Patients in nursing homes face many fears and uncertainties and may feel they have no one to advocate for them. Nursing home abuse is rampant, with nursing homes often mismanaged and state oversight not enough. Never has this been more evident than during the Covid-19 pandemic, a pandemic caused by a novel coronavirus. In addition to the higher risk of infection and death from Covid in the elderly, nursing homes may exacerbate the problem by failing to follow guidelines, and the government may exacerbate the risk with poor and dangerous policies. Due to the isolation that occurs during quarantine, families may be less able to oversee the care of their loved ones, and indeed, with a disease so new and unknown, it may be difficult for families to keep up with changing guidelines. Nursing homes may be deficient in keeping loved ones informed about the potential for, or actual, illness, and transfers to the hospital. During times like these, many families and patients might reach out for a nursing home abuse lawyer to help guide and protect them.
According to the CDC, as of the end of August, over 200.000 Covid cases were reported in nursing homes. Another 129,000 Covid cases were suspected, and 56,196 nursing home residents had died of Covid. That constitutes around 40% of all Covid deaths! In addition to deaths, there are thousands of people termed “long-haulers;” people who get very sick for many months. These individuals are often not discussed by policy makers, who focus only on eventual recovery rates and deaths.
Others minimize the plight of the elderly and disabled, whether inadvertently or not. This contempt for the old and sick can be see in the constant verbiage of “only.” The public is urged not to worry because “only” the elderly were dying. There’s no need to panic, people said, because “only” those who were sick before are at risk.
We think every life counts and cutting it short by even a short time due to nursing home abuse is condemnable.
There are a few different ways nursing homes have failed patients, two in particular that are due to facility failures, and one that is largely government created. These three forms of nursing home abuse are detailed below.
Nursing Home Abuses That Have Led to Patient Deaths
1. Failure to separate patients. Nursing staff and patients alike have faced danger and even death due to the failure of facilities to separate their Covid patients from the general population. Hospitals and nursing homes failed their patients early on by not complying with guidelines, and generally just failing to exercise common sense. Negligence and malfeasance both seem to be at work.
The Center for Medicare and Medicaid Services have taken the lead since March in trying to inspect nursing homes and keep up with the dangers. Almost all nursing homes have been inspected at some point in order to assess compliance with infection control guidelines. Immediate risks were found at triple the rate that infection risks were found in general in 2019. The term “immediate jeopardy” is defined by a situation where noncompliance with CMS requirements is likely to cause serious injury, serious harm, serious impairment, or death to a resident. Yet the average fine assessed to nursing homes was only $55,000.
Furthermore, these infection control visits are far less comprehensive than typical annual visits, and many layers of danger to residents may be overlooked.
Most nursing homes have been facially compliant with reporting of Covid numbers, but 3300 deficiencies have been found and these nursing homes have been issued a total of $5.5 million in fines.
In addition to poor sanitation, a key way that nursing homes put their residents at risk has been by failing to keep infected individuals separate from healthy populations. Numerous examples can be found online. For example a nursing home in Miami Springs, Florda found that 11 roommates of patients who tested positive for Covid, that is, patients who were highly at risk of having been infected themselves regardless of whether testing showed it yet, were placed in the rooms of healthy patients, drastically increasing the risk of the spread of the disease. CMS dealt harshly with this facility, levying a $235,000 penalty and ending admissions to the home.
This kind of nursing home abuse has been rampant throughout the pandemic. In one case of utter denial, an Iowa assistant director of nursing at a nursing home insisted at the end of May that they did “not have any Covid in the building.” Despite the orders of a community doctor to isolate several patients with obvious signs of illness, including fevers and falling oxygen levels, the assistant director refused to do so and within weeks, 61 patients were shown to have the virus and nine people had died.
It is fairly well known that physical isolation of Covid patients is the best way to prevent the spread of the illness, with quarantines being imposed in certain situations. So, it seems unbelievable that such simple protocols weren’t followed in nursing home situations.
2. Facility workers spreading the virus
The virus raced through nursing homes early on, and states like Florida began restricting visitation from family and friends. Unfortunately for residents, these steps were not enough. It became obvious that something else was causing the spread of the virus at breakneck speed. Staff, who are poorly paid and artificially kept as part-time workers, are often forced to work at more than one facility. A recent change in guidelines means that asymptomatic people are not recommended to be tested – yet asymptomatic people can easily spread the disease. Asymptomatic staff awaiting test results or who have not been properly tested can take the virus with them from facility to facility. They can do so unwittingly, not yet knowing their sick, or more outrageously, knowing they are ill and not wanting to miss a paycheck. A recent report by the National Bureau of Economic Research found that the average nursing home is linked to 15 other facilities through their staff. In some areas, restrictions have been put on workers working at more than one facility, but with there being such high demand for workers especially during these difficult times, governments and facilities in most areas have not found a way to implement such strict rules.
Yet a solution to the spreading of Covid between facilities by staff members must be a priority. Everyone is put in danger with systems being what they currently are.
3. Government deliberately placing covid patients in nursing homes
With all the risks listed above, a nursing home doesn’t seem like the best place for a sick person to be. While nursing homes may have exercised bad, and even malicious, judgment, even nursing homes making positive efforts were thwarted by government confusion and bad policy. Although it had been known for many years that a pandemic was likely at some point, the government seemed entirely ill-prepared.
In New York, California, and New Jersey, early on the state ordered that nursing homes must readmit residents sent to hospitals with the coronavirus and accept new patients as long as they are deemed “medically stable.” Other states later followed suit. States say they were following federal orders.
Some states designated certain nursing facilities solely for Covid patients, a logical step that surely saved many lives.
Government and military regulations were typically unbending and created catch-22 situations. In New York, a ship had been deployed from the federal government to take pressure off hospitals and nursing homes, but federal rules made it impossible to utilize the ship to any logical end. The federal government wouldn’t allow Covid patients on board, apparently intending for other overflow from the hospitals to go there, but that did little to relieve the pressure when the large majority of patients in the hospitals were Covid patients. Eventually New York and the federal government worked it out so the ship could be used for Covid patients, but how many people died first?
Patients were released to nursing homes during times when personal protective equipment was not being adequately supplied, and the surge in patients was causing staff to interact with larger numbers of patients, increasing the risk of spreading infection. Hospitals were sometimes unable or unwilling to ensure the “stable” patients being released to nursing homes were noninfectious.
Some facilities in some areas were allowed an exemption if they could show that they could not care safely for the Covid patients—surely the case in places where the facilities were operating at 50% staffing—but not all facilities filed for such exemptions.
Other issues in nursing homes during the pandemic
Rates of infection were high in nursing homes even before the pandemic. There were real concerns about protocol and follow-through.
The journalist Ed Yong calls the country’s response to the pandemic a “serial monogamy” of solutions; ineffective because the country seems to only be able to focus on one reductive solution at a time, rather than recognizing multiple steps are required at once to prevent more infections and deaths. Nursing home care, from federal, state and local government to internal policies, needs to follow this warning. There has been a significant deficiency in getting nursing homes the PPE that is absolutely essential to protecting the staff and residents at nursing home. Testing, retesting, contact tracing, protective equipment (some is better than none), isolation and separation, are all only parts of what must be a multi-faceted, organized effort to implement life-saving policies and protocols. Protecting workers who get sick can prevent poor decision-making that leads to spread of illness.
If you think nursing home abuse contributed to your loved one’s death, or if you have concerns about medical, sexual, financial, or emotional abuse in a nursing home, contact one of our attorneys here for advice.