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Basic changes to assisted living may mean abuse, neglect for many

Working with the public interest group ProPublica, PBS’s “Frontline” recently aired a major report revealing that assisted living facilities across the U.S., lack fundamental state or federal oversight -- yet the industry is increasingly taking on the responsibilities of more highly-regulated nursing homes. Over the past two decades, the reporters found, the assisted living industry has undergone profound changes -- and they may be leaving vulnerable seniors open to abuse and neglect.

Since its introduction, assisted living has customarily been promoted as a home-like atmosphere for seniors who are generally able to live independently could have limited monitoring and access to quick intervention in case of emergency. They were generally expected to be a step between independent housing and skilled nursing care.

Unfortunately, over the past 20 years or so, the industry has profoundly changed. Today, many seniors who require extensive medical care or supervision, such as those suffering from dementia, are living in assisted living homes instead of skilled nursing facilities. In many states, including Pennsylvania, assisted living homes are not has highly regulated, or inspected as regularly, as are nursing homes.

That can lead to serious problems. In a 2011 Senate committee meeting on the subject, for example, one senator brought up several instances in which poor care, abuse or neglect clearly injured residents in these facilities. One was a 2005 case in which emergency room workers reported having to remove 50 maggots from an open wound on a residents face. That led to a grand jury investigation, but when a resident died under suspicious circumstances the following year, the facility was closed.

Why aren’t assisted living facilities regulated with the same attention as skilled nursing homes? The reporters concluded that the industry has fought back hard against efforts to do so. In New York, for example, the legislature spent four years crafting and succeeded in passing enhanced regulatory standards and enforcement mechanisms for assisted living homes. Just as they were to go into effect, however, an industry lawsuit stripped out some of the most important measures, such as the requirement that a nurse be on staff if any residents needed dementia care.

You can read the entire report by clicking the source link below. If your loved one is a resident of an assisted living facility and you suspect understaffing or any form of neglect or abuse, please act right away.


  • Frontline, "Life and Death in Assisted Living," A.C. Thompson and Jonathan Jones for ProPublica, Oct. 29, 2013
  • Philadelphia Inquirer, "Troubled care facility closes; The assisted-living home was called a 'danger' after a resident's death," Ken Dilanian, April 26, 2006

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