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Nursing home residents are one of society’s most vulnerable populations. Often, residents have a reduced ability to advocate for themselves due to their health issues, and they may have little contact with the outside world. Thus, Maryland nursing home abuse and neglect is not often reported, and when it is reported, nursing home administration too often ignore the complaints. Even when nursing home administration reports a complaint, the Maryland government is often slow to respond.

The State of Maryland Nursing Homes

According to a recent government study, Maryland ranks seventh-worst in the nation for on-time investigation of nursing home complaints. Perhaps because of that fact, Maryland nursing homes are notorious for the level of care they provide. In fact, reports of Maryland nursing home abuse rose 25% between 2016 and 2017. And with about 15% of nursing home residents and their families saying they would not recommend the nursing home that houses their family member, it seems that some instances of abuse and neglect are going unreported or uninvestigated. However, two pending bills hope to improve Maryland’s response time to complaints of nursing home abuse and neglect.

A recent news report discusses two proposed bills. Under proposed Senate Bill 386, the Maryland Department of Health would have 10 days to respond to a report of nursing home abuse or neglect that resulted in actual patient harm. If the report indicates that there is an immediate threat to a resident, the Department must initiate an investigation within 24 hours and begin the investigation within 48 hours. The proposed bill would also add 10 full-time employees to the state’s Office of Health Care Quality.

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While all Maryland nursing homes have a duty to ensure the safety of their residents, the fact remains that instances of nursing home abuse and neglect have risen to record levels. The causes for the increase in the numbers of reported instances of abuse and neglect are believed to be related to both societal and business factors.

For one, more elderly Americans are in need of the services that a nursing home can provide. With the percentage of dual-income households on the rise, there are fewer families who have someone able to stay home and provide care to aging loved ones.

At the same time, the nursing home industry has gone through a consolidation over the past several decades, with several major players running a large number of the nursing homes across the state. This has led to an increased focus on cost-cutting and preserving the profits of the nursing home. Of course, one of the first places where management looks to save money is in the cost of labor. However, as the number of skilled nurses decreases, the nurses on duty are left with an unmanageable number of patients to assist.

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Maryland nursing homes have an unwavering duty to provide a safe and secure facility for their residents. However, over the decades since nursing homes have become more and more popular, it has been made clear that not all nursing homes take that responsibility as seriously as they should. Indeed, it seems that most nursing homes prioritize keeping expenses to a minimum over providing a safe home for their residents.

In a frightening new trend, nursing home staff members have begun to drug residents rather than provide them with the intensive care they need. According to a recent news report discussing one instance of over-drugging that occurred in a Texas nursing home, employees engaged in what has come to be known as “drug diversion,” whereby a nursing home employee takes the prescription medication from one patient and administers it to another patient for whom the medication has not been approved.

Aside from violating the basic principles of humanity, the practice of drug diversion presents clear risks to the safety of nursing home residents. For one, the medications that are most often the subject of over-drugging are powerful anti-psychotic medications that can cause serious adverse reactions with other medications. The report mentioned above explains that employees will often administer anti-psychotic drugs to residents whom they believe to be difficult.

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Over the past several decades, there has been a societal shift in the United States toward a household in which both parents work out of the home. Indeed, as of 2016, roughly two-thirds of all families were composed of two income earners. Most often, this means both parents are away from the home during the day.

Unlike in years past, today’s working families do not have the ability to care for their aging loved ones. This has correspondingly led to an increase in the number of elderly people being admitted to nursing homes. Currently, it is estimated that there are over 3.5 million nursing home residents. And while Maryland nursing homes present a good solution in theory, in reality, nursing homes are rarely “as advertised.”

Too often, nursing homes are understaffed with underqualified employees. This creates a situation in which abuse and neglect are rampant. Indeed, it is estimated that over 40% of nursing home residents will experience some form of abuse during their stay, and nearly 90% of nursing home residents report being neglected. Given the limited interaction between a nursing home resident and the outside world, it is believed that these figures may be an underestimation.

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Recently, a state appellate court issued a written opinion in a personal injury case brought by the family of an infant who was beaten to death by a nanny. The case was filed against the nanny, as well as the daycare centers that previously employed the nanny. The court was tasked with determining whether the daycare centers that previously employed the nanny could be held liable for the nanny’s criminal conduct.

The case is important to Maryland personal injury victims, including victims of nursing home abuse and neglect, since it illustrates the outer limits of the liability of a facility – whether daycare or nursing home – for former employees.

The Facts of the Case

The plaintiffs found a nanny on a child-care website to watch their infant son. The plaintiffs ran a background check on the nanny, and after finding that there had been no reports, they hired the nanny. About a month after the nanny started watching the plaintiff’s son, they discovered that she had beaten the young boy badly. He later died from the injuries he sustained.

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Over the past few years, Maryland nursing home arbitration agreements have become very common. Essentially, an arbitration agreement is a contractual term between the resident and the nursing home in which the parties agree that, in the event a claim arises, neither party will file a case in the court system. Instead, the parties agree that they will submit the case to an arbitration panel, which will then issue a binding decision.

The issues with arbitration are now well known, although that was not always the case. At first blush, arbitration does not necessarily seem like a bad thing because it can result in the quicker resolution of claims and may reduce the costs associated with litigating a case. However, studies have shown that, on average, the rulings of arbitration panels tend to favor the company over the individual. One reason for this is that the company selects the specific company that will conduct the arbitration.

Given the importance of a person’s right to access the court system, courts require that arbitration agreements clearly show the parties’ intent to waive their rights before an arbitration agreement will be enforced. Additionally, courts must determine that the arbitration agreement is written in good faith and treats both sides fairly. Courts have also rejected arbitration agreements in cases involving the survivors of those who signed the original contract, finding that the survivor was not a party to the contract.

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When a Maryland nursing home accepts a resident into their care, the nursing home assumes an affirmative duty to provide an acceptable level of care to the resident. This entails ensuring that all physical needs are met, including the administration of medication, allowing residents to use the restroom as often as needed, and ensuring that residents get the appropriate level of nutrition.

Given the tasks involved, running a nursing home is not an easy business, and many nursing homes operate on thin margins. Thus, nursing home management often are in a position in which they are trying to staff the home with the fewest number of employees possible. While this saves money, it also can prevent residents from obtaining the care necessary to live in a safe and secure environment.

When a nursing home fails to provide sufficient coverage to care for the needs of its residents, and a resident suffers harm as a result of this failure, that resident or their family may be able to obtain financial compensation for any injuries caused by the home’s negligence. Of course, a Maryland nursing home neglect plaintiff must be able to establish each element of their claim by introducing admissible evidence. Often, this consists of direct evidence, such as video recordings or witness testimony. However, nursing home neglect cases can also proceed on circumstantial evidence of abuse or neglect. This would include otherwise unexplainable bruises or bedsores.

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Maryland nursing homes have never enjoyed a sterling reputation for the care they provide to residents. While there are many quality facilities staffed with caring individuals, unfortunately, they seem to be in the minority. More often than not, nursing homes are operated with their for-profit motive placed above all else. This means staffing homes with as few employees as possible, among other things.

When nursing home management tries to cut corners by reducing the number of nurses, the chance increases that those nurses who are on duty will be overworked. And while there is never an excuse for abusing a patient, research has shown that overworked nursing home employees are more likely to commit abuse or neglect than those who feel their workload is manageable.

For years, Maryland nursing home abuse went largely unnoticed. Certainly it was occurring behind closed doors, but since residents rarely have contact with the outside world, reports were rarely made. And when reports were made, they were too often brushed aside by family members. However, with the increased availability of video cameras, more families are able to place hidden cameras in their loved ones’ rooms. In many cases, the footage from these cameras is admissible in a lawsuit against a nursing home or employee.

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Earlier this month, an appellate court issued a written opinion in a personal injury lawsuit discussing the validity of an arbitration agreement. The court ultimately concluded that the arbitration agreement, which was signed by the plaintiff on behalf of his deceased father, was not enforceable against the plaintiff to preclude a wrongful death lawsuit against the defendant nursing home facility.

The case is important to Maryland nursing home litigants because, like the statute discussed in the case, Maryland’s wrongful death statute creates an independent claim that is not derivative of the rights of the deceased.

The Facts of the Case

The plaintiff’s father was a resident in the defendant nursing home. Prior to being admitted to the nursing home, the resident was required to sign a pre-admission contract containing an arbitration agreement. The resident, however, was unable to sign the form due to his physical condition. The form was stamped “unable to sign,” and the plaintiff signed the form on his father’s behalf. Underneath his signature, the plaintiff wrote “son.”

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When a nursing home employee engages in abuse of a patient, two different types of lawsuits can follow. First, the local state government can opt to criminally prosecute the individual nursing home employee. If the employee is found guilty, they may face fines, probation, or even incarceration.

The other type of Maryland nursing home lawsuit is a civil case for damages. A civil lawsuit, also known as a personal injury lawsuit, is brought by the victim of the abuse or their family member, rather than by the local prosecuting authority. In addition, the focus of the case is not so much on the employee’s violation of the law, but instead on whether the employee violated a duty of care he owed to the nursing home resident. Importantly, even if a criminal lawsuit is not pursued, a nursing home resident or their family member may pursue a civil nursing home abuse lawsuit on their own.

If successful, a nursing home resident or their family may recover compensation for the injuries sustained by the abused resident. Depending on the circumstances surrounding the abuse, compensation may include amounts for past and future medical expenses, loss of enjoyment, decrease in quality of life, and any pain and suffering caused by the abuse. In some cases, punitive damages may also be appropriate.

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