When people consider access to justice they typically think of entities that assist people dealing with housing, immigration, and domestic violence issues. While these are important areas of concern for many access to justice organizations, the scope of access to justice is far broader, and there are myriad ways in which civil legal aid organizations help protect the rights of vulnerable Marylanders, including monitoring nursing home care facilities. The Access to Justice Commission champions additional funding for civil legal aid so that they can do this live-saving and important work.
Recently, a group of nursing facility residents with disabilities and mobility impairments filed a class action lawsuit against the Maryland Department of Health in the U.S. District Court for Maryland. The lawsuit, which alleges violations of the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act, aims to compel the state agency to enforce accountability among nursing facilities. These facilities are accused of failing to honor residents' federal and state rights and neglecting to provide necessary services that ensure their health, safety, and quality of life.
The lawsuit highlights the State's failure to conduct annual surveys of over 80% of nursing facilities, coupled with a significant backlog of overdue complaints. This lack of oversight has purportedly led to widespread harm, depriving residents of their dignity and essential care, endangering their health, and violating regulations governing Medicare and Medicaid-funded facilities.
The representative plaintiffs in this case are individuals with mobility-related disabilities who depend entirely on nursing facilities for basic needs such as toileting, eating, mobility, and personal hygiene. The lawsuit details harrowing conditions where high-need residents are often left unattended for hours in soiled linens and clothing, as their calls for assistance go unanswered. Many plaintiffs are unable to leave their beds or rooms without staff assistance, and the alleged neglect ultimately resulted in prolonged confinement and the development of severe bed sores. Forcing residents to live under such conditions violates both state and federal regulations, and poses a serious harm if they are not addressed.
The State’s regulatory failures are particularly pronounced in facilities with majority Black residents. Over 50% of such facilities have received the lowest ratings on the Centers for Medicare and Medicaid Services (CMS) Care Compare website, demonstrating a significant inequity in the quality of care provided.
Regan Bailey, Litigation Director at Justice in Aging, emphasized the gravity of the situation: “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. That tradeoff 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 tradeoff becomes unconscionable. It’s the state’s role to keep nursing facilities from treating people this way.”
Ashley Woolard, Lead Attorney for the Health and Benefits Equity Project at the Public Justice Center, highlighted the issue of complaint backlogs: “Even when residents are able to file a complaint with the state about their care, those complaints end up in a backlog of thousands of others and may go unanswered for years. The state has received more than 13,000 complaints over the past three years and fewer than half have been investigated. Right now, Maryland’s nursing facility residents have been left without a lifeline to the agency responsible for investigating allegations of abuse, neglect, and other serious rights violations.”
Sheila Boston, a partner at Arnold & Porter, stressed the importance of the lawsuit: “Our lawsuit aims to ensure that our clients who have mobility impairments can live in nursing homes that provide a safe and supportive environment. The special needs of those living in nursing homes are worthy of our attention and prioritization.”
This lawsuit, brought forth by the Public Justice Center, Justice in Aging, and Arnold & Porter, seeks to hold Maryland accountable and ensure that nursing facility residents receive the care and respect they deserve. Sadly, the case highlights the urgent need for regulatory enforcement and the systemic issues that have left vulnerable residents in precarious conditions.
For more details, you can read the complaint here.
You can access information about the Public Justice Center, Justice in Aging, and Arnold & Porter by visiting the links below.
Public Justice Center - https://www.publicjustice.org/en/
Justice in Aging - https://justiceinaging.org/
Arnold & Porter - https://www.arnoldporter.com/en