Corrective action required after photos and videos of multiple M.M. Ewing Continuing Care Center residents, including a dead man, were taken and shared

CANANDAIGUA — The use of social media for ill purposes is forcing employers to revisit policies and tighten security.

That is what UR Medicine Thompson Health had to do last summer after an investigation revealed that five certified nursing assistants, or CNAs, at M.M. Ewing Continuing Care Center took photographs and videos of residents on their cell phones and shared some of that content on the internet.

According to a recently obtained document through a Freedom of Information Law request, 10 residents were affected in numerous incidents. One nursing assistant admitted to taking and sending a photograph of a resident after he died.

The Continuing Care Center, a 188-bed residential healthcare facility, was at the center of a probe involving the state Department of Health and state Office of the Attorney General concerning the use of Snapchat. The mobile app allows users to share photos, video or messages known as “snaps” with a list of contacts.

The breach of privacy and policy resulted in the firing of four CNAs and the resignation of a fifth.

Thompson Health released a statement at the time of the investigation. Approached for this report, the health system stated it “will not have any further comment.”

The investigation involving record reviews and interviews was completed July 24, 2018. Thompson was to complete a “Plan of Correction” by Sept. 5, 2018. The document obtained through the FOIL request from the state Department of Health is a “Statement of Deficiencies and Plan of Correction.” It contains redacted portions because of state privacy law.

The document reveals the investigation began after an administrator received a telephone call June 29 from a member of the public who reported a CNA had taken a photograph of a resident who was dead, and had sent it to her. The CNA denied taking the photograph but was suspended pending an investigation. That CNA later admitted to it.

As noted in the document: “‘The copy of the photograph shows the resident’s (redacted). There is also a copy of a text conversation" between that CNA, identified as CNA #1, and the community member.

A July 18 update report from the Attorney General’s Office interview with CNA #1 revealed she admitted to taking and sharing photographs and videos of eight residents — identified as Residents #7, #8, #9, #10, #11, #12, #13 and #14.

When interviewed by the facility, CNA #1 admitted she had taken the photograph of the man who had died, “because she was upset that the resident had passed away.”

In incidents involving the other CNAs, the statement reveals that CNAs #2 and #3 “admitted to the Attorney General’s Office and facility administrator” that they had received photographs of Resident #12 from CNA #1.

On July 11, CNA #4 admitted he had taken a photograph of Resident #12. That CNA said “he was not sure why he took the photograph. He said that he did not send the photograph to anyone and had deleted it from his cell phone.”

On July 12, CNA #3 said “that she believed CNA #1 was taking videos of Resident #12’s behaviors. CNA #3 reported that CNA #1 said she needed to send that to CNA #5.”

On July 18, in a verbal report from the Attorney General’s office to the facility, “CNA #1 had admitted to taking five videos of Resident #12 mostly yelling and swearing and sent them to CNA #5.”

The investigation revealed CNA #3 admitted “that she had received several photographs of Resident #11 from CNA #1." She said that “everyone on the unit on the evening shift was using their cell phones.”

Other details 

• A registered nurse manager said she “was not aware the evening CNAs were using their cell phones to take photographs and video of residents. She said all staff had been educated on the policy not to take and disseminate photographs previous to these incidents.

• Resident #4 said she saw staff use their cell phones while they were in her room. She said she was not aware of staff taking photographs or videos but was aware of staff making and receiving phone calls on their cell phones.

• The family of Resident #5 said they had seen staff using cell phones, including in Resident #8’s room. She said a male CNA working the evening shift was using his cell phone but she could not tell exactly what he was doing. She did not know the CNA's name but that he had been terminated.

• The director of nursing said when she went on rounds on the floors, she did not see staff using cell phones. “She said she thinks it was occurring behind closed doors. She said staff are allowed to carry cell phones but not use them.”

• The administrator said that once it was discovered that CNA #1 admitted to taking photographs and videos, several other CNAs were also accused. “CNAs #2, #3,#4, and #5 all admitted to taking photographs and videos and distributing many of them to each other and others in the community.” The administrator said staff knew what they were doing was wrong, and they were hiding what they were doing. The administrator said “the involved CNAs were removed from care and have been terminated.”

Regarding Thompson’s response, the statements revealed that eight of the 10 residents affected by the actions (excluding the resident who had died and the other no longer a resident) had had their care plans reviewed for psychosocial well-being by the nurse manager “and there was no revisions required.”

A plan of correction involved a number of measures including staff huddles at the time of shift changes with attention to “no cell phone use in resident care areas ... and no taking photos of anything which includes residents, selfies or still life.”

The plan also called for a registered nurse educator to “provide in service education to all associates who have contact with residents in the CCC … ” and conduct an “Abuse Prevention Program” at least annually for all associates. The program has a new, enhanced focus on photography and prevention of resident abuse.

The plan also called for “a standardized point of care audit paying attention to cell phone use” in resident rooms to be completed every month for three months and then quarterly. Results will be reported quarterly to the Performance Improvement Committee for action, if necessary.

The plan of correction was to be completed by Sept. 5, 2018.

An alarming trend?

The investigation last July at Continuing Care coincided with other cases around the country where nursing home residents fell victim to employees’ misuse of Snapchat and similar social media. In one such case,  Newsweek reported the arrest by Georgia police of three assisted living center employees after the trio appeared in a profanity-laden Snapchat video surrounding a dying elderly woman.

In Canandaigua, City Police Chief Stephen Hedworth said this past week that his office was “aware of the situation” last year at Continuing Care, though not involved in the investigation and police made no arrests.

In general, Hedworth said city police officers work collaboratively with Thompson Health involving certain instances that require law enforcement. Hedworth said his office is also involved in routine exercises and meetings with health system staff to review recommendations, training measures, go over policies and so forth. However, Thompson provides its own security for its facilities.

“They have their own security division,” said Hedworth.

Thompson's July 17, 2018, statement read: “UR Medicine Thompson Health deeply regrets this breach of privacy and lack of respect shown to any affected residents and their families. We are reaching out to the families to personally offer our sincere apologies …

“Upon hiring, all staff at M.M. Ewing Continuing Care Center receive training on protecting and respecting resident privacy. This training is reinforced on a continuous basis. These individuals received this training and disregarded it, in violation of our professional expectations and our organization’s corporate culture.

“Going forward, we are requiring additional training for our employees on requirements for respecting resident privacy and exploring additional measures to ensure compliance. Thompson Health is firmly committed to ensuring all our staff members provide respectful, compassionate care.”