Nursing Home News

Federal Nursing Home Bill Could Improve Maryland Elder Care

September 30, 2021 | Lebowitz & Mzhen

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.

Combatting Poor Maryland Nursing Facility Outcomes

September 9, 2021 | Lebowitz & Mzhen

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.

Maryland Nursing Home Reporting Requirements

July 16, 2021 | Lebowitz & Mzhen

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.

What Rights Do Nursing Home Residents Have in Maryland?

April 27, 2021 | Lebowitz & Mzhen

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.

Nursing Home Rating System Masks Problems in Maryland Nursing Homes

March 18, 2021 | Lebowitz & Mzhen

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.

Could Maryland Be Undercounting Its Reports of Nursing Home COVID-19 Deaths?

February 3, 2021 | Lebowitz & Mzhen

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.

Why Are Nursing Home COVID Deaths Underreported?

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.

COVID-19 Complicates the Identification and Reporting of Maryland Nursing Home Abuse and Neglect

January 6, 2021 | Lebowitz & Mzhen

One of the reasons that Maryland nursing home abuse and neglect are so horrible is because they can fly under the radar for so long. Nursing home residents who are being abused or neglected may be cognitively impaired and not even understand what is happening to them, or have trouble letting other people know. Unfortunately, the COVID-19 pandemic has only exacerbated this problem, making it even harder for Maryland nursing home abuse and neglect to be identified and investigated.

The COVID-19 pandemic has hit nursing homes particularly hard, and many of them are hot-spots for the virus, with the unfortunate combination of group living and COVID-vulnerable residents. Extra precautions have been taken in many to prevent the spread of infection within the facilities, or from the facilities to the surrounding area. This led to the Centers for Medicare and Medicaid Services to halt on-site visits and surveys to state-run nursing homes, and, in general, investigators and those tasked with monitoring the facilities have not been able to enter nursing homes to respond to complaints.

Additionally, due to the COVID-19 pandemic, many nursing homes have restricted the visiting of residents. Before, family members played an important role in spotting nursing home abuse and neglect—they might notice red flags before anyone else. If they suspected that their loved one was being mishandled, not being given their medicine, or being underfed, they were able to report that concern or ask their loved one about it. But now, with COVID-19 concerns and restricted visiting hours and opportunities, family members may not be able to play this important role, and abuse and neglect might go unseen.

Maryland Nursing Homes Must Continue to Protect Residents as COVID-19 Vaccines Roll Out

December 24, 2020 | justia.admin

Many nursing home residents rightfully rejoiced this week as nursing homes began receiving vaccines for distribution. Long-term care facilities have suffered many of the COVID-19 deaths in the country. At least a third of COVID-19 deaths in the United States have been among residents and employees of nursing homes and other long-term care facilities. There have now been more than 20,000 cases of COVID-19 in Maryland nursing homes, group homes, and assisted living facilities and at least 2,200 resident deaths during the pandemic. Deaths in these facilities have accounted for about half of the state’s death toll.

According to a recent news report, CVS and Walgreens pharmacies are finally beginning to distribute COVID-19 vaccinations this week in the state’s long-term care facilities. Many residents are anxious to get vaccinated and end a long period of isolation from their families. Vaccinations have begun to be administered in facilities just as the conditions in the facilities have deteriorated again. According to the American Health Care Association and National Center for Assisted Living, there have been almost 20,000 cases and about 5,000 deaths per week in recent reports.

However, even as residents and staff are beginning to get vaccinated and celebrate this milestone, Maryland nursing homes and long-term care facilities must still take care not to spread COVID-19 in the facilities by relaxing precautions yet. Vaccinations are voluntary, so most nursing homes likely will not be able to vaccinate all residents and staff. Facilities may also have difficulty obtaining informed consent from patients who lack the capacity to make the decision on their own. Facilities will still have to protect residents who do not get the vaccine. In addition, it is not clear if the vaccine will be 95 percent effective among older people who are more vulnerable to disease in general.

Neglect in Nursing Homes Has Increased During COVID-19 Pandemic, Advocates Say

November 25, 2020 | Lebowitz & Mzhen

Although there has been significant attention given to the risk and prevalence of COVID-19 in nursing homes throughout the pandemic, the pandemic may be the cause other detrimental circumstances suffered by Maryland nursing home residents. According to one news source, advocates say that workers in nursing homes that are overburdened because of the pandemic have not been able to properly care for residents and that many are suffering as a result. Advocates say that there has been a surge of reports of neglect, including residents being left in dirty diapers until their skin peeled off and others with bedsores that cut to the bone. In addition, some residents’ mental health has significantly declined because of their prolonged isolation, which some believed led to their death. One expert estimated that for every two COVID-19 victims in nursing homes, another died prematurely due to other causes.

The numbers suggest that other residents who were lucky enough not to contract COVID-19, were also impacted—as staff attended to infected residents or because staff members were absent because they were infected themselves. A 75-year-old man became so malnourished and dehydrated that his weight dropped to 98 pounds. There were signs of an untreated urinary infection, poor hygiene, and that he was not getting the help he needed to eat. His son claims that the nursing home abandoned his father. An 83-year-old woman in another nursing home died from dehydration, according to her daughter. As COVID-19 spread throughout her facility, while she did not contract COVID-19 herself, staff members failed to ensure she was drinking enough fluids. Federal data reveals that almost 1 in 4 nursing homes report staff shortages now in 20 states.

What Rights to Maryland Nursing Home Residents Have?

A Maryland nursing home resident has the right to be free from abuse and neglect and live in a safe facility. A Maryland nursing home claim can be filed in cases where nursing homes or their staff have abused or neglected a resident. Some potential signs of abuse and neglect are bedsores, unexplained injuries, insufficient funds, and fear of certain persons. Signs of neglect may include poor personal hygiene, lack of mobility, unexplained injuries, unsanitary living conditions and inadequate security, physical symptoms from lack of nutrition, and psychological issues, including anger, resentment, and depression.

How Could a President Biden Affect Nursing Home Regulations in Maryland?

November 4, 2020 | Lebowitz & Mzhen

Maryland nursing homes must meet certain standards under state and federal regulations. They must follow state laws and regulations applicable to nursing homes. In addition, facilities that accept Medicare and Medicaid patients are also required to meet federal nursing home standards. Federal and state regulators ensure compliance by conducting surveys, visits, and investigations.

According to a recent news report, the Democratic candidate for president Joe Biden has said that he plans to spend $775 billion to expand community-based senior services if elected. He also wants to enact nursing home reform in the wake of the coronavirus pandemic. The current administration has generally maintained less oversight with a goal of reducing perceived paperwork burdens and focusing on public-private partnerships to tackle issues. For example, the administration plans to rely on retail pharmacies CVS and Walgreens to distribute a COVID-19 vaccine in nursing homes. The administration has proposed less frequent surveys of the highest-ranked nursing facilities to concentrate on “low performers.”

Biden has said he would make federal nursing home surveys more frequent and increase the current penalties to force compliance with federal standards. He also proposed requiring that each facility have a mandatory infection disease specialist, requiring the federal Department of Health and Human Services (HHS) to audit nursing home cost reports, and increasing personal protection equipment (PPE) supplies by invoking the Defense Production Act. The proposal also calls for restoring a previous ban implemented by President Obama on forced arbitration agreements for residents—a ban that President Trump reversed.