Two years ago, Diane Hathaway of Glenwood had serious concerns about the care her mother was receiving in a southern Iowa nursing home.
Hathaway’s mother, Evelyn Havens, had complained of verbal abuse, rough handling by the aides, and long delays in having her call light answered. Before her death in January 2021 at age 96, Evelyn had also been hospitalized, twice, for severe dehydration, bed sores and an infection.
Although state inspectors would later determine the concerns were valid, citing the home for five federal regulatory violations, Hathaway wasn’t satisfied. Several months before her mother’s death, Hathaway had asked the administrator of the home about the possibility of installing a camera in her mother’s room to document or discourage acts of abuse or neglect. The administrator refused to consider it, she says, citing the federal Health Information Portability and Accountability Act, or HIPAA.
Aware that nothing in HIPAA prohibits patients from documenting their own care in a nursing home, Hathaway hired an attorney to pursue the matter. “But the home wouldn’t budge,” she said. “They wouldn’t even consider it.”
Now Hathaway is asking state lawmakers to approve a bill that would prohibit Iowa’s care facilities from banning resident-installed cameras in nursing homes. So far, though, the legislation hasn’t gained traction, and it continues to face stiff opposition from the nursing home industry’s lobbyists.
“I just don’t understand how people can turn a blind eye to this,” Hathaway says. “But I’m just one person. I can’t fight these lobbyists.”
Shannon Strickler, president and CEO of LeadingAge Iowa, which represents many Iowa nursing homes, says her organization’s opposition to the legislation is based on concerns over residents’ privacy. She acknowledges that many nursing homes have installed their own camera systems in common areas to monitor the staff, but says those cameras don’t capture residents receiving personal care.
“We’ve reviewed the issue with our member facilities and a lot of their concerns have to do with resident privacy,” Strickler said. “The cameras are pretty invasive on resident privacy.”
Hathaway says the privacy argument “doesn’t hold water.” Residents and their guardians, she says, should be the ones to determine whether their own privacy is at risk. In addition, she says, the legislation has specific provisions intended to ensure the protection of all residents’ privacy.
“That doesn’t seem to matter,” Hathaway said. “Our legislative leaders, the lobbyists and the nursing homes all continue to hide behind this excuse of ‘privacy’ to block this bill.”
A spokeswoman for the Iowa Health Care Association said that organization opposes cameras in nursing homes because they would “jeopardize resident privacy and rights under the Health Insurance Portability and Accountability Act” and infringe on the “privacy of roommates, other residents, staff and visitors, and could violate other laws, such as federal wiretapping laws.” The association didn’t say which specific elements of those federal laws would be violated.
Hathaway says House File 268 and Senate File 2057 specify that a resident’s roommate must consent to camera monitoring to ensure the protection of everyone’s privacy, and the home itself must be informed in advance of any recording devices that are used. In addition, rooms that are subject to camera monitoring would be identified with signage, alerting other residents to the presence of the camera.
The bill also provides that any recordings derived from the cameras could be used in civil court, provided the recordings are not altered in any way. While that might be enough to spark opposition among some care facility owners, Hathaway argues that cameras don’t differentiate between good-quality care and substandard care – which means the video can be used to exonerate nursing homes if they are confronted with false allegations of wrongdoing.
The House bill was referred last year to the chamber’s Human Resources Committee, which is chaired by Rep. Ann Meyer, a registered nurse and a Republican from Fort Dodge. Since then, the bill has not advanced, although a similar bill, which has yet to be introduced, is reportedly being worked on by another House Republican.
On the Senate side, the legislation has yet to win approval from the Senate Human Resources Committee, which is chaired Sen. Craig Johnson, a Republican and business developer from Independence.
In addition to LeadingAge Iowa, the legislation is opposed by the nursing home industry’s other main lobbyist, the Iowa Health Care Association. It is also opposed by other care providers such as Mosaic, Hope Haven Area Development Center, and Exceptional Persons Inc. The only entity registered as supporting the legislation is the Iowa Association for Justice.
The Iowa Long-Term Care Ombudsman’s Office, which was created to advocate for residents of the state’s care facilities, has not registered on either the House or Senate bill, indicating it is not lobbying lawmakers on any aspect of the proposal.
In recent years, 13 states — including Illinois, Missouri and Minnesota — have passed laws guaranteeing residents the right to deploy cameras inside their room. Other states, such as New Jersey, have gone even further, setting up camera-rental programs run out of the state attorney general’s office.
Another supporter of the Iowa legislation, Julie Ryan of Council Bluffs, says she doesn’t understand why lawmakers are so resistant to letting residents of nursing homes document their own care.
“We have cameras everywhere these days,” Ryan said. “We have even cameras in doggie day-care centers. But when it comes to protecting our elderly people, we don’t have that protection in Iowa.”
In Minnesota last year, two female aides at a care facility were arrested after the home’s own video-camera system allegedly captured the two exposing themselves to a female resident. The aides also shot video of themselves kissing the elderly woman on the lips, twerking, gyrating on her lap and then shooting foam balls at the woman’s head from a toy gun.
In North Carolina, the daughter of an 86-year-old nursing home resident placed a hidden camera in her mother’s room in 2020, and within 24 hours captured video of workers verbally and physically abusing the blind woman. The workers were fired but were not criminally charged.
The Iowa legislation states that any nursing facility that knowingly violates a resident’s rights under the proposed new law would be subject to unspecified “licensee discipline” and that any individual who obstructs a camera or interferes with the recording would be guilty of a serious misdemeanor.
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