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Senator Asks Privacy Regulators to Stop Abuse of Nursing Home Residents on Social Media

ProPublica reported in December about three dozen inappropriate posts by employees of nursing homes and assisted living centers. A top Democrat wants details on efforts to combat the trend.

“We all want our loved ones to receive the quality of care and attention they deserve from the professionals to whom we entrust their care,” Sen. Tom Carper said in a statement. (Manuel Balce Ceneta/AP Photo)

A U.S. senator has asked government regulators what, if anything, they’re doing to stop nursing home workers from taking degrading and dehumanizing photos of residents and posting them on social media.

In a letter sent Tuesday to the Office for Civil Rights of the U.S. Department of Health and Human Services, U.S. Sen. Tom Carper, D-Del., referenced a ProPublica story from last year that identified about three dozen inappropriate posts by employees of nursing homes and assisted living facilities. Some included naked photos and videos of residents, many of whom have dementia.

Inappropriate Social Media Posts by Nursing Home Workers, Detailed

See details of 37 incidents since 2012 in which workers at nursing homes and assisted-living centers shared photos or videos of residents on social media networks. Read more.

“This type of abuse is unacceptable and falls short of our moral obligation to the ‘least of these’ in our society,” Carper, ranking member of the Senate Homeland Security and Governmental Affairs Committee, said in a statement. “We all want our loved ones to receive the quality of care and attention they deserve from the professionals to whom we entrust their care.”

The Office for Civil Rights is the agency that enforces the federal patient privacy law known as HIPAA. It can impose both civil and criminal penalties for violations, but it rarely does so, we reported last year.

Carper asked the office how many complaints it has received related to social media use in nursing homes. He asked how many have resulted in civil penalties or a referral to the Department of Justice. And he wanted to know if the office planned to issue guidance to nursing homes on the use of social media and HIPAA, more formally the Health Insurance Portability and Accountability Act.

Deven McGraw, the office’s deputy director for health information privacy, said in an email Tuesday that the office would reply to the senator’s letter but that “there is nothing I can release to you at this point.”

In December, ProPublica identified 35 instances since 2012 in which workers at nursing homes and assisted-living centers surreptitiously shared photos or videos of residents, some of whom were partially or completely naked. At least 16 cases involved Snapchat, a social media service in which photos appear for a few seconds and then disappear with no lasting record.

The incidents illustrated the emerging threat that social media poses to patient privacy and, at the same time, its powerful potential for capturing transgressions that previously might have gone unrecorded. Abusive treatment is not new at nursing homes. Workers have been accused of sexually assaulting residents, sedating them with antipsychotic drugs and failing to change urine-soaked bed sheets. But the posting of explicit photos is a new type of mistreatment — one that sometimes leaves its own digital trail.

Since then, we’ve identified two more cases, both involving Snapchat. In January, a former nursing assistant at a Wisconsin assisted-living facility was charged with a felony for allegedly taking a video of a mostly naked resident and posting it on Snapchat. She admitted her action to the facility’s executive director and said “it was immoral and very terribly wrong,” the criminal complaint said.

About the Series

This year, ProPublica has been chronicling how weaknesses in federal and state laws, as well as lax enforcement, have left patients vulnerable to damaging invasions of privacy.

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And in February, a nursing assistant in Indiana was charged with felony and misdemeanor counts for posting a video of a patient in the shower. According to WNDU TV, the video “depicted an 85-year-old dementia patient naked in the shower while the staff sprayed her with water. Witnesses to the video told supervisors they heard [the aide’s] voice in the recording saying ‘look at this crazy bitch she doesn’t like taking showers.’”

Carper is the second senator to call for a review of the inappropriate posts. In December, Sen. Joe Donnelly, D-Ind., called on the Senate Aging Committee to investigate the issue. “It is troubling and disturbing that some seniors are unwillingly and unknowingly victims of exploitation and abuse on social media by some nursing home workers,” Donnelly, who serves on the aging committee, said in a statement.

In December, we reported that the Office for Civil Rights had not penalized any nursing homes for violations involving social media or issued recommendations to health providers on the topic.

McGraw expressed outrage when told about the incidents. “If we don’t have pending investigations on any of these cases … they would be candidates for further inquiry from our end,” she said, adding that the office also should issue guidance on social media and the privacy law.

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