Social media has the potential to change industries in completely unexpected ways. It can also raise difficult questions.

Some of those questions are being addressed by the nursing home industry after a number of social-media-related controversies came to light in recent months. All involved nursing home employees using Snapchat or other networks to inappropriately comment about residents.

Concerns about social media misuse by nursing home employees were first highlighted by the nonprofit media outlet ProPublica last December. This week, ProPublica reported on the case of an Iowa caretaker who used Snapshat to distribute embarassing photos of a resident. The caretaker, who has not been publicly named, lost her job but could not be disciplined by state health authorities.

Such accounts have led to scrutiny from federal officials, including Sen. Charles Grassley (R-IA). “It speaks to the lowest instincts of humankind that you never expect people to do,” Grassley said.

The American Health Care Association, which represents long-term-care providers, has drawn attention to such incidents in recent months. Documents obtained by ProPublica reveal that AHCA has created guidelines for care centers on how to deal with social media issues. In particular, the group recommends that care centers create and maintain official policies on social media:

The policy should define what employees can or cannot do on social media, and should operate as a code of conduct or guide that clearly defines what the care center expects from its employees when it comes to online behavior. The social media policy should be included with other center policies governing employee conduct, and employees should sign an acknowledgement form and receive training on the policy. If/when employees violate the social media policy, employees should understand that they will be subject to discipline, up to and including termination. Lastly, centers should implement a process to periodically review the social media policy.

In comments to ProPublica, AHCA Vice President of Legal Affairs Dianne De La Mare noted that managing the use of social media is a common challenge for nursing homes, especially because they employ a large number of younger workers.

“We don’t want this stuff to happen anymore. To the greatest degree we can stop it, we want to,” De La Mare said.

Banning smartphones on premises is impractical, she added. “A lot of the younger people, your phone is like your wallet,” she said.