CMS to Crack Down on Abuse of Nursing Home Residents on Social Media

Nursing homes would face stiff penalties—which could include being booted from Medicare—for failing to take steps to stop a disturbing practice: sharing embarrassing photos or videos of residents.

CMS issued a memorandum Friday to state health agencies telling them to make sure all nursing homes have policies to bar staff from taking photographs that are demeaning to residents, including those that portray abuse. The move comes after Pro Publica reports that detailed abuses using Facebook, Instagram, and Snapchat. In some cases, residents were naked, had soiled themselves, or were dead. The news organization found 47 incidents since 2012, inlcuding several very recent egregious examples.

“Nursing homes must establish an environment that is as homelike as possible and includes a culture and environment that treats each resident with respect and dignity,” the memo reads. “Treating a nursing home resident in any manner that does not uphold a resident’s sense of self-worth and individuality dehumanizes the resident and creates an environment that perpetuates a disrespectful and/or potentially abusive attitude toward the residents.”

CMS deemed it necessary to remind states that federal law requires nursing homes to be places where “all individuals are treated as human beings.”

States must ensure that nursing homes have policies that apply to staff, consultants, contractors, volunteers, or any other caregiver acting on a facility’s behalf. CMS goes on to point out areas of federal regulations that apply, including:

· Patients’ rights to privacy and confidentiality of all personal and clinical records, including communications with family and other residents.

· Rights to be free of verbal, sexual, physical, and mental abuse, including corporal punishment and involuntary seclusion.

· Nursing homes and assisted living centers must develop procedures to prevent such abuse, neglect, or mistreatment.

Facilities will be required to incorporate training about social media abuse into other training, but doing so will not absolve them of responsibility of abuse occurs. Facilities will have the duty to (1) report social media abuse, (2) conduct investigations, (3) take corrective action and (4) follow-up and report on findings. Facilities that find abuse must punish or fire the staff involved and counsel the resident who is harmed.

If a crime is suspected, nursing homes must call the police, the memo states. If a nurse or nurse’s aide is involved, the abuse must be reported to the state licensing authority or its nurse aide registry.

State agencies have 30 days from the memo’s release to add questions about social media abuse policies to their next scheduled survey of the facilities they supervise. Nursing homes and assisted living centers may be asked to provide copies of written policies.

US Senator Charles Grassley of Iowa reacted strongly to the Pro Publica reports, sending letters to the Justice Department, the Office of Civil Rights, and social media companies on what they would do to prevent abuse. “We need to prevent it, and we need to punish it when it happens,” he told NPR yesterday.

An industry trade group, the American Health Care Association, had issued its own guidelines on how to address social media issues, suggesting that facilities have an online “code of conduct” for employees.