Bill would require long-term-care facilities to allow cameras that monitor resident care

Jane Casey

The camera that Jane Casey hid in her mother’s assisted living facility may have been against the law, but it put her on a journey to find a way to legally track the care of a vulnerable population.

In 2013, Casey was successful in getting Virginia legislators to pass a law to allow electronic monitoring in nursing homes and assisted-living facilities, if the resident or authorized family member agreed. Casey was disappointed, though, by a clause added during General Assembly negotiations: allowing facilities the option to refuse.

This year Casey returned to ask legislators to toughen the regulation by requiring that nursing homes allow the cameras.

Senate Bill 553, sponsored by Sen. John Cosgrove, R-Chesapeake, sailed through the Senate, and the measure is being considered by the House.

“Unless we get this bill passed, we have nothing,” Casey said. “What we need is for nursing homes not to be able to say no. Until then, people will be neglected.”

The Virginia Health Care Association supports the voluntary regulations that resulted from the 2013 action, but said it has concerns about the mandatory nature of the current bill, citing the Health Insurance Portability and Accountability Act privacy law.

“The bill as currently drafted raises concerns for us related to its mandatory nature, as well as the practicality of implementation, which raises questions of legal liability, HIPAA compliance, and other privacy issues,” read a statement provided by the organization’s communications department.

Several other states already have these laws, riding a tide of families who want to monitor care of relatives who can’t communicate well due to illness or disease.

Texas was the first to adopt one in 2001. Since then, New Mexico, Oklahoma, Washington and Illinois have passed laws requiring nursing homes to allow residents and their families to place cameras in their rooms. Maryland allows it but doesn’t require that nursing homes agree to a request.

The laws generally make residents and their families responsible for buying, installing and maintaining the equipment. Illinois is the most recent state to pass a law – the governor signed it in August – and also set up a $50,000 public fund to help residents who couldn’t afford the equipment.

Some advocacy groups that have supported the laws say they can act as a deterrent to abuse and neglect. The nursing home industry has concerns, though, about the privacy and dignity of residents, and whether they’re able to consent to the around-the-clock monitoring. The nursing home industry also questioned what the liability would be for facilities and their employees.

Virginia’s regulations require the written consent of the residents, or their authorized representative, and that of roommates, if there are any. Also a sign must be posted outside the room to let staff, caregivers and visitors know about the monitoring.

Casey became interested in monitoring when her mother developed dementia and macular degeneration that impaired her vision. She couldn’t live independently anymore.

Even in high-quality places, Casey often found the care to be substandard. Her mother lived in several retirement communities and assisted-living facilities before moving to Lake Prince Woods in Suffolk in 2009. That’s where Casey bought the surveillance camera hidden in a picture frame. The video she reviewed showed an employee changing her mother’s clothing and linens without appearing to say a word.

When Casey brought that up, along with some other lapses in care to an administrator, she was asked to remove the camera. Casey later moved her mother to a home that she and her husband had built on their property in Suffolk and hired caregivers for when they couldn’t be with her. She died three years later at 96.

The regulations that the 2013 law led to are still in the promulgation stage, according to Erik Bodin, director of the Virginia Department of Health’s office of licensure and certification. State health and executive branch officials are reviewing some final changes, after which the regulations will be posted for a 60-day public comment period, probably in the spring.

He said that if the bill passes, changing the regulations from voluntary to mandatory, that law would go into effect on July 1. The regulations would likely need to be changed shortly after that through a process that takes less time, he said.

Even though the bill is too late to help her mother, Casey believes it will help others in the same situation, who need protection. But even if it passes, there’s another important element: “It depends on whether families want to pay attention.”

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Bill would require long-term-care facilities to allow cameras that monitor resident care