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But when a nurse insisted on notifying police — against the wishes of her boss — the call triggered an investigation.

And women just down the hall from the resident came forward, with their own allegations against Gomez.

"The doctors are not comfortable sending you home unless you're safe," said Northwestern Medicine's Dwayne Dobschuetz, a nurse practitioner who started making house calls by bicycle a year ago for the health system's geriatrics department.

"It's easier to admit older patients than to send them home." One of his patients, Marvin Shimp, 87, has lost much of his vision to macular degeneration, but lives independently.

With Medicare penalizing health care systems for unneeded care, hospitals have financial incentives to change.

Older adults in the emergency room use more resources and are admitted to the hospital more frequently than other age groups.

The man was eager to get home because he now cared for a daughter with Alzheimer's disease.

It would have windows and skylights instead of windowless spaces with glaring bulbs. Physical therapists and pharmacists would be ready to help out. Northwestern's geriatrics ER has soundproofed rooms with comfortable beds and windows.

Hospitals in New York, New Jersey, Pennsylvania, North Carolina, Wisconsin, Illinois and Georgia formed a collaborative to share ideas.

That means asking more questions, asking them earlier and, when possible, avoiding a hospital stay for many older patients. More than 30 percent of older adults go home from a hospital stay with a minor or major health problem they picked up at the hospital.

But for an ER doctor, sending an elderly patient home sometimes feels risky.


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