Articles Posted in Nursing Home News

Most seniors in the United States are not financially independent, and at least partially rely on federal programs to help them to pay for health care, housing, and other expenses. Because the federal government finances so much of the senior care in the U.S through the Medicare and Social Security programs, the Federal Government has control over the quality of care given to seniors who are patients at facilities that accept Medicare payments. The federal government often uses this regulatory power to require nursing homes to provide better care for their patients.

The Centers for Medicare and Medicaid Services, an administrative branch of the Federal government, recently released guidelines for nursing home care to address two areas of concern that have arisen in the past few years. Specifically, the CMS guidelines address issues with overcrowding in nursing homes and the lack of appropriate infection control measures being taken to protect patients and residents from infection. These new sets of guidelines wil go into force in October 2022.

Our national experience addressing the Covid-19 pandemic brought problems in nursing homes to the forefront of Americans’ attention. Overcrowded rooms, in conjunction with poor infection control measures, resulted in nursing homes becoming a hotbed for infection during the initial phase of the pandemic. These experiences have taught public health experts lessons, which are reflected in the new guidelines. The CMS established that nursing homes are required to have an infection control specialist staffed onsite at the nursing home for at least 8 hours per day. Additionally, the guidelines encourage nursing homes to limit occupancy in rooms to two residents per room. If properly followed, these new guidelines should protect nursing home residents from avoidable infection.

When we send our loved ones to nursing homes, we expect them to be taken care of by properly licensed, professionally trained, and caring staff members. After all, many of our elders and loved ones have complex health needs that require regular attention and care that nursing home staff members are specifically trained and equipped to address. When these facilities fail to conduct reasonable diligence into ensuring the quality of their staff, however, this lack of care can potentially result in injury to our loved ones.

According to a recent news report, a recent government investigation into issues surrounding nursing homes uncovered a registered nurse working while her license was suspended. The woman was arraigned recently on felony charges after the investigation found that she tampered with vials and syringes containing substances she knew were intended for patients who required pain relief in the critical care unit. She removed the original substances from the vials and syringes, replaced them with another liquid, and returned the containers. The incident remains under investigation, but officials noted that the woman had a previous criminal history while working as a nurse as well.

Unfortunately, Maryland is no stranger to similar incidents, especially in nursing homes. Long-term care facilities have a responsibility both to their residents and to the community to exercise reasonable diligence when hiring professional staff to care for vulnerable and elderly residents. When a facility fails to do so, its lack of care could constitute negligence. When the nursing home fails to protect its residents as the first line of defense when hiring staff, it could be held responsible for any subsequent injury that takes place.

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.

What Can Lead to A Medical Malpractice Case Against a Nursing Home?

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.

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.

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.

How Common Is Nursing Home Abuse in Maryland?

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.

For years, policymakers have known about the pervasive presence and impact of nursing home abuse in America. Recently, a bipartisan federal investigation revealed that lacking care for seniors has been disproportionately clustered within less than five percent of the nation’s nursing home facilities.

According to a recent article, poor nursing home care has been clustered among facilities listed under the Special Focus Facility (SFF) program. Facilities listed under the SFF program include the country’s worst-performing institutions, which “substantially fail” to meet basic care standards required by the federal government. Some commentators have noted that SFF nursing homes are considered “repeat offenders” who have a “pattern of neglecting and harming vulnerable residents.” Until recently, landing on the SFF list was shameful—but without proper enforcement or rehabilitation mechanisms in place, many facilities have not been held accountable.

To combat the issue, however, policymakers are stepping up to the plate. Legislative action from Congress could improve and expand quality care in nursing homes not just in Maryland but across the country. A new bill known as the Nursing Home Reform Modernization Act of 2021 proposes to expand the list of monitored facilities, increase resources for facilities that are underperforming, and establish an independent Advisory Council to inform federal agencies how to provide the best care possible and evaluate nursing home facilities.

Nursing home residents in Maryland deserve to live in a safe and sanitary environment free from abuse and mistreatment. If abuse or certain other incidents occur at a Maryland nursing home, the nursing home is required to report the incident to the state. Facilities that receive federal funding must abide by federal regulations, and under federal regulations, a facility is required to report all allegations of mistreatment, neglect, or abuse, including injuries of unknown sources, and misappropriations of resident property. Incidents must be reported to the state within 24 hours. Maryland nursing homes are required to investigate all allegations of abuse and reports from investigations must be reported to Maryland’s Office of Health Care Qualify within five working days of the alleged violation.

Do Maryland Nursing Homes Have a Duty to Stop Abusive Staff Members?

Yes, Maryland nursing homes are required to have policies and procedures in place to keep residents safe and free from abuse. Abuse can include physical and mental abuse, exploitation, or neglect. This includes abuse conducted by staff members as well as other residents. Facilities that fail to report abuse are subject to fines and other sanctions. Victims of abuse may be able to receive financial compensation through a Maryland nursing home claim.

Nursing Home Faulted for Failing to Report Suicide Attempt

Recently, a nursing home was cited after it failed to report a suicide attempt as required. According to one news source, the facility reportedly failed to report a suicide attempt in which the resident had attempted to wrap sheets and cords around their neck. No internal investigation was conducted and the facility failed to report the incident to the health department as required. The recent inspection also revealed that a staff member borrowed $200 from a resident, which was also a violation. The staff member was supposed to repay the money in monthly installments and when the staff failed to make a payment, the resident complained to the facility. Yet, the facility failed to report the misappropriation of the resident’s money. The facility was also faulted for failing to report physical abuse among residents and failing to provide enough supervision and assistance to prevent accidents among residents. The facility was placed on a government list of the nation’s worst nursing homes earlier this year which included 86 nursing homes across the U.S.

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Even if a family has to rely on a nursing home to care for a loved one, the resident still has rights that must be protected by the facility. Maryland nursing home residents have the right to live in a safe environment, free from abuse and neglect. Abuse includes physical and sexual abuse, as well as mental abuse and verbal abuse. Residents also have the right to participate in their health care and treatment to the extent possible. They have the right to consent to or refuse treatment and to be fully informed in advance about treatment and any proposed changes in treatment. They have the right to privacy to make private phone calls and to write and receive mail that will not be opened by anyone else.

Which Government Entity Oversees Maryland Nursing Homes?

In Maryland, the state’s Office of Health Care Quality monitors care in health care facilities across the state. Anyone who suspects abuse or neglect should report it to the Department of Health’s Long Term Care Unit. Federal regulations also require nursing homes to have policies and procedures in place to prevent abuse, neglect, and exploitation and to investigate and report allegations of abuse. But even in cases where no charges are filed against the facility or staff members, injured residents or their families may be able to file a Maryland nursing home lawsuit against the facility. In a negligence case, a plaintiff must demonstrate that the nursing home failed to meet its duty to adequately care for and protect the resident from abuse. Examples of nursing home neglect cases are failing to maintain sanitary living conditions and failing to maintain a resident’s personal hygiene, which can cause serious illness in some residents.

The U.S. Nursing Home rating system was introduced twelve years ago, providing for ratings from one to five stars. It was meant to provide a way for people to evaluate and compare nursing homes for their loved ones. However, an investigation by the New York Times recently revealed that the rating system is not an accurate reflection of the quality of care given at a nursing home. The investigation found that many nursing homes have manipulated the system to improve their ratings and hide problems, raising serious concerns for Maryland nursing home residents.

The rating system is based on a combination of self-reported information and on-site inspections. The investigation found that the information submitted to the Centers for Medicare & Medicaid Services (C.M.S.) is often wrong, making facilities appear cleaner and safer, and that the government rarely audits the data provided through self-reporting. Accidents and health issues are often unreported, it also found. Abuse and neglect were discovered through inspections at five-star facilities, but the inspectors rarely found the infractions serious enough to lower the ratings. A previously conducted study from the University of Chicago found that nursing homes did not report about 40 percent of residents who were hospitalized after serious falls.

It also found that the nursing homes were not prepared for the pandemic in part because the rating system allowed them to ignore staffing requirements and infection-control deficiencies. Over 13,000 nursing home residents have died due to COVID-19. The Times found that residents at five-star facilities were about as likely to die due to COVID as residents at one-star facilities. At some nursing homes with five-star ratings, “residents developed bed sores so severe that their bones were exposed.” The son of a resident at a five-star facility on Long Island who died from COVID-19 in the spring believed that the facility was short-staffed or overcrowded because before contracting COVID-19, his mother was moved from a private room into one with other residents.

Maryland residents who have loved ones in nursing homes have likely been particularly worried about their loved ones’ health, as well as nursing home abuse and neglect, during the COVID-19 pandemic. Due to the large numbers of people living in one area and the relative vulnerability of those living in nursing homes, it is perhaps not a surprise that the facilities have been hit particularly hard by COVID-19. Outbreaks have spread through nursing homes at alarming rates, and there are concerns that they have potentially been fueled by negligent staffing, medical neglect, and lack of proper sanitation procedures. Additionally, there have been high death rates of individuals living in nursing homes, with recent news revealing that those rates may have been undercounted.

Last month, New York State Attorney General Letitia James released a new report based on an investigation into nursing home policies that caused abuse and neglect and threatened the lives of residents and staff alike. One of the key findings in this report was that the number of nursing home deaths tied to COVID-19 has been undercounted by Governor Andrew Cuomo’s administration by as much as fifty percent.

Part of the problem that seems related to the fact that the state only counted residents who died on nursing home property, rather than including those who were transferred to a hospital. But the new report indicates that many deaths occurred in hospitals once residents caught COVID-19 in their nursing homes and were then transferred. For example, one facility reported five confirmed and six presumed COVID-19 deaths to the state’s Department of Health. But the same facility reported a total of 27 COVID-19 deaths at the facility itself and another 13 deaths in hospitals. Discrepancies like this were found in multiple nursing homes.

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