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16 Jan

Wisconsin said it didn't have a single substantiated report of abuse in the last five years.

And when states provided a further breakdown of how many allegations had been substantiated, the results demonstrate just how few accusations end up being proven -- whether it's because of the extreme hurdles posed by aging victims, the destruction of evidence or half-hearted investigations by facilities and regulators.

Of the 386 cases in Illinois, 59 were considered substantiated.

More than 16,000 complaints of sexual abuse have been reported since 2000 in long-term care facilities (which include both nursing homes and assisted living facilities), according to federal data housed by the Administration for Community Living.

But agency officials warned that this figure doesn't capture everything -- only those cases in which state long-term care ombudsmen (who act as advocates for facility residents) were somehow involved in resolving the complaints.

More than 500 facilities had been cited for failing to investigate and report allegations of sexual abuse thoroughly to authorities or for not properly screening employees for potentially abusive pasts. They're owned by huge corporations and regional chains but also by nonprofits and mom-and-pop small business owners.

One nursing director told a state inspector that "if the facility reported all allegations it would be numerous and the State Agency wouldn't want that either." Because of this lack of investigation or reporting, it's hard to determine how many of the alleged cases of abuse were substantiated or resulted in criminal proceedings. And the issue is only becoming more pressing as the elderly population booms, with the number of Americans over age 65 projected to more than double between 20.

But most states could not say how frequently abuse investigations involved sexual allegations, often stating that sex abuse allegations are not categorized separately from other forms of abuse.

The federal government doesn't specifically track all sexual allegations either.

When asked by CNN, the agency conducted a specialized search using sex-related keywords.

But because not every case was sexual in nature, CNN had to review each case individually to filter out any irrelevant citations.