Many residents and their families lack the requisite level of trust important to providing care in the long term care setting. This sentiment can be evidenced by family members’ requests for video cameras in resident rooms. Facilities are now learning how to respond to these requests.
Texas, New Mexico, Washington, Oklahoma, Illinois and Virginia are the only states to date that have passed legislation on video cameras in resident rooms. In Virginia, the legislature left the particulars to the Department of Health, which is charged with promulgating regulations by July 1, 2017. For the remaining five states, their laws prohibit hidden cameras in resident rooms for privacy and consent reasons. Electronic monitoring must be with the informed consent of all room residents. When a resident lacks capacity to consent, that person’s designated responsible party can provide consent. The January 2016 Illinois statute requires the facility to speak with the resident and roommates, regardless of their mental acuity, and document their responses to electronic monitoring. Family member requests are not sufficient to initiate electronic monitoring. The consent forms must release the facility from liability for violation of privacy rights of all residents in the room. These statutes also allow a resident’s roommate to place restrictions on video camera use, such as pointing it away from the roommate’s side of the room, muting the audio recording or limiting recording times.
The statutes also require a conspicuous notice outside the room entrance to warn all entering that they will be videotaped. Some statutes require a similar notice at the entrance to the facility. The facility can require that the camera be in plain view. The requesting resident must pay for all costs associated with the video monitoring, with the exception of electricity.
In states with electronic monitoring statutes, facilities may not refuse a request to monitor as long as all consents are procured and the resident follows the required notice and set-up protocols. These states also define tampering with the recording as a criminal misdemeanor.
If the recording documents abuse or neglect, the viewer must report the abuse or neglect pursuant to the laws of the facility’s state. Further, if the recording is not in the possession of the facility and the facility is informed of abuse, some statutes require that a copy of the recording be provided to the facility. The recording is typically considered the property of the resident because the resident paid all costs related to the video recording and set-up. The Virginia Department of Health’s 2004 suggested guidelines for video monitoring give the facility the option of designating ownership of the recordings. If the recording is facility property, it must be maintained in the resident’s chart. A facility-owned recording must be made available to the resident, the responsible party and any authorized family members upon request. Maintaining the recording in the chart may obligate the facility to know what is contained in the recording to the same extent that the facility should know what is contained in the resident’s chart.
No statutes or regulations require facilities to provide electronic monitoring. However, facilities will need to respond to requests to set up electronic monitoring. In states that have no laws on electronic monitoring, facilities generally can refuse monitoring as long as no resident rights are violated. In states without laws or regulations, facilities can allow monitoring, but should protect privacy rights with written consents and notices. Limitations on when or where the camera is recording can also be included to preserve the dignity of residents.
The common first response to video cameras in resident rooms is often absolute rejection for understandable reasons related to preserving the dignity of the residents, privacy violations and chilling effect on staff interaction with residents. Interestingly, many reported uses have yielded results showing no standards violations by staff.