Nursing Home News

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.

Will Maryland Be the Next State to Enact Strict Nursing Home Camera Laws?

February 4, 2020 | Lebowitz & Mzhen

Each year, more states enact laws that allow for cameras in nursing homes and assisted living homes, which provide much-needed protection for residents. The laws allow residents and their families to place cameras in the residents’ rooms. In 2003, Maryland enacted a law requiring the Maryland Department of Health and Mental Hygiene to develop guidelines for electronic monitoring. Under those guidelines, the state currently allows electronic monitoring in Maryland nursing homes with resident consent—but only if the nursing home allows it.

Meanwhile, other states continue to enact electronic monitoring laws, many that provide much greater protections to residents. According to a local news source, Minnesota recently passed an electronic monitoring law to protected elderly adults. The law, entitled the Elder Care and Vulnerable Adult Protection Act of 2019, took effect on January 1, 2020. A state ombudsman said that electronic monitoring is a right included in the state’s Home Care Bill of Rights.

The law was advocated for by families whose loved ones were abused or mistreated. Under that state’s law, there is a consent form required in order to obtain the monitoring device. Providers such as nursing homes must tell residents about the law and have the forms available to use. Consent is required from all people living in the same room. Before the law was enacted, according to the ombudsman, residents and their families were installing cameras, but there was nothing to stop others from removing the cameras. Under the new law, residents there can install cameras without letting the providers know.

Centers for Medicare and Medicaid Services 2020 Priorities Signal Increased Protections for Maryland Nursing Home Residents

January 28, 2020 | Lebowitz & Mzhen

The Centers for Medicare and Medicaid Services (CMS), an agency that oversees Medicare and Medicaid and works to identify and eliminate nursing home fraud and abuse, recently released a memorandum detailing their 2020 priorities. These updated priorities are important for Maryland families to understand, as they affect the rights of nursing home residents as well as a resident’s ability to recover in case of nursing home neglect or abuse.

One of the major updates included in the 2020 memorandum concerns arbitration agreements. Arbitration agreements, if signed, require an injured nursing home resident to settle disputes with the home through a confidential arbitration process, rather than in court. This process operates privately, and while it is much faster than traditional litigation, plaintiffs lose any right to appeal and evidence shows plaintiffs are more likely to lose in arbitration. CMS’s recent memorandum states that the agency will allow nursing homes to use binding arbitration agreements with their residents, but that such agreements cannot be required as a condition of receiving care. For instance, if a resident refuses to sign the agreement, nursing homes cannot refuse to care for them solely on that basis. Additionally, CMS indicated in the memorandum that nursing homes must also explain to residents or their representatives that they can still receive care without signing.

CMS also stated that it plans to make changes to how instances of abuse and neglect are reported and investigated. For instance, new guidelines released later this year may include changes in the time frame required for investigations, the collection of certain evidence and investigative report, and general new policies and procedures to be implemented in nursing homes to catch instances of abuse.

Proposed Legislation Would Ban Arbitration Agreements in Nursing Home Contracts in Maryland and Elsewhere

January 6, 2020 | Lebowitz & Mzhen

Abuse and neglect are serious problems in Maryland nursing homes, and incidents can lead to physical and psychological injuries, and even premature death. Maryland law allows victims or their families to file lawsuits against negligent nursing homes when incidents occur, but many residents may be waiving that right without knowing it.

The use of mandatory arbitration agreements in nursing home contracts forces an injured resident to settle disputes with the nursing home through a private and confidential arbitration process, rather than in court. According to a recent news report, last month, two Congressional representatives introduced a bill that would ban nursing homes from requiring or asking residents to enter into mandatory arbitration agreements when moving into a home.

The use of arbitration by nursing homes has been a hotly debated topic. Advocates say that the process is speedier and less costly for abuse and neglect victims, while still allowing them a chance to receive the same financial compensation and other remedies available in court. Critics, on the other hand, claim that mandatory arbitration forces victims to give up their right to a day in court, allows negligent nursing homes to get away with abuse without hurting their reputation, and is unfairly biased against victims, especially since the nursing homes are repeat players who can form relationships with arbitrators.

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.

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.

Government Accountability Office Report Highlights Risk of Maryland Nursing Home Abuse

November 26, 2019 | Lebowitz & Mzhen

Across the country, approximately 1.4 million elderly or disabled individuals receive care in over 15,000 nursing homes. While many of these nursing homes take great care of their residents, a recent study from the U.S. Government and Accountability Office (GAO) finds that, unfortunately, nursing home abuse still occurs with some regularity. Because residents often have physical or mental disabilities and limitations, they are some of the most vulnerable to abuse. Maryland residents should be aware of potential issues of abuse when choosing a nursing home for themselves or a loved one.

The GAO’s report found that citations of nursing home abuse more than doubled between 2013 to 2017, with a particularly significant increase in severe cases of abuse. Importantly, the report also found gaps in the oversight of nursing homes. The Centers for Medicare & Medicaid oversee a program with state agencies to monitor nursing home safety, but their ability to do so may be limited for several reasons. First, state agencies who survey nursing home abuse typically do not note abuse and perpetrator time, meaning the Centers for Medicare & Medicaid may not have a complete picture of who is committing the abuse, or what type is most common. Second, when nursing homes report incidents, they typically lack vital information, which often delays state agencies’ investigations. And third, the GAO found gaps in the Centers for Medicare & Medicaid’s processes for referring incidents of nursing home abuse to law enforcement, which can slow down investigations and make it harder to end abuse in the homes overall. The GAO, finding these problems, also made recommendations to the Centers for Medicare and Medicaid on how they can fix them and improve the safety of nursing homes and the processes for dealing with abuse.

Cases of abuse in Maryland nursing homes, which can include medical neglect or physical, verbal, or sexual assault, can cause intense emotional distress and trauma for the victim and their families, not to mention medical bills for past and possibly continuing care. While the GAO’s report may hopefully lead to increased safety in Maryland nursing homes, there will, unfortunately, still be tragic instances of abuse. If tragedy does strike in a Maryland nursing home, state law allows the victim, or their family, to sue the home for negligence. The money won in a suit, while it can never undo the damage done, may help the recovery and healing process.

Social Media and Maryland Nursing Home Abuse

November 5, 2019 | Lebowitz & Mzhen

Recently, a national news publication reported on a disturbing assisted living center abuse case. The case highlights issues that many Maryland nursing home abuse victims and their families experience.

According to the report, police investigated an assisted living facility after they received a call from a person who stated that they saw an egregious video of two women with dementia fighting posted on social media. The video shows a staff member pushing one resident while another resident is lying on the floor. The investigation revealed that, although the altercation did not amount to a “fight club,” as initially reported, the events were alarming and deviated from appropriate standards that nursing homes are expected to conform to. The employees permitted the residents to fight with each other while an employee physically assaulted another resident. Police conceded that the investigation was challenging because the victims are experiencing the symptoms of dementia and, therefore, cannot adequately articulate the events. The employees were terminated and are facing serious criminal charges.

In situations such as this, nursing homes and their employees often face civil charges in addition to criminal charges by residents and their families. In Maryland, nursing home abuse lawsuits are often steeped in allegations of abuse, negligence, malpractice, and premises liability. Nursing home abuse cases are typically the most disconcerting type of claim. These cases involve an intentional act or reckless disregard for the health and safety of the resident. Some examples of nursing home abuse are when a caretaker physically or sexually assaults a resident.

Maryland Nursing Home Residents at Risk of Foodborne Illnesses

October 22, 2019 | Lebowitz & Mzhen

As the population ages, and life expectancy continues to increase, nursing homes are becoming a part of more and more Americans’ lives. As a result, Maryland nursing homes are caring for more residents than ever. Family members who place their loved one in a nursing home want to ensure that they are safe and being taken care of, but sometimes finances or other concerns force families to place loved ones in subpar institutions. Unfortunately, loved ones can suffer from nursing home abuse that often goes unreported. A common yet overlooked form of this abuse is food safety violations, which occur frequently in Maryland nursing homes and can cause serious illness, or even death.

A recent investigative report found that there are thousands of food safety violations in nursing homes across the country each year. According to a news article discussing the report’s findings, cockroaches, flies, mold, and mouse droppings are just a few of the unsanitary conditions found in nursing homes over the last three years. In fact, unsafe food handling was the third most frequent violation in nursing homes in 2018. That same year, 33% of nursing homes were issued citations for not safely storing, preparing, and serving food. And many of these instances are not just one-time mistakes: since 2016, approximately 33% of all nursing homes were cited multiple times for the same food safety violations.

These safety violations, while concerning in any kitchen, are of utmost concern in nursing homes because people over 65 are especially susceptible to foodborne illnesses. Unlike restaurants where a patron can get up and leave, nursing home residents often have no choice but to stay and eat in their institution. The result can be deadly: the report also found that, between 1998 and 2017, there were 230 foodborne illness outbreaks in long-term care settings such as nursing homes, which resulted in at least 45 deaths, 532 hospitalizations, and 7,648 people getting ill.

Centers of Medicare & Medicaid Services Creates Alert to Warn of Nursing Home Abuse

October 14, 2019 | Lebowitz & Mzhen

Incidents of Maryland nursing home abuse can be challenging to quantify because many victims are unable to report their injuries. Additionally, loved ones are often placed in subpar institutions because their families did not have the means or ability to evaluate the facility adequately. These factors, in addition to many others, have caused a rising rate of nursing home abuse incidents in Maryland.

According to a recent news report, the Centers for Medicare & Medicaid Services (CMS) launched a consumer alert feature on its website designed to warn people of nursing home violations. The CMS operates a website called “Nursing Home Compare,” which provides consumers with information about Medicare and Medicaid certified nursing homes in the United States. The website enables individuals to see whether a nursing home meets the minimum federal standards regarding things such as staffing, health, and safety. However, the website does not readily provide a way for people to discover any instances or allegations of abuse against a nursing home. In fact, a recent Senate report publicized a government finding of increasing nursing home abuse cases by facilities that rated as poorly performing but did not receive additional scrutiny.

The new alert intends to offer consumers a new and easy way to identify nursing homes with citations and other safety violations quickly. The alert will go live in October, 2019 and will flag facilities that had negative inspection reports on abuse in the past year or behaviors that could have led to harm in the past two years.