Nursing Home News

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.

COVID-19 Pandemic Exposing Dangers of Maryland Nursing Home Abuse and Neglect

October 6, 2020 | Lebowitz & Mzhen

It’s no secret that the COVID-19 pandemic has had an especially large impact on nursing homes, where tens of thousands of residents and staff members have gotten sick and even died. Because nursing homes combine communal living and vulnerable individuals, and because they often have high rates of abuse and neglect, the COVID-19 pandemic has hit those living in a nursing home particularly hard. In some homes, hundreds of residents have caught COVID-19, with dozens dying. The pandemic is thus raising concerns for Maryland families who have placed family members in nursing homes; many are fearful that nursing home abuse and neglect could be fatal for their loved ones.

In some cases, the situation has gotten so bad that the FBI has been sent to raid nursing homes with a high number of COVID-19 cases. According to a recent news report, two Pennsylvania nursing homes were raided and searched just last month by investigators from the FBI, as well as the state attorney general’s office and other agencies. This followed concerning reports of deeply troubling conditions and practices, including a lack of trained nurses, filthy living conditions, and lax sanitation protocols. Data from the State Department of Health shows that 447 residents and staff members tested positive for the disease as of early September, and 73 people had died.

Tragically, this example is just one of many nursing homes across the country, failing to keep their residents safe during a deadly pandemic. But it is important to know that many of the issues leading to the spread of disease were present even before COVID-19 began spreading through the United States. Nursing home abuse and neglect is not new, but COVID-19 is showing just how widespread and deadly it can be. While there have been reports of unsanitary and even filthy living conditions at Maryland nursing homes before, the lack of sanitation is especially apparent when a contagious disease is spreading through the facility. The same is true for medical neglect: a long-standing issue at many facilities, but even more deadly during the pandemic. Even just carelessness on the part of the staff—not wearing a mask at all times, failing to wash their hands regularly—now has an incredibly large impact on the safety and well being of nursing home residents, many of whom require constant care and are unable to move out and care for themselves.

Maryland Nursing Homes Are Still Being Hit Hard by Coronavirus

September 28, 2020 | Lebowitz & Mzhen

Nursing homes continue to be hit hard by the coronavirus. Across the U.S., over 40 percent of deaths in the country are linked to nursing homes. In Maryland nursing homes, the numbers are even higher. As of September 25, there have been 2,146 deaths across the state in nursing homes, group homes, and assisted living facilities, which accounts for 57% of the total deaths in the state. Maryland has seen 753 resident deaths and 7 staff deaths during the week of September 23.

According to a recent news report, one nursing home in Sykesville, Maryland is facing hundreds of dollars in fines after the state found it failed to isolate residents and notify staff during an outbreak. For example, the facility moved an exposed resident to a room with a negative resident, who both later tested positive. Some newly admitted residents also were not isolated, despite having sufficient rooms to do so. Maryland nursing home residents may be able to take action against the facility based on its failure to protect and properly care for residents.

Other states have explored solutions to mitigate the spread of COVID-19 in long-term care facilities. As one news source reported, in New Mexico, the state worked with a healthcare operator to set up a nursing home that it dedicated to treating long-term care patients infected with the coronavirus. It was set up to reduce the spread of COVID-19 in long-term care facilities in the state. Deaths in nursing homes in New Mexico make up 34% of the total deaths in the state.

Maryland Nursing Home Abuse and Neglect May Be More Common at For-Profit Nursing Homes, New Study Finds

September 21, 2020 | Lebowitz & Mzhen

When someone is searching for a Maryland nursing home to place a loved one, it’s likely that a facility’s status as for-profit or non-profit is not high on the list of priorities. Typically, the difficult decision of where to place a loved one who needs part- or full-time care is made based on location, price, and the services offered. Many families may not even think to look into the for- or non-profit status of the facility, instead prioritizing finding a place nearby where their loved one feels safe, or perhaps even knows people already there.

However, a recent study might make Maryland families rethink their priorities when searching for a nursing home. According to the study, senior residents in for-profit nursing homes are almost two times as likely to have health problems linked to poor care, compared to those living in non-profit homes. Additionally, among residents studied at for-profit homes, there were more clinical signs of neglect, such as dehydration in clients with feeding tubes, broken catheters, bedsores, and improperly managed medications.

The leading researcher in charge of the study believes the results show that more oversight is needed in nursing homes, especially for-profit homes. However, the U.S. government is currently considering rolling back existing regulations meant to protect nursing home residents. The existing regulations were put into place to improve resident safety and well-being, to prevent nursing home neglect and abuse, and to improve reporting systems when neglect and abuse do happen. Tragically, the last part is very important—incidents of nursing home abuse and neglect often go unreported, as residents may either be too frail and ill to understand what is happening to them, or may fear retaliation if they report.

Maryland Nursing Homes Were Unsanitary Before The Pandemic, Now COVID-19 Is Making Matters Worse

August 27, 2020 | Lebowitz & Mzhen

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.