Attorney General Anthony Brown, left, testifies Tuesday in support of a bill to require video cameras inside nursing homes and assisted living facilities. With him is Zak Shirley, director of the office of Medicaid Fraud and Vulnerable Victims Unit, and Tammy Bresnahan, AARP Maryland’s senior director for advocacy. (Photo by William J. Ford/Maryland Matters)
After he fell and fractured his hop in May 2022, 75-year-old dementia patient Ellsworth Johnson-Bey was treated at a local hospital before being returned to an acute care center where the fall occurred.
Johnson-Bey never left his bed again. He eventually contracted pneumonia, developed blood clots in his lungs and was later diagnosed with COVID-19, dying at a local hospital on Sept. 5, 2022.
It was only because a video camera inside the nursing home captured geriatric nursing assistant Obiageriaku Iheanacho shoving Johnson-Bey before that May fall, that prosecutors were able to arrest and convict Iheanacho, then 36, for first-degree assault and vulnerable adult abuse.
The case represents one of many reasons why Attorney General Anthony Brown (D) wants the legislature to make it a state requirement to have video cameras installed at nursing homes and assisted living facilities.
“Video evidence has been crucial in securing justice for victims of abuse,” Brown said in testimony Tuesday before the Senate Finance Committee. “Opponents have raised concerns about the cost of video recording equipment and data storage, but the cost of inaction is far greater in terms of the harm to victims.”
But the cost of complying with Senate Bill 465 is a real concern, said Allison Ciborowski, president and CEO of LeadingAge Maryland, which is comprised of more than 150 nonprofit aging-service organizations. She said the estimated cost to purchase and install equipment ranges from $50,000 to $200,000, while annual maintenance and storage cost would be $40,000 to $80,000.
“These costs would be particularly burdensome for smaller, rural communities that are already operating on thin budgets,” she said to the committee.
The bill, requested by Brown, would require video equipment be installed in common areas, such as meeting and living rooms, entrances or hallways of nursing homes. Video would have to be maintained for at least 120 days, and video capture would have to be continuous and without interruption. Video could not be taken in private spaces such as bedrooms, bathrooms or “a place where a resident receives medical care.”
The videos would be policed by the Health Department’s Office of Health Care Quality (OHCQ), but a fiscal note with the bill said that office needs another $729,000 in fiscal 2026 to hire eight health care facility surveyors to do its job. The figure would rise to $977,000 in another four years.
No one from the department testified on the bill Tuesday.
But Sen. Benjamin F. Kramer (D-Montgomery) said the Health Care Quality office “has totally failed the most vulnerable in our nursing homes” for lack of inspections at nursing homes and assisted living facilities. He asked Brown if the money needed for the Health Care Quality office might not be better spent in the attorney general’s office.
“We always welcome more resources. However, in this case, the answer is no because that’s not our authority,” Brown said.
That was echoed by Zak Shirley, director of the attorney general’s office of Medicaid Fraud and Vulnerable Victims Unit, who said his office can prosecute individuals for certain abuses, but “I can’t prosecute a facility for not doing their job over the long term.” He said his office receives between 30 to 40 reports of adult abuse per month.
Danna Kauffman testified against the bill, noting that abuse is already reported to the Health Car Quality office, to the state Board of Nursing and, “to a certain extent,” to law enforcement. Kauffman, an attorney and managing partner at SMWK in Annapolis, was representing LifeSpan Network, a senior care provider association based in Columbia.
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She said some of the bill’s language – “for the purpose of detecting the abuse, neglect, or exploitation of residents” – paints nursing facilities and their workers in a bad light.
“That is a message I think we have to stop sending to individuals if we want them to work in our communities, and we desperately need them to work,” Kauffman said. “The state should really be focusing on what it should be doing and not an unfunded mandate.”
Kauffman added that the state should provide more resources, such as better educating geriatric nursing assistants.
Kramer said he appreciates “all that, but I’m not convinced that these issues are mutually exclusive.”
“You put in greater resources [and] that’s a wonderful thing. But that doesn’t mean we should not simultaneously be doing our best to ensure that health, well-being and safety of the residents of the nursing home,” he said.
The House version of the bill is scheduled to be heard Thursday by the Health and Government Operations Committee.