Does Your Care Setting Have to Allow In-Room Cameras?

| March 20, 2016

Utah lawmakers approved legislation in early March that would require assisted living communities to grant resident requests to install monitoring equipment in their rooms.

Utah lawmakers approved legislation in early March that would require assisted living communities to grant resident requests to install monitoring equipment in their rooms.

If Gov. Gary Herbert signs the bill, which is expected, Utah will join 5 other states -- Illinois, New Mexico, Oklahoma, Texas, and Washington -- in requiring that residential care settings say “yes” when residents and their families want a camera.

Utah is only the 2nd state to focus its camera legislation on assisted living. Most of the other state statutes focus exclusively on nursing homes. A 2003 amendment added assisted living to the Texas camera statute.

Utah isn’t the only state currently exploring ways to handle requests for in-room cameras. Regulators in Virginia are working with providers and consumers to draft guidelines for camera use in that state’s nursing homes. Three camera-related bills were introduced into Missouri’s legislature in February.

Growing Interest in Electronic Monitoring

Electronic monitoring has gained attention in recent years because of growing concerns about abuse and theft in long-term care settings, according to Long-Term Living magazine.

That attention might cause policy makers in your state to consider putting a camera statute on the books, says Steve Maag, director of residential communities at LeadingAge. Or, a family member may express interest in installing a camera in a relative’s room.

When responding to either scenario, providers will need to examine a host of issues related to protecting the privacy and confidentiality of residents, their roommates, and their caregivers, says Maag.

Monitoring Residents in Utah

McKnight's Senior Living and Deseret News report that Utah’s Assisted Living Facility Surveillance Act (H.B. 124):

  • Requires that residents and families notify the assisted living community about the presence of in-room cameras. 
  • Requires written consent for the monitoring device from a resident, his or her legal representative, and any roommates affected by the camera.
  • Allows a community to tailor consent agreements and establish additional guidelines to meet its individual circumstances while protecting residents, staff members, and others.
  • Prohibits residents from being expelled or denied admission because they desire monitoring equipment. 
  • Allows the assisted living community to require a resident to place a sign near the entrance of the room to warn visitors that the room is being monitored. 
  • Prohibits the use of devices that can be connected to the Internet. 
  • Offers providers some protection from liability related to their ability to meet residents’ privacy concerns. 

Developing Regulations in Virginia

Virginia legislators passed a law in 2013 allowing nursing homes to refuse a family’s request to monitor a resident.

A new bill (S.B. 553) was sent to Gov. Terry McAuliffe in early March. It establishes a work group of stakeholders that will make recommendations about specific regulations, including whether nursing homes should be required to allow monitoring. According to The Virginian-Pilot, the stakeholder group will consist of nursing home representatives and resident advocates.

3 Bills in Missouri

Missouri State Representative Andrew McDaniel is sponsoring 3 bills that would allow video and audio devices in resident rooms in residential care, assisted living, intermediate care, and skilled nursing settings. Residents or their representatives -- as well as any affected roommates -- would have to approve the monitoring. None of the bills have been assigned to committee.

Unlike Utah’s bill, Missouri’s Authorized Electronic Monitoring in Long-Term Care Facilities Act (H.B. 1652) would:

  • Allow equipment to be connected to the Internet so that family members and legal representatives could view activities in the room from a remote location.
  • Require care settings to post signs informing visitors about the monitoring. The signs would be required outside all rooms with monitoring equipment and at all building entrances if one or more resident rooms are electronically monitored. 
  • Permit a resident or a care setting to turn off or block a recording device under certain conditions. 

A 2nd bill (H.B. 1654) is intentionally less detailed than H.B. 1652 so members of a House committee could address their concerns through amendments. A 3rd bill (H.B. 1655) would permit residents of homes for veterans to install electronic monitoring equipment in their rooms.

McKnight's Senior Living reports that an unsuccessful bill, introduced in Missouri last year, faced opposition based on concerns related to the privacy of residents and their visitors as well as:

  • The potential for “frivolous lawsuits” related to the provision of care.
  • The “chilling effect” the installation of such equipment could have on workforce development.
  • The temptation to depend too much on monitoring devices to ensure quality of care. Opponents of the legislation maintained that pre-employment background checks, training after hire, and sufficient staffing are also needed to promote quality, according to McKnight’s.

What Should Members Do?

Whether LeadingAge members are developing their own policies about in-room cameras, or responding to camera-related legislation at the state level, Maag suggests that “there are a host of issues that have to be dealt with.” Those include:

  • Privacy: First and foremost, organizational policies and state legislation must place a high priority on protecting the confidentiality and privacy not only of residents, but also of their roommates and of staff in the care settings.
  • Technology: Organizational policies and state statutes should address privacy concerns associated with different surveillance methods, including recordings that are designed for later viewing, and live feeds streamed over the Internet. “There are a host of questions that you need to ask about technology,” says Maag. “Who will have access to those recordings and how will they be secured? And how will you protect those live feeds from being hacked?”
  • Relationships: Organizations and policy makers must also address how to reduce any negative impact that the presence of monitoring equipment might have on the relationship between the community and residents or family members.