For many blog regulars, the flurry of discussion about troubling events at Assisted Living Facilities is enough for them to think that we’ve re-named this site to the Assisted Living Abuse Blog. While I can assure you that we have no plans to change our url structure, the profusion of concerning incidents at Assisted Living Facilities is indeed a disturbing trend in the senior care industry and one which we intend on following.
The rapid expansion of assisted living facilities (ALF’s) is nothing surprising considering how lucrative they can be for the operators. Compared to nursing homes which have lengthy state and federal regulations in place and fixed Medicare reimbursement rates, Assisted Living Facilities are really a business operators dream come true. Generally loosely regulated and with prices controlled by what the market will bear, there’s little reason to doubt why the rush is on amongst the senior living companies to cash in on this stream of gray-haired clients.
Get Em In & Hold On
In addition simply getting well-to-do individuals and families to register for services at ALF’s, the business model also requires these facilities to keep on caring (and cashing the checks) for the residents. While the hold-em theory may be effective from a business perspective, it may be contrary to what the patient actually needs from the perspective of care.
Even over a relatively short period of time– 2-3 years– a patients condition can deteriorate significantly to the point that they very much are a different person than they may have been when they we admitted to the facility.
Knowing When to Say When
As a patient’s condition changes and their level of care requirements escalate, an inherent conflict begins to develop between the medical needs of a patient and the business model of the ALF. Sure, some accommodations can be implemented. Professional care givers can be hired and other outside assistance can be brought in for the patient. However, as ALF’s are not medical facilities (yes, nursing homes are considered to be), there’s only so much outside care that can be incorporated under the parameters of assisted living.
As a lawyer who has working on lawsuits involving negligence occurring within assisted living facilities, I am reminded over and over again about this inherent conflict between the business plan of assisted living facilities and the care needs of the people they are caring for. In particular, I sense the most severe conflict in situations involving the care of dementia and Alzheimer’s patients living in ALF’s. While the practice of caring for Alzheimer’s patients in ALF’s has produced somewhat of a cottage industry, the lack of meaningful and clear-cut regulations presents real dangers to this group.
Dangers of Holding On For Too Long
As a progressive condition, Alzheimer’s patients may remain ‘physically’ healthy in appearance while their cognitive function continues to slide. In the absence of trained staff and regular monitoring, this group of residents can rapidly outgrow the capabilities of care available at ALF’s.
Yet again, I was reminded of the horrors that can accompany a person who is ill suited for living at an assisted living facility when I read about a recently filed wrongful death lawsuit against an assisted living facility in California. As reported by the Los Angeles Times, the family of a dementia patient alleges that the Sunrise Sterling Canyon Assisted Living Facility was negligent in the manner it assessed and provided care to an 89-year-old woman during her three-year stay at the facility. The lawsuit alleges that though the woman arrived at the facility with ‘mild’ dementia, her condition progressed to the point where she required specialized Alzheimer’s care. Always willing to accommodate resident needs, the facility moved her to a ‘specialized’ Alzheimer’s section of the facility.
Specialized care of not, the care provided to the woman rapidly deteriorated on a hot California afternoon. Without any oversight from the facility, the woman managed to access a courtyard at the facility (in her wheelchair) and baked in the afternoon sun. It wasn’t until the woman’s son arrived that her whereabouts were brought to the attention of the staff. Unfortunately, the lack of supervision had simply gone on too long as doctors’ attempts to cool her were unsuccessful. An examination my the medical examiner concluded that the woman’s death was due to hyperthermia– heat exposure.
As this lawsuit progresses through the court system, it will be interesting to see how a jury views this circumstance. While I imagine the facility will claim that it did what was required under the prevailing law applicable to ALF’s, I hope that the jury has the courage to recognize that this episode of gross neglect is largely due to a business literally trying to extract every nickle from their customers.
For more information on nursing homes in California look here. For laws related to California nursing homes, look here.
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