It's more than just death panels that were not but are:
"Elder advocates raise concerns on assisted living" by Kay Lazar | Globe Staff September 21, 2014
In Stoughton, an elderly woman walked out of a locked dementia unit at an assisted living residence in May, wandered into another room and fell from a second-story window.
That same month, at a Framingham assisted living facility, two staffers were arrested for allegedly slapping and pinching two elderly residents who have Alzheimer’s, and filming a third who was partly undressed.
In July, an 88-year-old man with a history of falling, and who had a tube in his chest for dialysis treatment, apparently tripped in the bathroom of his Revere assisted living residence and bled to death before staffers reached him.
Residents in Massachusetts assisted living facilities are in harm’s way too often, and the Executive Office of Elder Affairs, the state agency charged with overseeing the 224 residences, is ill-equipped to protect these increasingly frail residents, elder advocates say.
Even a key staffer at the agency is worried. Peter Antonellis, compliance officer at Elder Affairs who inspects the facilities, said the agency has just two ombudsmen to handle the thousands of complaints that pour in each year involving assisted living residences.
I'm doing the best I can running this blog.
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“I think most elders and their families think this is a regulated industry, but we don’t have the staff to regulate it,” Antonellis said.
Where is all the money going?
Many elders who once would have moved to nursing homes when their health declined are instead choosing to remain in assisted living, often because the cost is significantly less than nursing homes.
And a nursing home means no po$$e$$ions at all, requirement is total poverty to qualify for government help(?).
As a result, the populations in these loosely regulated, apartment-like facilities have been profoundly transformed, with a growing segment of residents who are increasingly frail.
That shift, combined with limited oversight, is jeopardizing the welfare of the 13,700 people who live in these de facto nursing homes, elder advocates and safety specialists say. Assisted living residences were designed as nursing home alternatives for older adults who need help with everyday activities, such as bathing, dressing, and cooking, yet are still capable of living independently.
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Antonellis said he has repeatedly alerted his superiors that reports of serious incidents at facilities are languishing for weeks or months at the agency, and that no one seems to be analyzing them for patterns that may point to larger issues....
The $uperiors in the regulator's office come from industry, right? Saw this in the meningitis murders.
A spokeswoman at Elder Affairs disputed Antonellis’s assessment, saying the agency converted an antiquated paper-based reporting system to electronic files last year and does not have a backlog.
Uh-oh.
“The department takes any instance of elder abuse or neglect seriously, whether it comes from an outside party or a member of staff,” spokeswoman Martina Jackson said. “Staff work diligently to process the reports they receive and review the underlying incidents, cooperate with law enforcement on criminal matters, and order corrective action when necessary.”
End recording.
Yup, you guys doing a great job.
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Finances represent one of several ways assisted living facilities differ from nursing homes. Nursing homes are largely federally funded and regulated, and must adhere to a slew of federal, state, and local safety rules and inspections. Assisted living residences are largely paid for by consumers out of their own pockets, with oversight left to states.
Many states regulate assisted living residences as health care facilities, but Massachusetts remains among a handful that still consider the facilities more similar to apartment living, said Karl Polzer, former senior policy director at the National Center for Assisted Living, a trade association.
When the 1994 Massachusetts assisted living law was written, few people envisioned the seismic shift that has occurred, with the facilities evolving into de facto nursing homes.
Paul Raia, vice president of clinical services at the Alzheimer’s Association of Massachusetts and New Hampshire, said he believes it is time for state regulators to “redefine the concept” and rules of assisted living to match the frailty of today’s residents....
Thomas Cocorochio battled many health problems, with a failing heart and kidney, and instability that led to frequent falls. But the 88-year-old former Everett resident fought the idea of living in a nursing home, so assisted living was a family compromise, said his son, Michael Cocorochio.
When a tube was inserted in July near his neck for kidney dialysis, and he was discharged from the hospital back to Prospect House in Revere, no one told the family that the octogenarian needed to be careful about dislodging the tubing, his son said.
“If I had it to do all over again, I would have been happier if the hospital said this is touchy, you need to put him in a cocoon,” Cocorochio said.
His father apparently fell one evening shortly after a family member visited in late July. He pushed a button to call for help, but bled to death before staffers reached him. It’s not clear how long it took for help to arrive, but Cocorochio said the family received a call from the facility about his father’s death within an hour after the relative’s visit.
Warren Strong, a spokesman for Prospect House, said patient confidentiality laws preclude him from discussing the Cocorochio case, but said staffers routinely analyze serious incidents to determine whether policies or practices need to be updated to prevent a repeat.
“We don’t want anyone to reside in our community if they are not safe, but often it is the families that want them to stay,” Strong said, echoing a dilemma expressed by others in the industry.
Despite staff training, criminal background checks, and dedication, resident injuries occur, but they are isolated incidents, said spokeswomen for the Arbors assisted living in Stoughton, where an elderly woman wandered out of a locked dementia unit and fell out a window earlier this year, and at Framingham’s Emeritus at Farm Pond, where two staffers allegedly abused three Alzheimer’s patients.
“We take the charge of promoting and safeguarding our residents’ health and safety seriously and respond promptly to allegations regarding our residents’ safety and health,” said Emeritus spokeswoman Kristin Puckett.
Massachusetts’ assisted living law prohibits facilities from accepting or retaining residents who require skilled nursing care for more than 90 days in a year. But interviews with industry and government officials suggest that rule has not been widely enforced.
Instead, residents requiring skilled nursing have been allowed to stay in assisted living and hire private nurses, said Robert Larkin, an industry leader and president of Senior Living Residences, a network of 12 assisted living facilities in Massachusetts.
“It’s like as if it were their home,” Larkin said. “That works really well.”
Meanwhile, as the ranks of older adults with dementia continue to swell, so too do the number of assisted living residences with special care units, locked wings that target dementia care.
Prison when old and weak. Not a joyful thought of the future.
Massachusetts regulations for these units, as with the more traditional assisted living facilities, do not mandate minimum staffing levels, nor oversight to ensure patients are capable of taking their medications.
The fear of losing one's mind and body is always present. It's actually more of a fear than the terrorists, if you want the truth about it.
Instead, the rules allow “self-administered medication management,” with staffers reminding patients to take their medications and documenting whether they took them or refused.
Raia, with the Alzheimer’s Association, worries that too many dementia patients may not be getting their medications under this relaxed approach.
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Safety specialists voice similar concerns about vulnerable residents in the event of fires.
Assisted living residences are treated like apartment buildings, meaning local building inspectors are required to conduct fire safety and building code reviews only once every five years, and then just in kitchens, dining halls, and other shared areas
The state’s elder affairs agency also surveys assisted living residences every two years, primarily focusing on operating plans, interviews with staff, residents, and inspections of common areas.
Nursing homes, in contrast, receive annual inspections from state building inspectors, are required to provide annual training of employees by fire departments, and undergo annual state Health Department surveys.
With costs for Massachusetts assisted living residences already among the highest in the country — ranging from $4,800 to $7,000 monthly, according to state data — industry leaders say they are loathe to layer on more regulations that could further raise costs and deplete consumer choices.
Larkin, president of Senior Living Residences, compares the mounting debate about safety versus independence to the relationship between parent and child.
“We all want independence for ourselves, but we are less enthusiastic about it for our children and our aging parents,” he said. “Seniors know what they want.”
One thing they don't want is to have to haggle and change health care plans every year. They just want good, decent health care that will be there.
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Also see:
End-of-life care needs concrete reforms, not sweeping rhetoric
Follow-up data hazy on elderly cases
Another "computer system that is outdated and flawed!"
Another failed legacy of the Patrick administration. They are piling up even faster the closer he gets to that door.
UPDATE:
"Residents of assisted living homes would receive significant new protections under rules proposed Friday by Massachusetts regulators — changes aimed at closing gaps that threatened elders’ safety....
Ann Hartstein, secretary of the Executive Office of Elder Affairs, has been watching over them.
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