Introduction

Nursing homes are meant to be safe spaces for elderly and vulnerable patients to receive the care they need. Over the past decade, the digital age has provided a vehicle for one of the most appalling abuses of nursing home patients. Nursing home employees across the country are posting dehumanizing, humiliating photos and videos of their elderly patients on social media networks such as Snapchat, Instagram, Facebook and others, an egregious violation of these patients’ privacy, dignity and the law.

This type of abuse can have serious emotional and psychological consequences for those affected. Not only does it compromise their privacy and confidentiality, but it can also lead to humiliation, embarrassment, and even feelings of betrayal. Additionally, it can expose vulnerable patients to potential harassment or bullying online, as well as cause undue stress and anxiety.

Why nursing home workers post photos of patients online.

There are several reasons why nursing home staff members may post photos or videos of patients on social media. The staff may do so out of a misguided sense of humor, seeking to entertain themselves or others at the expense of their patients. Beyond that, staff may be maliciously seeking to inflict shame, embarrassment or harm upon a patient out of spite or as a form of retribution. In other cases, staff may be trying to document instances of patient abuse or neglect in order to expose it to the public. However, regardless of the intentions behind it, this behavior is never acceptable and can lead to serious consequences.

Violations of state and federal laws.

The posting of photos or videos of nursing home patients on social media violates both state and federal laws. The Health Insurance Portability and Accountability Act (HIPAA), for example, is a federal law that mandates the protection of patient privacy and confidentiality. Under this law healthcare providers, including nursing home staff members, are required to obtain written consent from patients before sharing any personal health information, including photos or videos. In addition to violating HIPAA, posting photos may also subject federal or state criminal laws resulting in serious legal consequences, including fines and even imprisonment.

In 2015, ProPublica, an independent nonprofit investigative public interest news website, compiled and published dozens of examples of social media abuse (e.g., naked photos and videos of defenseless patients) that had been substantiated and had resulted in criminal charges or reported in law enforcement or state investigation reports (Ornstein, 2015).

Following are a few examples…

• Fremont, Michigan — A nursing assistant snapped a photo of a female patient with Alzheimer’s disease on the toilet with her private parts exposed, drew an obscene picture over the photo, and shared it on Snapchat. The nursing assistant was fired and pled no contest to a felony charge of using a computer to commit a crime. It’s worth noting that the facility had written up the employee twice previously for using her cell phone and social media at work.
• St. Charles, Illinois — One nursing home assistant recorded another using a nylon strap to lightly slap the face of a 97-year-old patient with dementia. In the video, which was posted on Snapchat, the patient could be heard crying out, “Don’t! Don’t!” as the employees laughed. They were fired, pled guilty to a misdemeanor count of battery and were sentenced to probation and community service.
• Gridley, California — Five nursing assistants were fired and prosecuted for shooting and sharing photos and videos of patients on Snapchat. In one, a nursing assistant was “twerking” (dancing in a sexually provocative way) over a patient’s head. In another, a patient wearing only underwear was carried by a male nursing assistant over his shoulder. Some involved patients who were inappropriately exposed or appeared to be deceased. One nursing assistant said pictures and videos were sent on many occasions. The facility failed to report the abuse in a timely manner because, the administrator told inspectors, “there was no concrete evidence that it had occurred.” Two of the former employees entered pleas of guilty or no contest to felony elder or dependent adult abuse; the others of failing to report the abuse, a misdemeanor.
• Hubbard, Iowa — A nursing assistant was fired after sharing a photo on Snapchat of an elderly, incapacitated patient with his pants down and feces on his legs, shirt and left hand. The patient had extreme cognitive impairments due to dementia. The staff member captioned the photo “shit galore” and sent it to several other employees, one of whom reported it to the home’s administration. Hardin County Deputy Sheriff Jeffrey Brenneman said his office recommended that the nursing home contact state regulators, but did not file any criminal charges. The Iowa Department of Inspections and Appeals fined the facility a mere $1,000 for the incident but did not pursue criminal charges because the patient’s genitals were not exposed.
• Green Bay, Wisconsin — Two nursing home employees shot photos and videos of nude and partially nude elderly patients and shared them on Snapchat. One picture showed a patient vomiting; another video showed a patient being assisted with an obstructed bowel. Both employees were fired and pled no contest to misdemeanor counts of disorderly conduct and invasion of privacy through use of a surveillance device.
• Los Angeles, California — Police were notified after a video was posted to Instagram showing one employee “bending his rear-end over the patient’s head and [expelling] gas over the patient’s face.” The incident was reported to the nursing home’s administration by an employee. The patient told inspectors that “facility employees passed gas in his face as often as every month.” These two employees no longer work at the facility.

Bear in mind that these examples constitute only some of the very small number of perpetrators who actually got caught. No doubt, countless others haven’t yet been caught. Consider how many others have shot and shared cruel, dehumanizing photos or videos of patients but were never caught because they didn’t use social media, or because they weren’t exposed by someone who cared enough to hold them accountable. Finally, consider those who abused patients and were able to avoid detection because they weren’t foolish enough to photograph their own criminal acts, and you begin to realize that this problem is much more prevalent than we know.

Lack of accountability.

One of the most disturbing aspects of social media abuse is the cavalier attitude toward this crime that seems to permeate many nursing homes. Consider the case of a former nursing assistant in Indiana, who pled guilty to one count of voyeurism for sharing a photo of a patient’s back side and buttocks on Snapchat. After entering a plea agreement, she served only three days in jail with probation.

The nursing home received no citations and paid no penalties.
In an interview, the nursing aide tried to justify her conduct by claiming she didn’t take the picture for malicious reasons and the patient didn’t even know it happened. “They just blew everything out of proportion,” she claimed. “It was just a picture of her butt. How many people take a picture of people’s butts?… I worked in health care for five years. Everybody takes pictures of the patients all the time. I’m not the only one” (Ornstein, 2015).

The convicted aide had the audacity to argue that people searching for nursing homes for relatives have bigger issues to worry about than privacy violations involving social media. “There is so much abuse that goes on,” she said. “Nursing homes are so short staffed. Every facility I worked in, every time I went in, patients would be soaked from head to toe in pee and they sat in it for hours. They were treated like animals. I understand taking pictures is bad, but there are so many worse things that need to be taken care of, too.”

Nursing homes must act to prevent social media abuse.

Clearly, nursing home management must pay closer attention to their employees’ use of social media. Facilities must develop dedicated social media policies, train — or retrain — staff on those policies, and encourage staff to report violations. They must enforce those rules, not just pay lip service to them. If there’s no punishment for social media abuse because no one is watching, staff have no incentive to follow the rules. At the very least, employees caught exploiting patients on social media should be terminated immediately and reported to law enforcement. The nursing homes should ensure regular audits and monitoring to ensure compliance with their social media policies.

Some lawmakers have advocated for banning cell phones or other devices that allow nursing home staff to photograph patients in areas where patients are receiving care. But, of course, the ideal solution is to hire workers who would never commit these crimes in the first place.

It’s a sad commentary about the nursing home industry, and perhaps society in general, that we’ve reached a point where there’s even a need to develop policies and procedures to ensure that patients’ privacy and dignity are protected from abuse and exploitation by staff. But this need is very real. And it is inevitable that as technology evolves, so will the means and mechanisms by which nursing home patients can be targeted and exploited by staff.

What you can do.

If you’re a family member of a nursing home patient, talk to their care team about the facility’s policy on the use of social media. Is there one? Does it extend beyond just HIPAA requirements to privacy violations and exploitation? Are employees trained regularly? Do they know what constitutes abuse and exploitation on social media?

If you suspect that your loved one has been a victim of social media abuse, it is important to take action immediately. Here are some steps that families can take to report social media abuse in nursing homes:

1. Document the abuse: If you come across any posts or images on social media that appear to be inappropriate or exploitative of your loved one, take screenshots and document the details of the post such as the date, time, and who posted it.
2. Contact the nursing home administration: Reach out to the nursing home’s administration to report the social media abuse. Provide them with the documentation you have collected, and ask them to take immediate action to address the situation. They should investigate the incident and take appropriate disciplinary action against any staff member involved.
3. File a complaint with the oversight agency: You can file a complaint with the regulatory body in your state that oversees nursing home facilities. In Indiana, that agency is the Indiana State Department of Health (ISDH).
4. Notify authorities: You can also contact local law enforcement or adult protective services in your area.
5. Consult a lawyer: If your loved one has suffered emotional or physical harm as a result of the social media abuse, you may want to consider consulting with a lawyer who specializes in elder abuse cases. They can help you navigate the legal system and take appropriate legal action against the nursing home and any staff members involved.
6. Educate others: Share your experience with others and raise awareness about the issue of social media abuse in nursing homes. Encourage others to be vigilant about their loved ones’ privacy and to report any suspected abuse immediately.

Conclusion

In conclusion, the posting of photos or videos of patients in nursing homes on social media is a serious form of abuse that can have lasting emotional and psychological consequences for those affected. Healthcare providers must take their legal and ethical obligations seriously, and nursing homes must implement strict policies and procedures to prevent this type of behavior. Patients and their families must also be proactive in protecting their privacy rights and reporting any instances of abuse or mistreatment. By working together, we can ensure that nursing homes remain safe and respectful environments for our elderly and vulnerable loved ones.

FAQs

1. What is social media abuse in nursing homes?

Social media abuse in nursing homes refers to the unauthorized posting of photos, videos, or other personal information of patients on social media platforms by nursing home staff members. This type of abuse violates patient privacy and confidentiality and can have serious emotional and psychological consequences for the patient.

2. How can social media abuse in nursing homes be prevented?

To prevent social media abuse in nursing homes, staff members must receive proper training on patient privacy and confidentiality. Nursing homes should also implement strict policies and procedures regarding the use of social media by staff members, foster a culture of reporting of violations by staff, and conduct audits to ensure policies are being followed. Patients and their families can also take steps to protect themselves by being vigilant about their privacy rights and reporting any instances of abuse or mistreatment. Holding responsible employees and facilities accountable will help deter others in the future.

3. What should I do if I suspect my loved one has been a victim of social media abuse in a nursing home?

If you suspect your loved one has been a victim of social media abuse in a nursing home, it is important to take action immediately. Document the abuse, contact the nursing home administration, and file a complaint with the appropriate authorities if necessary. You may also want to consult with a lawyer who specializes in elder abuse cases if your loved one has suffered emotional or physical harm as a result of the abuse.

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You may be interested in …

• How Common is Nursing Home Abuse and Neglect?
• Voyeurism Felony Charge for Indiana Nursing Home Employee
• Another Indiana Nursing Home Aide Charged with Felony Voyeurism After Videotaping a Patient in the Shower

 

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Jeff Powless is an attorney and the author of the 2017 book, Abuses and Excuses: How To Hold Bad Nursing Homes Accountable.  Abuses and Excuses breaks new ground in helping patients and families hold bad nursing homes accountable, sharing a wealth of insider strategies and insights. It’s an eye-opening account of corporate greed, acts of neglect and abuse, an insidious industry culture of cover-up, and the actual harm that inevitably befalls vulnerable nursing home patients all across the country with shocking frequency.