Maryland officials have wrapped up pandemic-prompted inspections of 226 nursing homes with a pricey rebuke to long-term care facilities that have failed still to safeguard the elderly, sick, and injured from Covid-19, putting them at “immediate jeopardy,” instead.

Three facilities were slapped with six-figure fines after state inspectors faulted them in June and July for improperly isolating potentially contagious residents, including new admissions: Collingswood Rehabilitation and Healthcare Center ($275,000) and Potomac Valley Rehabilitation and Healthcare Center ($120,000), and Kensington Healthcare Center ($294,000).

Inspectors also asserted that a patient died at Potomac Valley after a nurse failed to provide basic life support, and the Washington Post reported, based on state data, that “at least 78 residents from the three facilities have died since the spring of Covid-19 … and more than 270 have been infected with the virus.”

The facilities defended their care and told inspectors and the Washington Post that they put the highest priority on residents’ health and well-being, though they have dealt with difficult and unprecedented challenges posed by the coronavirus.

The facilities can challenge their fines, but the newspaper noted that inspectors warned they also “could have Medicaid and Medicare funding for new admissions suspended for a period of time and be barred for two years from operating training programs for nurse aides….”

‘Gravely serious and extremely concerning’

A trade industry official (shown above) told the newspaper that Maryland sent a strong message to owners and operators with its inspections and fines:

“’The regulatory and quality of care violations outlined and alleged in these state documents are gravely serious, and extremely concerning,’ said Joseph DeMattos, president and chief executive of the Health Facilities Association of Maryland. ‘Some of the violations are related to Covid-19 and some are not. And while these centers have the right to appeal, we all have a sacred obligation to work with federal, state leaders and others to ensure the quality and safe care of our loved ones.”

But loved ones of infected residents at the facilities expressed anger about the state findings, telling the Washington Post:

“’Downright negligence — they did not protect their patients,’ said Mike Sheppard, whose mother, Lorraine Sheppard, died of covid-19 three weeks after moving into Potomac Valley in April. Lisa Jacobi, whose father-in-law, Robert Jacobi, also died soon after being admitted to Potomac Valley, said the $120,000 fine ‘feels like nothing, like a slap on the wrist and nothing else.’”

Maryland, Virginia, and the District of Columbia — like governments nationwide — have battled the novel coronavirus’s devastation in nursing homes and other long-term care centers. As of mid-August, a tally by the New York Times found that Covid-19 has killed 68,000 residents and health workers at the facilities — 41% of all the disease’s fatalities in the country. More than 400,000 residents and their care givers have been infected. In Maryland, the Washington Post said that almost 15,000 staff and residents have tested positive for the coronavirus, with 2,000 dying of the illness — more than half of the state’s death toll from the pandemic.

Maryland seems to have borne a greater brunt of coronavirus-related harms at its long-term care facilities than have Virginia or the District of Columbia, with the Washington Post noting that in May, regulators fined the Sagepoint Senior Living in La Plata, the site of one of the state’s worst nursing home outbreaks, $320,000, and its owners subsequently saying it would fight that punishment.

The newspaper also reported this:

“In June, more than two dozen other nursing homes were ordered to pay several hundred dollars each for failing to report Covid-19 information to the state. But fines exceeding $100,000 have been rare in the state — and in neighboring Virginia and D.C.”

According to state officials, 100 of 226 facilities in the state underwent Covid-19 surveys (inspections) from June 21 to Aug. 16: 75 complied with state and federal requirements, with 22 cited but not fined for deficiencies, and the three hit with big fines, the newspaper reported.

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them and their loved ones by abuse and neglect in nursing homes and other long-term care facilities. The relentless suffering, sickness, and death that has exploded in these institutions has gone beyond unacceptable, and it is high time their owners and operators were subjected, at minimum, to stringent oversight and corrective regulatory actions, including fines and other penalties.

Lost voting rights

The shambolic and shameful response to the coronavirus pandemic has caused major suffering for residents and their loved ones, including a new wrong and indignity: the prospective of loss of one of their fundamental rights as Americans — the right to vote. This is what ProPublica, a Pulitzer Prize-winning investigative site reported:

“How to vote during a pandemic poses a dilemma for many Americans, who worry about the health risks of voting in person and whether the U.S. Postal Service will be able to deliver mail-in ballots on time. Such concerns are multiplied for nursing home residents. Most, though not all, of the roughly 2.2 million Americans living in nursing homes or assisted living communities are elderly — and thus at higher risk of dying from the coronavirus. They’re also part of the most politically engaged demographic in the country. In 2018, 66% of Americans over 65 voted, compared with just 35% of those 18 to 29 …

“[But] family and friends who helped [the institutionalized] vote in prior elections can’t visit them — and may have taken ill or died from Covid-19 themselves. Swing states such as Florida and Wisconsin have suspended efforts to send teams to nursing homes to assist with voting. Despite a federal law that residents must be ‘supported by the facility in the exercise of’ their rights, two states — North Carolina and Louisiana — prohibit staff from actively doing so. While many other states allow voters to appoint a helper of their choice, voting assistance may be a low priority for understaffed institutions struggling with Covid-19 outbreaks. And polling places are being moved from nursing homes and assisted living facilities to sites less affected by the virus. For example, Somerville, Mass., relocated voting from a nursing home to a school a little less than a mile away.”

We’ve got a lot of work to do to ensure that Americans in long-term care stop suffering a disproportionate burden of death and infection by Covid-19 and that they share in their constitutionally guaranteed rights, not only of voting, but of life, liberty, and the pursuit of happiness.