Disabled nursing home residents sued the Maryland Department of Health and Health Secretary Laura Herrera Scott this week for allegedly violating the Americans With Disabilities Act and other federal requirements by failing to inspect facilities and address a backlog of complaints of subpar and even dangerous conditions.
Some of the plaintiffs developed bed sores and others are at risk of developing lesions from being left immobile in those conditions for too long, according to a complaint filed Wednesday in the U.S. District Court for the District of Maryland, Northern Division.
“Maryland is just not doing its job for nursing home residents,” said Liam McGivern, senior litigation attorney for Justice in Aging, a nonprofit legal advocacy organization representing the plaintiffs. “It needs to do better, and it needs to better right now.”
The state health department declined to comment on any specific allegations in the lawsuit.
“The Maryland Department of Health is committed to providing the best care to Maryland residents,” agency spokesman Chase Cook said in an email.
Poor care disproportionately affects minority communities in the state, the lawsuit states. More than half of the nursing facilities in Maryland with a majority of Black residents have a one- or two-star rating out of five on the Centers for Medicare and Medicaid Services care website, according to the complaint.
Plaintiffs’ attorneys argue that lapses in timely inspections and investigations violate state and federal requirements for facilities that receive Medicare and Medicaid dollars.
Maryland has the second-highest percentage of overdue annual inspections in the nation, after Kentucky, according to data published by the Centers for Medicare and Medicaid Services. More than 80 percent of the state’s nursing homes have a recertification survey that is at least 17 months late. According to the CMS data, the state has failed to inspect 104 nursing facilities for more than four years — delays that the lawsuit alleges have led to violations of residents’ rights and in some cases may have led to serious injuries.
McGivern said that all states experienced a backlog in inspections after the coronavirus pandemic, but most other states have invested in digging out of that hole.
“Maryland is an outlier in recovering from that,” he said.
The lawsuit alleges that despite legislative efforts going back to 2018, Maryland’s health department has not sufficiently staffed the team tasked with inspecting nursing homes, leaving positions unfilled. The agency also canceled an agreement with Montgomery County, the state’s most populous jurisdiction, that allowed 10 county inspectors to complete surveys at nursing facilities, replacing them with just four state employees.
The lawsuit also alleges that the department has a backlog of uninvestigated complaints from nursing home residents who have reported harmful treatment and conditions inside their facilities. According to the plaintiffs’ attorneys, the agency has received more than 13,000 complaints over the past three years but investigated fewer than half.
“When older adults and others with mobility-related disabilities enter nursing facilities, they generally have to give up a lot — their lives in the community, their sense of independence,” said Regan Bailey, litigation director at Justice in Aging. “That trade-off is significant, but to not actually get the care you are entitled to, to be treated in a way that robs you of your dignity, then that trade-off becomes unconscionable.”
Irene Connor, one of the named plaintiffs in the case, is a 54-year-old woman who entered a nursing facility for rehabilitation care after suffering serous injuries following a fall in her apartment. According to the lawsuit, Connor, who uses a wheelchair, has waited hours for nursing staff to respond to her call bell, has been left in soiled clothing for hours and has had staff put a fresh incontinence brief over a soiled one.
The suit alleges that the health department last inspected the facility where Connor lives in August 2022. Connor filed a complaint to the state agency in September 2023, and the suit alleges that the agency has not yet investigated that complaint.
The other named plaintiffs in the lawsuit make similar allegations.
According to the complaint, the health department has not inspected the facility where Michael Nevin, a 61-year-old man diagnosed with quadriplegia, has lived since 2020; Herman Dressel, 75, hit his head when a staff member tried to move him alone inside a nursing facility that allegedly has not been inspected since November 2022; and Richard Hollman, 57, who lives in a “persistent vegetative state,” developed bed sores from not moving frequently enough, most recently a Stage 2 pressure ulcer in January. The nursing facility where Hollman resides has not been inspected since 2022, the lawsuit alleges.
McGivern said an outcome favorable to the plaintiffs would benefit all Marylanders, even as the lawsuit focuses on nursing home residents with mobility impairments. He said they can easily be overlooked, and even devoted family members can struggle to know when their loved one’s rights are being violated.
“It’s the state’s job to do that,” he said, “and the state is just not doing its job.”
