Two years ago, Diane Hathaway of Glenwood had serious concerns about the care her mother was receiving at a southern Iowa nursing home.
Hathaway’s mother, Evelyn Havens, had complained of verbal abuse, rough handling by aides and long delays for her call light to respond. Prior to her death in January 2021 at age 96, Evelyn had also been hospitalized, twice, for severe dehydration, pressure sores and infection.
Although state inspectors later determined the concerns were valid, citing the home for five violations of federal regulations, Hathaway was not satisfied. Several months before her mother’s death, Hathaway had asked the home’s administrator about the possibility of installing a camera in her mother’s bedroom to document or deter acts of abuse or neglect. The administrator declined to review it, she said, citing the federal Health Information Portability and Accountability Act, or HIPAA.
Realizing that nothing in HIPAA prohibits patients from documenting their own care in a nursing home, Hathaway hired an attorney to pursue the case. “But the house was not moving,” she said. “They wouldn’t even consider it.”
Now Hathaway is asking state lawmakers to approve a bill that would prohibit Iowa care facilities from banning cameras installed by residents in nursing homes. So far, however, the legislation has not gained traction and it continues to face stiff opposition from nursing home industry lobbyists.
“I just don’t understand how people can overlook 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 about resident privacy. She acknowledges that many nursing homes have installed their own camera systems in common areas to monitor staff, but says those cameras do not capture residents receiving personal care.
“We have reviewed the issue with our member facilities and many of their concerns have to do with resident privacy,” Strickler said. “The cameras are quite intrusive to residents’ privacy.”
Hathaway says the secrecy argument “doesn’t hold up.” Residents and their guardians, she says, should be the ones to determine whether their own privacy is at risk. In addition, she says, the law contains specific provisions aimed at ensuring the privacy of all residents.
“It doesn’t seem to matter,” Hathaway said. “Our legislative leaders, lobbyists and nursing homes all continue to hide behind this ‘privacy’ excuse to block this bill.”
A spokeswoman for the Iowa Health Care Association said the organization opposes cameras in nursing homes because they ‘would compromise residents’ privacy and rights under the Portability Act. and health insurance liability” and would violate “the privacy of roommates, other residents, staff, and visitors, and may violate other laws, such as the federal wiretapping laws. The association did not specify which specific elements of these federal laws would be violated.
Hathaway says Home file 268 and Senate File 2057 specify that a resident’s roommate must consent to camera surveillance to ensure everyone’s privacy is protected, and that the home itself must be notified in advance of any recording device used. Additionally, rooms subject to camera surveillance would be identified by 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 may be enough to spark opposition from some healthcare facility owners, Hathaway argues that the cameras don’t differentiate between good quality care and substandard care – which means video can be used to exculpate nursing homes if faced with false allegations of wrongdoing.
The House bill was referred last year to the House Human Resources Committee, which is chaired by Representative Ann Meyer, a registered nurse and Fort Dodge Republican. Since then, the bill has not moved forward, although a similar bill, which has yet to be introduced, is reportedly being drafted by another House Republican.
On the Senate side, the legislation has yet to gain approval from the Senate Human Resources Committee, which is chaired by Sen. Craig Johnson, a Republican and Independence business developer.
In addition to LeadingAge Iowa, the other main nursing home industry lobbyist opposing the legislation, the Iowa Health Care Association. It is also opposed by other healthcare providers such as Mosaic, Hope Haven Area Development Center and Exceptional Persons Inc. The only entity listed as supporting the legislation is the Iowa Association for Justice.
Iowa’s office of the long-term care ombudsman, which was created to advocate for residents of state care facilities, did not sign on to either the House bill or the Senate bill. , indicating that he is not pressuring 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 in their bedrooms. Other states, like New Jersey, have gone even further by setting up camera rental programs run by 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 reluctant to let nursing home residents document their own care.
“We have cameras everywhere these days,” Ryan said. “We even have cameras in dog daycares. But when it comes to protecting our seniors, we don’t have that protection in Iowa.
In Minnesota last year, two assistants in a care facility have been arrested after the home’s own video camera system captured the two exposing themselves to a female resident. Helpers also filmed video of themselves kissing the elderly woman on the lips, twerking, spinning in her lap, then shooting foam balls at the woman’s head with a toy gun.
In North Carolina, the 86-year-old daughter of a nursing home resident placed a hidden camera in her mother’s bedroom in 2020 and, within 24 hours, captured video of verbally and physically abusing workers of the blind woman. The workers were fired but have not been criminally charged.
Iowa law says any nursing facility that knowingly violates a resident’s rights under the proposed new law would be subject to unspecified “licensee discipline” and that anyone who obstructs a camera or interfere with the recording would be guilty of a serious misdemeanour.