For several years, we have written about Maryland nursing home abuse and neglect cases, which can have tragic consequences for residents and their families. Unfortunately, instead of the situation improving, some reports suggest that the COVID-19 pandemic could be making the situation worse, as thousands of residents are passing away in nursing homes, potentially due to negligent care. Any facility that has a large number of residents living in one community can be dangerous during the pandemic, and more than 37,000 residents in nursing homes have died since early March, raising concerns of inadequate protections or staffing.

Recently, ABC News reported in-depth on the issue. The article detailed the story of seven daughters who decided to move their father, a former corrections officer, into a Maryland nursing home this past February. Unfortunately, within three months of being in the home, their father died after testing positive for COVID-19. But before he died, he was in a severe condition, leading his daughters to believe that inadequate care at the nursing home may have contributed to or even caused his death. One daughter reported that, when her father originally went to the hospital (weeks before he died), the hospital staff told her that her father had lost 30 pounds and that he was so dehydrated “his blood was like mud.”

Typically, when someone is injured due to negligence or abuse in a Maryland nursing home, they have the ability to bring a personal injury lawsuit against the facility to recover for medical expenses, pain and suffering, and more. However, Maryland is one of the several states across the country that has laws in place to protect healthcare providers during a declared public health emergency. Now, during the COVID-19 pandemic and its severe effect within nursing homes, Congress is considering instituting similar protections for nursing homes. This could be a major barrier for plaintiffs who want to bring claims against nursing homes, making these suits an uphill battle. Supporters of the measures claim they protect nursing homes from frivolous claims against them, but critics point to how important it is that families affected by a nursing home’s negligence have an avenue of relief.

On several occasions, we have written about arbitration clauses in Maryland nursing home abuse and neglect cases. An arbitration clause is an agreement, typically within a nursing home resident’s contract or the papers required to sign when moving in, that says any disputes that arise will be handled through arbitration rather than through litigation. Arbitration proceedings are confidential and final, and the agreements mean that residents have signed away their right to sue the nursing home in court if they suffer abuse or neglect at their hands. Arbitration tends to be favored by nursing homes because it costs them less, the outcomes tend to be more favorable to the nursing home, and they can avoid bad publicity.

In a recent opinion, a state appellate court considered the validity of arbitration agreements even when the organization listed in the agreement as the arbitrator was no longer hearing cases. The case sheds light on how arbitration issues might play out in Maryland. According to the court’s written opinion, the plaintiff placed her husband in a nursing home and signed an arbitration agreement that all disputes would be solved by arbitration in accordance with procedures from the National Arbitration Forum. However, the National Arbitration Forum decided in 2009 that it would no longer get involved in consumer disputes. So, when the plaintiff’s husband died, and the plaintiff sued the nursing home for negligence and wrongful death, she argued that the contract language requiring arbitration was impossible to comply with, and thus invalid. The district court agreed with her, holding that the case could proceed through the court system as though no arbitration agreement was ever signed.

However, on appeal from the nursing home, the appellate court found that the agreement was enforceable despite the forum being unavailable to arbitrate the dispute, and that the forum-selection language in the agreement was incidental, not central, to the contract. As such, it found that the nursing home did not mean that only the National Arbitration Forum could arbitrate agreements. The plaintiff thus could not sue the nursing home in court, but rather had to go through arbitration with a different arbitrator.

When someone sends a family member to live in a Maryland nursing home, they trust that the facility and individual staff members will keep their loved one safe. However, incidents of assault in nursing homes contribute to a significant portion of claims of nursing home abuse in Maryland, and staff members who cause these harms should be held accountable for their actions. Maryland caregivers who work closely with seniors should never exploit their position or access to residents for personal reasons.

According to a recent news report, a former nursing assistant was sentenced to a year in prison after pleading guilty to charges related to abusing seniors in a nursing home. The investigation revealed that the staff member had inappropriately touched several residents in an assisted living center, and was facing multiple charges, including second-degree rape of a frail, elderly, or vulnerable individual, and two counts of fourth-degree assault with sexual motivation.

Although officials believe that there were likely other victims in the nursing home, the perpetrator was only charged with the assault of four seniors because the others had either passed away or were no longer able to provide statements, due to their age and condition. In addition to prison time, the staff member was fired from his job and had his nursing assistant license revoked. He will also serve 18 months of community custody, will be required to obtain a sexual deviancy evaluation, and is barred from having any contact from individuals in similar care facilities or nursing homes.

Claims of Maryland nursing home abuse often focus on abuse by staff members—but abuse by fellow residents occurs as well. Residents may be charged and convicted of crimes in some cases, but the facility may be liable for its role in the abuse as well.

Residents in Maryland nursing homes deserve to be treated with dignity and respect and to live in a safe environment. This means that nursing home facilities must have proper policies and procedures in place and adequate staffing to reasonably protect residents. Although a facility cannot ensure the safety of every one of its residents, some incidents are avoidable if proper measures are taken. A facility may be liable, for example, if a staff member failed to do routine checks or failed to protect other residents from a known violent resident.

A study conducted by the National Consumer Voice for Quality Long-Term Care found that almost twenty percent of residents in the study experienced resident-on-resident abuse. The study also found that resident-on-resident abuse often occurs and escalates specifically because staff members are absent. Residents involved in resident-on-resident abuse were more likely to be younger, less cognitively impaired, less physically impaired, display disturbing behaviors, live in a dementia special care unit, and white. The National Long-Term Care Ombudsman Resource Center recommends adopting a person-centered approach to prevent resident-to-resident abuse incidents, by identifying and documenting incidents and developing individual strategies.

Nursing homes in Maryland are required to meet certain standards under federal and state regulations. For example, Maryland nursing homes must meet state laws and those facilities that accept Medicare and Medicaid patients must also meet federal standards. The Maryland Department of Health’s Long Term Care Unit ensures that state and federal standards are met by conduct site visits, surveys, and investigations.

A nursing home may be liable for injuries to a resident if the home fails to follow federal and state regulations or if it fails to adopt and maintain adequate policies and procedures. Many nursing homes have been criticized for their responses to coronavirus and failures to take adequate measures to protect residents by, for example, failing to quarantine sick residents or to have their staff wear protective equipment. The U.S. Centers for Medicare and Medicaid Services issued specific COVID-19 guidance in March.

If a Maryland nursing home resident becomes sick with COVID-19, the resident may be able to sue the facility for negligence or wrongful death if it failed to adequately protect residents or if it failed to properly care for the resident. A plaintiff in a Maryland nursing home case must show that the nursing home failed to meet its duty to provide adequate care for the resident based on the circumstances.

Maryland’s confirmed COVID-19 cases among residents in Maryland nursing homes and assisted-living facilities have continued to rise over the past weeks. As of May 16, 2020, there are now 5,329 confirmed resident cases and 984 confirmed resident deaths in the state. As cases grow, stories of neglect and substandard care in facilities have also continued.

In one nursing home in northern New Jersey, at least 53 residents have died from COVID-19. According to one news source, the nursing home, Andover Subacute and Rehabilitation Center II, had one of the largest outbreaks in the state, one of the hardest hit in the nation. Federal and state inspectors began investigating the 543-bed facility after police found 17 bodies piled in a morgue after receiving an anonymous tip that a corpse was stored in a shed. A federal inspection report was released detailing the state of the nursing home, which shows how the pandemic has overtaken nursing homes across the United States. The report’s findings include that one patient was found dead in bed after suffering from a high fever for days—after staff failed to notify a doctor of the patient’s fever. In addition, sick residents who were tested for coronavirus and waiting for the results were not quarantined away from healthy residents. Also, thermometers that employees used to take their temperatures at the beginning of each shift did not work. The report found that the nursing home put its residents in “immediate jeopardy” and the facility was fined $220,000.

The National Guard was called after the facility failed to adequately staff and protect staff and residents. The National Guard members were called in to clean and disinfect the facility. Residents had complained that clothing and bed sheets had not been washed. The facility is temporarily barred from accepting new patients and the facility will continue to accrue penalties until it addresses the issues in the report.

Healthcare providers across the United States continue to grapple with challenges related to providing care to patients suffering from COVID-19, otherwise known as the novel coronavirus. Almost 60% of COVID-19 victims in Maryland are long-term care and nursing home residents. In response to the disproportionately high rate of infection in nursing homes, many states, including Maryland, have asked lawmakers to provide nursing facilities with immunity from lawsuits related to their care during the pandemic. Despite the inherent difficulties many residents and their families face pursuing lawsuits against negligent nursing homes, these facilities continue to push for additional protections against liability.

Even though the spread of disease and illness can become challenging to control, these entities have a responsibility to provide their residents and visitors with a safe environment and appropriate treatment. This includes ensuring that their staff is trained in proper hygiene and safety practices, providing staff and residents with protective gear, quickly diagnosing and identifying patients suffering from infectious diseases, and notifying visitors of any changes in visitation protocol. Despite these steps, outbreaks can still occur, and these facilities must have a plan in place to combat these instances. Infection control protocols include implementing stricter sanitation requirements, changing safety equipment requirements, and isolating high-risk or infected residents. The failure to respond to an outbreak effectively can result in deadly consequences for residents and staff.

Many families are beginning to file lawsuits against these facilities for their response to the COVID-19 outbreak. In response, many Maryland nursing home groups are asking the state to provide immunity based on the governor’s emergency declaration. A few states, including Maryland, protect providers during state and national emergencies. Nursing homes are anticipating that many lawsuits will include claims that the facilities did not have enough personal protective equipment (PPE) to protect their staff and residents. However, many residents and families are claiming that a lack of PPE is only one problem of many, and that clinicians and staff failed to diagnose and treat their loved ones quickly.

According to a recent news report, Maryland Governor Larry Hogan has directed state officials to provide detailed information on COVID-19 cases in Maryland nursing homes and assisted-living facilities and is adding two additional drive-thru COVID-19 testing sites in the state. As of May 2, there are over 24,000 confirmed cases in the state of Maryland, and 1,156 COVID-19 deaths. Maryland currently has the 12th highest rate of COVID-19 cases per capita and the 10th highest death rate per capita in the country. The highest number of cases are in Prince George’s County (7,041), followed by Montgomery County (4,919).

The state maintains a coronavirus resource webpage and has recently begun to publish data on COVID-19 cases in nursing homes and other assisted-living facilities in individual facilities in each county in Maryland. In nursing homes, assisted living homes, and group homes in the state there are now 3,218 confirmed resident cases, 525 resident deaths, 1,489 staff cases, and 8 staff deaths. Right now, Montgomery County has the highest number of total COVID-19 cases in nursing homes, assisted living homes, and group homes. In Montgomery County, there have been 717 confirmed resident cases, 382 confirmed staff cases, 148 resident deaths, and 1 confirmed staff death.

Examples of case information for certain facilities are as follows:

  • Manor Care Silver Spring: 58 resident cases, 17 staff cases, and 16 resident deaths
  • Regency Care of Silver Spring: 50 resident cases, 30 staff cases, and 10 resident deaths
  • Rockville Nursing Home: 36 resident cases, 15 staff cases, and 13 resident deaths
  • Wilson Health Care Center at Asbury Methodist Village: 47 resident cases, 16 staff cases, and 12 resident deaths
  • Brighton Gardens of Tuckerman Lane: 24 resident cases, 16 staff cases, and 8 resident deaths
  • Montgomery Village Health Care Center had 32 resident cases, 11 staff cases, and 8 resident deaths

In addition to five drive-thru testing sites in Bel Air, Columbia, Glen Burnie, Waldorf, and White Oak, the state is adding two additional sites in Owings Mills and Prince Frederick. However, tests are offered only to people who have symptoms and are at high risk for complications from COVID-19—and only for those with an appointment and with an order from a health care provider.
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Despite the concerning rate of COVID-19 (coronavirus) deaths, a recent news report indicates that officials are refusing to provide the public with a comprehensive and accurate list of Maryland nursing homes and long-term facilities where outbreaks have been confirmed. Many nursing home administrators, staff, and residents at these facilities remain in the dark about the presence of the infection at their facilities. Maryland Department of Health officials advised investigators and reporters that public disclosure was up to the local health department. However, many local health departments declined to release the names of affected facilities, reasoning that they need authorization from the state to share the information. This lack of transparency has added to the public’s fear and confusion about how to protect themselves and their loved ones. Maryland nursing homes that fail to engage in appropriate disease prevention practices and do not provide the public with crucial health and safety information may be liable for the spread of disease at their facilities.

Maryland nursing homes and long-term care facilities must limit the spread of disease and infection by taking precautions and acting quickly when an outbreak emerges. It is especially important because nursing home populations are at the highest risk of being affected by COVID-19. The Centers for Disease Control and Prevention (CDC) provides these facilities with guidance on how to keep COVID-19 from entering their facilities, identifying infections, preventing the spread of COVID-19, accessing personal protective equipment, and managing severe illnesses.

The guidelines make it clear that one of the most critical components of disease control is providing residents and staff with information about the disease. Staff and residents should receive education and training about signs, symptoms, and potential outbreaks. Further, residents and families should have information about what the facility is doing to protect their loved ones. Some common ways to limit the spread of disease are restricting visitors, reinforcing adherence to infection prevention, and implementing non-punitive, flexible sick policies for staff. These Maryland facilities must act swiftly to implement all of these recommendations before cases are identified at their locations. Maryland nursing homes that fail to engage in these safe practices and refuse to provide this crucial information may leave their residents and staff vulnerable to exposure and severe illness.

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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