testified in front of the committee to share the story of her mother, who was sexually assaulted while living in a nursing home. The hearing was meant to discuss the reports of abuse and neglect, and what can be done to protect those who are at risk of abuse.

“Elderly adults who experience abuse have a 300 percent higher risk of death compared to elders who are not abused,” says nursing home attorney Matthew Sharp. “It’s estimated that more than 25 percent of nursing home abuse and neglect cases go unreported, even though federal and state laws mandate reporting.”

Patricia Blank, a resident of Ohio, testified about her mother’s neglect. The nursing home where her mother was staying had received the “highest ranking from the Centers for Medicare and Medicaid Services (CMS) for quality of resident care.” However, that same facility had been fined for verbal and physical abuse a year prior to Blank’s mother’s death.

CMS has announced that updates will be made next month to the Nursing Home Compare database, its online tool for consumers researching nursing home quality. It will also make changes to the Five-Star Quality Rating System, which rates nursing homes based on inspections, quality measures and staff.

New guidance has also been issued that clarifies what information is needed to identify cases that are in immediate jeopardy. CMS believes the new guidance will allow for quicker identification of potential abuse cases.

Lawmakers questioned Dr. Kate Goodrich, director of the center for Clinical Standards and Quality at the Centers for Medicare & Medicaid Services, to find out what’s been done and what could be done to ensure quality facilities.

According to Goodrich, there are several factors that can cause a nursing home to fall behind on quality standards, including the inability to conduct comprehensive background checks on staff and not being able to retain quality staff.

An investigation by CNN in 2017 found that the federal government fined more than 1,000 nursing homes for mishandling or failing to prevent alleged cases of sexual abuse, including assault and rape.

Anyone can report nursing home abuse or neglect to the CMS through the state’s long-term care ombudsman program or state groups. State health investigators will examine all types of reported abuse at both nursing homes and assisted living facilities.