When families entrust a loved one to a nursing home, they expect safe, professional care. Unfortunately, some facilities fail to meet this standard, leading to neglect, mistreatment, or abuse. Legal and financial concerns become even more complicated for those relying on Medicaid or Medicare to cover nursing home costs.
Understanding how Medicaid and Medicare impact nursing home abuse claims in Maryland is critical for victims and their families. These programs influence facility oversight, resident protections, and legal options when abuse occurs.
How Do Medicaid and Medicare Regulate Nursing Homes?
Medicaid and Medicare play a significant role in nursing home care. Most facilities in Maryland accept Medicaid, which provides long-term care coverage for low-income seniors. Medicare, by contrast, covers short-term rehabilitation stays but does not pay for long-term residency.
<br />
These programs impose regulations as a condition of providing funding. Nursing homes that receive Medicaid or Medicare must comply with federal and state laws governing patient care, staffing levels, and safety standards. Facilities that fail to meet these requirements risk penalties, including loss of funding.
Despite these regulations, enforcement remains a challenge. Maryland has some of the longest delays in nationwide nursing home inspections, averaging nearly three years between reviews. This backlog allows some facilities to continue unsafe practices without timely intervention.
Nursing Home Abuse and the Role of Federal Oversight
Federal law requires nursing homes to meet minimum care standards to receive Medicaid or Medicare funding. However, violations are not always identified or properly addressed. Common issues include:
- Understaffing—a lack of caregivers leads to neglect, malnutrition, and untreated medical conditions;
- Poor training—inadequate staff education results in improper medication administration and increased injury risks; and
- Failure to report abuse—some facilities ignore or hide instances of mistreatment to avoid penalties.
While federal agencies oversee Medicaid-funded nursing homes, assisted living facilities operate with far less accountability because they primarily rely on private payments. Advocates argue this lack of regulation leaves many residents vulnerable to mistreatment.
Legislative Efforts to Strengthen Nursing Home Oversight in Maryland
Maryland lawmakers are considering new bills to improve nursing home and assisted living facility oversight. These proposals include:
- Mandatory video surveillance—requiring cameras in common areas to monitor and document potential abuse or neglect; and
- Increased inspection frequency—addressing long wait times by ensuring facilities undergo regular reviews.
Senior advocates support these measures, emphasizing the urgent need for stronger protections. Maryland’s inspection delays and the growing number of chronically ill residents in assisted living facilities make these reforms even more pressing.
What to Do If You Suspect Nursing Home Abuse
Early action is key for those concerned about a loved one’s safety. Nursing home abuse can take many forms, from physical harm to emotional and financial exploitation. Warning signs include:
- Unexplained bruises or injuries,
- Sudden weight loss or dehydration,
- Changes in personality or withdrawal from social interactions,
- Bedsores, infections, or worsening medical conditions and
- Missing personal items or unauthorized financial transactions
Suspecting nursing home abuse is a distressing experience, but taking immediate action can help protect your loved one. Documenting concerns is essential. Take photos of any injuries, record dates of incidents, and keep detailed notes about unusual behavior or medical issues. A well-documented record can strengthen a potential claim. Next, speak with the facility’s staff to address concerns directly. Ask about any changes in care, medication adjustments, or reasons for unexplained injuries. If answers seem inconsistent or vague, further action may be necessary.
Reporting suspected abuse is a critical step in holding negligent facilities accountable. Families can file complaints with Maryland’s Office of Health Care Quality (OHCQ) or report violations to the Centers for Medicare & Medicaid Services (CMS). These agencies investigate claims and can impose penalties on nursing homes that fail to meet care standards. However, investigations take time, and victims may need legal assistance to ensure proper action is taken.
Consulting a Maryland nursing home abuse attorney is essential when dealing with Medicaid and Medicare-funded facilities. State and federal laws affect these cases, challenging the legal process without proper guidance. A local attorney who understands Maryland’s regulations can assist families in proving responsibility, collecting evidence, and seeking compensation for medical costs, pain and suffering, and relocation expenses. Holding negligent facilities accountable helps victims recover and improves the safety for other nursing home residents.
Contact the Dedicated Maryland Injury Lawyers at Lebowitz & Mzhen to Learn More
If you or a loved one was recently injured due to another’s negligence, it’s important you take a few minutes to learn about your rights and what you can do to hold the at-fault party accountable. At Lebowitz & Mzhen, we have decades of combined experience handling all types of personal injury, wrongful death, and medical malpractice lawsuits on behalf of clients throughout Maryland and Washington, D.C. To learn more and to schedule a free consultation today, give us a call at 800-654-1949. You can also connect with us through our secure online contact form.