| Bills would control video in nursing homes Do cameras stop abuse or violate privacy? 04/08/2001 By Kendall Anderson / The Dallas Morning News Thor Hallen suspected his mother was being abused in an Austin nursing home but couldn't prove it. So he hid a camcorder in Maurine Hallen's room and caught staffers on tape throwing the 88-year-old woman into a chair and cursing at her.
John Gress / Special to the DMN
Thor and Becky Hallen used a hidden video camera to document abuses of his mother at an Austin nursing home. Proposed Texas legislation discourages use of hidden cameras but would allow taping with notification. The Hallens say that defeats the purpose of the camera.
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Using video cameras – visible or hidden – is not prohibited by Texas law, but some nursing homes routinely prohibit them in their admissions contract or discharge residents caught using them.
At least five states, including Texas, are considering legislation that would require long-term care centers to allow residents or relatives to run video cameras in their room.
The Texas proposal would discourage the use of hidden cameras but would allow residents to record videos in their rooms as long as adequate notice is posted for staff and other residents.
Other states include Arkansas, Florida, Maryland and Massachusetts.
The idea is to prevent abuse, but opponents worry the video recordings would violate the privacy of employees and residents and could be misinterpreted.
"Advancing technology will lead to an increase in the use of this kind of monitoring," said Sen. Frank L. Madla, D-San Antonio, who is sponsoring the bill with Sen. Mike Moncrief, D-Fort Worth. "The Legislature can remain silent ... and let families and courts experiment in determining how these devices will be used or the Legislature can ... put into law an outline of the rights and responsibilities."
The measure was approved by the Senate Health and Human Services Committee last month, and a companion bill, by Rep. Paul Sadler, D-Henderson, is in the House Committee on Human Services.
Lawmakers are overstating the effectiveness of both measures when they should be debating more substantive issues related to residents' rights, say officials with the nonprofit group Texas Advocates for Nursing Home Residents.
"There are little things [lawmakers] want to hold up and say 'look what we've done' that don't really mean much for nursing home residents. ... This is one of them," said Beth Ferris, the organization's legislative liaison.
The measures advocates want lawmakers to support include improving funding and staffing standards for nursing homes. They want legislators to kill several industry-supported proposals that restrict state oversight and cap punitive damages in nursing home abuse cases.
The video-camera bill says if a camera is used without informing nursing home officials, getting permission from roommates and posting a notice on the door, the person responsible could be civilly liable for violating privacy rights.
"This legislation discourages undercover use ... that's why families would be better off without it," she said.
The Hallens said getting permission from the nursing home to use the camera would have defeated its purpose.
"You're not going to catch them doing mean things in front of a camera – we definitely would not have been able to confirm what the bruises and skin tears told us without hiding the camera," said Becky Hallen, whose husband settled out of court in his mother's abuse case. "This measure is very misleading."
Maurine Hallen and her sister-in-law, Rose Borg, were living in an Austin nursing home in 1997 when relatives noticed bruises and skin tears on their bodies. The Hallens said they didn't get any answers when they asked about the injuries, so they hid a camera in the room the two bedridden women shared.
"We were just in shock when we saw that tape, but it confirmed what we had known but couldn't prove," said Mrs. Hallen, who now lives outside Portland, Ore., with her husband.
Several officials in the nursing home industry question the effectiveness of a hidden camera.
"Why have a hidden camera to catch something bad when having one out in the open might prevent that from happening?" asked David Latimer, president of the Texas Association of Homes and Services for the Aging, which represents more than 175 mostly nonprofit long-term care facilities.
But Mr. Latimer and some other industry officials said they do not support the measure because it could lead to privacy violations, misinterpreted video footage and unhappy employees.
"We already have a heavily regulated industry with people looking over our shoulders, now we are creating a climate of suspicion in a world of privacy and dignity," Mr. Latimer said.
Many industry officials have said they are struggling to stay afloat financially because of low Medicaid reimbursement rates from the state and staffing shortages.
Discussing the video camera proposal detracts from those key issues, said officials with the Texas Health Care Association, which represents 600 mostly for-profit long-term care centers.
"What we need to be focusing on is funding and staffing," said Tim Graves, executive director of the association. "I think it [a video camera] presents a false sense of security. Cameras do not protect people – people protect people."
Ms. Ferris said the inability of most nursing home residents and relatives to buy and install a camera renders the bill ineffective.
About 70 percent of the nation's nursing home residents are Medicaid recipients, and an estimated 60 percent get no regular visitors, national elderly advocates say.
"I don't think there will be enough cameras to help the facility as a whole – maybe one or two people in a 160-bed home ... but not everyone else," Ms. Ferris said. "I can see frustration among the caregivers, and so they get frustrated in one room and just go to the next, where there is no camera, and the frustration comes out there."
Ms. Ferris said she'd like nursing homes to put cameras in eating areas and hallways.
Industry officials say the sensitive nature of personal care means video cameras, hidden or not, threaten privacy rights – even for those who consent to being taped.
Misinterprations are likely to occur, Mr. Latimer said.
"Sometimes it's very difficult for a nurse aide to turn someone without having outcries of pain, and those cries don't mean someone did something wrong," he said.
Someone might also mistakenly think nurses are trying to hide something when they pull the curtain around a resident's bed during dressing or bathing.
The proposal would prohibit the editing of videotape and requires that any copying of tapes be done by a professional.
The bill also requires that if residents are mentally competent, only they can request electronic monitoring. If the resident is not mentally competent and has a legal guardian, only the guardian can request the monitoring.
All costs associated with the camera would be the responsibility of the resident or their family or guardian, under the proposal.
"This is certainly not a strong bill," said Lee Lutz, chairwoman of the Garland-Richardson Association of Family Councils.
But she said her group, which represents families with loved ones in nursing homes, supports the bill.
"Families I know are willing to support the bill because having some camera in the room would possibly protect their loved ones."
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