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If you have ever read a contract closely, there is frequently a clause included that compels the parties signing the contract to arbitrate, rather than litigate, if a dispute arises. These clauses are most commonly known as arbitration clauses and are often included in all kinds of contracts because arbitration is often less costly and more expedient than a traditional lawsuit when it comes to dispute resolution. The inclusion of an arbitration clause in a contract, however, does not automatically mean it is valid and enforceable. In fact, sometimes, if the terms of the arbitration clause are particularly unfair, the court could determine that the arbitration agreement is unenforceable and invalid.

According to a recent state court opinion, some arbitration clauses contained in nursing home residency agreements may be unenforceable because of unfair terms. The court noted, however, that if the unfair terms are severable, or removable, from the agreement, the arbitration clause could still be enforced. To succeed on a claim that an agreement is unconscionable, or unfair, there must be a showing that the contract was made under deceptive or confusing circumstances for one party so that bargaining power was limited, and if the terms of the contract itself are significantly unfair to one party.

In the case at hand, several terms in the arbitration agreement were deemed “undoubtedly unconscionable” by the court. The unjust terms included a waiver of attorneys’ fees and costs, an inability to appeal, a limitation on discovery, a one-sided arbitration obligation, and a confidentiality provision.

Abuse in neglect in nursing homes and long-term care facilities can sometimes be hard to detect. Families often place their loved ones in a facility after the elder has experienced some form of cognitive decline or illness. The symptoms of aging may mirror those of nursing home abuse, and as elderly residents may suffer from communication, memory, or cognition issues, it can be difficult to determine if a loved one is being properly cared for while living in a nursing home or long-term care facility. Bedsores, also known as pressure ulcers, are one condition that is noticeable to family and may be a sign of serious abuse or neglect.

A recently published article in a legal trade publication discusses bedsores in nursing homes and the abuse or neglect that the condition may be evidence of. Initially, bedsores are a skin condition that develops in patients as a result of being left in the same position for an extended period of time. Nursing home residents who spend all day in a bed or wheelchair without changing positions may develop bedsores. Some symptoms of bedsores include tenderness, swelling, discolored skin, abnormally textured skin, and a pus-like discharge from the affected area.

If left untreated, bedsores can worsen and cause serious health problems. What starts as a condition only affecting the outer layers of skin can move deeper and deeper into the body, as far as the bones, and ultimately may cause infection and become untreatable. Infections caused by bedsores are a cause of death for many nursing home and long-term care facility residents. The risk of death notwithstanding, untreated bedsores are a source of extreme discomfort and can make your loved ones’ lives very difficult.

The arrival of the Covid-19 pandemic has combined with other economic factors to cause an employment shortage in hundreds of industries worldwide. Healthcare is most likely the hardest-hit industry by Covid-19 related staffing shortages. Within the healthcare industry, nursing homes and long-term elder-care facilities suffer from some of the worst staffing shortages on record. Understaffed nursing homes and long-term care facilities result in increased instances of abuse, neglect, and even sometimes-fatal medical malpractice. In an effort to address the chronic nationwide staffing shortages in nursing homes, the U.S. Federal Government has announced plans to enforce national minimum staffing guidelines for nursing homes and other similarly situated facilities.

According to a recently aired national public radio broadcast, the staffing shortages at several nursing homes have become a dangerous problem. The increased risks and workloads presented by the pandemic have made nursing home jobs less desirable. Employers nationwide, including nursing home administrators, are reluctant to increase employee compensation out of a fear that paying more will cut into the companies’ profits. In response to the shortages, the Biden administration has initiated plans to use the Centers for Medicare and Medicaid Services to implement minimum staffing requirements to ensure that the staff is adequate to ensure quality. According to the report, the changes should go into effect within a year.

How Does the Nursing Home Staffing Shortage Impact Residents?

Nursing home residents and their families have the right to adequate care that meets industry standards for such care. The staffing shortages over the last two years have resulted in increasing instances of concern in nursing homes nationwide. Observers have noted increases in bedsores, excessive weight loss, high rates of Covid-19 infection, as well as widespread overprescription of antipsychotic medications to control resident behavior. Residents who have received these types of substandard care, or suffered other acts of neglect, abuse, or malpractice, may be entitled to financial damages for their loss and suffering. A qualified Maryland, D.C., and Virginia area medical malpractice attorney can help victims pursue a case for damages.

Some experts have estimated that over 1 million Americans have died from the virus that causes Covid-19. Hospitals, nursing homes, and medical providers are not responsible for keeping all patients alive and well during a deadly pandemic, as that would not be possible. Although medical providers are not legally responsible for every death that happens on their watch, if an injury or death is caused, worsened, or not prevented because a medical provider acts negligently, then the injured party or their representatives may have a claim for damages. A recently published news report discusses one such case, in which the family of a woman who died of Covid-19 while living at a nursing home has sued the nursing home for wrongful death.

The plaintiffs in the recently decided case are the relatives of a 65-year-old woman who died of Covid-19 in April of 2020 while residing at a New York nursing home that is operated by the defendant. According to the facts discussed in the plaintiffs’ complaint, the defendant failed to uphold the proper standard of care in treating the patient. Specifically, the complaint alleges that there was an unreasonable delay in diagnosing the patient and that once the diagnosis was made, the nursing home negligently failed to give her the proper treatment for the disease. The complaint alleges that the nursing home’s negligence in failing to properly treat the patient was the ultimate cause of her death.

In response to the plaintiff’s lawsuit, the defendant filed a motion to dismiss, claiming that as a medical provider in a Covid-19 related case, they were immune from suit based on a law passed in 2020 by the state legislature. In response, the plaintiff argued that the immunity law was repealed in 2021 and that the repeal applies retroactively to acts of negligence that occurred in 2020. Because the law was in fact repealed, the court ruled in favor of the plaintiffs, and the suit will proceed toward trial.

Choosing the right nursing home to send our loved ones is often a stressful and research-intensive process. After all, we want our most vulnerable family members and loved ones to be cared for properly with the attention, quality of care, and comfort they need and deserve. When nursing home facilities and staff fail to provide these basic necessities of care, however, they must be held accountable for their actions.

According to a news report, first responders arrived at a local nursing home after a resident had called 911 for the second time that day. Among the 98 residents of the facility, many of them had been left to sit in their own waste with limited water, medication, and food for hours. When firefighter crews arrived on the scene, they paired off with EMS crew members and went from room to room to check on residents, monitor their vital signs, and administer medication. For the firefighters, it was the first time they had been asked to respond and care for nearly 100 people at once. The incident remains under investigation.

Shockingly, according to the National Center on Elder Abuse, approximately 95 percent of nursing home residents have been neglected or have witnessed some form of neglect. Unfortunately, Maryland is no stranger to similar incidents of neglect in nursing homes.

When we send our loved ones to nursing homes, we expect them to be taken care of by properly licensed, professionally trained, and caring staff members. After all, many of our elders and loved ones have complex health needs that require regular attention and care that nursing home staff members are specifically trained and equipped to address. When these facilities fail to conduct reasonable diligence into ensuring the quality of their staff, however, this lack of care can potentially result in injury to our loved ones.

According to a recent news report, a recent government investigation into issues surrounding nursing homes uncovered a registered nurse working while her license was suspended. The woman was arraigned recently on felony charges after the investigation found that she tampered with vials and syringes containing substances she knew were intended for patients who required pain relief in the critical care unit. She removed the original substances from the vials and syringes, replaced them with another liquid, and returned the containers. The incident remains under investigation, but officials noted that the woman had a previous criminal history while working as a nurse as well.

Unfortunately, Maryland is no stranger to similar incidents, especially in nursing homes. Long-term care facilities have a responsibility both to their residents and to the community to exercise reasonable diligence when hiring professional staff to care for vulnerable and elderly residents. When a facility fails to do so, its lack of care could constitute negligence. When the nursing home fails to protect its residents as the first line of defense when hiring staff, it could be held responsible for any subsequent injury that takes place.

Nursing homes and long-term care facilities are facing endemic levels of reported abuse and neglect, presenting challenges to those in the field who seek to provide safe and effective care for our aging population. For all the reported instances of abuse, there are many occurrences that are never discovered or reported, suggesting that the problems of abuse and neglect in U.S. nursing homes are worse than they appear. A recently published news report discusses an instance of sexual assault in an Atlanta, GA assisted living facility that went unreported to law enforcement for over four days, inhibiting the ability of authorities to properly investigate the incident.

According to the local news report, a CNA at the luxury assisted living facility in Atlanta, GA walked into a resident’s room and witnessed another employee on top of a resident with his clothes off, apparently raping the resident. The witnessing employee reportedly told the attacker to stop what he was doing, reported the incident to a supervisor, and gave the victim a bath. Police were not immediately called after the attack was reported. Although the CNA’s decision to give the victim a bath may have offered her some comfort, the bath itself destroyed evidence of the assault and may have prevented authorities from making an arrest once the attack was reported.

Although it appears from the context of the news report that the reporting employee was only trying to do what was best after she witnessed the assault, the fact that authorities were not called after a forcible rape was witnessed suggests that the employees of the nursing home in question are woefully undertrained. Unfortunately, this lack of training and accountability is prevalent throughout the American nursing home industry. Large multi-state companies have purchased nursing home systems nationwide and consolidated ownership and operation of such facilities into smaller and smaller ownership groups.

Nursing home neglect has been in the headlines a lot recently, as nursing homes across the country struggle to keep a full staff. The COVID-19 pandemic, as well as several other industry-wide challenges, has resulted in many nursing homes losing large numbers of employees, as well as a corresponding difficulty in finding available workers.

Nursing home neglect occurs when nursing home employees fail to provide the level of care a resident needs. When family members decide on a nursing home, one of the primary factors they use is the institution’s safety record. Unfortunately, nursing home neglect is often swept under the rug by nursing home management, which means it is not reflected in their ratings. However, some instances of neglect are impossible to hide.

For example, the owner of a South Carolina nursing home was recently arrested and charged with neglect, exploitation and breach of trust of the residents in his care. More specifically, the charges included 10 counts of neglect of a vulnerable adult, two counts of exploitation of a vulnerable adult and one count of breach of trust with fraudulent intent.

The last couple of years has been extremely difficult for much of America. The nursing home industry is no exception. Starting with the COVID-19 pandemic in early-2020 all the way up through today, nursing homes are having an increasingly difficult time providing adequate care for their many residents. Not surprisingly, the instances of nursing home abuse and neglect are also increasing, as those that remain on staff in long-term care facilities are overworked. Despite these challenges, a nursing home’s duty to its residents does not change and when a nursing home fails to provide the necessary level of care—for whatever reason—residents and their families can take legal action against the facility.

An all-too-common example of what many families are experiencing comes from a recent news report. A woman noticed a sharp decline in the quality of care her mother was receiving. At first, it was smaller things, but when her mother contracted COVID-19 and things didn’t seem to improve, she called the police. Police officers arrived and arranged to have the elderly woman transferred to a nearby hospital. The woman is in stable condition.

Continuing their investigation, police officers then tried to call the facility to learn more about what was going on behind closed doors. No one picked up. Eventually, police contacted the local Department of Health, which opened an investigation into the facility. All new admissions into the nursing home were also frozen.

If you have decided to send your loved one to a Maryland nursing home in the near future or have already done so, then you understand the difficulty of making such a decision. Conducting thorough research into the options near you and ensuring that your loved ones are receiving quality care at the facility you choose can be really stressful—especially if there is no information available for you to reference to make an informed decision.

According to a recent report, the Centers for Medicare & Medicaid Services (CMS) announced that it would begin to report weekend staffing and staff turnover for nursing homes with greater transparency. Information on weekend staffing, such as the numbers of registered nurses and the total number of nurses in general working on the weekends at each nursing home over a quarter will be publicly available on a website. Details about total nurse turnover, the percentage of nursing staff that stopped working at a nursing home, and the number of administrators who stopped working at a nursing home over a 12 month period will also be made available.

For consumers, this data will be important for a number of reasons. First, having access to a nursing home’s staffing environment can be important for determining the quality of care your loved ones will receive. At facilities with low turnover rates, for example, it is more likely that the quality of care will be higher, and the overall residential experience will be better. Low turnover rates in nursing homes are also typically correlated to higher nursing home ratings.

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