Maryland Nursing Home Lawyer Blog

Governor Terry Branstad of Iowa has asked the Iowa Legislature to pass a bill requiring nursing homes to notify residents when a registered sex offender moves into the facility. Courts often order individuals into nursing home care after a plea or conviction, and some of those individuals must also go on the sex offender registry under the same order. Iowa officials estimate that fifty to fifty-five registered sex offenders currently reside in nursing homes in the state. Discussion of nursing home abuse and neglect often focuses on the action, or inaction, of nursing home staff, but residents may also face the risk of abuse from fellow residents.

The governor’s proposal arose from an incident last year at a nursing home in Pomeroy. An 83 year-old male convicted sex offender suffering from dementia who suffered from dementia assaulted a 95 year-old female resident. After the man was released from a facility designated for sex offenders, a judge had ordered him to be placed in the nursing home.

Shortly after the incident in Pomeroy, the governor convened a group to review laws relating to sex offenders in long-term care facilities. The proposed legislation is based on their recommendations. The governor announced the bill during his weekly radio address on January 9. In addition to notification of other residents or their representatives, nursing homes would have to create a written safety plan for use when a sex offender resides in the facility. He suggested that facilities might choose to designate an area to focus on sex offender residents, comparing the idea to wings designated for Alzheimer’s patients and other conditions.

The bill creates a delicate question about how to balance the right of nursing home residents to a safe living environment with the right of convicted sex offenders to also get an appropriate level of care. Nursing home residents are among the most vulnerable of people, and the notion that they might face abuse by a fellow resident with a possible history of abuse seems to shock the conscience. Once convicted sex offenders have served their punishments, however, they ostensibly have the same rights to nursing care as anyone else. Governor Branstad acknowledged the need to balance the interests of resident and public safety with the right to receive care, particularly when a person has been committed to care via a court order.

Continue reading "Proposed Bill Would Require Notification of Nursing Home Residents on Sex Offender Registry" »

October is Long-term Care Residents’ Rights Month, a time to celebrate the rights and dignity of people living in nursing homes. Thanks to strong legislation and regulations, nursing home residents have a legal guarantee of certain protections against abuse and neglect. Residents do not give up their rights as adult citizens solely by virtue of entering a nursing home environment. All nursing homes participating in Medicaid and Medicare must respect the rights covered by this law.

Congress passed the 1987 Nursing Home Reform Act after a study conducted by the Institute of Medicine found alarming rates of inadequate care, abuse, and neglect in nursing homes around the country. The Institute recommended a wide range of reforms that became law as part of a budget bill. The law aims to protect the physical, mental, and psychosocial wellness of nursing home residents by requiring nursing homes to provide certain services and creating a “Resident’s Bill of Rights.” Nursing homes must comply with the law in order to remain eligible to accept Medicare and Medicaid payments. Laws passed in 2010 expand on the rights protected by the 1987 law.

Nursing homes are required by this law to provide each resident with a personalized comprehensive care plan, along with periodic assessments of their care. They must provide nursing and social services, as well as rehabilitation and the ability to dispense prescription medications. Facilities with more than 120 beds should employ a full-time social worker to assist residents.

The Residents’ Bill of Rights lists numerous rights protected by federal law. These include:
- Freedom from abuse, neglect, or restraint;
- Privacy;
- Dignity;
- A clean and safe environment;
- Accommodation of particular medical and other needs;
- Communication and visitation with others;
- Participation in one’s care plan and frequent updates regarding one’s health condition;
- Complaint without fear of retribution;
- Control of one’s own finances, if possible; and
- Refusal of treatment when desired.

The Nursing Home Reform Act created an enforcement procedure that begins with routine inspections by state governments to review a nursing home’s certification. Surveyors may also investigate specific complaints or allegations, reviewing the amount of danger faced by residents and the likelihood that the alleged incident might occur again. One serious consequence of non-compliance with the law involves loss of Medicare and Medicaid eligibility. The law allows penalties ranging from remedial training for staffers to state management of the nursing home or outright termination of the home’s provider agreement with the state.

Continue reading "October is Long-term Care Residents’ Rights Month in Maryland and around the Country" »

As our attorneys have discussed in a related Baltimore nursing home lawyer blog post, pressure sores, or decubitus ulcers, are a rampant nursing home and assisted-living problem plaguing around one million people across the country every year, with nearly 60,000 deaths from complications of the advanced stages of pressure sores. Decubitus ulcers are sores that are entirely preventable, with proper nursing home care.

Pressure sores often develop at nursing home or assisted-living facilities when patients are elderly, or have limited mobility and rest for long periods of time without moving positions, which applies pressure to specific areas of the body and cuts off blood circulation, leading to skin deterioration or breakdown.

With proper nursing home staff attention, pressure sores can be prevented before they develop into the four stages of pressure sore development, often leading to soft tissue loss, deep painful craters, damage of joints and tendons and massive infections like sepsis or osteomyelitis, which can lead to nursing home injury or even death.

Other contributing pressure sore factors include dehydration, poor nutrition and lack of vitamins and minerals, as well as understaffed nurses, and health care staff without proper bed sore prevention and treatment training, which can lead to nursing home negligence—where elderly or immobile residents are left to sit for long periods of time without being moved, without having soiled undergarments changed, or without properly being cared for.

Continue reading " Decubitus Ulcers and Nursing Home Negligence" »

In a recent blog, our nursing home lawyers based in Baltimore, Maryland discussed the Nursing Home Reform Act of 1987, (NHRA) and the standards and services legally available to residents under the act, to prevent nursing home negligence, abuse, or substandard care.

The main objective of the NHRA is to make sure all nursing home residents are entitled to receive quality care and attention in a nursing home environment that improves and maintains their highest mental and physical health and psychosocial well being. To secure that quality care is provided in homes, the NHRA requires that homes provide each resident with certain services, and a Bill of Rights.

As our Baltimore nursing home attorneys reported previously in a blog, nursing homes receive Medicare and Medicaid payments for long-term resident care only if they receive state certification to be in compliance with the NHRA requirements. To monitor whether or not nursing homes meet the requirements, the act established a certification process that requires each state to conduct surveys in the home that are unannounced and poised at irregular intervals, at least once every 15 months.

The surveys reportedly focus on the residents’ quality of care, rights, quality of life, and the home’s provision of resident services. Targeted surveys are also performed, with resident interviews, and any nursing home negligence or other resident complaints against the home are required to be investigated.

Continue reading "Federal Nursing Home Reform Act Compliance" »

As our Baltimore, Maryland nursing home injury attorneys discussed in a recent blog, under the federal Nursing Home Reform Act of 1987, (NHRA), all residents living in nursing homes are entitled to receive quality care and attention in an environment that improves and maintains their highest physical, mental health and psychosocial well being.

According to AARP, in 1986, Congress ordered a nursing home study to be performed by the Institute of Medicine, IOM. The study reportedly revealed widespread nursing home negligence, abuse, and substandard care. The IOM proposed massive reforms, a large majority of which became law in the passing of the NHRA, which is part of the Omnibus Budget Reconciliation act of 1987, (OBRA).

The NHRA secures quality care by requiring certain nursing home services to every resident and by establishing standards for these services. Required services include, periodic assessments of each resident, pharmaceutical, rehabilitation, and social services, a care plan for each resident that is comprehensive, and the services of a full-time social worker if there are more than 120 beds in a nursing home.

A Bill of Rights was also established under the NHRA to secure quality care for each resident. Under the Resident’s Bill of Rights, a resident has the right to freedom of nursing home neglect, abuse and mistreatment, and the right to treatment that is free from physical restraints. Under the act, residents and patients also have the right to privacy, the right to be treated with dignity, the right communicate freely, the right to have medical, social, physical and psychological needs accommodated, the right to exercise self determination, and the right to participate in reviewing their own plan, with full disclosure in advance about any changes in treatment, care, or status change within the nursing home. Nursing home residents are also entitled to communicate any problems without experiencing any discrimination or retaliation.

Continue reading "Residents’ Rights under the Nursing Home Reform Act of 1987" »

As our Baltimore nursing home attorneys reported in a recent blog, fighting forced arbitration in nursing homes has long been a problem, as many residents and families unknowingly sign away their right to seek justice when filling out complicated contracts for long-term resident care.

According to a recent report by the American Association for Justice (AAJ), systemic nursing home abuse and neglect is not revealed in many homes due to nursing home arbitration clauses found in the fine print of admission contracts—that residents and their families rarely see, not realizing that they are signing away their rights to access court.

The Fairness in Nursing Home Arbitration Act of 2009 was introduced last year by Representative Linda Sanchez of California, and would eliminate forced arbitration clauses in nursing home and long-term care contracts. The act would reportedly provide that a pre-dispute arbitration agreement between a long-term care facility or nursing home and a resident or family member acting on the resident’s behalf, would not be valid or specifically enforceable.

Our Maryland nursing home neglect and abuse law firm is committed to ensuring that nursing home abuse and neglect victims and their loved ones receive the personal injury compensation they are owed. Contact Lebowitz & Mzhen today.

Civil Justice System Uncovers Abuse and Neglect of Elderly Americans, Kansas City.com/American Association for Justice, October 7, 2010

H.R. 1237 – Fairness in Nursing Home Arbitration Act of 2009, Open Congress.org, February 26, 2009

Related Web Resources:

National Center on Elder Abuse (NCEA)

Maryland Department of Aging

According to recent news that our Baltimore, Maryland nursing home attorneys have been following, thousands of low-income nursing home residents in the state of Maryland will reportedly have millions of dollars of debt paid, after a class action nursing home lawsuit involving Medicaid payments has reached a settlement—the second-largest settlement in state's history.

Maryland nursing home residents reportedly filed the lawsuit in 2005, claiming that the Maryland Department of Health and Mental Hygiene was in violation of both state and federal laws by confirming that the state could cover the residents’ nursing home costs with Medicaid, a federal and state program for the poor. The lawsuit reportedly claims that the department didn’t factor in the health care cost that each resident totaled while waiting to qualify for Medicaid coverage in the homes--that led to a significant amount of debt.

According to the U.S. Department of Health and Human Services Centers for Medicare and Medicaid Services (CMS), the U.S. federal agency that administers Medicaid, states are required to factor in this kind of debt when computing the income of nursing home residents, but had been reportedly calculating the cost incorrectly. States have been requiring recipients of Medicaid to make co-pays, regardless of their previous debts.

Now Medicaid managers for the state of Maryland and other states will stop requiring Medicaid co-pays from individuals who accrued debt while living in nursing homes while waiting for Medicaid eligibility. The patients will reportedly be able to use their own money to pay the past-due nursing home bills, and the state will make up the difference by paying the nursing homes directly.

Continue reading "Maryland Nursing Home Class Action Lawsuit Settled with State for $16 Million" »

In recent news, that our Hartford, Maryland Nursing Home Injury Attorneys have been following, a nursing home abuse lawsuit has brought to light the problem of unreported sexual abuse incidents in Kentucky nursing homes.

According to the Lexington Herald-Leader, Mae Campbell, an 88-year old, was sexually abused two times while being a resident at Hazard Nursing Home. Campbell suffers from Alzheimer’s disease, and was reportedly sitting in a hallway last year, in view of other staff members and a nursing supervisor, when a male nursing home resident sexually assaulted her by ejaculating onto her face. She was reportedly sexually abused three months later by another male resident of the home who had allegedly entered her room to perform a similar sexual act. The nurse on duty was told by her supervisor not to discuss the incident with anyone because Campbell had not been harmed.

Under Kentucky law, staff members and officials of nursing homes are legally mandated to report nursing home neglect or abuse. The Cabinet for Health and Family Services issued the home a Type A citation, claiming that Hazard Nursing Home did not follow state regulations and failed to protect Campbell from sexual contact that was unwanted, failed to protect her health and safety as a resident, failed to report the sexual abuse allegations to the necessary state agencies, and failed to investigate the sexual abuse allegations thoroughly.

The Herald-Leader reported that Campbell’s sexual abuse was only discovered after depositions in a wrongful death case led to a former nurse’s aide’s description of Campbell’s sexual assault, where the former employee claimed that she stopped working at Hazard Nursing Home after the incident, as she thought the home should have protected Campbell better. Another former nurse also admitted to witnessing Campbell’s other assault. She was told not to discuss it with anybody—because Campbell had not been harmed.

Continue reading "Sexual Abuse in Kentucky Nursing Homes" »

Our Washington D.C. Nursing Home Abuse Attorneys recently discussed the topic of chemical restraints in a blog, and the unnecessary use of antipsychotics in nursing homes. The Food and Drug Administration (FDA) estimates that around 15,000 nursing home deaths occur every year from the off-label use of antipsychotic medications that are unapproved by the FDA.

Center for Medicare Advocacy Senior Policy Attorney Toby Edelman, recently released a statement in reaction to a Senate Special Committee on Aging hearing, claiming that nursing home residents die every day from the inappropriate use of antipsychotic medications given to residents who have no diagnosis of psychosis. Edelman claims that nursing home facilities are violating the Controlled Substances Act and the 1987 Nursing Home Reform Law, by failing to provide the residents with proper medical attention, and physicians who are available to treat them 24 hrs a day.

According to the statement, under the 1987 Nursing Home Reform Law, every resident must be under the care of a physician, and each nursing home must provide a physician for medical care in case of an emergency, with another physician on-call. Edelman claims that nursing homes and long-term care pharmacies have long been relying on the practice of “chart orders,” for medications, where nurses assess the nursing home resident’s changed condition, and contact the physician—who then prescribes pain medication recommendations.

The Drug Enforcement Administration (DEA) has reportedly begun to enforce the rules and policy of the Controlled Substances Act, requiring physicians to write and sign prescriptions, sending nursing home and nursing home pharmacy industries into a frenzy, claiming that without these practices, residents will not receive the pain medication they need.

Continue reading "Resident Death and Antipsychotic Drug Violations in Nursing Homes" »

In recent Maryland nursing home injury news, more than 24 hospitals in the state of Maryland are taking part of the Maryland Patient Safety Center’s (MPSC) SAFE from FALLS initiative, a program providing state facilities with a "road map" to prevent patient and resident falls—to reduce personal injury and harm.

The Maryland program, based on an original program in Minnesota, was created through the Maryland legislature, with the Delmarva Foundation and the Maryland Hospital Association chosen as operators, to work to decrease nursing home and healthcare falls overall, and decrease the severity of resident falls, especially falls with personal injury.

The SAFE from FALLS "road map" was developed by studying acute care, home health care, and nursing home care—the three environments that the project is aiming to help. The program was then tested in these healthcare settings during 2008 and 2009. Today there are reportedly 50-60 nursing homes using the program’s road map, with 30 hospitals and 12 home health agencies as well.

According to the Centers for Disease Control and Prevention, every year, an average 100-bed nursing home reports around 100-200 nursing home falls. Nearly 1,800 people living in nursing homes reportedly die in this country every year from injuries related to nursing home falls. Those nursing home residents with falls that are non-fatal can suffer serious nursing home injuries.

Continue reading "Program Aims to Reduce Falls in Maryland Nursing Homes" »

Our Maryland Nursing Home Abuse Attorneys recently wrote a blog about a series of violent elder abuse incidents that occurred in Veterans nursing homes in the state of Texas, as published in the Dallas Morning News.

The Dallas newspaper has recently reported that after publishing the articles last month, legislators in the Senate have now taken notice, and raised questions about the safety and management of the state-owned veterans nursing home facilities this week, with two Senate committee hearings.

Last month, the Dallas Morning Star found that the criminal investigation of two former nursing home workers, accused of nursing home abuse, were stalled for two years because of conflicts between the state inspectors, police, and nursing home administrators.

When the police reportedly looked into the nursing home abuse allegations in 2007, police officers defaulted to the state inspectors. In March, felony charges were finally filed against the former nursing home employees, accusing them of harming two residents in the separate 2007 incidents.

Continue reading "Senate Pushes Reform After Alleged Nursing Home Abuse in Veterans Home" »

In yesterday’s blog post, our lawyers from Lebowitz and Mzhen, LLC, discussed the resent release of the annual state-by-state check-up of healthcare ratings, in the National Healthcare Quality Report from 2009, which includes Maryland’s ratings on nursing home care, and the use of physical restraint.

Nursing home restraint is a physical or pharmacologic restraint used to keep a resident or patient from moving freely, and is only allowed when medically necessary, as it can also cause patients to become weak or develop other health complications like pressure sores, isolation, loss of walking ability, incontinence, or injury from trying to escape the restraints, leading to possible injury or wrongful death.

Restraints have been used in nursing homes when impaired residents with mental conditions are prone to nursing home falls, wandering, or the potential for personal injury—but are controversial as they have been also been used for the purposes of discipline, or for the convenience of the nursing home—leading to nursing home abuse and neglect.

The Center for Medicare and Medicaid Services (CMS) reports that the use of physical and chemical restraints has reduced substantially after the implementation the CMS restraint regulation in 1990, showing that physical restraints had serious negative effects including the risk of wrongful death, and nursing home abuse and neglect.

Continue reading "Physical Restraints in Maryland Nursing Homes" »

In recent Maryland Nursing Home News, the state has received the results of the 2009 National Healthcare Quality Report, first ordered by Congress in 2003, to monitor the quality of healthcare, including nursing homes across the country.

The report is published by the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality, and according to the study, the overall the quality of Maryland’s health care rates between weak and average.

According to the Ethan Moore, the Health Policy Director of the Health Facilities Association of Maryland, Maryland nursing homes reportedly provided “expert care” in the 2009 study, but the critical issue Moore expects to arise in Maryland’s future is providing the projected explosion of the 65-year and older adult residents with proper Maryland nursing home healthcare and safety in the next twenty years.

Moore stated that Maryland has neither the budget nor capacity to take care of this future increase of seniors in nursing homes—but hopes that the state can find a solution to provide residents with quality care nursing homes and communities that are free from nursing home abuse and neglect in the future.

Continue reading "Maryland Nursing Homes Rated in National Healthcare Quality Report" »

In a recent blog, our Maryland Accident Attorneys discussed the topic of whether bed rails in Maryland nursing homes are a potential health hazard, or whether they protect the health and safety of residents.

According to the Food and Drug Administration (F.D.A.), nearly 2.5 million nursing home and hospital beds are currently used in this country. In an F.D.A. study, from 1985 to 2008, there have reportedly been 772 incidents where hospital and nursing home patients have been trapped, stuck, or strangled in beds that had rails. Out of this number, 176 were saved by the staff before experiencing injury, 136 experienced personal injuries that were nonfatal, and 460 patients died.

Bedrails are designed to aid in helping patients pull themselves up, turn into a different positions in the bed, provide a feeling of security, and keep patients who are frail, or who have been diagnosed with dementia or Alzheimer’s safe from harm, such as falling, or rolling out of bed.

Unfortunately these very patients often get trapped or stuck in the space between the mattress and the bedrails, causing personal injury, strangulation, suffocating, and wrongful death, which can result in a Maryland personal injury lawsuit. Bedrail injuries can often result in nursing home falls, when a patient attempts to climb over the rails, bruising or scrapes to the skin, as well as a feeling of restriction, and agitated behavior from being restrained.

Continue reading "F.D.A. Bed Rail Safety Guidelines for Maryland Nursing Homes" »

In a previous blog, our Hartford, Maryland Nursing Home Attorneys discussed the ongoing and serious issue many nursing homes are facing today—how to keep elderly residents who share facilities with younger mentally ill patients and criminals, safe from nursing home abuse and violence.

The Chicago Tribune reported today after an historic Illinois court settlement, that thousands of mentally ill patients are likely to move out of nursing homes over the next five years and into settings that are more community-based, due to a new legal agreement that has been created to rework the long-term health care system in Illinois.

According to the Chicago Tribune, more than any other state, Illinois uses nursing home facilities to house younger mentally ill adults, and this includes thousands of residents with felony records. The Tribune spearheaded a massive investigation recently, reporting a long list of nursing home violence, sexual assault, substandard care, and drug abuse in nursing home facilities, where psychiatric patients weren’t adequately supervised or monitored to maintain their safety as well as the health and safety of the elderly residents of the nursing home, to prevent resident injury or harm.

The agreement reportedly plans for state officials to offer around 4,500 nursing home residents who are mentally ill a choice between staying in the 24 large facilities that are known as IMDs, or “institutions for mental diseases,” or to move into smaller environments that are better suited for their disabilities and reportedly less expensive. The settlement reportedly only covers residents of the IMDs, which will still leave nearly 10,000 mentally ill residents living in nursing home facilities without the IMD classification among elderly and disabled residents.

Continue reading "Landmark Settlement Moves Mentally Ill Residents Out of Nursing Homes" »

Maryland Lawmakers headed to Annapolis last week for the annual 90-day session of the Maryland General Assembly, and Delegate Sue Hecht from Frederick County, a Democrat, has returned to support one of her bills that would allow families to use video cameras to monitor the treatment of elderly residents in a nursing home or assisted living facility.

Hecht is reportedly reintroducing Vera’s Law, HB557—Video Monitoring Legislation, a longtime bill she has worked on, to allow elderly residents to have video monitoring in their rooms for protection against nursing home abuse, negligence and violence.

Delegate Hecht originally introduced the bill after she witnessed her grandmother experience nursing home abuse by a nurse’s aid while residing in a home, over ten years ago. Vera’s Law is named after her Grandmother.

Hecht also reintroduced this legislative proposal in 2009—to give assisted nursing home and assisted living facility residents and their families the right to install video cameras or monitoring devices in the resident’s room, with consent of the roommate. The bill from 2009 did not require that the monitoring was paid for by the facility—the cost would be covered by the resident or resident’s family, as would the mounting device for the camera.

Continue reading "Maryland Lawmaker Supports Nursing Home Video Monitoring Legislation" »

As Maryland Nursing Home Injury Attorneys, we have been following the Chicago Tribune article published yesterday about an epidemic of unnecessary and dangerous drugging going on in nursing homes—causing nursing home injury and threatening the lives of elderly residents.

The report details that many vulnerable elderly residents in nursing homes are being given strong psychotropic drugs that they neither need or want—leaving them with dangerous side effects like tremors, severe lethargy, and a high possibility for falls or wrongful death.

This review of more than 40,000 federal and state inspection reports found that a wide variety of nursing homes ranging from high end facilities to run down centers, are in violation for improperly treating patients with psychotropic drugs. The violations included chemical restraint, unnecessary drug administering, dosages exceeding safety standards, and cases where dosages led to nursing home resident falls.

Since 2001, the Tribune identified 1,200 nursing home violations that involved psychotropic medications. These infractions reportedly affected 2,900 residents, although the actual statistics are likely to be far higher, as regulation inspections are only enforced once every 15 months.

Congress passed landmark laws protecting patients from unnecessary drugs in 1987—and since then, it is unlawful for facilities to give psychotropic drugs to patients without a doctor’s orders, patient’s consent and treatment justification.

Continue reading "Unnecessary Drugging in Nursing Homes Threatens Lives of Residents" »

As Maryland Nursing Home Abuse and Neglect Lawyers, we support the rights for Maryland residents to receive quality care, and be protected with treatment that is free from criminal acts, abuse, and the kind neglect that often results in injury or wrongful death. Under the Nursing Home Reform Act of 1987, all residents living in nursing homes or long-term care living facilities are entitled to receive this quality of care and attention in an environment that improves and maintains their mental and physical health.

Nursing home abuse and neglect occurs when a facility fails to protect and care for the residents, by paying proper attention to situations that could cause harm or pain. In an effort to educate families and consumers, and protect residents' rights, the National Consumer Voice for Quality Long-Term Care (NCCNHR) publishes a consumer fact sheet aimed to prevent future nursing home abuse and neglect violations. The NCCNHR reports these common violations:

• Poor positioning of the body, which can lead to bedsores and frozen joints.

• Lack of cleanliness, hygiene, and proper toileting—causing incontinence, falls, bedsores.

• Resident malnutrition and dehydration

• Not assisting residents with walking, which can lead to immobility, and falls

• Abuse from a staff member, visitor, or intruder—which can involve using physical force in feeding, while administering medicine, or while moving a resident

• Ignoring, antagonizing, or depriving a resident of adequate needs, which can lead to emotional and psychological abuse.

• Inappropriate sexual touching or forcing residents into performing sexual acts

Other common nursing home injury violations to be aware of include failure to supervise residents adequately, administer proper medication to each resident, and provide patients who are mentally ill or who have dementia with special attention and care.

Continue reading " Nursing Home Abuse and Neglect Violations" »