It turns out there is more to be said about Maryland’s recently completed, pandemic-related checks on hundreds of nursing homes and long-term care facilities.

Three facilities, indeed, got expensive rebukes from state inspectors, but dozens more were hit with milder fines that also suggest widespread issues in the institutions, notably with the crucial concern of infection control.

In contrast to the Washington Post’s previous coverage of the sizable fines for Collingswood Rehabilitation and Healthcare Center ($275,000) and Potomac Valley Rehabilitation and Healthcare Center ($120,000), and Kensington Healthcare Center ($294,000), the Baltimore Sun said it, too, had obtained Maryland records indicating:

“Sixty-four nursing homes in Maryland failed to take sufficient infection control measures to protect residents from the coronavirus …Ten have faced significant fines based on the inspection surveys, from $70,000 to $380,000, including two previously reported by The Sun. The 54 others were ordered to develop a plan to fix the problems. Forty-five facilities received smaller fines for not completing mandatory testing and not reporting records to the state.

“The large number shows the challenges in protecting a particularly vulnerable population and that more attention is needed, observers say. Seniors, many of whom have underlying health conditions, have made up a disproportionate share of deaths in Maryland from Covid-19 …”

Besides the three facilities identified earlier as subject to sizable fines by Maryland regulators, The Sun identified other homes slapped with big penalties in July, including: Brinton Woods Nursing and Rehabilitation ($315,000) St Joseph’s Ministries ($280,000); Cadia Healthcare ($215,000); Overlea Health and Rehabilitation Center, ($150,000); and Heritage Harbour Health and Rehabilitation, ($78,000).

Owners and operators of the facilities named in the Baltimore Sun article declined to comment, or they said they intended to appeal state penalties they described as unfair and unsubstantiated.

The newspaper noted that the infection control and other lapses might have gotten less attention before the pandemic, but they have become serious matters now:

“According to the inspection[s] … deficiencies at the nursing homes included such things as failing to keep incoming residents who potentially carried the virus separate from other residents, or lax cleaning and hand hygiene that subjected staff and residents to potential infection. Many of the facilities have reported infections. Some facilities were cited for deficiencies unrelated to the virus but uncovered during the inspection visits, such as lack of proper care for residents or record-keeping troubles.”

Regulators also slapped institutions with small fines for failing to undertake coronavirus testing as the state has ordered and for record-keeping problems.

Sen. Clarence Lam, a doctor and a Howard County Democrat who the Sun said has closely followed the state’s coronavirus response in long-term care facilities, commented to the newspaper about the latest oversight activities:

“The number of deficiencies [the state is finding] is surprising given that there has been so much attention to Covid in nursing homes. Why hasn’t the state done more to help these facilities get a grasp of this problem? … There is a lot to be concerned about.”

In my practice, I see not only the harms that patients suffer while seeking medical services, but also the damage that can be inflicted on them and their loved ones by abuse and neglect in nursing homes and other long-term care facilities. Residents of “the DMV” — the District of Columbia, Maryland, and Virginia — can count themselves fortunate still that they still have active local media outlets to serve as watchdogs of governments and institutions in the area. That may mean that audiences get different views of situations and may need to piece together the various reports to give themselves a fuller view of key concerns.

The articles by the Washington Post and the Sun taken together show how much work must be done before nursing homes and long-term care facilities end up in a far better place than before the coronavirus pandemic — not just in dealing with a novel illness but also in improving basics of the safety and quality of care, such as stringent infection control. Regulators need to keep stepping up with vigorous oversight of long-term care facilities, and it may be that action will be merited in the civil justice system.

Keeping institutions running at their best, not in slap-dash fashion, will matter greatly as facilities seek to reopen, so their lonely and fearful residents can benefit from the attention and care they more typically get from loved ones.

Besides infection control, of course, long-term care facilities must step up their testing, tracing, and isolating of coronavirus cases. They must stop shirking their responsibilities for these must haves, even as state and federal authorities both assist them and hold them accountable for the safety and quality of their care.