Maryland Nursing Home Lawyer Blog

Understaffed Nursing Homes Use Diagnoses to Hide the True Rate of Resident Drugging

September 23, 2021 | Lebowitz & Mzhen

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.

Protecting Maryland Seniors from Sexual Assault

September 16, 2021 | Lebowitz & Mzhen

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.

Combatting Poor Maryland Nursing Facility Outcomes

September 9, 2021 | Lebowitz & Mzhen

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.

Staffing Concerns in Maryland Nursing Homes Arise After Vaccine Mandates

August 31, 2021 | Lebowitz & Mzhen

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.

Arbitration in Maryland Nursing Home Disputes

August 25, 2021 | Lebowitz & Mzhen

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.

What to Do When You Suspect Maryland Nursing Home Abuse

August 18, 2021 | Lebowitz & Mzhen

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.

Delta Variant Raises Concerns at Maryland Long-Term Care Facilities

August 11, 2021 | Lebowitz & Mzhen

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.

How the Covid-19 Pandemic Exacerbates Problems of Nursing Home Abuse and Neglect

July 31, 2021 | Lebowitz & Mzhen

Instances of nursing home abuse and neglect have been widespread since before 2020 and the advent of the Covid-19 pandemic. The arrival of the novel virus presented many challenges to elder care that have reduced the quality of life of many nursing home residents. Instances of abuse and neglect have also sharply increased since the beginning of 2020. A recent trade publication describes some of the factors and issues related to the Covid-19 pandemic that has put a strain on the nursing home industry and contributed to increased instances of abuse and neglect.

The rise of Covid-19 put a strain on the staffing of nursing homes, assisted living centers, and long-term care facilities. Illness, lockdowns, and travel restrictions made it more difficult for nursing homes to find qualified staff to offer care to their residents. Understaffed nursing homes resulted in residents being neglected as there were simply not enough skilled workers to offer care that met a reasonable standard. In some cases, the needs of residents increased as a result of the lessened social interaction and restrictions on family contact caused by covid-19 restrictions.

Although reduced staff and increased need help explain the uptick in abuse and neglect instances, these explanations do not make a valid justification for substandard care. Nursing home residents who have been victims of abuse or neglect, and their families, are entitled to recourse. Nursing homes often carry malpractice and liability insurance to cover their financial responsibilities in the event of abuse or neglect. The nursing home and long-term care industries contribute billions of dollars in profits to owners and executives, funded by both private payers and the federal government through Medicare and Medicaid. Victims need not shy away from seeking compensation simply because the pandemic made administering nursing homes more difficult for the owners and executives.

Reporting Elder Abuse and Neglect Against Maryland Nursing Home

July 25, 2021 | Lebowitz & Mzhen

The abuse and neglect of older adults and vulnerable individuals in nursing homes is a growing concern for many families whose loved ones require medical care at these facilities. While some types of abuse may be evident to outsiders, Maryland nursing home abuse and neglect goes undiscovered in many situations. In these cases, the victims may suffer long-term abuse resulting in serious consequences such as death.

Maryland has certain mandatory reporting laws in place that require medical providers, police officers, and human service workers to report suspected cases of elder abuse. In cases where the reporter is a staff member of a hospital or public health facility, they must report the situation to the organization’s head. Although the law requires mandatory reporting, others who suspect abuse should also report their concerns. Despite the laws, many people fail to report abuse for fear of retaliation or retribution.

In addition to physical abuse, older adults and vulnerable individuals are more likely to face exploitation and neglect in these facilities. Further, older adults who reside in these institutions may turn to self-neglect and self-harm after experiencing this type of abuse. Staff and family members should look for signs of abuse when interacting with nursing home residents, especially on residents who cannot communicate effectively.

Maryland Nursing Home Reporting Requirements

July 16, 2021 | Lebowitz & Mzhen

Nursing home residents in Maryland deserve to live in a safe and sanitary environment free from abuse and mistreatment. If abuse or certain other incidents occur at a Maryland nursing home, the nursing home is required to report the incident to the state. Facilities that receive federal funding must abide by federal regulations, and under federal regulations, a facility is required to report all allegations of mistreatment, neglect, or abuse, including injuries of unknown sources, and misappropriations of resident property. Incidents must be reported to the state within 24 hours. Maryland nursing homes are required to investigate all allegations of abuse and reports from investigations must be reported to Maryland’s Office of Health Care Qualify within five working days of the alleged violation.

Do Maryland Nursing Homes Have a Duty to Stop Abusive Staff Members?

Yes, Maryland nursing homes are required to have policies and procedures in place to keep residents safe and free from abuse. Abuse can include physical and mental abuse, exploitation, or neglect. This includes abuse conducted by staff members as well as other residents. Facilities that fail to report abuse are subject to fines and other sanctions. Victims of abuse may be able to receive financial compensation through a Maryland nursing home claim.

Nursing Home Faulted for Failing to Report Suicide Attempt

Recently, a nursing home was cited after it failed to report a suicide attempt as required. According to one news source, the facility reportedly failed to report a suicide attempt in which the resident had attempted to wrap sheets and cords around their neck. No internal investigation was conducted and the facility failed to report the incident to the health department as required. The recent inspection also revealed that a staff member borrowed $200 from a resident, which was also a violation. The staff member was supposed to repay the money in monthly installments and when the staff failed to make a payment, the resident complained to the facility. Yet, the facility failed to report the misappropriation of the resident’s money. The facility was also faulted for failing to report physical abuse among residents and failing to provide enough supervision and assistance to prevent accidents among residents. The facility was placed on a government list of the nation’s worst nursing homes earlier this year which included 86 nursing homes across the U.S.