Articles Posted in Infections in Nursing Homes

The Centers for Disease Control (CDC) recently revised its COVID-19 guidelines to state that the coronavirus can be spread through aerosols, raising questions about the practices of Maryland nursing homes. It was previously known that the virus could be spread through respiratory droplets, such as when an infected person coughs, talks, and breathes. But experts now say that the virus is also spread through aerosols, which can remain in the air for hours and travel more than six feet. Experts still believe that the virus is mainly spread through respiratory droplets, but believe that airborne transmission does occur. Dr. Anthony Fauci stated that he was pretty confident that there was some airborne transmission of COVID-19.

Aerosols are microscopic droplets or particles and remain suspended in the air for some time, as opposed to respiratory droplets, which drop to the ground. Aerosols can accumulate in a confined space like a poorly ventilated room. Air purifiers and open windows can help to mitigate aerosol transmission by increasing ventilation within a confined space.

Some researchers have raised this issue in regards to nursing homes. Some research reported on one case of a COVID-19 outbreak in a nursing home with inadequate ventilation. One ward in a nursing home had a rate of 81% positive COVID-19 cases among residents, as opposed to no cases among the other six wards in the nursing home. Based on the low rate of the virus in the community, fast rate of transmission within the ward, the documented poor ventilation, and despite the use of surgical masks, the data suggested that the outbreak was caused by aerosol transmission due to inadequate ventilation.

It’s no secret that the COVID-19 pandemic has had an especially large impact on nursing homes, where tens of thousands of residents and staff members have gotten sick and even died. Because nursing homes combine communal living and vulnerable individuals, and because they often have high rates of abuse and neglect, the COVID-19 pandemic has hit those living in a nursing home particularly hard. In some homes, hundreds of residents have caught COVID-19, with dozens dying. The pandemic is thus raising concerns for Maryland families who have placed family members in nursing homes; many are fearful that nursing home abuse and neglect could be fatal for their loved ones.

In some cases, the situation has gotten so bad that the FBI has been sent to raid nursing homes with a high number of COVID-19 cases. According to a recent news report, two Pennsylvania nursing homes were raided and searched just last month by investigators from the FBI, as well as the state attorney general’s office and other agencies. This followed concerning reports of deeply troubling conditions and practices, including a lack of trained nurses, filthy living conditions, and lax sanitation protocols. Data from the State Department of Health shows that 447 residents and staff members tested positive for the disease as of early September, and 73 people had died.

Tragically, this example is just one of many nursing homes across the country, failing to keep their residents safe during a deadly pandemic. But it is important to know that many of the issues leading to the spread of disease were present even before COVID-19 began spreading through the United States. Nursing home abuse and neglect is not new, but COVID-19 is showing just how widespread and deadly it can be. While there have been reports of unsanitary and even filthy living conditions at Maryland nursing homes before, the lack of sanitation is especially apparent when a contagious disease is spreading through the facility. The same is true for medical neglect: a long-standing issue at many facilities, but even more deadly during the pandemic. Even just carelessness on the part of the staff—not wearing a mask at all times, failing to wash their hands regularly—now has an incredibly large impact on the safety and well being of nursing home residents, many of whom require constant care and are unable to move out and care for themselves.

Nursing homes continue to be hit hard by the coronavirus. Across the U.S., over 40 percent of deaths in the country are linked to nursing homes. In Maryland nursing homes, the numbers are even higher. As of September 25, there have been 2,146 deaths across the state in nursing homes, group homes, and assisted living facilities, which accounts for 57% of the total deaths in the state. Maryland has seen 753 resident deaths and 7 staff deaths during the week of September 23.

According to a recent news report, one nursing home in Sykesville, Maryland is facing hundreds of dollars in fines after the state found it failed to isolate residents and notify staff during an outbreak. For example, the facility moved an exposed resident to a room with a negative resident, who both later tested positive. Some newly admitted residents also were not isolated, despite having sufficient rooms to do so. Maryland nursing home residents may be able to take action against the facility based on its failure to protect and properly care for residents.

Other states have explored solutions to mitigate the spread of COVID-19 in long-term care facilities. As one news source reported, in New Mexico, the state worked with a healthcare operator to set up a nursing home that it dedicated to treating long-term care patients infected with the coronavirus. It was set up to reduce the spread of COVID-19 in long-term care facilities in the state. Deaths in nursing homes in New Mexico make up 34% of the total deaths in the state.

Nursing home negligence and abuse is a huge problem in Maryland and across the entire country. Even before the COVID-19 pandemic hit earlier this year, this blog reported on Maryland nursing homes’ negligence and the devastating effects it can have on residents and their families. However, the COVID-19 pandemic has made matters even worse in many nursing homes. A recent news report documented the harsh realities of COVID-19 within nursing homes and how a widespread lack of safety and sanitation protocols has become potentially deadly.

The report discusses one nursing home that received a citation in October of 2019 for failing to “provide and implement an infection prevention and control program.” The report that accompanied the citation found that staff members would engage in shocking behavior—one, for example, used a soiled towel to wipe a resident’s buttocks and then failed to wash their hands before going back to work. In the aftermath of this report, however, residents’ relatives said that the home did not take steps to change their behavior. One woman discusses the care her 93-year-old mother received, saying that she could not rely on the nursing home staff to take care of her or keep her healthy, and witnessed her being injured or roughhoused. Once, she had to clean fecal matter from her mother’s fingernails or dispose of adult diapers left on her bed. Tragically, the woman’s mother passed away in early April from a COVID-19 outbreak that the nursing home failed to control.

The concerns discussed in this home are not unique. In fact, nursing homes across the nation and in Maryland have very similar problems, with substandard living conditions for residents and a lack of proper sanitation. This caused problems before the COVID-19 pandemic, but has worsened since the pandemic spread across the United States in March of this year, causing outbreaks and deaths among nursing home staff and residents.

In the event of the death of a resident at a Maryland nursing home, the resident’s family may be able to recover compensation through a Maryland wrongful death lawsuit.  However, determining fault in a nursing home abuse or neglect case is not always straightforward, and the assistance of a skilled personal injury lawyer can be an invaluable asset to families who are unfamiliar with the process.

Maryland’s Wrongful Death Act allows family members to file a civil claim against parties at fault for the decedent’s untimely death. A wrongful death claim is intended to compensate family members that have suffered a loss due to the loss of the decedent. It also permits the decedent’s family to hold wrongful actors responsible in the same way that the decedent could have if the decedent had lived.

A wrongful death claim is often filed by a spouse, parent, or child of the decedent. Such plaintiffs are considered “primary” plaintiffs under the Act. Only a primary plaintiff can file a wrongful death claim, if one exists. If the decedent does not have a living spouse, parent, or child, the claim can be filed by a “secondary” plaintiff. A secondary plaintiff is another individual who was related to the decedent by blood or by marriage and who was substantially dependent upon the decedent.

Recently, an industry news source recorded a fascinating podcast including an interview with a former assistant U.S. attorney who discussed legal issues that could arise for nursing homes from the COVID-19 pandemic. The podcast discusses how nursing home abuse and neglect cases may be affected by the virus. The information is very important for residents of Maryland nursing homes or those who have loved ones in these facilities.

The podcast discussed the various immunity laws passed for health care providers as a result of the pandemic in states across the country. These laws are not brand new—some states have long had immunity provisions that kick in automatically whenever a state of emergency is declared. Most of the current immunity provisions in effect now during the COVID-19 pandemic change the level of culpability that facilities can be held to in nursing home abuse or neglect cases that have to do with the disease.

Typically, someone bringing a nursing home abuse or neglect case has to prove that the actions of the facility amounted to negligence and contributed to resulting injuries, illness, or death. However, the immunity provisions typically increase the standards. According to the podcast speaker, the provisions basically say that nursing home facilities and the individuals working within them will no longer be responsible for negligent behavior. Instead, they can only be held liable at a higher standard, such as gross negligence or reckless disregard. This makes it much harder for victims of nursing home abuse or neglect to hold the facilities responsible, because it’s a higher bar of proof to reach. In other words, it might not be enough to show that the nursing home or employees acted negligently or carelessly and caused the spread of COVID-19 or even a COVID-related death. Instead, potential plaintiffs might have to prove that the nursing home was extremely careless, perhaps even maliciously or willingly, which is much harder to prove as a matter of law.

Recent figures now show that nursing homes make up many of the country’s COVID-19 deaths. In fact, according to a recent report by the New York Times, 43 percent of coronavirus-related deaths in the United States are linked to nursing homes and long-term care facilities. In Maryland specifically, long-term care facilities make up a staggering 60 percent of the state’s COVID-19 deaths.

Throughout the country, COVID-19 deaths in nursing homes and long-term care facilities account for at least 54,000 deaths. So far, many large groups of coronavirus cases have occurred in nursing homes, prisons, and food processing facilities, where social distancing is difficult or impossible. And although there were more cases in prisons and food processing plants, the deadliest clusters have been mostly in nursing homes, where residents are particularly vulnerable because of their age and underlying health problems.

The report found that where large outbreaks occurred in nursing homes, 17 percent of people infected with COVID-19 died, compared to around a five percent death rate among COVID-19 patients in general. In three states, over 75 percent of all COVID-19 deaths are linked to nursing homes and long-term care facilities.

For several years, we have written about Maryland nursing home abuse and neglect cases, which can have tragic consequences for residents and their families. Unfortunately, instead of the situation improving, some reports suggest that the COVID-19 pandemic could be making the situation worse, as thousands of residents are passing away in nursing homes, potentially due to negligent care. Any facility that has a large number of residents living in one community can be dangerous during the pandemic, and more than 37,000 residents in nursing homes have died since early March, raising concerns of inadequate protections or staffing.

Recently, ABC News reported in-depth on the issue. The article detailed the story of seven daughters who decided to move their father, a former corrections officer, into a Maryland nursing home this past February. Unfortunately, within three months of being in the home, their father died after testing positive for COVID-19. But before he died, he was in a severe condition, leading his daughters to believe that inadequate care at the nursing home may have contributed to or even caused his death. One daughter reported that, when her father originally went to the hospital (weeks before he died), the hospital staff told her that her father had lost 30 pounds and that he was so dehydrated “his blood was like mud.”

Typically, when someone is injured due to negligence or abuse in a Maryland nursing home, they have the ability to bring a personal injury lawsuit against the facility to recover for medical expenses, pain and suffering, and more. However, Maryland is one of the several states across the country that has laws in place to protect healthcare providers during a declared public health emergency. Now, during the COVID-19 pandemic and its severe effect within nursing homes, Congress is considering instituting similar protections for nursing homes. This could be a major barrier for plaintiffs who want to bring claims against nursing homes, making these suits an uphill battle. Supporters of the measures claim they protect nursing homes from frivolous claims against them, but critics point to how important it is that families affected by a nursing home’s negligence have an avenue of relief.

Nursing homes in Maryland are required to meet certain standards under federal and state regulations. For example, Maryland nursing homes must meet state laws and those facilities that accept Medicare and Medicaid patients must also meet federal standards. The Maryland Department of Health’s Long Term Care Unit ensures that state and federal standards are met by conduct site visits, surveys, and investigations.

A nursing home may be liable for injuries to a resident if the home fails to follow federal and state regulations or if it fails to adopt and maintain adequate policies and procedures. Many nursing homes have been criticized for their responses to coronavirus and failures to take adequate measures to protect residents by, for example, failing to quarantine sick residents or to have their staff wear protective equipment. The U.S. Centers for Medicare and Medicaid Services issued specific COVID-19 guidance in March.

If a Maryland nursing home resident becomes sick with COVID-19, the resident may be able to sue the facility for negligence or wrongful death if it failed to adequately protect residents or if it failed to properly care for the resident. A plaintiff in a Maryland nursing home case must show that the nursing home failed to meet its duty to provide adequate care for the resident based on the circumstances.

Maryland’s confirmed COVID-19 cases among residents in Maryland nursing homes and assisted-living facilities have continued to rise over the past weeks. As of May 16, 2020, there are now 5,329 confirmed resident cases and 984 confirmed resident deaths in the state. As cases grow, stories of neglect and substandard care in facilities have also continued.

In one nursing home in northern New Jersey, at least 53 residents have died from COVID-19. According to one news source, the nursing home, Andover Subacute and Rehabilitation Center II, had one of the largest outbreaks in the state, one of the hardest hit in the nation. Federal and state inspectors began investigating the 543-bed facility after police found 17 bodies piled in a morgue after receiving an anonymous tip that a corpse was stored in a shed. A federal inspection report was released detailing the state of the nursing home, which shows how the pandemic has overtaken nursing homes across the United States. The report’s findings include that one patient was found dead in bed after suffering from a high fever for days—after staff failed to notify a doctor of the patient’s fever. In addition, sick residents who were tested for coronavirus and waiting for the results were not quarantined away from healthy residents. Also, thermometers that employees used to take their temperatures at the beginning of each shift did not work. The report found that the nursing home put its residents in “immediate jeopardy” and the facility was fined $220,000.

The National Guard was called after the facility failed to adequately staff and protect staff and residents. The National Guard members were called in to clean and disinfect the facility. Residents had complained that clothing and bed sheets had not been washed. The facility is temporarily barred from accepting new patients and the facility will continue to accrue penalties until it addresses the issues in the report.

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