Lights, camera, lawsuit
Elizabeth Leis Newman
To give credit where it's due, when the New York Times does a story on nursing homes, it tends to give up enough space to get multiple sides, not to mention sources that include the industry checklist of Professional People With Thoughts.
The topic du jour this time tackled the issue of nursing home cameras. The news peg is that, as of Nov. 1, Oklahoma joined New Mexico and Texas in allowing residents to install and watch surveillance cameras in their rooms.
As McKnight's John O'Connor wrote earlier this year, long-term care should start to expect cameras to become more omnipresent.
But as the NYT explained, and which the American Health Care Association's Greg Crist expanded on to me, is that while cameras are far from pervasive, administrators need to know both the law and that residents' families may have legitimate concerns.
“What we have said is to welcome the conversation,” Crist advised. “But we need to manage expectations.”
The first place to start is to become familiar with what the state says. Some states, such as Maryland, require a sign on the door before putting in a camera.
Secondly, there should clear parameters and goals outlined. I know, that sounds like a corporate board retreat, but by asking the right questions you can ascertain both what the family or resident is looking for, and stop potential problems. For example, who will be reviewing the footage? Is the goal to see what is happening at night? In the case of the anecdotal story featured in the New York Times, the camera didn't capture the petty thievery but instead discovered resident abuse. Less dire circumstances could find cameras recording consensual sexual interactions between residents, or an unwelcome friend or family member visiting. It's important to hash out “if this/then what” in these conversations.
Crist notes that the camera issue reflects “a convergence between two forces.” One is the members of the Baby Boomer generation, who want private rooms and have reasonably high expectations of privacy, and the other is the rapid abatement in the price of purchasing technology.
“It used to be a video camera was a big gift, and now you can use video on your phone,” he noted.
Which brings up another point: You cannot remind your employees often enough about HIPAA and privacy requirements, and to communicate a clear policy related to the use of phones with camera or video. It is, for example, a bad idea to shoot your coworkers doing wheelchair races down the hallway on the night shift and post it to YouTube. Or to assume an uploaded photo of a resident on Facebook is private.
At the same time, it's not bad to assume, whether you are speaking in public, doing a good deed, or yelling at a resident, that eyes are everywhere. Surveillance cameras are not a replacement for security, Crist reminds, also adding that sometimes even the threat of putting in a camera can be a successful deterrent to bad behavior.
Elizabeth Newman is Senior Editor at McKnight's. Follow her @TigerELN.