Articles Posted in Nursing Home News

The United States Constitution guarantees all citizens equal access to our court system. However, courts have repeatedly held that the right of access to the court system, like many other important rights, can be waived. In theory, by signing an arbitration agreement a person gives up their right to file any future claim in the court system and agrees to resolve the claim through binding arbitration.

Arbitration clauses are used in many situations, including employment contracts, cell phone contracts, and, of course, nursing home contracts. However, there is a serious concern that those who are asked to sign an arbitration agreement – and, in the process, give up fundamental constitutional rights – do so unknowingly. Indeed, it is not uncommon for the victim of Maryland nursing home abuse to file a claim, only to learn for the first time that they must resolve the claim through arbitration

Despite the important rights that a person gives up when agreeing to arbitration, too often, arbitration clauses consist of a few paragraphs in a much longer contract. These contracts are usually written in small print and, at first glance, would seem to be unimportant. Thus, when consumers, nursing home residents, or employees are presented with these lengthy documents, they frequently overlook the arbitration clause, or at least fail to fully comprehend the importance of the document that they have just been asked to sign.

One would like to think that aging service members are provided with the care and compassion they deserve as they begin to require more and more assistance with their daily routine. However, Veterans’ Administration (VA) nursing homes have been continually under scrutiny for the poor quality of care they provide residents. A recent report illustrates just a few of the horrors that VA nursing home residents across the country are experiencing.

According to a report by USA Today, in VA nursing homes across the country, veterans are suffering actual harm due to a variety of deficiencies. Evidently, private inspectors determined that residents in 52 of the 99 surveyed homes suffered some type of actual harm based on the inadequate level of care being provided by staff. A Washington, D.C. VA nursing home was among those in which residents suffered actual harm. Several other VA nursing homes were found to have put residents in “immediate jeopardy.”

One of the most common problems inspectors found was that residents in many of the VA nursing homes suffered from preventable bedsores. Bedsores develop when a person who is confined to a bed remains idle for too long. Bedsores can be prevented by frequently rotating a resident, or providing a resident with ample cushion under their body. Inspectors noted that one resident developed five bedsores in just six months. However, when inspectors went to visit this resident, they determined that no staff member had moved the man, or provided him with additional cushions to alleviate the condition.

While sexual assault has always been a concern among those who have family members living in Maryland nursing homes, given the recent headlines those concerns have come to the forefront. Back in December of last year, a 29-year-old resident in a long-term care facility gave birth to a baby boy. The woman had been incapacitated and in long-term care since she was three years old.

According to a recent news report, police have arrested a man they believe raped the woman. After the resident gave birth, police obtained a DNA sample from the baby. Police then obtained DNA samples from each of the nurses at the care facility where the resident was staying. Evidently, the DNA taken from the baby matched one of the nurses who was charged with overseeing the resident. The nurse had been working at the facility since 2011, and there is no indication at this point that there had been any previous complaints or similar incidents. Of course, given the compromised condition of the residents in the facility, it is likely that other incidents would not necessarily be reported.

Signs of Sexual Assault

Certainly, this news comes as a shock to many. However, sexual abuse is not uncommon in nursing homes and skilled care facilities. One reason for this is the compromised condition of the residents make them ideal victims for predators. In addition, many nursing home residents have little contact with those outside of the facility, and fear that they may not be believed if they did make a report.

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Over the past several years, there has been a significant increase in the number of reported instances of Maryland nursing home abuse and neglect. In part, this is due to increased awareness of the problem, as social media has allowed for news of these disturbing events to disseminate more easily. However, experts still believe that the majority of nursing home abuse and neglect goes unreported.

Experts believe that there are several causes of nursing home abuse and neglect. Not surprisingly, most of the causes relate to the environment created by nursing home management rather than specific issues with individual nurses or employees. However, some nurses are better suited for the job. Often, this is due to the level of training or experience the nurse has obtained.

Studies have shown that low staffing levels are correlated with increased instances of abuse and neglect. Thus, it is generally agreed that the more stressful the work environment, the more likely employees are to “snap.” According to a recent article, Maryland and Virginia nurses are offered some of the lowest rates to provide in-home care to residents. Apparently, in-home nurses in Virginia and Maryland make only $20 to $35 per hour. This is about 30% lower than nearby states. As a result, qualified nurses are leaving Maryland and Virginia to pursue employment in states where they can earn a better living. Thus, residents are having a difficult time securing in-home nurses, especially during off-peak hours and on weekends.

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Study after study has shown that one of the root causes of Maryland nursing home abuse and neglect is understaffing. Federal regulations require that a Registered Nurse is on staff seven days a week for at least eight consecutive hours a day. And in general, the fewer qualified staff members a nursing home has, the more work each staff member must take on. Without a registered nurse on staff, the level of care a nursing home can provide is greatly limited. At some point, overworked employees face a reduced ability to perform the functions of their job with the patience and care that is required.

According to a recent industry news report, a few weeks ago the Center for Medicare and Medicaid Services (CMS) issued a new rule that will increase the agency’s oversight of nursing homes in an attempt to lower the number of homes that operate with reduced staffing levels. States have always been required to survey nursing home staffing levels. However, under the old rule, only 10% of those surveys had to be conducted during the weekend and off-peak hours. However, the new rule requires that state conduct 50% of surveys during weekend and off-peak times.

The new rule uses payroll-based journal data to identify the 20% of nursing homes in each state with the lowest level of staffing on the weekends and during off-peak hours. Once the 20% in each state is identified, the CMS will provide the names of the facilities to state agencies. Each state will then be responsible for following up with additional surveys. If a facility remains out of compliance, it will be sanctioned accordingly. Understaffing can also result in a nursing home receiving a low star-rating.

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Although most people would prefer not to have their loved ones move into a Maryland nursing home, there is often little choice in the matter. As a result, nursing homes have become commonplace in Maryland and across the country. When a family trusts a nursing home to care for an aging loved one they assume, at a minimum, that their loved ones will receive the appropriate care.

The Standard of Care in Nursing Homes

Nursing homes are required to provide a certain level of care to residents. This is called the “standard of care.” The applicable standard of care varies based on the particular jurisdiction, and is often based upon local, state, and federal laws and regulations. Generally, although a nursing home cannot guarantee the safety of its residents, a nursing home must exercise reasonable care so that residents do not suffer physical injury and unnecessary mental distress. The applicable standard depends on the resident’s condition, which has to be evaluated by the nursing home, and addressed in properly caring for the resident. That means that if a resident has special needs, the nursing home should provide appropriate treatment and supervision to meet the standard of care for that particular resident.

Veteran’s Administration Nursing Home Among the Nation’s Worst

An internal report from the Department of Veterans Affairs found that a Veterans Affairs nursing home in Brockton, Massachusetts had “blatant disregard” for veteran safety, according to one news source. The Department of Veterans Affairs (VA) began its investigation of the facility after a nurse brought her concerns to the VA’s attention. Residents at the VA nursing home in Brockton were almost three times more likely to develop bedsores than residents at private nursing homes, and were generally more likely to experience serious pain.

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As the average lifespan in America continues to increase, more and more families will need to rely on Maryland nursing homes to provide care for their aging loved ones. Indeed, nursing homes offer a necessary service; however, reports have recently come to light that nursing home abuse and neglect are rampant. Perhaps more alarming are the results of a recent government study indicating that of all the cases of nursing home abuse requiring hospitalization, 28% went unreported until the resident arrived at the hospital.

Instances of nursing home abuse and neglect are underreported for several reasons. One reason is that many residents are embarrassed to report what happened to them, or fear that they will be seen as troublesome by family members. Another reason is that the residents who are victims of abuse or neglect are often not in a condition to articulate what they are experiencing, and in some cases, residents have no one to report the abuse or neglect to.

According to a recent industry news source, the Centers for Medicare & Medicaid Services proposed a new regulation that would impose significant monetary fines upon employees of skilled nursing facilities who fail to report abuse, neglect, or other crimes within a certain period. Not only would the new regulation require an employee to report abuse or neglect that was witnessed, but it would also require an employee to report a “reasonable suspicion” that abuse or neglect was occurring. The idea behind the newly proposed regulation would be to encourage employees in these facilities to speak up on behalf of the residents who are the victims of abuse or neglect.

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This past month, the state of Maryland announced a settlement due to the involuntary discharge of nursing home residents in violation of Maryland’s Patient’s Bill of Rights.

Medicare Recipients’ Rights and Involuntary Patient Transfer and Discharge

Maryland’s Patient’s Bill of Rights protects the rights of individuals in nursing homes. Under the Bill of Rights, Medicare recipients are entitled to certain rights, including having access to doctors, specialists and hospitals, being treated with respect and free from discrimination, receiving health care services in a language the patient can understand, and appealing certain decisions about health care payment, coverage of services, and prescription drug coverage.

The Bill of Rights explicitly provides certain safeguards to nursing home residents who are involuntarily discharged. Discharged patients are at high risk for mortality, and discharge is meant to be an option of last resort for nursing homes. HG § 19-345.2 provides specific procedures for providers to follow before discharging or transferring a resident. Those procedures include having a post-discharge care plan, medical assessments, and written documents from the resident’s attending physician. Providers also are required to provide residents with at least a 3-day supply of medications.

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Nursing home residents in Maryland and throughout the country have the right to live in a safe environment, free from abuse and neglect. Claims against nursing homes can range from physical mistreatment and sexual abuse, to neglect, financial exploitation, and psychological abuse. Cases of Maryland nursing home abuse or neglect may not be obvious, as a resident may have difficulty communicating and may not even be aware of the neglect or abuse.

It is important for families to remain vigilant to identify cases of abuse and neglect, by looking out for warning signs, including poor hygiene and unexplained injuries. Although licensed care facilities are required to follow certain laws and regulations under federal and state law, some individuals are being under-cared for in unregulated, unlicensed homes, increasing the risk of abuse and neglect to those individuals, as one study recently found.

Abusive Unlicensed Care Homes Pose Serious Risks

A year-long study raised concerns about serious risks at unlicensed care homes in the United States, finding that “egregious crimes” are being committed against residents, according to one news source. RTI International, an independent, non-profit research firm, conducted the study for the Office of Disability, Aging, and Long-Term Care Policy and the Office of the Assistant Secretary for Planning and Evaluation of the U.S. Department of Health and Human Services.

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Abuse and neglect are serious problems in Maryland nursing homes, and in nursing homes across the country. Earlier this month, prosecutors who initially filed criminal charges against two nurses based on the allegedly negligent care they provided to residents asked the judge to dismiss the case. According to a local news report, despite the nurses’ claims that they had been taking care of a resident, video evidence showed that they did not step foot in her room for 17 hours. The video also showed that the nurses repeatedly left the elderly woman naked in her bed with the door wide open.Evidently, after the family discovered the nursing home neglect, they reported it to the authorities, and charges were initially filed. However, prosecutors recently asked the judge to dismiss the case in favor of allowing the state board of nursing to handle any disciplinary sanctions. The board would have the power to revoke the nurses’ licenses and place them on the registry of known abusers.

Although the prosecutors did not come right out and say it, what seems to be motivating their decision is the fact that in Iowa, where the abuse occurred, there is no statute allowing nursing home residents to install cameras to monitor staff. Thus, the prosecutors may be fearful that if they brought the case, the video would be inadmissible at trial, and this may create a bad precedent moving forward.

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