Maryland SNF Class Action Suit: Nursing Home Residents Seek Mandatory Inspections

Happy Hump Day! Reg’s Blog is back up and running!

Lots of stuff has happened over the past couple of weeks that the site was under construction or should I say, remodeling. I’ll try to get caught up on the important stuff and ultimately, get current as new events, etc. happen.

Yesterday, an interesting lawsuit dropped in Maryland. A group of nursing home residents filed a lawsuit, class action suit, seeking to require the state to inspect all of its skilled nursing facilities at least annually. The suit alleges that the state is violating the federal Americans with Disabilities Act.  The suit is brought by five anonymous residents.  The text of the complaint is available here: Maryland SNF Class Action Suit

The basis of the suit is that the state’s lack of routine, required surveys and inspections have place residents at risk of poor care and harmful outcomes.  Maryland’s history of overdue surveys dates back to 2002. A federal agency found staff cutbacks resulted in surveys “being less systematic than originally planned.” A recent Senate investigation noted that only 1 out of 9 facilities had inspections within the last two years.

State nursing home survey offices have suffered the same types of staffing shortages affecting facilities, as noted in reports issued last year by the US Senate Special Committee on Aging. In 2022, Maryland’s delays led the nation at 1,021 days, or (approximately) 34 months between standard surveys,

The suit alleges (in the complaint), “Because of Plaintiffs’ mobility impairments, this lack of accountability leaves Plaintiffs in situations where they are vulnerable to neglect and mistreatment, which lead to pressure ulcers, falls and unnecessary seclusion.  Plaintiffs have suffered and continue to suffer personal degradation and significant physical and psychosocial harm as a result of Defendants’ failures.”

The Centers for Medicare & Medicaid Services (CMS) has identified the impact of surveyor shortages.  The result is a pilot of a new strategy called the Risk-Based Survey process. The goal is to allow “consistently higher-quality facilities” to receive a more focused survey, theoretically cutting down on delays for others.

“Higher quality could be indicated by a history of fewer citations for noncompliance, higher staffing, fewer hospitalizations, and other characteristics (e.g., no citations related to resident harm or abuse, no pending investigations for residents at immediate jeopardy for serious harm, compliance with staffing and data submission requirements),” per CMS.

What is interesting about this suit is that it will likely serve as a model for similar actions in other states.  Maryland is not the only state with significant backlogs including complaint investigations. Undoubtedly, the advocate groups will watch this suit closely.  Personally, I’m not sure what other spin-off litigation may arise as a result of this suit, but I suspect, given how rich the litigation playing field is today for SNFs, individual actions (wrongful death, actual harm) are likely to follow.

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