Resident Safety

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 Residents’ Rights

December 11, 2020 | Lebowitz & Mzhen

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.

Learning to Identify Warning Signs of Maryland Nursing Home Abuse or Neglect

November 11, 2020 | Lebowitz & Mzhen

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.

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.

The Danger of Heat Stroke for Maryland Nursing Home Residents

August 13, 2020 | Lebowitz & Mzhen

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.

Maryland Causes of Action in COVID-19 Nursing Home Cases

April 20, 2020 | Lebowitz & Mzhen

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.

Understaffing Poses Serious Problems in Maryland Nursing Homes

March 5, 2020 | Lebowitz & Mzhen

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.

Standards for Caring for Nursing Home Patients in Maryland

December 27, 2019 | Lebowitz & Mzhen

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.

Are Residents Permitted to Install Cameras In Maryland Nursing Homes?

December 21, 2019 | Lebowitz & Mzhen

Nursing home abuse, while unfortunately common, is often difficult to catch or prove. Often, the victims are seriously disabled and vulnerable, and they may be unable to tell someone about the incident or even remember the incident at all. If they do manage to tell someone, their credibility may be undermined by the nursing home itself, denying that the incident happened and blaming the victim’s disability for causing them to lie or imagine things. Because of this, more and more nursing home residents and their families are installing cameras in nursing homes to monitor interactions between staff and the resident and look for instances of abuse.

Sometimes, these cameras can be the sole reason why a negligent nursing home is held responsible for the abuse that occurs in their facility. For example, a recent Minnesota nursing home recently discovered a video of a caregiver physically and verbally abusing a severely disabled resident. According to a local news report covering the incident, the staff member taunted the resident with derogatory and humiliating language, calling them vulgar names and asking them “do you think you have a hole in your brain?” The video also shows the caregiver tapping the resident’s face “in a slapping-type motion.” Without the video, the incident may never have been uncovered; the resident is partially paralyzed and has lost the ability to understand or express speech, and it is highly unlikely that they ever would have reported it themselves.

Fortunately for Maryland residents, the state’s laws allow a resident, or their family with the resident’s permission, to place hidden video cameras in the resident’s room. These video cameras can increase transparency in nursing homes and make it easier to catch incidents of abuse when they happen. They can also make it easier to pursue a resulting personal injury claim against the nursing home. Many personal injury cases against nursing homes likely would not have been won without video evidence, since the nursing home generally denies that any abuse occurred, and it can be difficult without hard evidence for plaintiffs to prove otherwise. Maryland is one of only a handful of states that allow video camera installation in nursing homes, and the nursing home industry actively fights against similar laws in other states.

Nursing Home Compare Website Adds Abuse Warning Icon, Upsetting Maryland Nursing Homes

December 16, 2019 | Lebowitz & Mzhen

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.