The above is a news story regarding poor conditions at an assisted living facility in Georgia, but it frankly could occur at any senior care facility--- in any location.  While the specific complaints regarding patient care are nothing new-- inadequate care, unsanitary conditions, ect., this story provides a needed reminder that residents and their families can not and should not put up with inferior care at a facility of any type.  

While the specific circumstances are of course disheartening, I was frankly proud of the residents and their families for voicing their displeasure with the care to officials from the state and to a local television station.

As a lawyer who has represented numerous families in injury cases stemming from poor care at a nursing home or assisted living facility, voicing these complaints is important from both an injury prevention standpoint as well as getting officials involved to documents these conditions in order to impart real change. 

While I may lack any concrete numbers to substantiate my theory, I deeply believe that facilities simply can not afford to provide inferior care when numerous families voice their displeasure.  In the world of senior care and housing, poor ratings has the potential to translate to lower profits--- something that facility operators simply can not bear to see.

Consequently, if your loved one is receiving inferior care at a long-term care facility, I would suggest you file a complaint with the applicable regulatory agency (usually, the state department of health) or you may look up the regulatory agencies at Nursing Homes Injury Laws to determine where your grievance should be made.  Further, if you see poor care don't be shy about discussing it with other families--- your complaints may just be heard with a bit of a louder voice and perhaps carry a bit more weight?

While a grand jury investigation has cleared the other patient involved in the altercation of any wrong doing, attention is now being focused on the assisted living facilities actions--- or perhaps more accurately—inactions in the days following the melee at their institution.  In addition to failing to provide medical care, an investigation into the skirmish revealed the following concerning facts:

• The patient’s wife was told by staff that her husband’s injuries amounted to no more than a ‘cut on the lip”
• There is no evidence to substantiate that the owner of the facility was timely notified following this incident
• Evidence suggests that the facility attempted to conceal the extent of the patients injuries by sedating him and positioning him in his bed in a manner to make his injuries appear less severe than they actually are

Officials from the Texas Department of Aging and Disability have already cited Sky West for their inattention to the patient’s injuries and failing to summon the care of a doctor, but now state prosecutors are analyzing the circumstances to determine if the ALF’s actions have criminal consequences. 

While we can debate the reasonableness of the grand jury’s decision not to pursue charges against the individual involved in the altercation, I certainly hope that the individual employees involved in this incident get prosecuted to the fullest extent of the law.  As caregivers to a particularly vulnerable group of people, staff at Sky West--- and all facilities caring for the elderly, have a responsibility to both accurately inform patient's families regarding the extent of injuries and to obtain medical treatment in a timely manner.  

Related:

Nursing Home Responsible For Choking Death Of Patient

Neglect alleged at assisted living facility, Amarillo.com November 16, 2011

Delayed Medical Attention To Blame For Death Of Nursing Home Patient

Some Nursing Homes Seem To Have A 'Wait And See' Approach When It Comes To Getting Medical Treatment For Their Injured Patients

The department of Health and Human Services estimate that close to one million people currently live in the more than 38,000 assisted living facilities scattered across the country.  According to some experts, the number of assisted living residents may soon surpass the number of people living in nursing homes over the next decade.

Because assisted living facilities are an quickly evolving segment of the senior care market, their role remains somewhat of a mystery to many. I came across Dave Carpenter’s article “Assisted living options: What you need to know” which does a great job enumerating responsibilities and information about assisted living facilities in a clean and articulate manner.  Below is an except from Dave’s recent article.

• What they are

Assisted living facilities are residential communities that offer different levels of health or personal care services for seniors who want or need help with some daily activities — anything from cooking to transportation to dressing and bathing.

What they’re not is nursing homes that address major medical needs. They are designed to provide a home-like setting for residents who want to live independently with minimal assistance.

• Who lives there

The average age of residents in assisted living facilities in 2009 was about 87, according to the National Center for Assisted Living, an organization representing long-term care providers. Three-quarters of the residents are female. They stay at the assisted living residence for an average of about 28 months, and the majority then move on to a nursing facility.

• Services provided

Services offered vary widely but typically include 24-hour emergency care, some medical services and help with medications, limited assistance with personal care, meals, housekeeping, laundry, transportation and recreational activities. Large facilities may have private apartments as well as shared and private rooms. 

• First steps

AARP suggests checking with a state or local agency on aging, the yellow pages, the Assisted Living Federation of America and the American Association of Homes and Services for the Aging, as well as with friends, neighbors and books on retirement.

If looking on behalf of your parents, check your own local neighborhoods first. Most residents of assisted living facilities in urban areas who have children live within five to seven miles of them, according to Eichelbaum.

• Finances

The cost of assisted living facilities varies greatly depending on size, location and services. The median rate for a private room is $3,261 a month, or just over $39,000 a year, according to Genworth Financial Inc., which compiles an annual costs survey among long-term care service providers. If you need a home health aide on top of that, the median cost nationwide is $19 an hour.

Neither Medicare nor health insurance policies pay for assisted living. Medicaid covers only some services, and not in every facility or every state.

Long-term care insurance may cover most of the costs, depending on your policy. But if you haven’t bought coverage well ahead of time, you may not be eligible and able to afford it.

AARP says four out of five residents pay for assisted living out of pocket. Veterans who need assistance can qualify for up to $1,949 a month if married, $1,644 if single or $1,055 for surviving spouses through the Aid and Attendance Pension.

• Alternative option

There are three basic types of living options for seniors as they age: independent living, assisted living and skilled nursing. To avoid needing to move every time more assistance is needed, continuing care retirement communities are worth considering. They offer a variety of services for all three levels within one community. But this tiered approach is expensive. Entrance fees can range from $100,000 to $1 million, and monthly charges can range from $3,000 to $5,000, increasing as needs change. 

• Advance preparation

Do the research before you have an immediate need. Having an idea of the cost and availability of options in your community is essential. If local facilities aren’t appropriate or affordable, it may be worth considering relocating to a community with one that fits you or your parents better.

It’s probably too late for your elderly parents to obtain long-term care insurance, but getting it for yourself in your 50s or early 60s is an important step to finance your own future care in an assisted living facility or elsewhere.

Getting siblings to agree ahead of time to a plan for an aging parent and how to finance it is important too, says Amy Goyer, AARP’s family expert. “If you wait until the crisis time, often the burden just falls on who’s closest,” she says. “That can be much harder and unfair for some family members.”

• Scores of residents from Dunedin’s Rosalie Manor wandering the streets
• Staff at Miami’s Angelica Gardens locking a 72-year-old resident in a closet without air conditioning
• A 98-year-old Living Legends resident being sent to the hospital with two black eyes, a fractured neck

Patients with developmental disabilities and other conditions like Alzheimer's or dementia are most at risk for episodes of self-inflicted harm-- be it intentional or not. 

Consequently, facilities that care for these people must take additional precautions that go beyond merely keeping some of these materials out of sight.  Because many of these people remain vigorous and able-bodied, facilities should ensure that potential dangerous materials are kept in a sure area and train staff on this potential threat to resident safety.

Tragically, an episode involving a developmentally disabled man at a Washington Assisted Living Facilty made headlines when he died after drinking laundry detergent.  The Seattle Times reported that the 30-year-old man was transferred to a community living program months before the deadly incident where he was to be supervised by an organization that concentrates in caring for those with disabilities.  It was also reported that this man lived alone.

Presently officials with The Department of Socials Health Services and local police are investigating the circumstances surrounding this incident.

While we await the results from this investigation, I'm sure that authorities will focus both on this man's background with respect to any similar incidents in the past as well as why a potentially deadly poison was so accessible. Hopefully this agency will take a second look at the way it care for people with similar disabilities an implement much stronger safeguards to prevent similar incidents from occurring in the future.

Related:

Brookdale Assisted Living Facility Fails To Learn From Mistakes: Dementia Patient Dies After Ingesting Detergent

Are Group Homes A Viable Alternative To Nursing Homes?

Dementia Patient Found In Freezer At Assisted Living Facility: An Isolated Event Or Real Cause For Concern?

Acute renal failure following detergent ingestion (pdf) Singapore Med J 2009; 50(7) : e256

Originally proposed by Governor Mark Dayton, the policy was tailored by the state's Health and Human Services Committee (HHSC), with the primary goal of providing cost savings to the state.  Within the first two years of the program, state officials believe it may save the state $3.8 million.

According to chairman of the HHSC, Jim Abeler, the state has a real interest in educating people about different types of care alternatives.  Abeler fears that people many not have a full understanding of how expensive the care can be during a long-term stay. "The backstop for people paying cash when they go broke is the state." Further reasoning, "[s]o we're on the hook for the choices people male about how people spend their money in their long-term care."

Not surprisingly, the program is opposed by several assisted living facilities and trade groups who claim that the new law is overly burdensome and interferes with personal decision making of the individual.  

"We completely oppose it.  It's really government overreach - telling a person a person who wants to use their own private dollars how they have to use those dollars," according to Eric Schubert, vice president of communications and public affairs at Ecumen assisted living.

Incidentally, Minnesota has already adopted a similar preadmission consultation for people seeking admission to nursing homes in the state.

As an attorney involved in long-term care litigation, I strongly support this law and wish other states would adopt similar measures.  Of course, the transition to an assisted living facility or nursing home is indeed a significant change, but too often-- I find families confused about the real impact of both the economic and the legal implications of their decision.  In addition to a frank discussion about the cost of care, I also hope this this program provides information about what the care limitations are at each living arrangement (group home, assisted living or nursing home).

Read more about this law impacting Minnesota assisted living facilities here.

Related Nursing Homes Abuse Blog entries:

7 Steps To Reduce The Stress Associated With Moving To A Nursing Home

More Regulations In Store For Assisted Living Facilities In Georgia

In Rare Move, State Moves To Close Assisted Living Facility Following Discovery Of Abuse & Neglect

Family Claims Assisted Living Facilities Neglect Resulted In Death Of Mentally Disabled Woman

Assisted living facilities have been popularized because they provide residents with assistance with basic daily living needs such as: meals, cleaning, bathing and socialization.  However, it is important to remember that unlike nursing homes, assisted living facilities can not provide medical care.

Like living facilities of all types-- and for all ages, a little leg work is necessary to help distinguish the good from the inferior. 

As someone who frequently receives inquiries from individuals and families regarding the selection of these facilities, I was happy to see a very informative article to help families with many of the difficult decisions they encounter when placing a loved one.  

The following suggestions are from Kimathi Lewis' article "Ten Tips For Finding the Right Assisted Living Community" that recently appeared on CascadePatch.com.  I hope you find these as valuable as I did.

1) Know what you or your family member needs

An honest assessment of you or loved one’s physical and mental needs is important. Perhaps a doctor’s input can help. But the assessment should include whether they can bathe and dress on their own? Do they need help with their medications? Do they need laundry and/or housekeeping assistance?

2) Understand the pricing and what it includes or excludes.

What happens to the charges if your loved one needs more care and services? How much notice will they give if the monthly fee will increase? Are meals, laundry and housekeeping included in the monthly fee? Are there extra fees for medication reminders or assistance? Are there any entrance fees or move-in fees? Are there any additional fees for cable or local phone services? Ask staff if there are any charges that you haven’t asked them about. Also ask them what happens if your family member runs out of private funds.

3) Observe the staff and find out about their credentials and training.

During the tour, watch how the staff interacts with the residents. Do they know their names and talk with them respectfully? Ask the administrator about the hiring process. Is staff given background checks? Is there on-going training and education after they are hired? Is there a licensed nurse on-site 24/7 or just on call? What is the staff to resident caregiver ratios?

4) Understand how the community handles increased level of care needs.

Regulations are sometimes broad in assisted living, so find out how the facility evaluates resident’s needs and how often. How is that information communicated back to you and how quickly? What additional services do they have available when the need arises? What kinds of conditions would require your loved one to transfer to a nursing home or other level of care? If a move is necessary, how much notice would they give you?

5) Investigate the opportunities for socialization and recreation.

Some residents have physical challenges that can lead to isolation, find out if the staff provides adequate opportunities for socialization. When you are touring these facilities, observe if there are any group activities or events. Are residents participating? Ask to see the events calendar and find out about planned activities for the year. Are there opportunities for residents to go on shopping trips to area malls or out to local restaurants? Does staff go along to assist residents who need extra help? The evening meal is often an important part of the day for assisted living residents. Observe a meal. Do residents seem to be socializing and enjoying the dinner?

6) Find out about health-related activities.

Some residents have dietary needs that require special meal plans. Find out the facility will accommodate those needs. Are there exercise programs that are geared towards a resident’s specific needs? Are their opportunities to exercise their mind and what programs do the facility provide for mental stimulation.

7) Assessing the facility’s environment

In light of the need for support, is the location convenient for family and friends to visit? Is the facility located in a safe neighborhood? Is there a nearby hospital? Is there a physician that makes rounds onsite? If not, how far away is to a physician’s office? Does the facility seem clean and well-maintained? Is the facility handicap-accessible? Are there features like handrails in the hallways and elevators if the community has more than one floor? Are there handrails in the bathrooms? Is there a walk-in shower? Is there room for a wheelchair? How far is the walk from suites to the common areas such as the dining room, kitchen and activities areas? Is there a 24-hour emergency response system? Ask to see it and be sure it is accessible in the bathroom as well as the main living and bedroom areas of the apartment. Are there smoke alarms and sprinklers in the suites and throughout the community? Are residents allowed to decorate their suites as they like including hanging pictures on walls?

8) Assessing the facility’s programs

Some residents seek out daily devotions. Is there a room allotted for church or daily devotion? Are events and activities planned for evenings and weekends too? Are there intergenerational events planned with local schools, scout troops, and youth organizations? Are there additional fees to participate in daily programs? Are there planned outings to weekly community events? Is the transportation that takes residents on outings handicapped accessible?

9) Assessing the facility’s dining

Take the time to check out the weekly menu and find out if all three meals are included in the monthly fee? Are beverages and healthy snacks available all day long? Does a dietician help in menu planning? Does the dining room and kitchen look and smell clean? Are tables and chairs clean and in good repair? Can the community accommodate special dietary needs? Is the dining room easily accessible to those with wheelchairs? Are there staff members available to help escort residents to the dining room at meal time? Observe a meal and note if there is additional staff to help accommodate the increased physical needs assisted living residents sometimes require.

10) Assessing the facility’s residents

Perhaps, the best way to find out the intimate details of a facility is to talk to residents and their families. Introduce yourself to family members you see arriving and departing as you tour. Ask them how long their loved one has lived there? What do they like and dislike about the community? Introduce yourself to residents you pass on the tour. Ask them how long they’ve lived there and how they like it. Ask current residents what they like and don’t like about the community. Pay attention to the appearance of current residents. Do they seem cared for and well-groomed?

Related Nursing Homes Abuse Articles

Breakdown In Care At Assisted Living Facility Proves More Deadly Than Patient's Dementia

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Are Tougher Rules Called For At Assisted Living Facilities?

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According to the senior executive director at the facility, Brian Beausoleil,  the concerns centered around: the timing of resident care assessments, management of medication inventory, evaluation of response time to emergency calls and evacuation planning. 

The terms of the suspension require Emeritus to submit a corrective plan as to how the facility will address the violations.

Accord to Mr. Beausoleil, this is an "isolated situation".  But no need to worry about this situation...

We look forward to receiving a clean survey report in a few weeks so that we may return to business as usual.

Business as usual?

Situations such as this make me question the safety of patients at this facility--- now and in the future.  Surely, a written plan of correction can be prepared and submitted to officials in short order, but doesn't it take some time to train staff?  

Am I the only one who views Mr. Beausoleil's comments as a bit dismissive of the underlying safety issues?  Here we have a leader at the facility seemingly more concerned about resuming 'business as usual' when there are apparent problems that threaten his residents.  With leadership such as this, I fear that this corrective plan is nothing more than window dressing on an underlying problem.  

Related:

Admissions Suspended At An Emeritus Assisted Living Facility Following The Discovery Of: Medication Errors, Bed Sores & Falsified Medical Records

Wrongful Death Lawsuit Alleges That An Emertus Assisted Living Facilities Gross Neglect Of Dementia Patient Results In Death

Maybe The Negative News Headlines Are Beginning To Get Inspections Of Long-Term Care Facilities Ramped Up

State suspends certification of Framingham assisted living facility, The MetroWest Daily News by Scott O'Connell August 9, 2011

Then, in the wake widely publicized investigative report from The Miami Herald concerning the lack of investigations into injuries and deaths at assisted living facilities throughout the state, an investigation into the suspicious death was initiated.

The investigation recently completed by the Department of Children & Families cites many errors made by the adult care facility that collectively contributed to Ms. Nava's drowning death in a pond adjacent to the facility.   Despite claims from the facility that all elopement precautions were in place at the time of Ms. Navas' death, state investigators uncovered the following:

• Broken surveillance cameras
• Sleeping staff
• Out of order door alarms
• Unlocked gate leading to a pond

While I'm sure this family is saddened by the blatant safety lapses discovered by state investigators, I hope that the findings bring some closure to this tragedy.  If anything positive can come of this tragedy, I hope that these findings reinforce the need for timely investigations on the part of regulatory authorities.  How many other untold tragedies were perpetuated upon innocent people at this ALF during the three years following Ms. Navas' death?

Related:

Family Sues Florida Nursing Home For Death Of Wandering Resident

Assisted-living facility blamed in woman’s drowning death, Miami Herald, July 16, 2011

Abuse & Cover-Up At Assisted Living Facility Caring For the Disabled

Two caregivers responsible for caring for a mentally and physically disabled man face criminal charges following an intensive police investigation that points the finger at them for his death at Richmond State Supported Living Center in Fort Bend County (Texas).  An autopsy of the disabled man, revealed that he died from blunt force trauma to his abdomen.

Prosecutors believe that the caregiver responsible for providing non-medical care to the man struck him in the stomach in the early morning hours of October 8th of last year. A nurse who was scheduled to make regular checks on the disabled man-- and reported to officials that she apparently had done so-- later confessed that bed checks never took place.

The non-medical caregiver has been charged with intentional injury to a child/elderly/disabled person and can face 5 to 99 years if convicted.  The nurse is charged with injury to a child/elderly/disabled person with criminal negligence and may face jail time of up to two years.

Related:

Caregivers Must Exercise Patience When It Comes To Caring For Alzheimer's Patients

Group Homes Plagued By Patterns Of Abuse & Lack Of Employee Accountability

Nursing Home Cover-Up: NY Aides Lied About Doing Their Jobs

Nurse Charged With Rape Of Disabled Patient

Among the new rules for assisted living facilities in Georgia:

• Certified medication aides will be allowed to help residents with their prescriptions
• More non-ambulatory will be permitted to remain at assisted living facilities as opposed to being transferred automatically to nursing homes
• Private-pay assisted living facilities will face different regulations than their publicly funded counterparts

As the distinctions between assisted living facilities, group homes and nursing homes get clarified, facilities will be given an opportunity to phase in the new regulations over an extended period of time.  Most of the new assisted living regulations will be put into full effect next year.

As alternative care facilities take on a larger role in the care of our seniors, I am glad to see the new regulations proposed.  If nothing else, hopefully the new regulations will help families learn the specific types of care each facility can provide in a clear-cut manner.

Read more about the new regulations applicable to assisted living facilities in Georgia here.

Acknowledging these difficulties, some assisted living operators have elected to evade some of the laws by morphing their facilities into something new and different--- and not subject to the regulations applicable to them.

One of the largest operators of assisted living facilities, Assisted Living Concepts, has grabbed news headlines when they announced that they were going to reorganize some of the assisted living facilities that they operate in Iowa and begin to operate them as 'senior housing communities' where they simply own the building, but utilize the services of a different company to provide health care services to the residents.

On the surface, the change in operating procedure may seem like little more than a corporate shakeup, but a closer look quickly reveals the real intention behind the change is to evade the pesky regulation applicable to the the operation of an assisted living facility. 

Turns out, despite its massive operation, Assisted Living Concepts wasn't so good at safely operating their facilities.  At its Dubuque facility, Iowa officials found numerous problems including:

• Poorly formed care plans
• Unreported resident injuries
• Medication errors
• Staff that were inadequately trained to care for patients
• Neglect

All told, the (former) assisted living facility was fined more than $65,000 for its violations. 

Recognizing this legal loophole, the Iowa legislature has drafted legislation that attempts to hold facilities-- regardless of their title-- responsible for their care of their residents.  

As we begin to see the proliferation of alternative type senior housing arrangments, it is crucial that legislatures take a proactive approach to the regulation of the facilitiles that operate under misleading titles.  Let's see if other states have the foresight to identify this developing issue in the senior care industry.

Related:

Who Needs To Abide By Regulations? All Troubled Assisted Living Facilities Need To Do Is Re-Organize In Order To Avoid Compliance With Safety Laws

Dubuque facility headed to court over fines, Des Moines Register by Clark Kaufman, June 11, 2011

Another Iowa Assisted Living Facility Chooses To Abandon Its License

Pesky Government Regulations No Problem For Assisted Living Facility In Iowa

It's a pretty thin line many assisted living facilities must walk between giving their patients freedom to go as they wish and protecting them from--- well,... themselves.  

Today, I'm noticing that there are many assisted living facilities that simply view monitoring their patients as an afterthought and many residents who likely require supervision aren't getting as much as they require for their optimal functioning.

Sure making a determination as to: how, if, or when an assisted living resident can leave the facility is not easy. Yet, there may be no more important decision when it comes to the safety of assisted living patients. Certainly, as residents needs change, the staff needs to reconsider the safeguards it has in place for the patient as well.

I began thinking of this balance between giving patients freedom and ensuring their safety when I read about a man who wandered from a North Carolina Assisted Living Facility to his death.  Just one day after Dallas Sherwood 'Sweet' Stevens walked from Aversboro Assisted Living Center, he was found dead in a small pasture. 

Reports of his death indicate that 62-year-old Stevens had a cognitive impairment  and required medication.  Yet the Aversboro facility allowed the man to stay at their facility which was known to have an 'open door' policy, referring to the ability of residents to come and go as they wish.

Certainly, no one wants to unnecessarily restrain a person against their wishes, but it seems like the facility is certainly in a better position to assess the needs of a patient than any one else. 

And one more thought...

Civil liability issues aside, when it comes to situations where a patient wanders from a nursing home or assisted living facility, I strongly feel that the facility should bear the costs associated by law enforcement when they conduct extensive searches for missing patients.

In the case of the search for Mr. Stevens, a Silver Alert was issued and more than 50 law enforcement officers and police equipment were diverted in the search for Mr. Stevens.

Related Nursing Homes Abuse Blog Entries:

Nursing Home Patient Dies When Struck By Car In Busy Street. What Was He Doing There?

Lack Of Door Alarms Allows Assisted Living Patient To Wander To Her Death

Assisted Living Facilities Need To Re-Evaluate If They Are Capable Of Caring For Dementia Patients

Woman Dies From Hypothermia After Wandering From Assisted Living Facility

However, sometimes enough is just enough at dangerous facilities simply cannot be given further opportunities to improve without further jeopardy to the people who live there.  For just the fifth time in the last five years, the Texas Department of Aging and Disability Services found such horrendous living conditions they were forced to order a Corpus Christi assisted living facility to close.

On April 15th, Texas officials ordered Affordable Quality Care Assisted Living Facility to close following confirmation of residents who were repeatedly abused and neglected.  Citing information gathered from facility employees and general observation by state investigators, the state's report chronicled horrendous care such as:

• Patients forced to wear soiled diapers around their necks
• Patients left unattended on toilets for hours on end
• Incontinence pads pinned to clothes
• Staff roughly handling patients in wheelchairs
• Patients with unknown and undocumented injuries
• Unlabeled medications

As a lawyer who litigates matters involving the negligence of assisted living facilities, I hope more states begin to flex their regulatory muscle when it comes to the regulation dangerous assisted living facilities, group homes and residential care facilities for the elderly.  Certainly, the transition to other facilities may not be easy for the patients, but when dangerous conditions abound, enough is enough.

Related:

Unlicensed Chicagoland Retirement Home To Shut Its Doors

When It Comes To Governmental Oversight, Assisted Living Residents Are On Their Own

Hypothermia Confirmed As Cause Of Death In Nursing Home Wandering Case

Nursing Home Injury Laws: Texas

State says abuse found at assisted living facility, AP Texas News,, May 6, 2011

OSHA was critical of the way the facility both handled the way it disposes of medical supplies and how it reacted to the incident.  Amongst the safety violations, Paradise Park was found guilty of:

• Failing to immediately test the blood of an individual involved in a needle stick incident
• Failing to ensure that the results of blood tests were communicated to the nurse practitioner involved in the incident
• Failing to provide a hepatitis B vaccine to the employee within 10 days of her exposure
• Inadequately training employees about safety in the workplace

Given the opportunity of these dangerous conditions to cause serious harm to employees, I am certainly glad that OSHA got involved.  However, while employee safety is indeed important, what about the safety of the residents at this facility.  How many of them were potentially exposed to contaminated needles as a result of this sloppy care?

Related:

Dirty Needles May Be Cause Of Hepatitis B Outbreak In Nursing Home

Are Tougher Rules Called For At Assisted Living Facilities?

An Inspirational Tale: Daughter Doesn't Let Chicagoland Assisted Living Facility Push Her Around

Officials from the North Carolina Department of Health have confirmed that unsafe diabetes care practiced by staff at Glen Care of Mount Olive was to blame the patients deaths.  It was estimated that needles used to test patients’ blood sugar levels were reused by staff at the facility, which resulted in the hepatitis outbreak.  Further, none of the staff involved in the incidents had taken any training course related to infection control.  Nor, were there any regulations requiring them to do so.

Unlike nursing homes, where laws generally specify who may administer drugs, at assisted living facilities and other types of non-traditional senior living arrangements, few laws address how drugs are to be administered to patients.

In fact, assisted living facilities (and other types of residential care facilities for the elderly) are not permitted to render any type of medical care.  Rather, when and if a patient requires medical attention it is the duty of the facility to either relocate the individual or seek outside medical care.

As evidenced by the situation in North Carolina, some assisted living facilities are squirming around regulations restricting medical care, by asserting that the administration of medications to patients is not ‘medical care’.  Because assisted living facilities aren't medical facilities and thus cannot employ nurses or other formally trained medical staff, some facilities have implemented the use of medication aides.

After obvious lapses in basis sanitation, North Carolina legislators are now introducing legislation that would impose stricter training and higher performance standards for medication aids and others who provide medication to people in assisted living facilities.  The bill introduced by Representative Jennifer Weiss would impose requirements such as: 

• Competency requirements for adult care medication aides
• Specialized infection control guidelines
• Authorize state human services inspectors to review assisted living facilities on an annual basis or needed to insure the requirements are met
• All new employees of assisted living facilities would be required to take an infection control class beginning in 2013

The Growth of Assisted Living Faculties Needs to Be Accompanied By Regulation

As the cost of long-term care continues to climb, assisted living facilities, group homes and residential care facilities for the elderly have become increasingly popular as less costly alternatives to nursing homes.  While many of these facilities do provide emotional support and assistance with daily living needs, other facilities need to be reminded of their limits with respect to providing medical care for people.

As we see by the situation at this North Carolina assisted living facility, even relatively basic medical care does require specialized training of staff.  Hopefully, the new legislation will take hold to protect these particularly vulnerable people and will draw attention importance of intensified regulation of these living arrangements.

Related:

Dirty Needles May Be Cause Of Hepatitis B Outbreak In Nursing Home

Investigation Determines Serious Safety Violations At Sunrise Assisted Living Facilities That Threaten Patient Safety

Are Group Homes A Viable Alternative To Nursing Homes?

Are seniors in residential care facilities and other alternative living arrangements at risk for developing bedsores?

Sure we can look at seniors and say, “Hey, he’s just an old geezer, maybe he had a another couple of decent years in him?  What’s the big deal if he died today or tomorrow?”

Alternatively, I suggest the value of our later days, months, and years really have more significance and value as many seniors gain a new perspective on life only when seeing the inevitable coming their way.

A Florida jury obviously acknowledged life’s significance when they blamed an assisted living facility for the untimely death of a 99-year-old resident at the facility—yes, that's correct 99! 

The Miami Herald reported that the family of Francis Tremblay was awarded more than $2.3 million in a wrongful death lawsuit against the facility.  In particular the lawsuit centered on the fact that Living Legends Retirement Center (Florida) failed to protect Ms. Tremblay for repeated falls. 

In all, Ms. Tremblay fell almost one dozen times at the facility prior to a fall-related incident, which ultimately claimed her life after suffering from various fractures and cuts. 

While I imagine the defense lawyers for the assisted living facility cautioned the jurors about the fact that Ms. Tremblay far exceeded her life expectancy, the jurors must obviously have been angered by the fact that employees at the facility reportedly expressed their safety concerns regarding the repeated falls to the deaf ears of the facility administrators.

While the award cannot change the care that was provided to Mr. Tremblay, I hope that this award serves somewhat of a reminder that our seniors—even the very senior seniors deserve to be treated with dignity and respect.

Related Nursing Homes Abuse Blog Entries:

Florida Nursing Home Accused Of Abuse

Family Sues Florida Nursing Home For Death Of Wandering Resident

Inspection Report Confirms Unsanitary Living Conditions In Florida Nursing Home

Nursing Home Injury Laws: Florida

Rosenfeld Injury Lawyers: Nursing Home Injuries

Over the course of her stay at the assisted living facility, the staff gradually provided less and less assistance for Ms. Brown's daily living needs.  In addition to lack of daily care, the lawsuit further claims that the staff at the facility failed to properly supervise Ms. Brown which resulted in multiple falls.  It was a fall in December, 2009 that resulted in fractures to her hip and shoulder that lead to Ms. Brown's death shortly thereafter.

Despite Assisted Living Concepts ongoing profitability as a chain of assisted living operators (having more than 34% increases in quarterly profits compared with last year), the lawsuit alleges that the company fails to pass along adequate funds for the facility to hire and train sufficient staff to ensure the safety of its residents.

As a lawyer who commonly represents the elderly in lawsuits against assisted living facilities and nursing homes, I frequently attribute the poor care to the facilities parent company that frequently makes a conscious decision to cutting staffing levels to a bare-boned levels.  I frequently see facilities hiring the least qualified staff and continually paying them far lower wages than they would make in other settings.

Read more about this wrongful lawsuit against an assisted living facility here.

Related:

Assisted Living Fall Leads To Wrongful Death Lawsuit

Hours After Admission To Illinois Nursing Home For 'Respite Care', Resident Fractures Hip

Did Assisted Living Facilities Neglect Result In Patient's Impacted Bowel & Death?

Class Action Lawsuit Against Skilled Healthcare Seeks Damages For Chronic Understaffing Of Nursing Homes

That it is, until recent investigations at the facilities that revealed conditions that were so pathetic, that that assisted living facilities were shut down and the operator of the facilities was arrested.  

Melissa Pacheco was recently arrested and charged with 69 counts of abusing vulnerable adults who were living at three assisted living facilities she owned.

In addition to physically disgusting problems discovered at the facilities such as: broken plumbing, urine and feces on the floors, along with bug infestations.  In addition to the horrid living conditions, investigators found more disturbing conditions on the patients living in Pacheco's facilities.

Many of the physically disabled and mentally challenged patients were found to have:

• Open wounds
• Dehydration
• Untreated medical complications
• Untreated fractures

Sadly, despite the deplorable living conditions and patients with suffering from obvious neglect, employees at the facility never stepped forward as they feared they would lose their job if they reported the conditions to authorities.

While I certainly can appreciate the fear of losing a job in this rough economy, I find the failure of the staff at these facilities to report the dangerous conditions and visibly injured patients to authorities inexcusable.  As caregivers who deliberately ignored these conditions, I hope the Attorney General prosecutes these people to the fullest extent for not ensuring the safety of their patients.

Related:

Nurse Charged With Sexually Abusing Two Nursing Home Residents

Caregivers Charged With Abusing Elderly In New York Nursing Homes

Nurse Charged With Abuse & Neglect After Abandoning Residents At Assisted Living Facility

Nightmare Nurse Arrested on 69 Counts of Abusing Vulnerable Adults, by James King Phoenix New Times February 10, 2011

Nursing Home Injury Laws: Arizona

The article chronicles the troubles encountered by Laura Merens, who’s 89-year-old father died shortly after arrangements had been made for him to live at an assisted living facility in the Northern Suburbs of Chicago.  Sadly, Ms. Merens’ father was never able to enjoy the $6,876 for  ‘arrangements’ his daughter had arranged for him at The Park of Golf Mill in Niles, IL. 

However, like many nursing homes and assisted living facilities, The Park required extensive pre-payment for services such as: food, apartment, and recreational activities. 

Never having utilized any of the benefits--- over ever stepping foot in the facility for that matter-- Ms. Meren’s requested a refund of the pre-paid services from The Park’s parent company, Horizon Bay Retirement Living.  Despite several requests for re-payment of expenses, the facility was unwilling to refund any of the expenses--- that is until Ms. Meren’s got the Problem Partners involved.

Shockingly, once the publicity that accompanies a large newspaper columnist’s request for a refund came along, a refund check was issued to Ms. Meren for a substantial portion of her payments. 

Surely, as consumers, people at nursing homes and assisted living facilities deserve to get their monies worth.  Hopefully, this story will serve as an inspiration for others to keep pursuing facilities that fail to act in an ethical manner and take advantage of a captive audience.

Related:

Daughter battles assisted-living facility after father dies, by Jon Yates Chicago Tribune February 6, 2011