Articles Posted in Nursing Home News

As the coronavirus continues to spread across the United States, officials are tracking cases in nursing homes, where residents are at a heightened risk. According to a recent report, state officials have now reported at least 60 Maryland nursing homes and senior living facilities have confirmed coronavirus cases in the state. There have been six deaths at one facility in Mount Airy. Health officials have reported that 147 nursing homes across 27 states have at least one resident with coronavirus, according to one news report.

The Centers for Disease Control and Centers for Medicare and Medicaid Services looked into the high fatality rate at the Life Care Center nursing home in Kirkland, Washington, where at least 35 residents or staff have died from the virus. CMS found that the center failed to quickly identify and manage sick residents, notify the state’s health department about the rate of respiratory infection among its residents, and failed to have an adequate backup plan when the facility’s primary clinician became sick.

Seniors are at a greater risk because they are more susceptible to complications from the virus, a CMS administrator said in a statement. People over 65 years old are at a high risk of serious illness and death from the virus, according to the CDC. CMS said it would enhance its inspection process for nursing homes in light of its findings.

Nursing homes fill an important role in today’s society; as the population ages and life expectancy increases, more and more Americans are placing their loved ones in nursing homes to care for them when they are no longer able to care for themselves. Unfortunately, not all nursing homes are safe for residents, and sometimes residents may suffer abuse or neglect from the individuals tasked with caring for them. While the federal government has regulations governing nursing homes and standards of care, the current administration has recently attempted to loosen these regulations, causing concern for Maryland nursing home residents.

The proposal to relax regulations governing nursing homes was introduced in July of 2019 but has been drawing particular attention recently due to the coronavirus. According to an article in the New York Times, the federal government’s proposed changes would loosen regulations established during the Obama administration meant to curb deadly infections and diseases in nursing homes. Specifically, the rule would eliminate the requirement that nursing homes employ at least one specialist in preventing infections. Infection-prevention specialists are currently supposed to be at all nursing homes in the country, ensuring that employees are washing their hands and following other safety procedures. Their role is considered especially important when considering that, every year, about 380,000 nursing home residents are killed by infections.

While this proposed change is of concern even without the current pandemic, the coronavirus illustrates the vulnerability of nursing homes to infectious diseases. For example, one nursing home in Washington state has lost 13 residents to coronavirus, and dozens of other residents and employees have gotten ill. National reports indicate that the elderly are particularly susceptible to the coronavirus, with a significantly higher death rate than the general public. Additionally, those living in nursing homes are less able to practice social distancing, increasing their risk. Thus, advocates are urging the federal government to withdraw the proposed changes, which could lead to increased medical neglect, less infection control, and more illnesses and deaths in nursing home populations.

Individuals across the world are beginning to experience the devastating impact of Covid-19, commonly known as the novel coronavirus. The new strain of the virus has been identified in every state and is linked to the death of over 150 U.S. residents. Out of these deaths, at least 40 are connected to a single nursing center in Washington, and residents of other long-term care facilities. The widespread exposure throughout these nursing facilities shines a light on the fundamental problems nursing homes have containing the spread of disease. Maryland nursing homes should take the necessary precautions to limit the spread of these types of fast-spreading diseases and infections.

The coronavirus shares some similarities to the flu in that it quickly spreads through person-to-person contact or through respiratory droplets. Further, although the flu can be severe and have high rates of mortality, experts have years of studying the flu and generally know what to expect each season. In contrast, relatively little is known about the new virus and the diseases it causes. However, it is clear that, like the flu, the disease is highly contagious and spreads quickly.

Maryland nursing homes should follow the Center for Disease Control (CDC) recommendations for preventing the spread of disease. These diseases thrive and spread quickly in confined spaces, such as, assisted-living facilities and long-term care facilities. Healthcare workers must follow strict procedures to prevent serious illnesses, injuries, and deaths to their residents. Nursing home workers should practice proper hand hygiene, wear protective equipment, restrict visitors from contacting infected patients, and prevent infected healthcare staff from contacting patients. Nursing homes that do not engage in these practices may be responsible for the spread and consequences of a virus.

With the population aging and life expectancies increasing, nursing homes are becoming a part of more and more Maryland residents’ lives. Although many Maryland nursing homes offer quality care and safe facilities, nursing home abuse and neglect are still persistent problems across the state. It can be difficult to know the risk of this type of abuse and neglect when choosing a nursing home. While there may be warning signs to look for – such as past instances of abuse, or unclean or unsecure facilities – there are some cases where a seemingly fine nursing home may make decisions that then lead to abuse and neglect. Specifically, facilities that fall into financial trouble may cut staffing in the home, leading to new problems in a previously fine home.

For example, one nursing home was recently cited by the Centers for Medicare and Medicaid Services for making staffing decisions that led to several dangerous incidents. According to a news report covering the story, the home, which once operated seemingly without issue, suffered financially in recent years, leading them to cut staffing to save money. These personnel cuts led to an increase in quality-of-care violations cited by state regulators, with six violations in 2017 that jumpted to 22 in 2018 and 36 in 2019. The incidents included not having portable liquid oxygen tanks for patients who needed them, hiring an unlicensed caregiver, allowing a kitchen worker to supervise the dementia ward, and multiple instances of sexual abuse and medication errors. Additionally, inspectors found that the home, because it was short-staffed, was unable to adequately respond to residents’ requests for assistance. Some residents reported soiling themselves as they waited 40 minutes for someone to come to help them.

Incidents like these, which were particularly bad at this specific nursing home, unfortunately happen in facilities all across the country. Oftentimes, the patients are extremely vulnerable and frail, and may be unable to defend themselves or even tell someone else what is happening. Because of this, it is particularly difficult to catch nursing home abuse and neglect. When it is identified and caught, however, the state law allows the victims and/or their loved ones to file a suit against the home and hold them accountable for their actions. These suits may be difficult but can result in significant monetary compensation for those who have been harmed as a result of negligent staffing or other negligent actions performed by the nursing homes.

Each year, more states enact laws that allow for cameras in nursing homes and assisted living homes, which provide much-needed protection for residents. The laws allow residents and their families to place cameras in the residents’ rooms. In 2003, Maryland enacted a law requiring the Maryland Department of Health and Mental Hygiene to develop guidelines for electronic monitoring. Under those guidelines, the state currently allows electronic monitoring in Maryland nursing homes with resident consent—but only if the nursing home allows it.

Meanwhile, other states continue to enact electronic monitoring laws, many that provide much greater protections to residents. According to a local news source, Minnesota recently passed an electronic monitoring law to protected elderly adults. The law, entitled the Elder Care and Vulnerable Adult Protection Act of 2019, took effect on January 1, 2020. A state ombudsman said that electronic monitoring is a right included in the state’s Home Care Bill of Rights.

The law was advocated for by families whose loved ones were abused or mistreated. Under that state’s law, there is a consent form required in order to obtain the monitoring device. Providers such as nursing homes must tell residents about the law and have the forms available to use. Consent is required from all people living in the same room. Before the law was enacted, according to the ombudsman, residents and their families were installing cameras, but there was nothing to stop others from removing the cameras. Under the new law, residents there can install cameras without letting the providers know.

The Centers for Medicare and Medicaid Services (CMS), an agency that oversees Medicare and Medicaid and works to identify and eliminate nursing home fraud and abuse, recently released a memorandum detailing their 2020 priorities. These updated priorities are important for Maryland families to understand, as they affect the rights of nursing home residents as well as a resident’s ability to recover in case of nursing home neglect or abuse.

One of the major updates included in the 2020 memorandum concerns arbitration agreements. Arbitration agreements, if signed, require an injured nursing home resident to settle disputes with the home through a confidential arbitration process, rather than in court. This process operates privately, and while it is much faster than traditional litigation, plaintiffs lose any right to appeal and evidence shows plaintiffs are more likely to lose in arbitration. CMS’s recent memorandum states that the agency will allow nursing homes to use binding arbitration agreements with their residents, but that such agreements cannot be required as a condition of receiving care. For instance, if a resident refuses to sign the agreement, nursing homes cannot refuse to care for them solely on that basis. Additionally, CMS indicated in the memorandum that nursing homes must also explain to residents or their representatives that they can still receive care without signing.

CMS also stated that it plans to make changes to how instances of abuse and neglect are reported and investigated. For instance, new guidelines released later this year may include changes in the time frame required for investigations, the collection of certain evidence and investigative report, and general new policies and procedures to be implemented in nursing homes to catch instances of abuse.

Abuse and neglect are serious problems in Maryland nursing homes, and incidents can lead to physical and psychological injuries, and even premature death. Maryland law allows victims or their families to file lawsuits against negligent nursing homes when incidents occur, but many residents may be waiving that right without knowing it.

The use of mandatory arbitration agreements in nursing home contracts forces an injured resident to settle disputes with the nursing home through a private and confidential arbitration process, rather than in court. According to a recent news report, last month, two Congressional representatives introduced a bill that would ban nursing homes from requiring or asking residents to enter into mandatory arbitration agreements when moving into a home.

The use of arbitration by nursing homes has been a hotly debated topic. Advocates say that the process is speedier and less costly for abuse and neglect victims, while still allowing them a chance to receive the same financial compensation and other remedies available in court. Critics, on the other hand, claim that mandatory arbitration forces victims to give up their right to a day in court, allows negligent nursing homes to get away with abuse without hurting their reputation, and is unfairly biased against victims, especially since the nursing homes are repeat players who can form relationships with arbitrators.

Nursing homes must meet certain standards in caring for their residents. The standards that must be met vary, depending on the jurisdiction and the local laws and regulations. Generally, the standards require that a nursing home must provide its residents with a safe environment and that it must exercise reasonable care in caring for its residents. In a Maryland nursing home abuse or neglect case, a plaintiff must show that the nursing home failed to meet its duty in properly caring for the resident under the circumstances. Courts may use different standards, such as national standards set forth for nursing home care and a nursing home’s internal policies.

Many nursing home cases involve neglect rather than intentional abuse. Examples of potential neglect include unsanitary living conditions and poor personal hygiene, which can cause sicknesses, especially to residents who are often already sick and elderly.

Almost 35,000 people die each year from drug-resistant infections, according to recent data from public health officials. The latest projection of deaths in the country is double the previous estimates, revealing the prevalence of drug-resistant infections, as one recent news source reported.

More Maryland families are searching for nursing homes for their loved ones. Many utilize the Nursing Home Compare website run by the Centers for Medicare and Medicaid Services (CMS), which offers information on certified nursing homes across the country. The website allows families to compare how nursing homes rank for health inspections, staffing, resident care, and more. In October, CMS announced an addition to the website to better inform consumers about nursing home abuse:  adding a new abuse warning icon – a red circle with an open palm – next to the names of nursing homes with a history of abuse or neglect.

The plan sparked immediate backlash and controversy, with advocates from the long-term care industry speaking out against the new icon. According to a new article covering the controversy, leaders from AMDA (the Society for Post-Acute and Long-Term Care Medicine) have called the new icon “misguided,” arguing that it will actually be counterproductive to patients and will negatively affect the motivation of staff members in nursing homes. A spokesperson from the American Health Association even called the red hand “dumb,” arguing that it is overly punitive and may improperly lead consumers away from quality nursing homes.

The government and supporters of the icon stand by their belief that the icon is beneficial to consumers. The CMS administrator wrote in October that the icon puts “critical information at consumers’ fingertips, empowering them and incentivizing nursing homes to compete on cost and quality.” Opponents, in response, argue that the icon could make consumers not even consider certain nursing homes, even if the abuse was long ago and resolved appropriately. Additionally, nursing homes without icons may be discouraged from reporting new incidents of abuse, out of fear of earning an icon on the website. Instead of an icon, opponents argue that the best way to end nursing home abuse is to encourage reporting of incidents.

Across the country, approximately 1.4 million elderly or disabled individuals receive care in over 15,000 nursing homes. While many of these nursing homes take great care of their residents, a recent study from the U.S. Government and Accountability Office (GAO) finds that, unfortunately, nursing home abuse still occurs with some regularity. Because residents often have physical or mental disabilities and limitations, they are some of the most vulnerable to abuse. Maryland residents should be aware of potential issues of abuse when choosing a nursing home for themselves or a loved one.

The GAO’s report found that citations of nursing home abuse more than doubled between 2013 to 2017, with a particularly significant increase in severe cases of abuse. Importantly, the report also found gaps in the oversight of nursing homes. The Centers for Medicare & Medicaid oversee a program with state agencies to monitor nursing home safety, but their ability to do so may be limited for several reasons. First, state agencies who survey nursing home abuse typically do not note abuse and perpetrator time, meaning the Centers for Medicare & Medicaid may not have a complete picture of who is committing the abuse, or what type is most common. Second, when nursing homes report incidents, they typically lack vital information, which often delays state agencies’ investigations. And third, the GAO found gaps in the Centers for Medicare & Medicaid’s processes for referring incidents of nursing home abuse to law enforcement, which can slow down investigations and make it harder to end abuse in the homes overall. The GAO, finding these problems, also made recommendations to the Centers for Medicare and Medicaid on how they can fix them and improve the safety of nursing homes and the processes for dealing with abuse.

Cases of abuse in Maryland nursing homes, which can include medical neglect or physical, verbal, or sexual assault, can cause intense emotional distress and trauma for the victim and their families, not to mention medical bills for past and possibly continuing care. While the GAO’s report may hopefully lead to increased safety in Maryland nursing homes, there will, unfortunately, still be tragic instances of abuse. If tragedy does strike in a Maryland nursing home, state law allows the victim, or their family, to sue the home for negligence. The money won in a suit, while it can never undo the damage done, may help the recovery and healing process.

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