Articles Posted in Resident Safety

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.

All over the country, it seems every business has a “help wanted” sign posted. From restaurants to movie theaters to grocery stores, the COVID-19 global pandemic has left businesses of all types and sizes short-staffed.

Unfortunately, nursing home facilities have been no exception to this issue. Many nursing home workers and certified nursing assistants have reported feeling burnt out and exhausted, resulting in a mass exodus of departures from long-term care facilities around the country. In light of staffing shortages, however, who will take care of our elderly and most vulnerable?

According to a recent news report, an ambitious new initiative is training National Guard service members to become certified nursing assistants in their latest deployment at a large nursing home facility. The facility was hobbled by a major exodus of employees because of the COVID-19 pandemic, which resulted in the nursing home shutting down entire wings of the facility. As a result, neighboring hospitals have been able to send new patients to long-term care centers like this nursing home, which is already stretched thin because of its lack of staff.

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.

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.

Unfortunately, instances of abuse and neglect are far too common. The state of Massachusetts recently announced a settlement with a nursing home arising from allegations that the nursing home failed to adequately care for residents and failed to ensure that staff members were competent to provide services for residents. A state investigation revealed that between April 2018 and December 2019, the nursing home allegedly failed to adequately train staff members to properly care for certain residents, failed to have the proper equipment to care for certain residents, and failed to prevent the development of pressure ulcers on residents. The state also reached settlements with seven other nursing homes in 2019 after state investigations found that the nursing homes maintained procedures that directly caused the death, injury, or potential injury to residents.

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.

Nursing home residents may feel as though they have lost the ability to make decisions for themselves and that they have no rights when they enter a facility. This may be particularly true during the COVID-19 pandemic, when many nursing homes have limited the movement of residents and while many facilities struggle to meet resident needs. However, all Maryland nursing home residents have rights and legal protections, even during a pandemic.

Maryland’s Office of Health Care Quality monitors the quality of care in the state’s health care facilities. Under Maryland law, suspected abuse of assisted living residents must be reported to the Office of Health Care Quality. Reports of abuse can be made at 877-402-8219. Maryland’s Department of Health Long Term Care Unit investigates complaints of abuse and assists with the prosecution of abusers.

Under the Code of Maryland Regulation 10.07.09.08, Maryland nursing home residents are afforded some of the following basic rights.

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Many Maryland families will one day make the decision to place a loved one into a nursing home, if they have not already. As the population ages, nursing homes are becoming more and more necessary for individuals who can no longer care for themselves and need assistance in their daily activities. While many residents may have pleasant experiences in their nursing homes, the tragic fact is that nursing home abuse and neglect are still common occurrences in Maryland and nationwide. In fact, one survey of nursing home residents showed that up to 44% of them had been abused at some point, and almost 95% had witnessed someone else be neglected. Despite its prevalence, this abuse and neglect might sometimes fly under the radar, especially when the resident victims are ill, confused, and unable to report it themselves.

Thus, unfortunately, the onus may be on family members to identify abuse or neglect in nursing homes. In some situations, the signs will be subtle, or easily written off as something else. Still, family members should, when visiting their loved ones in Maryland nursing homes, pay close attention to some “red flags” that may indicate abuse or neglect.

Some of the signs are situational—what are the living conditions like? Unsanitary conditions in the residence may be a sign of general neglect. Other signs have to do with resident behavior. Does the resident act oddly when staff members are around? Do they have sudden unusual behaviors, such as a fear of being touched or extreme irritability? Lastly, the physical condition of the resident can shed some light on the situation. Unexplained bruises, cuts, or other injuries should definitely raise concern, as should poor hygiene, sudden weight loss, falls, fractures, or infections.

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.

During the hot and humid summer months in Maryland, nursing homes have a responsibility to keep temperatures under control within the facilities in order to keep residents safe and healthy. Older adults are more susceptible to heat-related health issues. As a result, Maryland nursing homes should monitor residents for signs of heat exhaustion and heatstroke and if a resident exhibits symptoms, the facility should immediately check for heat-related health issues and treat residents. A facility’s failure to do so may result in the facility being liable for any resulting injuries.

Heat exhaustion is when a person overheats and can lead to severe heatstroke. Heatstroke can occur when the body temperature rises to 104 degrees or higher. Heatstroke requires emergency treatment, and if untreated, it can affect a person’s brain, heart, kidneys, and muscles. If treatment is delayed, the damage to the body increases, and serious injuries and death are more likely to occur.

A person experiencing heatstroke may exhibit symptoms of confusion, slurred speech, seizures, vomiting, a racing heart rate, and other symptoms. Once someone begins to experience these symptoms, they need to be cooled down immediately, for example, by putting the person in a cool tub of water. Heatstroke as a result of being exposed to a hot environment (as opposed to heatstroke caused by engaging in strenuous activity) is most common among older adults and those with chronic illness, such as heart or lung disease.

There are different causes of action that an individual may be able to bring in a COVID-19 Maryland nursing home case, depending on the circumstances. Causes of action in a Maryland nursing home case can include negligence, wrongful death, battery, false imprisonment and infliction of emotional distress.

Negligence is among the most common causes of action. Generally, in a Maryland negligence claim, a plaintiff must show that a defendant owed the plaintiff a duty, the defendant breached that duty, the plaintiff suffered an injury or loss, and the damages proximately resulted from the defendant’s breach of the duty. In a Maryland nursing home case, a nursing home may be liable for negligence if the home was negligent in caring for the resident, in failing to keep the resident safe, or in another way. For example, failing to segregate a positive COVID-19 resident, to inform other residents, to test symptomatic residents, or to require staff to wear protective gowns and masks might be potential cases of negligence.

Wrongful death claims are another common cause of action in nursing home cases. In the tragic event of the death of a nursing home resident, a nursing home may be liable for the wrongful death of the resident. Wrongful death claims brought under Maryland’s Wrongful Death Act allow claims against a defendant “whose wrongful act causes the death of another.” In COVID-19 cases, these claims would likely be brought for similar reasons as a negligence claim.

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.

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