The last two years have been extremely difficult for nearly everyone in the medical and caregiving fields. The nursing home industry has been hit especially hard. Nursing homes nationwide have had to deal with the effects of a global pandemic that targets older individuals, while workers from the top to the bottom of the medical field have been experiencing increasing levels of burnout. As a result of the increasing demand for medical workers and assistants, along with the dwindling supply, nursing homes throughout the country have been experiencing severe staffing shortages. The AARP (formerly known as the American Association of Retired Persons) has started a lobbying effort in Virginia in an attempt to get the state government on board with minimum staffing and sanitation standards for nursing homes in the post-pandemic era.

According to a press release detailing the AARP’s efforts to lobby the Virginia Legislature, long-standing and well-known issues surrounding nursing home care have gotten to a point where they must be addressed. The pandemic has brought long existent staffing issues in nursing homes to the forefront of public attention. Nursing home staff have been chronically undertrained and underpaid for decades, though the increases in stress and difficulty from the job brought on by the pandemic have exacerbated staffing shortages. While the free market can help solve staffing and other issues in many industries, the nursing home industry is unique because the federal and state governments pay for the majority of nursing home care in the U.S. through the Medicare and Medicaid social programs.

The AARP is encouraging the state and federal governments to step in with legislation that requires nursing homes to meet minimum staffing and training standards for their residents. Specifically, the group is urging the legislature to set a minimum staff ratio that must be met for a nursing home to operate, as well as increased training in infection control and sanitation. According to polling mentioned in the press release, the vast majority of Virginia voters approve of the requested changes, and the pressure is now on lawmakers to pass legislation to meet voter demands and improve the conditions of nursing homes within the state.

All over the country, it seems every business has a “help wanted” sign posted. From restaurants to movie theaters to grocery stores, the COVID-19 global pandemic has left businesses of all types and sizes short-staffed.

Unfortunately, nursing home facilities have been no exception to this issue. Many nursing home workers and certified nursing assistants have reported feeling burnt out and exhausted, resulting in a mass exodus of departures from long-term care facilities around the country. In light of staffing shortages, however, who will take care of our elderly and most vulnerable?

According to a recent news report, an ambitious new initiative is training National Guard service members to become certified nursing assistants in their latest deployment at a large nursing home facility. The facility was hobbled by a major exodus of employees because of the COVID-19 pandemic, which resulted in the nursing home shutting down entire wings of the facility. As a result, neighboring hospitals have been able to send new patients to long-term care centers like this nursing home, which is already stretched thin because of its lack of staff.

This holiday season, many friends and family members are planning to gather to celebrate. For our loved ones staying in nursing homes who may be unable to join, however, paying them a visit could both lift their spirits and allow you to check on their overall well-being. After all, when we send our family members to nursing homes, we entrust the care of our most vulnerable loved ones to them and their staff—and we should ensure that they are safe, well taken care of, and looked after.

According to a recent news report, a former nursing home staff member was indicted after allegedly sexually assaulting a resident. The former staff member was working as a housekeeper at the nursing home facility and allegedly raped an 81-year-old resident with dementia. As described in the indictment, the staff member, through forcible compulsion, assaulted the elderly and disabled victim in her room early in the morning. He was charged with rape in the first and second degree, a criminal sexual act in the first and second degree, and endangering the welfare of an incompetent or physically disabled person in the first degree in New York.

Although sexual abuse in nursing homes is rare compared to other types of abuse that can take place, it may be because the rates of sexual abuse are underreported.

As we approach two years into the Covid-19 pandemic, it’s easy to forget that the first wave of the pandemic struck nursing homes and long-term care facilities extremely hard. The risk factors for severe cases of Covid-19 correspond with the nature of the nursing home industry. Elderly, disabled, and often immunocompromised individuals are housed together in confined areas, while undertrained and underpaid employees often commute from other areas to care for the residents.

Although the nature of nursing home care helps explain why the pandemic hit nursing homes so hard, this explanation is not always enough to justify some of the negligent care that nursing home residents have endured throughout the pandemic. A recently published news report discussing a nursing home that continues to operate after having 83 residents die from covid in the last two years suggests that some nursing homes are violating a duty of care to their patients by failing to protect them from infection.

According to the local news report, the nursing home in question, located in New Jersey, was subject to complaints from residents and family even before the pandemic. Family members of former residents allege that the conditions in 2019 were unhygienic and that the employees were improperly trained to care for the residents. Once the pandemic hit, the consequences of improper care were exacerbated, as family members of former residents claim that the administration of the home was inaccessible to loved ones and that sick and healthy people were commingled, encouraging infections to spread. At the time the article was published, 83 residents of the nursing home had died from Covid-19, and another 25 residents were currently sick with the virus.

Nursing homes are a necessity of life for many families. Whether an older person doesn’t have any family members who can care for them, their family are too busy, don’t possess the requisite skills, or don’t have the room; hundreds of thousands of people are admitted to nursing homes each year. While most nursing homes hire caring, diligent staff members to care for residents, that is unfortunately not always the case.

When a family sets out to select a nursing home, there is only so much they can do in terms of due diligence. So much of what goes on in a nursing home is behind closed doors. Perhaps it’s not surprising that many nursing homes take affirmative efforts to hide instances of abuse and neglect. However, what’s more concerning is a recent report from the New York Times indicating that the federal government knew about instances of physical and sexual abuse and failed to inform the public.

Generally, nursing homes are under a legal duty to disclose certain occurrences within the facility. For example, if one resident physically assaults another requiring the victim to be hospitalized, the nursing home must file a report with the state. One would assume that once a nursing home let federal authorities know of an incident, that the government would then make that information public. Indeed, this is exactly the type of information families need when deciding on a nursing home.

In light of the emergence of the new Omicron variant of Covid-19, Maryland nursing homes should take steps to prevent and reduce the likelihood of transmission amongst staff and residents. While people hoped that nursing homes and assisted living facilities have honed their strategies to keep the spread in check, the reality is that many of these facilities fail to engage in a flexible and adaptive approach to virus prevention. Some approach Maryland nursing homes can take include:

  • Encourage vaccination;
  • Consider local transmission rates in decision-making processes;

With the holidays fully upon us, many families are making plans to gather to celebrate the season. For those of us with loved ones in nursing homes, it also is likely you are planning a visit for the holidays. These visits are important both for family bonding and catching up, but also as an opportunity to ensure that our seniors are remaining safe, well taken care of, and looked after by the staff in nursing homes.

Unfortunately, even during a joyous and cheery holiday period, nursing home abuse continues to be a major issue—and Maryland residents are no stranger to these challenges. Regardless of the season, nursing home abuse affects thousands of families in each year. With as many as five million seniors affected by elder abuse every year, it is crucial that holiday visits are rich in family time, but also in ensuring that your loved ones are not experiencing any type of abuse at the hands of other residents, family members, or nursing home staff.

Being proactive during nursing home visits can sometimes be challenging, especially if you do not know what exactly to look for. It is crucial to understand who is at risk and who the common perpetrators of abuse are.

From the beginning of the COVID-19 pandemic, many states passed legislation or issued executive orders shielding nursing homes and long-term care institutions from liability for COVID-19 harms that residents may have suffered. Maryland is one of several states that have introduced legislation allowing for this type of immunity. While not every COVID-19 case in a Maryland nursing home is due to another’s negligence, the fact of the matter is that the harrowing number of cases reflects the persistent low standard of treatment and care many of these facilities provide. Despite guidance from federal and state agencies, many nursing homes provide subpar care to their residents.

In light of these complicated and unclear immunities, many people are left wondering what recourse they have if their family members suffer injuries because of the neglect of a Maryland nursing home. The Maryland Nursing Home Bill of Rights provides that residents have the right to receive quality care, and facilities must treat residents with respect. Generally, nursing homes that fail to meet this standard will be held liable for the damages that their negligence causes. This duty does not mean that nursing facilities have an obligation to prevent their residents or patients from all viruses and infections. However, they must maintain policies to prevent and control infections.

The Centers for Disease Control (CDC) provides Maryland nursing homes with guidelines on preventing the spread of disease within their facilities. These include:

Under Maryland, law nurses may be liable for medical malpractice if they fail to do what a reasonable nurse would do in a similarly situated circumstance, and a patient suffers harm as a result of that negligence. Many people think of medical malpractice claims in the context of a physician error; however, nursing is a critical part of a patient’s care, and deviance from appropriate care can have disastrous and deadly consequences. In most cases, these claims would fall under the nurses’ medical insurance coverage, the physician’s insurance, or the hospital’s medical malpractice coverage.

There are many different errors or a combination of mistakes that can result in a patient’s injuries. However, the leading causes involve medication errors and failure to monitor. While a physician holds the primary responsibility for prescribing a medication, nurses must ensure that they properly administer medications. This is critically important in hospital settings where nurses often use a dispensing cabinet to retrieve the medication. While these cabinets have many safeguards, the nature of a busy hospital often leads to nurses bypassing some of these protections. In these cases, nurses may run the risk of retrieving the wrong medication or dosage. Administering the wrong medication, too much medication, or the failure to administer medication can have deadly consequences on vulnerable patients. Furthermore, nurses may be liable if they fail to assess, monitor, and communicate a patient’s medical condition. Appropriate documentation and communication to the health team are critical to a patient’s well-being.

While the vast majority of nursing mistakes are because of negligence or accidents, some cases involve recklessness or the intent to cause harm. The New York Times recently reported that a nurse was convicted of capital murder for injecting air into four patients recovering from surgery. According to prosecutors, the nurse harmed at least 11 patients by engaging in this dangerous conduct; two of the patients later died. In support of their case, prosecutors presented telephone recordings where the nurse told his wife that he injected the air to prolong the stay of the patients so that he could accrue over time. However, he explained that he did not intend for the patients to die. In addition to criminal charges, the nurse and hospital may face civil charges from the families who received negligent and reckless treatment under his care.

When loved ones—or their family members—decide to go to live in a nursing home, they expect a safe environment. Most nursing homes care about the safety and health of their residents; however, in some cases, this is not the case. And while individuals are more likely to experience abuse as they age, the rates of abuse are higher for seniors who live in a nursing home. Because of this, it is important to recognize the signs of abuse in nursing homes and report suspected abuse as soon as possible.

According to a recent news report, a nurse at a health and rehabilitation center was accused of assaulting two residents. According to the criminal complaint, the nurse was in the room alone with the two elderly residents and sexually abused them. At least one of the residents reported that she was initially afraid to speak up because she thought she might be retaliated against—which would make her life at the nursing home that much worse. The nurse is facing charges of aggravated indecent assault without consent, indecent assault without consent, neglect of care of a dependent person, and abuse of care.

Unfortunately, elder abuse is somewhat common. According to facts and statistics published by the National Association of Nursing Home Attorneys, an estimated 5 million seniors are abused each year. And this abuse is more prevalent in nursing homes: 36% of nursing home residents witnessed abuse of another resident within the previous year. This abuse may include psychological abuse, financial exploitation, neglect, physical abuse, and sexual abuse.

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