Articles Posted in Infections in Nursing Homes

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.

Healthcare providers across the United States continue to grapple with challenges related to providing care to patients suffering from COVID-19, otherwise known as the novel coronavirus. Almost 60% of COVID-19 victims in Maryland are long-term care and nursing home residents. In response to the disproportionately high rate of infection in nursing homes, many states, including Maryland, have asked lawmakers to provide nursing facilities with immunity from lawsuits related to their care during the pandemic. Despite the inherent difficulties many residents and their families face pursuing lawsuits against negligent nursing homes, these facilities continue to push for additional protections against liability.

Even though the spread of disease and illness can become challenging to control, these entities have a responsibility to provide their residents and visitors with a safe environment and appropriate treatment. This includes ensuring that their staff is trained in proper hygiene and safety practices, providing staff and residents with protective gear, quickly diagnosing and identifying patients suffering from infectious diseases, and notifying visitors of any changes in visitation protocol. Despite these steps, outbreaks can still occur, and these facilities must have a plan in place to combat these instances. Infection control protocols include implementing stricter sanitation requirements, changing safety equipment requirements, and isolating high-risk or infected residents. The failure to respond to an outbreak effectively can result in deadly consequences for residents and staff.

Many families are beginning to file lawsuits against these facilities for their response to the COVID-19 outbreak. In response, many Maryland nursing home groups are asking the state to provide immunity based on the governor’s emergency declaration. A few states, including Maryland, protect providers during state and national emergencies. Nursing homes are anticipating that many lawsuits will include claims that the facilities did not have enough personal protective equipment (PPE) to protect their staff and residents. However, many residents and families are claiming that a lack of PPE is only one problem of many, and that clinicians and staff failed to diagnose and treat their loved ones quickly.

According to a recent news report, Maryland Governor Larry Hogan has directed state officials to provide detailed information on COVID-19 cases in Maryland nursing homes and assisted-living facilities and is adding two additional drive-thru COVID-19 testing sites in the state. As of May 2, there are over 24,000 confirmed cases in the state of Maryland, and 1,156 COVID-19 deaths. Maryland currently has the 12th highest rate of COVID-19 cases per capita and the 10th highest death rate per capita in the country. The highest number of cases are in Prince George’s County (7,041), followed by Montgomery County (4,919).

The state maintains a coronavirus resource webpage and has recently begun to publish data on COVID-19 cases in nursing homes and other assisted-living facilities in individual facilities in each county in Maryland. In nursing homes, assisted living homes, and group homes in the state there are now 3,218 confirmed resident cases, 525 resident deaths, 1,489 staff cases, and 8 staff deaths. Right now, Montgomery County has the highest number of total COVID-19 cases in nursing homes, assisted living homes, and group homes. In Montgomery County, there have been 717 confirmed resident cases, 382 confirmed staff cases, 148 resident deaths, and 1 confirmed staff death.

Examples of case information for certain facilities are as follows:

  • Manor Care Silver Spring: 58 resident cases, 17 staff cases, and 16 resident deaths
  • Regency Care of Silver Spring: 50 resident cases, 30 staff cases, and 10 resident deaths
  • Rockville Nursing Home: 36 resident cases, 15 staff cases, and 13 resident deaths
  • Wilson Health Care Center at Asbury Methodist Village: 47 resident cases, 16 staff cases, and 12 resident deaths
  • Brighton Gardens of Tuckerman Lane: 24 resident cases, 16 staff cases, and 8 resident deaths
  • Montgomery Village Health Care Center had 32 resident cases, 11 staff cases, and 8 resident deaths

In addition to five drive-thru testing sites in Bel Air, Columbia, Glen Burnie, Waldorf, and White Oak, the state is adding two additional sites in Owings Mills and Prince Frederick. However, tests are offered only to people who have symptoms and are at high risk for complications from COVID-19—and only for those with an appointment and with an order from a health care provider.
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Despite the concerning rate of COVID-19 (coronavirus) deaths, a recent news report indicates that officials are refusing to provide the public with a comprehensive and accurate list of Maryland nursing homes and long-term facilities where outbreaks have been confirmed. Many nursing home administrators, staff, and residents at these facilities remain in the dark about the presence of the infection at their facilities. Maryland Department of Health officials advised investigators and reporters that public disclosure was up to the local health department. However, many local health departments declined to release the names of affected facilities, reasoning that they need authorization from the state to share the information. This lack of transparency has added to the public’s fear and confusion about how to protect themselves and their loved ones. Maryland nursing homes that fail to engage in appropriate disease prevention practices and do not provide the public with crucial health and safety information may be liable for the spread of disease at their facilities.

Maryland nursing homes and long-term care facilities must limit the spread of disease and infection by taking precautions and acting quickly when an outbreak emerges. It is especially important because nursing home populations are at the highest risk of being affected by COVID-19. The Centers for Disease Control and Prevention (CDC) provides these facilities with guidance on how to keep COVID-19 from entering their facilities, identifying infections, preventing the spread of COVID-19, accessing personal protective equipment, and managing severe illnesses.

The guidelines make it clear that one of the most critical components of disease control is providing residents and staff with information about the disease. Staff and residents should receive education and training about signs, symptoms, and potential outbreaks. Further, residents and families should have information about what the facility is doing to protect their loved ones. Some common ways to limit the spread of disease are restricting visitors, reinforcing adherence to infection prevention, and implementing non-punitive, flexible sick policies for staff. These Maryland facilities must act swiftly to implement all of these recommendations before cases are identified at their locations. Maryland nursing homes that fail to engage in these safe practices and refuse to provide this crucial information may leave their residents and staff vulnerable to exposure and severe illness.

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