Calif. assisted living too often inadequate, …

California Assisted Living Too Often Inadequate, Dangerous or Deadly

Many California families consider assisted-living facilities to be positive options for their elderly loved ones who need supported residential services. Frighteningly, evidence of poor care and inadequate governmental oversight has flooded the media in a series of journalistic investigations and legislative hearings.

The assisted-living model

Assisted-living facilities are popular for elderly people who do not need the level of care of a traditional nursing home, but cannot live entirely independently. Usually, assisted living offers apartment-like units with on-site staff to help monitor residents when they need help with medical or other personal needs. Often such facilities offer patients other services like communal dining and recreational opportunity.

California regulatory oversight

Such residences are controlled by both federal and state law, but much of the licensing and quality oversight falls to the state of California and its agencies like the California Department of Social Services, including its Community Care Licensing Division, known as CCL.

An ugly discovery

Working with the CHCF Center for Health Reporting, The San Diego Union-Tribune published a special report in September 2013, followed by more reports, about an assisted-living system of more than 7,000 facilities rampant with neglect and abuse, including 27 resident deaths since 2008 - in just one county alone, San Diego.

Other problematic findings of concern include broken bones, sexual assault, bed sores, inspector bribery, unpaid fines, medication errors, inadequate medical monitoring and more. Allegations have been repeatedly made that fines for catastrophic injuries and safety violations are too insignificant to make a difference and that allegations of abuse or neglect get stuck in a governmental bureaucracy, rather than being investigated quickly by law enforcement.

Filling beds

Another problem detailed throughout the exposés is a practice by some facilities of filling beds with residents who are really too sick or disabled for the level of care in assisted living and should instead be placed in nursing homes or skilled nursing facilities that can provide the more intense medical services needed.

For example, a patient with severe bed sores needs almost constant monitoring and regular position changes by staff, something assisted living is not normally staffed to provide. Such situations have led to wrongful death when improperly treated pressure ulcers cause fatal infection.

The Residential Care Facilities for the Elderly or RCFE Reform Act of 2014

In response to The San Diego Union-Tribune piece as well as to similar articles by Frontline and others, California legislators announced in January 2014 a bipartisan package of several proposed bills aimed at improving conditions in assisted-living facilities in the state. Advocacy organizations and the industry itself are calling for improvements. Some of the legislative proposals include:

  • Liability-insurance requirements;
  • Tougher government enforcement of legal requirements;
  • More frequent inspections, including unannounced;
  • Significantly higher fines;
  • Increased mandatory staff training and more required job qualifications;
  • Public Internet access to facility records and regulatory violations; and
  • Better investigative standards in response to complaints.

Many of these proposals are supported by Gov. Jerry Brown's proposed 2014 state budget, which includes a large funding increase and more state licensing staff.

What to do in the meantime

As the proposals wind their way through the legislative process and even after the system is hopefully made safer, family members will be faced with inadequate and dangerous conditions in assisted living. If you are a Californian who suspects abuse or neglect of a loved one in assisted living, contact an experienced personal injury attorney to understand what legal rights and remedies may be available such as a personal injury or wrongful death lawsuit for damages.

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