Articles Posted in Resident Safety

Nursing home abuse and neglect have become endemic nationwide, and the mid-Atlantic region has been affected especially hard. Overworked employees, ineffective laws and regulations, and a profit-driven motive all contribute to instances of nursing home abuse and neglect. To ensure that their loved ones are being cared for appropriately and remain safe, some families have chosen to put surveillance cameras in their loved ones’ rooms so they can check up on them remotely. Placing a camera in a room may also preserve any possible evidence in the event of alleged abuse and neglect.

Maryland’s legislature enacted laws permitting and regulating the installation of cameras in nursing homes several years ago. A contemporaneously published national news report discussed the legislature’s reasoning for passing the law. According to the facts discussed in the news report, Maryland’s legislature was the first in the nation to pass a law that would allow nursing home residents and their families to install cameras in the resident’s rooms. Some nursing homes opposed the law, as it would result in more accountability and possible liability for any issues, but the legislature and elder health advocates stood their ground and the law was passed.

Are Cameras Allowed in Maryland Nursing Homes?

Under current Maryland law, nursing home residents and their families are allowed to place cameras in the residents’ rooms, but some conditions must be met. Both the resident and the nursing home must know of and approve of the camera. If a camera is not approved by a nursing home, whatever footage of abuse or neglect that is captured may not be admissible in a court of law. The laws in Virginia are substantially similar. Under these legal frameworks, it is essential for people seeking a nursing home for their loved one to confirm that they are allowed to place a camera in their room if they so desire.

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.

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.

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.

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