Degrading photos on social media pose threat to nursing home patients

In dozens of instances, nursing home workers across the country are posting embarrassing and dehumanizing photos of elderly residents on social media networks such as Snapchat, violating their privacy, dignity and, sometimes, the law.

ProPublica has identified 35 instances - two of them in Iowa - since 2012 in which workers at nursing homes and assisted-living centers have 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.

Some have led to criminal charges but most have not, even though posting patients' photos without their permission may violate the Health Insurance Portability and Accountability Act, the federal patient privacy law.

The incidents illustrate the emerging threat that social media poses to patient privacy but also its potential for capturing transgressions that previously might have gone unrecorded.

Abusive treatment is not new at nursing homes. Some workers have been accused of sexually assaulting residents, sedating them with antipsychotic drugs or failing to change urine-soaked bedsheets. But the posting of explicit photos is a new type of mistreatment.

In October 2014, for instance, a nursing assistant at the Riverside North Enrichment Community in Ames recorded a video showing a resident's genitals.

According to a criminal complaint described in the Ames Tribune, assistant Nakita Ladon Lowery of Ames shared the video over Snapshat. She pleaded guilty to one count of dependent adult abuse, a misdemeanor.

Around August 2013, two employees of the Bishop Drumm Retirement Center in Johnston were fired after posting at least one inappropriate photo on Instagram. Officials would not detail the nature of the photo.

This February at the Autumn Care Center in Newark, Ohio, a nursing assistant recorded a video of residents lying in bed as they were coached to say, 'I'm in love with the coco,” the lyrics of a gangster rap song ('coco” is slang for cocaine). Across a female resident's chest was a banner that read, 'Got these hoes trained.” It was shared on Snapchat.

The woman's son told government inspectors that his mother, who had worked as a church secretary for 30 years, would have been mortified by the video. Days after the incident, the home changed hands and is now known as Price Road Health and Rehabilitation Center.

The prior owner, Steve Hitchens, said the incident happened days before the home was sold and he does not recall details.

'Something hasn't happened now unless there's a selfie or Facebook posting about it,” said Marian Ryan, the district attorney of Middlesex County, Mass., whose office is pursuing elder abuse charges against two women there who posted videos of nursing home residents on Snapchat. 'The use of social media is just pervasive across every aspect of society.”

ProPublica identified incidents by searching government inspection reports, court cases and media accounts. Nursing homes seldom found problematic social media posts themselves - most came to light based on tips from staffers or members of the community, records show.

Ryan said she suspects such incidents are underreported partly because many of the victims have dementia.

The federal agency charged with enforcing the privacy law, the Office for Civil Rights in the Department of Health and Human Services, has not penalized any nursing homes for violations involving social media or issued any recommendations on the topic.

Deven McGraw, the office's deputy director for health information privacy, 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.

While it is impossible to know whether these incidents are increasing, ProPublica's analysis identified 22 cases in the past two years, but only 13 in the two years before that. That could partly reflect the explosive growth of social media and Snapchat in particular.

The incidents represent a tiny fraction of the content created by Snapchat's more than 100 million daily active users, who view more than 6 billion videos each day.

'This type of behavior is cruel and violates the Terms of Service promise Snapchatters make to respect other people's rights,” the company said in a statement. 'We believe that elderly people should be celebrated and cared for with respect and compassion.”

Greg Crist, a spokesman for the American Health Care Association, the nursing home industry trade group, said in an email that unauthorized photos and videos of residents are 'disturbing.”

Some homes, he noted, particularly those in rural areas, do not use social media themselves so they may not realize that 'many of their employees do, so they need to be vigilant and aware.”

Many nursing homes ban the use of cellphones on the job, but have had trouble enforcing those rules.

Some homes have allowed employees to keep working after warning them about using cellphones.

At Newaygo County Medical Care Facility in Michigan, a nursing assistant was written up twice for using her cellphone at work, including once for taking pictures, before she was accused of taking a picture of Mindy Mench's grandmother-in-law, Janet Hartranft, on the toilet in 2013. Hartranft died in 2014 at age 79.

The nursing assistant pleaded no contest to a charge of using a computer to commit a crime.

In an interview, the woman who was convicted, Reida Osterman, denied taking or posting the video and said she believes another employee picked up her phone and did it.

'If I could answer to the family, I would, but I can't tell them why because I did not post no pictures of anybody,” she said. 'I know for a fact I would never ever ever do anything to hurt anyone.”

The non-profit ProPublica newsroom worked with the Washington Post to publish its findings.