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With each passing year, more states are enacting laws that allow for the installation of cameras in nursing homes and other similar long-term care facilities. After all, sending our loved ones to nursing homes is never an easy endeavor. When we put our loved one’s care in the hands of strangers, it can often be challenging to feel at ease when abuse or neglect could be taking place behind closed doors. To proponents of allowing cameras in nursing home facilities, allowing cameras ensures increased accountability and safety from abuse and neglect for our loved ones.

According to a recent news report, other states are continuing to consider enacting laws that would allow cameras to be placed in their loved ones’ rooms in nursing homes. Proponents argue that such laws could go a long way in building a record and substantiating claims of abuse or neglect, instead of relying on staff who may fear repercussions as a result of reporting. Cameras could also be beneficial for nursing home staff to refute false claims. Although cameras will likely not solve all existing problems for elderly residents, proponents argue it could be a step in the right direction to increase transparency, accountability, and safety in these long-term care facilities.

In light of COVID-19, many nursing homes have had to close their doors to visitors because of public health and social distancing protocols. Because elderly residents of nursing homes remain a highly at-risk group in the midst of the global pandemic, many suspect that the ongoing pandemic increased the frequency of abuse or neglect taking place behind closed doors as in-person visits became restricted or limited.

Families of nursing home residents know all too well that they have to put a good amount of trust in nursing homes. Families cannot be with their loved ones all the time and some residents are unable to report abuse, or even understand that they are being abused in the first place. Abuse can take different forms, including physical, emotional, and financial abuse. There may be signs of abuse, such as broken bones and unexplained injuries, fear or distress, poor living conditions, and missing finances. Victims of Maryland nursing home abuse may be able to file a claim against the perpetrator, the facility, and anyone else responsible for the harm.

What Are Nursing Home Residents' Rights?

Maryland nursing home residents have the right to live in a safe and sanitary environment free from abuse. Nursing homes are required to report any allegations of abuse to Maryland’s Office of Health Care Quality within five working days of the alleged violation. They must also conduct an investigation and provide a report to the state. Nursing homes also have to have proper policies and procedures in place in order to prevent abuse and keep their residents safe. Nursing homes that fail to report abuse are subject to fines and other sanctions.

When we send our loved ones to a nursing home, it can often be a nerve-wracking process. Ensuring that our family members are taken care of, receiving quality care, and comfortable can shape up to be quite the challenging endeavor when it comes to finding the right facility and staff. Sometimes, however, our elders end up in nursing homes that may not be as great—and may not uphold the expected standard of care. When this happens, our seniors experience low-quality care and sometimes even abuse or neglect.

How Common Is Nursing Home Abuse in Maryland?

Unfortunately, Maryland is no stranger to elder abuse and neglect. In 2019, the Maryland Department of Aging reported that of 4,948 complaints that were investigated by the agency, 350 were alleged resident abuse cases. Separately, the Maryland Department of Health, Office of Health Care Quality received 1,427 reports of alleged abuse and 693 allegations of neglect in 2019.

For older individuals living with dementia, taking antipsychotic drugs nearly doubles their chance of death from heart problems, infections, and other serious ailments. But for years, nursing homes have used these drugs to control their patients who have dementia. Because of the increased risks to patients treated with antipsychotic medications, the government requires nursing homes to report the number of residents who are taking antipsychotics. However, the government does not keep a public record of residents who are prescribed antipsychotics if they are living with schizophrenia, Tourette’s syndrome, or Hungtington’s disease. As a result, the New York Times reports that some doctors at nursing homes are diagnosing residents with one of these three diseases and then prescribing these patients with antipsychotics in order to avoid the requirement that they include these patients in their reported number of antipsychotic drug use. Nursing homes engaged in this practice have the goal of making their facility look more appealing to the public. Because of this practice, it has become harder to get an accurate portrayal of the rate of antipsychotic drug use on residents in nursing homes

If a nursing home has a high rate of antipsychotic drug use, the government may give the facility a lower “quality of resident care” rating, which in turn would have negative financial consequences for the nursing home. The rating system was designed by Medicare to help patients and families evaluate various facilities. Because antipsychotics have been approved for treating patients with schizophrenia, Tourette’s syndrome, or Huntington’s disease, antipsychotic prescriptions in these instances are not included in a facility’s public tracking. As a result, some nursing home facilities have used this as a loophole to hide the true number of residents who are on antipsychotic medications. According to Medicare data, since 2012 the number of residents diagnosed with schizophrenia has increased 70 percent.

Do Nursing Homes Unnecessarily Medicate Residents?

Medicare’s website reports that less than 15 percent of nursing home residents are on antipsychotics, but because of the loophole, this number does not accurately include patients who have been diagnosed with schizophrenia. It is suspected that some understaffed nursing homes are using antipsychotic drugs to more easily subdue patients so that these facilities do not have to hire additional staff. This is considered nursing home abuse.

Each year, it is estimated that nearly five million elderly adults may experience some level of abuse, exploitation, or neglect. In addition, official reports are only made for one in every five cases of elder abuse.

With this in mind, sending our loved ones to a nursing home can often be an extremely stressful and challenging process. After all, you are entrusting the care and well-being of your family members and loved ones to a nursing home facility and its staff. Sometimes, even with due diligence and research into facilities, instances of nursing home and elderly abuse can take place. When these incidents happen, it is crucial that those who are responsible are held accountable for taking advantage of our loved ones.

According to a recent news release, a certified nursing assistant was charged with sexually assaulting two elderly residents at a nursing home during his overnight shifts. As a caretaker, the certified nursing assistant was responsible for changing, bathing, feeding, toileting, and helping as needed with incontinent residents at nursing facilities. An investigation by local authorities revealed that the certified nursing assistant allegedly sexually assaulted two elderly female residents by acting under the guise of providing assistance with washing or toileting, only to instead use it as an opportunity to sexually assault them. The nursing assistant was indicted on multiple criminal charges, such as indecent assault and battery upon an elder.

For years, policymakers have known about the pervasive presence and impact of nursing home abuse in America. Recently, a bipartisan federal investigation revealed that lacking care for seniors has been disproportionately clustered within less than five percent of the nation’s nursing home facilities.

According to a recent article, poor nursing home care has been clustered among facilities listed under the Special Focus Facility (SFF) program. Facilities listed under the SFF program include the country’s worst-performing institutions, which “substantially fail” to meet basic care standards required by the federal government. Some commentators have noted that SFF nursing homes are considered “repeat offenders” who have a “pattern of neglecting and harming vulnerable residents.” Until recently, landing on the SFF list was shameful—but without proper enforcement or rehabilitation mechanisms in place, many facilities have not been held accountable.

To combat the issue, however, policymakers are stepping up to the plate. Legislative action from Congress could improve and expand quality care in nursing homes not just in Maryland but across the country. A new bill known as the Nursing Home Reform Modernization Act of 2021 proposes to expand the list of monitored facilities, increase resources for facilities that are underperforming, and establish an independent Advisory Council to inform federal agencies how to provide the best care possible and evaluate nursing home facilities.

Although vaccine mandates may provide relief for some nursing home residents, some nursing homes worry that they may lead to understaffing in Maryland nursing homes and throughout the U.S. A federal vaccine mandate is going in effect, meaning that in many nursing homes, workers will be required to get vaccinated against COVID-19. Currently, 27% of nursing home staff have not been vaccinated, causing some to worry that those staff members will look for another job instead of getting vaccinated. Administrators said that some other healthcare providers who also receive federal funding, such as some hospitals, home health agencies, and community health clinics, do not yet require the vaccine and may provide alternative employment options for those workers.

Maryland’s governor recently announced that all employees at Maryland nursing homes and hospitals must be vaccinated or undergo ongoing screening and testing. Maryland nursing home staff must receive their first dose of a COVID-19 vaccine by September 1st. If a nursing home fails to comply or to report vaccination compliance, it will be subject to fines, penalties, and enforcement action. About 79% of staff members at Maryland nursing homes have been vaccinated so far.

A Maryland nursing home resident who contracts a communicable disease because of the nursing home’s failure to adequately protect its residents may be able to file a claim against the facility. State and federal regulations require nursing homes to adequately care for and protect residents. Nursing homes must continue to take precautions to help protect residents from contracting COVID-19. Even nursing homes residents who are vaccinated continue to need protection, as many are immunocompromised and may not be fully protected even with vaccines. This means that a nursing home may be liable for failing to take adequate protections to protect a resident from COVID-19. Facilities are still expected to take measures to protect residents, such as routine cleaning, investigating potential cases, isolating COVID-19 positive or suspected positive residents, and screening staff. The facility is also required to record infections and report them to health officials.

Often when an individual is injured or mistreated in a nursing home, they have already signed away their rights to bring a lawsuit. Instead, depending on the language of the contract they signed when entering the nursing home, they are required to arbitrate all claims brought against the nursing home. Arbitration is a form of alternative dispute resolution, where an arbitrator—instead of a judge—decides the outcome of the dispute and how much money the nursing home must pay.

A recent federal bill would forbid nursing homes from forcing residents to agree in advance to arbitration in cases where lawsuits are brought against the nursing home for inadequate and a lack of care. The bill would also require a 24-hour nurse to be available at nursing homes, along with requiring an infection prevention and control specialist. Nursing homes receive most of their financing through Medicaid and Medicare, meaning they must follow state and federal regulations—including this bill if it were to be passed by Congress. While it is unclear now whether this bill will be passed, it would provide nursing home residents with a mechanism to bring a lawsuit if they are injured or mistreated while living at a nursing home.

Should Nursing Home Residents Sign Arbitration Agreements?

While arbitrating nursing home disputes may not seem terrible for either party, it often limits the settlements plaintiffs will receive, as compared to a jury. An arbitration clause, literally forces the resident to arbitrate instead of suing the home—regardless of the allegations. While arbitrators are often impartial and will ensure the plaintiff’s claims are adequately heard, bills like the one being discussed now give residents the opportunity to bring a lawsuit if they have been neglected or abused. This is better than forcing everyone to bring all claims in front of an arbitrator.

Placing a loved one in a Maryland nursing home is not an easy decision. However, it is a choice that thousands of Maryland families must make each year. While most nursing homes truly care about the health and wellbeing of residents, that simply isn’t always the case.

According to a recent news report, a state health department report reveals that one nursing home engaged in repeated physical and verbal abuse of residents. Evidently, the nursing home is believed to have abused at least five residents. One instance cited in the report is based on the facility’s failure to provide medication to an elderly resident. Another incident documents the facility’s failure to follow up on allegations of neglect and abuse, allowing the employee suspected of wrongdoing to remain on the job.

Nursing homes not only have a duty to ensure residents are free from abuse, but also to continuously investigate all claims of wrongdoing. For example, if a staff member is alleged to have neglected or assaulted a resident, nursing home management must investigate the matter. Similarly, if one resident acts aggressively towards other residents, management must take affirmative steps to protect other residents.

Health officials are beginning to worry about outbreaks of COVID-19 in long-term care facilities again as the delta variant causes an increase in cases in the country. With the rollout of the COVID-19 vaccine and 81 percent of nursing home residents being vaccinated, deaths in long-term care facilities have decreased dramatically. However, the delta variant and the rate of vaccination among nursing home staff have caused some experts to worry. In some states, vaccinations rates among nursing home staff are less than 50 percent. The increase in cases with the rise of the variant is worrisome for Maryland nursing home residents.

The Centers for Disease Control and Prevention has said that although breakthrough infections (infections among those who are vaccinated) are rare but may be as transmissible, and warn that the delta variant is “highly contagious” and likely more severe. Health officials in some states have confirmed that unvaccinated staff members are spreading COVID-19 among nursing homes. An official in Mississippi said recently that there were over 100 outbreaks in the state’s long-term care facilities, 72 of them being in nursing homes. Seven residents died recently at a facility in Indiana where less than 50 percent of the staff was vaccinated. Some advocates have called for vaccine mandates for workers in long-term care facilities. Others worry that it will create more workforce shortages. In Maryland, over 10,000 residents have contracted COVID-19 and over 2,300 residents have died. 82% of residents have been vaccinated and 71% of staff.

What Are a Maryland Nursing Home's Duties to Residents?

Maryland nursing homes that accept Medicare and Medicaid patients are required to follow state and federal regulations. Federal regulations require nursing homes to provide adequate medical care to residents, which includes taking steps to investigate and control diseases within the facility, maintain a record of infections, isolate patients who become infected, and report diseases to local health officials. Maryland long-term care facilities that do not take adequate measures to prevent the spread of disease among residents or care for patients who contract a disease may be liable for injuries to residents. In a Maryland negligence claim, a plaintiff must show that the nursing home failed to meet its duty of care to adequately care for a resident in one or more ways. Maryland nursing home residents and their families may be able to file a claim against a long-term care facility for negligence, wrongful death, or another cause of action.

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