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'The Dark Rock We Don't Want to Look Under'

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Assisted Living facilities, operating virtually regulation free across Illinois and the U.S., are increasingly the subject of litigation in cases of neglect and incompetence as our nation’s exploding senior population becomes more dependent on full time care.

By: Patrick J. Giese

As our population ages, there has been a nearly insatiable demand for assisted living facilities. The 1990s saw unprecedented growth in this sector as major corporations bought, built, and filled assisted living facilities nationwide.  Emeritus Senior Living, America’s largest such corporation, raked in a stunning $1.6 billion in revenue in 2012.  Publicly traded on the New York Stock Exchange, Emeritus has an astounding number of facilities across the country, including five within 25 miles of Chicago.

Emeritus has also come under fire recently, as numerous lawsuits have been filed alleging neglect and incompetence.  Especially disturbing has been their documented lack of care for residents suffering from dementia, which number around 2/3 of all assisted living residents nationally.

Dementia affects more than 3.8 million Americans and has the highest direct health care costs of any disease in our country at $109 billion annually.   To put this in perspective, direct health care costs for heart disease are in the neighborhood of $102 billion.  Cancer comes in at around $77 billion.  Beyond the financial devastation, dementia wreaks havoc on family members and requires specialized, round-the-clock care from qualified health care personnel to prevent the patient from harming him or herself, or others.  The number of Americans suffering from dementia is expected to balloon to 9.1 million people by 2040.

Last month, PBS, in partnership with ProPublica, aired a Frontline episode chronicling the treatment provided at certain Emeritus facilities.  They painted quite a troubling picture.

Grieving relatives told their stories.  One resident with dementia inexplicably gained access to and consumed industrial strength dishwashing detergent, causing his death.  Emeritus President and CEO Granger Cobb called this death tragic, and attributed it to human error.  Another resident with dementia, Joan Boice, was neglected and suffered horrific ulcers before her death just three months after moving into the facility.  A California jury sent a clear message, awarding the family of Joan Boice $22,963,943.81 in punitive damages.  Jurors after the trial noted that the 81 cents was meant to remind Emeritus of the decedent’s age.

In the Boice case, attorneys proved that Emeritus hired incompetent staff.  Through discovery, the family’s attorneys learned that the young woman running the medications room at the facility had little to no training and was earning around $10 per hour to dispense drugs to hundreds of patients.  Though Emeritus facilities boast “Memory Care” departments to attract dementia sufferers, the Emeritus training program consisted of just one eight hour class.  Frontline also interviewed former Emeritus sales personnel who described a culture that blatantly valued profit over care by encouraging full occupancy despite the resident’s cognitive or physical capacities.

Distinct from nursing homes, which in Illinois are tightly regulated by the Nursing Home Act, assisted living facilities like the ones owned and operated by Emeritus are loosely regulated because they provide very little actual medical care.  In fact, residents at assisted living facilities typically only stay for around two years, before transferring to facilities capable of providing the required higher echelon of care.

Patricia McGinnis, of the California Advocates for Nursing Home Reform, attributes the glut of neglect to lack of regulation and corporate greed.  The national average monthly cost of assisted living is around $3,550.  Of course, Ms. McGinnis noted that companies like Emeritus, in the absence of any regulation, may charge whatever the market can bear.  Woefully ignorant and sometimes misled by aggressive marketing representatives, families move their loved ones into facilities believing they will receive the proper degree of care.

Every year, 400,000 Americans turn 75.  That rate will grow to 1 million annually in 15 years.  Given the dramatic skew in our population as a result of the baby boomer generation, this is a problem that is likely to grow.  Commenting on our society’s perpetual desire to bury its head in the sand on these issues, Dr. Catherina Hawes, a health care researcher at Texas A&M relayed a disturbing quote from a state regulator: “[assisted living is] the dark rock we don’t want to look under.”

Until states take legislative action, litigation remains the only mechanism to ensure that the corporations negligently running assisted living facilities are held accountable and to motivate them to provide the care the elderly deserve.  Responding to a cynic’s perspective on the “selfish” nature of bringing a lawsuit on behalf of a dead loved one, “it’s truly not the money, but the money is all that matters to Emeritus, and if that’s all that matters to them, it’s the only way to hurt them.”

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