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Podcast: What You Need to Know About Assisted Living

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(Photo courtesy of Frontline)

Earlier this month, ProPublica reporter A.C. Thompson and Jonathan Jones – in partnership with PBS Frontline - published a revealing expose on the assisted living industry and the largest provider of those facilities in the U.S. – Emeritus. The pair explained how and why the assisted living business has become so large, why the industry is loosely regulated by the states, and how Emeritus, in its quest for profits, endangered some residents by not providing enough qualified staff to care for them.

For the podcast, Thompson spoke to ProPublica editor-in-chief Stephen Engelberg about assisted living and how they told the narrative through the eyes of one resident (Joan Boice) who was fatally injured while in an Emeritus home. When asked what types of fines the state of California levies against assisted living facilities, Thompson said, “What you see in California typically is if you have an incident that leads to real serious physical harm or the death of a resident, you will see a fine. And that fine will be – wait for it - $150. Every now and then, there’s multiple violations, so you might see $300. And you don’t get the sense that these fines are really having any sort of deterrent effect on the companies that are getting them.”

He continued, “In California, you are going to be in a lot more trouble if you abuse an animal than if you abuse or neglect a senior in one of these facilities – a human being.”

Read the full story and watch the Frontline investigation as well.

Emeritus Senior Living

Aug. 13, 2013, 12:10 p.m.

As the nation’s largest assisted living provider, Emeritus was singled out for Frontline’s “exposé.” The program chose to focus on a few isolated incidents that occurred at a few of our communities a number of years ago in a completely sensationalized and lopsided way. This lead to Frontline airing many statements that were absolutely false.

For instance, in this introduction to the podcast, it states, “(Joan Boice) …was fatally injured while in an Emeritus home.” The truth of the matter is than Joan died while in a skilled nursing facility two months after she left the Emeritus community highlighted in the broadcast. She was not “injured” while at Emeritus. She was dying and she developed numerous conditions that are common among people who are in the process of dying. All of this is confirmed by the 34 non-Emeritus caregivers who took care of Joan. ProPublica’s efforts to blame Emeritus for Joan’s death is completely irresponsible and simply untrue.

Not even one mistake is acceptable to us, even when we have taken every reasonable precaution to prevent it. When we do make a mistake, we respond quickly and thoroughly, so we can remedy any problems. That’s why we were very disappointed by the broadcast and ProPublica’s constant hyping of the story, neither of which does anything to represent the dedication and commitment of our staff to each and every one of our residents. Frontline resisted our attempts to connect them with any of the wonderful stories of compassion and nurturing our residents experience every single day or the thousands of family members that are grateful to us for the care and support we provide to their loved ones. In our 20-year history, serving hundreds of thousands of residents, Frontline chose to focus on these isolated incidents, all of which happened many years ago and are not at all representative of Emeritus today. To learn more, we invite you to visit http://www.emeritusfacts.com.

In spite of the picture Frontline tried to portray, we have the best team of caregivers in the industry – who serve our residents with skill and compassion. This is demonstrated by the thousands and thousands of letters, emails, and comments we receive each year from residents and families who are incredibly grateful for the care they receive at our communities, some of which you can read at http://www.emeritus.com/family-voices.

Frontline and ProPublica chose to sensationalize several families’ tragedies in order to drum up ratings and readership. In doing so, they missed a real opportunity to elevate the nation’s discussion about caring for our seniors, which is a conversation worth having.

Debt Suspension Rights

Aug. 13, 2013, 12:44 p.m.

I would suggest that the scandalous world of Reverse Mortgages is forcing literally tens of thousands elders into non-familial assisted living programs.

Only one person can remain on the deed when a reverse mortgage is taken out. Additionally, Mortgage Insurance for the full value of the home is charged even if the elderly person just wants to take out a very modest monthly draw.

Say a home is worth 200,000 and is paid off. (Remember many elderly were able to pay off their homes because back in the 60’s, 70’s and 80’s home prices were lower). If the elderly person simply wants to take out a measly 500 dollars a month, they would be charged approximately 200 to 300 dollars a month in Mortgage insurance premiums. This in turn accelerates the interest rate charges on what is taken out as well since the overall debtload is being accelerated by the mortgage insurance, resulting in an ever increasing crescendo of financial sharks taking their cut.

Let the elderly take out a small draw without drowning them with mortgage insurance premiums. The example above would mean that after 10 years time the senior had withdrawn 60,000 dollars. However, because they most likely circulated that money locally, their home value could reasonably rise to 230,000. Meaning the net loss would only be 30,000 dollars after 10 years time!

What does this have to do with assisted living? If reverse mortgages did not take everyone’s name off the deed and offered the monthly draw with no mortgage insurance, family members could afford to live with their parents and take care of them. As it stands now, the moment a senior transfers from familial care to state run assisted living the family members would have to move out of the home so it could be sold!

Please consider “liking” Debt Suspension Rights facebook page. http://www.facebook.com/DebtSuspensionRights

There are other issues just as important that are stealing wealth from main street that debt suspension rights is offering solutions to.

It’s also interesting that they interview ex-employees who were present when the resident suffered an injury and in turn blame the company for their negligence. So all you have to do when you are employee is to blame your employer for your incompetence.

Are all the people responding to this story employees of the assisted living industry?
It was my understanding that the bait and switch sales approach was outlawed, assisted living could not and would not survive without bait and switch, corporate policy dictates that you tell the prospective victim whatever they want to hear and once the contract is signed, conveniently forget what you told them.
My experience was with Brookdale senior living in New Jersey, I saw the same problems that were reported in the story. We have the 2 largest assisted living chains on both coasts mistreating a vulnerable population.
Assisted living needs to be regulated just as strictly as nursing homes, what we have now in assisted living is what we had in nursing homes prior to regulation.
Federal regulation is needed, I have 3 complaints filed with the NJDOH since November 2012, that have yet to be investigated, when I question the NJDOH I am told we will eventually investigate.

Arizona Eagletarian

Aug. 13, 2013, 6:27 p.m.

Vigilance is necessary. There are important keys available to people who need to consider assisted living placements for themselves or their parents. Each state should also have an ombudsman office that can track complaints and resolution thereof for each licensed facility.

I’ve found those resources very important and valuable as my mother is planning such a move this month.

Don’t think for 1 minute you can rely on any state agency or ombudsman’s office for help, the complaint investigations are minimal at best, read the entire Frontline story, it is a fact I experienced it. I would suggest to anyone thinking of moving into assisted living to find a way to avoid it at all cost.

Arizona Eagletarian

Aug. 13, 2013, 6:54 p.m.

Well, Richard, as a figure of speech, I take your insight seriously. However, for many people, the cost of avoiding assisted living can be their lives.

It’s not resort living. It’s not independent living. But the reason the industry is growing is because it is necessary for a growing number of people.

Some people just have to learn the hard way. It’s not my Mother.

On the other hand… my mother has been living quite happily at Paul’s Run in Philadelphia for about 10 years. It’s part of Liberty Lutheran. Everyone I know who has visited her there, including me, have commented on the cleanliness and maintenance of the buildings and grounds and the intensely personal, thoughtful and professional care by all of the staff… dining room, maintenance, cleaning and of course medical and administrative. Paul’s Run could be a model for what assisted living (or a “Continuous Care Retirement Community” as they call it) should be.

My mother’s last name is not the same as mine, so no one at Paul’s Run could connect this posting to her, and I have no other relationship with Paul’s Run other than being an indirect “customer”.

Wow am I the only one who sees the merit in the Propublica report? Sadly it came to late to help with my wife’s care.
The following questions will provide food for thought;
What was the true meaning of assisted living, when the concept was developed?
Why is assisted living so much cheaper than a nursing home, the basic costs are the same, building, taxes, utilities, food, and so on, there is only 1 main area that assisted living can cut costs, and maintain their large profits, that is in the care area, compare care in a nursing home to care in assisted living. You get what you pay for, if you like a fancy facility and lack of proper care assisted living is for you.
What is assisted living afraid of? Look at the contract read it line by line, why are you required to sign away your right to proper recourse?
Would you sign a contract like that to purchase a car, or home? Why then are you willing to sign away your rights to protect a family member?
Why does assisted living fight so hard against federal regulation? A national corporation doing business in multiple states would welcome a set of standardized regulations that would allow them to use a single business model across the country. Assisted living is not fighting federal regulation, they are fighting the oversite that comes with the regulations. State oversite is poor at best allowing assisted living to define itself as needed in each state to maximize profits.
Assisted living is also afraid of unionization. Unionization would allow the care givers to speak with one voice, they would no longer be working in fear of losing their jobs if they did not follow corporate instructions right or wrong.
It is time to reform assisted living now, before more people are hurt, federal oversite is needed, as it stands now we have an industry calling itself assisted living functioning as nursing homes without proper oversite.
There are independent assisted living facilities through out this country doing a good job, but they are few and far between, and little by little the national chains will put the independents out of business if the national chains are allowed to continue without proper regulation.

Richard, if you look in the archives from a couple of weeks ago, you’ll see an article where ProPublica was accidentally copied on the game plan, including what to say, how to say it, and how to engage (or rather, to specifically avoid engaging) in the ongoing debate.

So, yes.  The overwhelming majority of people are employees.  They were asked to comment to “balance the discussion” or some similar nonsense that implies people in power need to be protected from the unwashed masses when they screw up.

John,
I’m not sure what you’re trying to say. However, it is inescapable that incompetent employees no matter what field they are in will blame external processes for their shortcomings. An objective report would have been more nuanced, and hence, boring. Remember that this report made no effort to compare this corporation to others, nor get objective experts to comment. Instead they interviewed experts who advertise themselves as plaintiffs expert witnesses(google them).

I have no problem believing the ProPublica reportage on this story. Assisted living is a huge industry, and, as one commenter has already pointed out, with all the costs associated with the physical building being equal, there’s only one place a corporation like Emeritus can cut back: they provide either poor or minimal staff. When my mother needed a nursing home, I went in to several (she was too disabled for assisted living). I pretended I was there to visit someone and so no one stopped me at any of these places. It’s the best way to find out about staffing numbers. Many homes had staff shortages—if it took me a long time to see a staff member, I crossed the home off my list. I did not want to present myself as a potential client and be “sold” a story about how great the care was. However, I know that not everyone has these kind of choices. I live in a big city and so had the opportunity to shop around.

I also pay companions to visit my mother at irregular times. I use my mother’s pension money to do this and, apart from one instance when my mother was being inappropriately drugged, everything is going well. Using a parent’s money this way is a really, really good idea and I recommend it. I hired a retired social worker and a young woman, a student, and they turn up whenever they have a couple of hours to spare. The staff know my mother is being monitored and it’s working to keep her safe. Between my visits and the companions, my mother sees someone from the outside every day.

I feel for the family in this story, however. I can certainly see how things started to go off the rails without them realizing. I’ve written a lot about my mother’s acute-care hospital. That’s where our nightmare took place. http://www.ireneogrizek.ca

Debt Suspension Rights

Aug. 14, 2013, 7:43 p.m.

So you were able to walk in right in by saying you were visiting someone and gain access to the facility?  Isn’t that an instant fail?

Debt:
Not really, this is supposed to be a person’s home. Visitors are encouraged and old people almost without exception welcome children,pets, and friends.
The real question is why Irene would have his mother live in a facility when he obviously has the means to keep her in his or her home with caretakers.
The next question is how he knows what “understaffing” is, can he define it?

Rich
An assisted living facility is cheaper because they are not required to offer “skilled care”:  pt,ot speech or, skilled nursing for diseases. Hence there are no rehabilitation services, except for ad hoc external ones.

Well, for starters, I’m a she, not a he. And my mother did live with me for 20 months. She is profoundly paralyzed, except for her right arm. So she is almost a quadriplegic. I promised her as much physical therapy as we could afford, and so I took all of her savings, paid for a live-in who was trained as a physio’s assistant and for 20 months, we lived like that. She got passive motion therapy every day, (I did it on our live-in’s two days off). I also took training to be a Personal Support Worker—6 weeks of it—so I’m actually qualified to work in a nursing home, although I already have a career. I also took a sabbatical (1 year) to be there for my mother.

At any rate, the therapy alleviated her pain and did so on a fairly permanent basis. It was neuro pain, so physical therapy was the best option. When her savings started to run out, she was the one who insisted on being moved into a home. So I promised her I would look for the best one. I don’t think there’s one person I know or who we encountered who thought I wasn’t taking good care of my mother, so your insinuations are baseless.

Most homes are not security conscious—quite the opposite. They WANT visitors. So it wasn’t hard to walk around. Of course, I didn’t go into any Alzheimer’s wards because they are usually secure and locked. But I walked around other floors and counted staff. At other times, I talked to visiting family members. That was very helpful too.

What’s good care? I’m not going to fall into the trap of running after a definition when it’s clear you are trying to bait here. However, good care is a bit like asking what “love” is—we have trouble defining it, but we all know it when we see it. 1 or 2 staffers for 30 - 40 patients is crazy and overloads workers.

Debt Suspension Rights

Aug. 14, 2013, 9:25 p.m.

It actually costs much much more to house a person in an assisted living facility than in a home. I don’t know the numbers, can anyone chime in with them? I would guess it costs 3,000 to 5,000 dollars per month for an assisted living situation on the low end.

Perhaps the high end could be 5,000 to 7,000 dollars a month?

However, keeping track of home health services might prove a daunting task for the state if suddenly millions more people stayed home and had family take care of them.

I think home health care should be modestly incentivized, there may just be too many people chasing an illusionary “dream” in which they travel many miles to work, stay all day doing a job they may not believe in, then come home and fall asleep on the couch chasing that dream.

While I think that is fine for people in their 20’s and 30’s, if those older want to caregive for a parent and live in the same home, that actually can REDUCE overall consumption of energy resources, which is actually a good thing, especially if they use the land around the home to grow food.

Debt Suspension Rights

Aug. 14, 2013, 9:29 p.m.

My point is that economic growth is fast becoming a myth.  The only economic growth that really matters in this day and age in my opinion is growth that occurs because of increased efficiency of existing non-renewable resources.

And that is an economic model that is too complex to state in soundbite on the nightly news.

So if an adult child lives in the same home as the parent, conserves water and power because they are there to monitor those things more closely, and no longer drives 15,000 miles a year to work, that may actually be reducing the strain on our economy, not adding to it.

Try explaining that one to the rich elite.

Debt Suspension Rights

Aug. 14, 2013, 9:53 p.m.

Irene, that is a tough situation to be in, when a parent is immobile to such a degree. That is my one big fear in providing caregiving. Once a person can’t move very well, it puts so much stress on themselves and their caregiver.

When my father could no longer walk prior to passing, the one thing I did which helped was request one of those triangles over the bed. The people who brought the bed to the home said nobody ever asks for that, but my father loved being able to use his arms to lift himself, even when he could not get out of bed, it made him feel like less of a burden.

He even clanged it one day when it was supper time and yelled out “Come and Get it”.

Wow, sounds like a lot of Assisted Living execs are making comments here, not the people who have been hurt by them. I know from first-hand experience placing a loved one in a residential care facility:  the abuse, the neglect, the “show” these home owners put on when a prospective customer comes in the door, and all the effort they put into keeping family & friends away. My loved one was locked in his room the first night he arrived (he called me with his cell phone), then eloped to the street and was picked up by police. This was just the beginning of a nightmare that went on and on.  In California, if they cause your death, it’s $150 fine, less than the fine for littering. The state is hopeless and is only required to inspect these places once every 5 years.

You’re right Lois. There are a lot of execs (or perhaps employees) here making comments. Reading the fine print before signing into one of these places is absolutely necessary, even if you have to pay a lawyer to interpret it for you: you have to make sure that visitors are allowed on a regular basis.  A nursing home in my area, just recently, was caught abusing patients. The patient’s family put a hidden camera in the room and caught it on tape. Whenever I visit my mother, I always have my smart phone ready to catch anything amiss. Since I am a qualified PSW, I occasionally stand in when my mother is having her clothing or diapers changed. I do this so I can check her skin. I’m not worried, however. The home she’s in is excellent. It’s just the occasional bad apple employee that can be a problem.

My parents invested in good insurance when they were younger, so it’s the insurance that pays for the home. I use my mother’s pension to money to pay for extras, including the unofficial “surveillance.” Totally, totally worth it.

Walter, my point was just to answer Richard’s question.  There’s a certain, documented degree of what amounts to astroturfing whenever an article is published on certain industries.  This one happened to be documented here, due to an e-mail mix-up, just two weeks ago:

propublica.org/article/note-to-staff-send-forward-oops

Just like the fast food protests were co-opted by SEIU and turned into a circus, this is unfortunately directed by the industry to protect itself, rather than employees making sure the truth is heard.

You can tell by the fact that no number of good deeds and well-run institutions compensate for the bad apples.  Honest posters would tell their story and then condemn the creeps making them look bad.

I mean, I’m in software.  Do you think I play up all the great software in the world whenever Windows crashes?  Of course not.  I want people to know the difference between the good stuff and the crap.  I want the bad programmers run out of the industry so they stop making me look bad by association!  It’s only the owners who want you to think the overall league batting average is all that matters.

Debt: its not cheaper to care for a person at home. Home care agencies charge from $17 to $24 dollars an hour. Thats about 12,000 a month for a full time caregiver.
Irene:
I took care of my mother at home for 3 years. She was healthy, but she had dementia. In that three years there was a 3;1 “staffing” ratio at my house. In spite of this staffing she lost weight, eloped once, and had several falls, one of which happened within inches of me, resulting in a hip fracture. The “staff” suffered from depression, lack of sleep,lack of exercise, back pain, and social isolation. We spent thousands of dollars on medical eqipment, special food, and the occasional caregiver for respite care. I can assure you that we were not better than any commercial living facility.

Debt Suspension Rights

Aug. 15, 2013, 12:06 p.m.

Walter, it is remarkably less expensive if a family member does it. Some if not all states have a program called “In home Support Services” in which if an elderly person has no more savings and less than a few thousand in other assets (but they can own a home) a family member can receive a very modest amount every month to provide caregiving services. Basically its minimum wage times a certain amount of allocated hours every month.

Unfortunately, some states appear to try and scare people from this program by warning them that they will have to reimburse the state for all of their wages if their parent passes before they do.

However, if the family caregiver has been doing it for a couple of years and lives at the home, that is apparently not true.

It is a sad day when the state competes with the taxpayer for taxpayer money, preferring to pay for state watched caregiving at probably 500% more money than having a family member do it at home.

When numbers are crunched, it appears to actually be more cost effective for an adult child to provide caregiving for their own parents than have their own job with all the associated costs of rent, transportation and insurance costs plus the cost of assisted living versus living in the same home with their parents. Of course this is not for everyone, but there can be all kinds of savings for both the family AND the TAXPAYER as well.

Debt:
It might seem that way. There is no cost to the State if someone goes into Assisted Living or has the assets or insurance for Long term Care, since in most instances the person pays for it. If a family member has to quit their job then it is quite a bit more expensive to the individual, even with programs like Pensylvania’s In-Home family caretaking program,which provides a small stipend to the family member.
Assisted living in Pensylvania can can run from 30,000 to > $100,00/ year but quitting a job, losing future social security benefits and health insurance can amount to just as much or more.

To Richard,
      I too went through NJ DOH and when I placed a complaint against an Assisted Living Facility in South Jersey for improperly chemically restraining my friend/partner who had early onset dementia. I work in the assisted living industry and I knew that there are horrible reprocussions to chemically restraining a resident with dementia because it can accelerate the disease. What I got in return was retaliation from the facility. The administrators were told by DOHSS that I placed the complaint. Since he was in a Medicaid facility and his POA didn’t want to be bothered, she relented and I was not allowed to see him at al,l for 4 months. His family did not visit often and I was the only one there for him for about 3 years. He is not a violent person it just that staff there are extremely disrespectful and staff were told to grab and physically restrain him, so he would try to get away but sometimes he couldn’t and it would get physical. He has always had a phobia with needles. I received a call from a resident there that witnessed it. After the first two initial weeks of being placed on these medications, he was barely able to walk and could not lift up his neck, I saw it along with his best friend, so I had to put a complaint, silly me.  No one in the state of NJ in a position of power did anything .  He was physically fit 56 year old, running, walking and content, 6’2 tall 218lbs now 3 months later 120lbs cannot walk, cannot eat for himself. He was asleep most of the time since taking a load of Depakote he did not need. The nursing home he is in now took him off the meds and guess what they realized he did not need the psychotropic drugs because he is not a violent man.
Like my nursing coworker said when I told her what they we giving him how much ,she said,  were they trying to put him in a coma??It is like night day since those meds were removed. He starting to walk and eat again.no longer has that faraway look in his eyes.  What that facility did was criminal and the NJ state agencies are complicated.

Debt Suspension Insurance

Aug. 15, 2013, 3:30 p.m.

Erosion of family wealth while not even being taken care of by a family member can seem unpalatable to some.

The idea is if the adult caregiver wants to give back to the mother or father, the math may add up in their favor.

Monthly overhead for adult son or daughter is most likely 2,000 to 4,000 dollars a month. Now add in what it costs to keep mom or dad in assisted living,  3,000 to 5,000 a month?  So between the two, we are talking an overhead of around 6,000 to 7,500 a month?

Instead, son or daughter caregives for mom or dad or both, lives with them. Doesn’t pay rent and is paid even minimum wage for I would guess 100 to 120 hours a month?  Minimal overhead, has wages deducted for taxes so it does register for social security.  Add in they may do work around the house, which can increase the value of the home or provide a nice garden. Much less wear and tear on the car as well.

I would suggest a family caregiver living with the parent or parents is saving the family wealth anywhere from 2,500 to 5,000 dollars a month.

Kathrine;

Thank you for confirming the horrible truth, the NJDOH will not act against a facility, I gave the DOH documented proof and they still take no action.
One of the problems are family members, they just do not care, they place someone in assisted living and walk away, that is not right and leads to the problems you and I witnessed.
I find the comments on here interesting, they attack the report, it was not a slanted report it was a true and accurate report.
Assisted living reform is long over due, federal oversite is needed, the states are not interested in policing these facilities
People seem concerned more with the cost of care than with the care itself, finding the right care has to be the first priority, cost is secondary, I spent 1/2 my retirement saving on my wife’s care, it was what had to be done.
Just so you know I filed my complaints after my wife passed away, because I was fearful of retaliation.

Debt:
I see your reasoning. Consider this:

Scenario1:  I send my dad to assisted living, and pay them $36000 year.
My family loses $36,000 year minus $18000 SSB; total loss= 18G/ year
Scenario 2
I quit my $72G W&B job and care for my dad. MY family loses $72G-$18G; total loss=  $54G/year.

Perhaps Government should get completely out of retirement and medical care. People can then participate in a free market and contract with Institutions that guarantee that we will never get old, develop age-related complications and die.

Debt Suspension Rights

Aug. 15, 2013, 7:08 p.m.

It’s not just the 18,000 thousand dollars. Depending on the scenario, if the adult son or daughter moves into the home, they no longer have rent plus significantly reduced transportation costs as well and can help REDUCE other monthly costs through common sense vigilance as well.

Living apart, costs could easily be 7,500 dollars a month for both parties, living together, costs could be 2,500 dollars. Not every family situation is the same of course. A single parent with their own family may not be able to make it work, an adult son or daughter without their own family probably can make it work if they want to.  A married couple might be able to make it work.

The other scenario is what type of job is being given up.  72,000 is no longer a median average. Median average salary in the U.S. I believe is in the low to mid 40,000 dollar range.

Debt Suspension Rights

Aug. 16, 2013, 12:49 p.m.

I am also not so sure you can simply dismiss the 18,000 coming from Social Security. That money would otherwise be going to the monthly costs and maintenance of having the home that is housing two generations of the same family as they provide caregiving at home.

I do agree that is someone has a solid income generating job, that giving that up can be risky, but I think we are talking about 20% of the population max, no?

OK we seem to be at a stand off, on 1 side we have the people who have seen the abuse and neglect in assisted living first hand, on the other side we have the people in denial, and the people more concerned about cost than care. Now throw in the political contributions made by assisted living, corporate control of government and we have little chance of reform.
I would like to propose a compromise, it may seem silly at first but it is a beginning. A warning label, warning labels are common place in society today, the government see fit to warn us about smoking, food, soft drinks, car seats, electrical shock and so on, instruction manuals contain more pages of warnings than instructions.
The warning label for assisted living would have to be prominently displayed at the entrance, and in all common areas and offices, it would have to be on all advertising, and stationary.
The label would say;  WARNING; Residing in this facility may cause undue emotional harm, depression, and physical pain, resulting in hospital admittance and or death.
We also need full disclosure of the referral fees paid to outside services, I just heard an add for a place for mom in the add they stressed the service is completely free, that is just not true, it is a service paid for by the assisted living industry, with fees of up to $1500.00 paid. Ask yourself, does the CEO of Brookdale Senior Living pay this fee, do the stock holders pay this fee, or is it added to the monthly fee paid by residents.

It is not just the large chains that need to be monitored. The smaller “mom and pop” facilities may or may not provide a competent level of care. The critical factor is the training of the staff, the nutritional value of the diet, the commitment to cleanliness of the facility. Too many places meet the bottom line minimum standards, which are minimum indeed. The administrators do not have the training to understand the limitations of the residents and most of the staff do not speak the same language of the residents. The states do not fund the regulatory agencies so that they can not do their job and the regulations are to vague to be enforced adequately. it is up to the family and friends to oversee care.

Saralea : actually the critical factor is the frailty and complexity of the resident. The more ill the resident is the more likely there are to be real and perceived shortcomings in care and the more likely something bad is going to happen. After all you would do magnificently in such a setting, but a sick handicapped person, not so well. Ronald Reagan, cared for at home, fell and broke his hip, as did pope John Paul, and both of them lost weight and died.
If you are old,sick, and disabled, nothing good is in store for you, no matter what the venue.

Yes, Uh oh, I am agreeing with you. The frailty of the individual dictates the level of care needed. Too many assisted living facility insist they can care for the more frail but they can’t and the options for placement are limited unless there are unlimited funds. Money equals choice. I know, I care for a friend who has limited resources and finding an adequate facility for her was no easy effort. I am in the facility at least once a week, so I can keep an eye on her. I take her to the doctor and make sure she gets her meds.
For me, I have unlimited long term care insurance, when it is my turn, I get more choices.

Debt Suspension Rights

Aug. 19, 2013, 11:48 p.m.

Saralea, I looked into long term care insurance for my parents, the premiums can be somewhat pricey and can add up quickly if the parent does not need the insurance in the foreseeable future.

People in assisted living need reorientation from their loved ones a few times EVERY DAY, and yet, that could produce depression once that person hangs up the phone or the IPad.

I wish this program was featured in CNN or any of the popular shows like nightline, dateline so that it can get more of a broader viewing to millions. The problem are the corporations but to me it lies on the state agencies in charge of oversight. Here in NJ, a group of us made legitimate complaints and had evidence yet not one state agency did an good investigation. We know this because employees who were involved, said they were not interviewed. These investigations are a joke. One of us had evidence that medical records were forged and some were destroyed and the nj dohhs only cited them for improper record keeping, their family member died of neglect and the facility tampered with medical records to cover it up. Slap on the wrist. Keep in mind the two administrators have been arrested several times before. Baby boomers are a strong voting force and the broader public needs to be aware that their own state agencies will not enforce oversight against these ALFs.

To Rich,
    Nationwide there are problems with state agencies inaction against ALF’s. Since when can anyone even your POA take away human and civil rights? Can you imagine how awful it is that a facilty can prevent someone from seeing a resident, the only person there for them in 3 years. It was soo bad that employees would run into me and plea for me to do something, anything to get him out of there. I did, I went to Senators, DOHHS, Ombudsman, disability rights nj, and no one protected my partner. His family did not care.  Employees would tell me that he was asking for me everyday, pleading to see me. Yet, I could do nothing I was not his POA, but silly me I thought NO one can take away his rights not the facility or his POA, yet what I got in return was retailiation and as long as he was in that facility I would not be able to see him. Thank God he got out of there although not the same. 
    What really gets to me is in that location it closed down before for mistreatment as another facility just changed its name. Do you remember in south jersey of a resident found frozen to death outside 40 ft from the front door before 6am.  Both same adminstrators though and get this, these two administrators have been ARRESTED before several times and DOHHS knows all of this!
    It makes me so upset to think about all the uproar with Michael Vick’s mistreatment of dogs, where is the uproar over the mistreatment of our fellow human beings? Some of these people are vetrans of world war II, where is the dignity with the treatment of these individuals? Where is the compassion that motivates these state agencies to do something?

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