Missouri state lawmaker urges 24-hour digital surveillance of nursing home common areas

by Alyse Pfeil

A room is left empty on the fourth floor at Northview Village Nursing Home in St. Louis on Saturday, Dec. 16, 2023. The living facility closed suddenly, much to the outrage of employees, volunteers and relatives of residents who returned to find their belongings and information of the whereabouts of loved ones.

Vanessa Abbitt, Post-Dispatch

JEFFERSON CITY — A yearslong debate over the prevention of elder abuse and surveillance in nursing homes was again deliberated by a panel of state lawmakers Tuesday.

The House Children and Families committee heard a proposal that would mandate assisted living facilities and nursing homes to maintain continuous video and audio surveillance of common areas. It would also require facilities to provide a copy of a recording to a resident or guardian in order to investigate abuse or neglect.

The legislative hearing came a day after a St. Louis aldermanic committee released a report with city, state and federal-level recommendations aimed at improving nursing home care.

In 2020, the state Legislature, after negotiations with nursing home industry groups, approved a measure permitting nursing home residents to place cameras in their rooms, should they choose to. It was designed to prevent abuse or neglect and aid investigations into misconduct at long-term care facilities.

But problems with long-term care facilities have persisted in Missouri.

At the end of last year, Northview Village Nursing Home shut down abruptly and transported residents to other facilities in the middle of the night — often without notifying family members and, in some cases, without medical records, medications and personal possessions.

Rep. Adam Schnelting, R-St. Charles, who is sponsoring the bill this year, said his proposal is meant to “ensure transparency and accountability.”

While presenting to the committee, Schnelting shared a personal story.

“My own mother was killed nine months ago in one of these facilities,” he said.

After suffering a stroke and paralysis, Schnelting said his mother was transferred to a rehab facility, where she said that someone was trying to kill her. The facility, Schnelting said, eventually reported that his mother had “secured unknown injuries.” She was taken to a hospital and died a number of days later.

Schnelting said that cameras would have allowed him and his siblings to know who entered his mother’s room during the time frame the injuries occurred.

Committee members expressed their condolences and some talked about mistreatment of their loved ones in long-term care facilities.

Rep. Holly Jones, R-Eureka, said her mother was “degraded” and neglected. She said the facility told her that common-area cameras weren’t working, and her mother refused to leave her room because she felt unsafe. Jones eventually removed her mother from the facility.

“My mother had dementia,” said Rep. Marlene Terry, D-Bellefontaine Neighbors. “And she had also told us that they were killing her. And they were. And to this day, I regret that I didn’t do something different to help her because she was telling the truth.”

But the committee also discussed potential challenges that could arise from the proposal, like placing burdensome costs on facilities or families or releasing recordings to anyone who requests them.

The Health Insurance Portability and Accountability Act, the federal law that protects sensitive patient health information, and privacy should be considered, said Rep. Ingrid Burnett, D-Kansas City, “not just because it’s federal but because it’s the right thing to do.”

The legislation brought opposition from nursing home industry groups who also raised privacy concerns.

Families today can choose to have cameras in the rooms of long-term care facilities, but a lot of residents don’t want those cameras said Jorgen Schlemeier, a lobbyist for Missouri Assisted Living Association.

Under Schnelting’s bill, even if a resident objected to digital surveillance, “by law, I would be mandated to be watched by a camera and my audio to be recorded,” Schlemeier said.

Nikki Strong, executive director of Missouri Health Care Association, said a long-term care facility “is that resident’s home. ... Residents have the right to determine whether or not they would be videoed.”

“We’re one of the most heavily regulated industries in the country,” Strong said.

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Missouri state lawmaker urges 24-hour digital surveillance of nursing home common areas