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.

Although much of nursing home regulation and action happens at the state level across the country, federal regulations also often impact the day-to-day operations and quality of care that our seniors receive in long-term care facilities. If you have a loved one living in a nursing home facility, it is always important to keep up to date with recent developments both at the state and federal level so that you can best protect your family members and advocate on their behalf if necessary.

According to a recent news report, the 8th Circuit Court of Appeals approved of a federal regulation that allows nursing homes to use arbitration agreements with residents but prevents them from making the agreements a prerequisite for admission to the facility. In its opinion, the three-judge panel rejected arguments from a group of nursing homes that claimed that the regulation was unlawful.

In its opinion, the court concluded that it was reasonable for the Centers for Medicare & Medicaid Services (CMS)—the federal agency that promulgated the regulation—to regulate the use of arbitration agreements in nursing homes. The regulation, the court reasoned, would further the well-being and overall health and safety of residents, especially when the elderly individual is first admitted into the facility.

When we send our loved ones to a nursing home, we expect them to be given the attention and quality care they deserve. Since the COVID-19 pandemic, however, many nursing homes have had to shut their doors to visitors as elderly residents have presented as high-risk for catching the virus, leaving abuse and neglect often concealed behind closed doors. As a result of outbreaks and quarantines, many facilities also became short-staffed—and many elderly residents suffered as a result.

According to a recent news report, a nursing home was fined $27,739 after elderly residents were neglected following staffing shortages. Based on a report released by the federal Centers for Medicare and Medicaid Services, the nursing home left residents with bedsores in their waste for up to eight hours at a time. In addition, the nursing home failed to protect residents from emotional and physical harm, abuse, and mental anguish. With more than 100 cases of COVID-19—including 37 staffers—reported at the nursing home during an outbreak earlier this year, the facility became even more short-staffed than ever before, with no registered nurses or supervising staff available to keep an eye on residents. At one point, there was only one certified nursing assistant per 53 residents, which prevented vital sign monitoring every few hours for significantly ill residents.

Unfortunately, Maryland is no stranger to similar elder abuse and neglect and staffing challenges in its nursing homes. In addition, many elderly Maryland nursing home residents have been subject to different kinds of physical, emotional, and sexual abuse.

With each passing year, more states are enacting laws that allow for the installation of cameras in nursing homes and other similar long-term care facilities. After all, sending our loved ones to nursing homes is never an easy endeavor. When we put our loved one’s care in the hands of strangers, it can often be challenging to feel at ease when abuse or neglect could be taking place behind closed doors. To proponents of allowing cameras in nursing home facilities, allowing cameras ensures increased accountability and safety from abuse and neglect for our loved ones.

According to a recent news report, other states are continuing to consider enacting laws that would allow cameras to be placed in their loved ones’ rooms in nursing homes. Proponents argue that such laws could go a long way in building a record and substantiating claims of abuse or neglect, instead of relying on staff who may fear repercussions as a result of reporting. Cameras could also be beneficial for nursing home staff to refute false claims. Although cameras will likely not solve all existing problems for elderly residents, proponents argue it could be a step in the right direction to increase transparency, accountability, and safety in these long-term care facilities.

In light of COVID-19, many nursing homes have had to close their doors to visitors because of public health and social distancing protocols. Because elderly residents of nursing homes remain a highly at-risk group in the midst of the global pandemic, many suspect that the ongoing pandemic increased the frequency of abuse or neglect taking place behind closed doors as in-person visits became restricted or limited.

Families of nursing home residents know all too well that they have to put a good amount of trust in nursing homes. Families cannot be with their loved ones all the time and some residents are unable to report abuse, or even understand that they are being abused in the first place. Abuse can take different forms, including physical, emotional, and financial abuse. There may be signs of abuse, such as broken bones and unexplained injuries, fear or distress, poor living conditions, and missing finances. Victims of Maryland nursing home abuse may be able to file a claim against the perpetrator, the facility, and anyone else responsible for the harm.

Maryland nursing home residents have the right to live in a safe and sanitary environment free from abuse. Nursing homes are required to report any allegations of abuse to Maryland’s Office of Health Care Quality within five working days of the alleged violation. They must also conduct an investigation and provide a report to the state. Nursing homes also have to have proper policies and procedures in place in order to prevent abuse and keep their residents safe. Nursing homes that fail to report abuse are subject to fines and other sanctions.

While perpetrators may face criminal charges, victims may also seek compensation for their injuries through a civil claim. Damages may include medical treatment for injuries (past and future), pain and suffering, disfigurement, loss of companionship, and more. A plaintiff must prove all of the damages claimed in a civil lawsuit. The plaintiff has the burden to prove damages, and the claim, by a preponderance of the evidence standard. In any case, anyone who is concerned that their loved one may have been abused should with a Maryland nursing home attorney as soon as possible.

When we send our loved ones to a nursing home, it can often be a nerve-wracking process. Ensuring that our family members are taken care of, receiving quality care, and comfortable can shape up to be quite the challenging endeavor when it comes to finding the right facility and staff. Sometimes, however, our elders end up in nursing homes that may not be as great—and may not uphold the expected standard of care. When this happens, our seniors experience low-quality care and sometimes even abuse or neglect.

Unfortunately, Maryland is no stranger to elder abuse and neglect. In 2019, the Maryland Department of Aging reported that of 4,948 complaints that were investigated by the agency, 350 were alleged resident abuse cases. Separately, the Maryland Department of Health, Office of Health Care Quality received 1,427 reports of alleged abuse and 693 allegations of neglect in 2019.

These issues, however, are not unique to only Maryland elders. To combat these challenges and to improve regulatory oversight over nursing home facilities, several U.S. senators recently introduced a new bill targeted at improving the quality of care for seniors all over the country.

For older individuals living with dementia, taking antipsychotic drugs nearly doubles their chance of death from heart problems, infections, and other serious ailments. But for years, nursing homes have used these drugs to control their patients who have dementia. Because of the increased risks to patients treated with antipsychotic medications, the government requires nursing homes to report the number of residents who are taking antipsychotics. However, the government does not keep a public record of residents who are prescribed antipsychotics if they are living with schizophrenia, Tourette’s syndrome, or Hungtington’s disease. As a result, the New York Times reports that some doctors at nursing homes are diagnosing residents with one of these three diseases and then prescribing these patients with antipsychotics in order to avoid the requirement that they include these patients in their reported number of antipsychotic drug use. Nursing homes engaged in this practice have the goal of making their facility look more appealing to the public. Because of this practice, it has become harder to get an accurate portrayal of the rate of antipsychotic drug use on residents in nursing homes

If a nursing home has a high rate of antipsychotic drug use, the government may give the facility a lower “quality of resident care” rating, which in turn would have negative financial consequences for the nursing home. The rating system was designed by Medicare to help patients and families evaluate various facilities. Because antipsychotics have been approved for treating patients with schizophrenia, Tourette’s syndrome, or Huntington’s disease, antipsychotic prescriptions in these instances are not included in a facility’s public tracking. As a result, some nursing home facilities have used this as a loophole to hide the true number of residents who are on antipsychotic medications. According to Medicare data, since 2012 the number of residents diagnosed with schizophrenia has increased 70 percent.

Medicare’s website reports that less than 15 percent of nursing home residents are on antipsychotics, but because of the loophole, this number does not accurately include patients who have been diagnosed with schizophrenia. It is suspected that some understaffed nursing homes are using antipsychotic drugs to more easily subdue patients so that these facilities do not have to hire additional staff.

Each year, it is estimated that nearly five million elderly adults may experience some level of abuse, exploitation, or neglect. In addition, official reports are only made for one in every five cases of elder abuse.

With this in mind, sending our loved ones to a nursing home can often be an extremely stressful and challenging process. After all, you are entrusting the care and well-being of your family members and loved ones to a nursing home facility and its staff. Sometimes, even with due diligence and research into facilities, instances of nursing home and elderly abuse can take place. When these incidents happen, it is crucial that those who are responsible are held accountable for taking advantage of our loved ones.

According to a recent news release, a certified nursing assistant was charged with sexually assaulting two elderly residents at a nursing home during his overnight shifts. As a caretaker, the certified nursing assistant was responsible for changing, bathing, feeding, toileting, and helping as needed with incontinent residents at nursing facilities. An investigation by local authorities revealed that the certified nursing assistant allegedly sexually assaulted two elderly female residents by acting under the guise of providing assistance with washing or toileting, only to instead use it as an opportunity to sexually assault them. The nursing assistant was indicted on multiple criminal charges, such as indecent assault and battery upon an elder.

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