July 2005
| Oversight: Little to not much Finding out about such incidents isn’t easy. “Every state has a long-term-care ombudsman who looks into complaints consumers have,” says Carol Scott, the Missouri long-term-care ombudsman. She adds that consumers would probably not think to call the state department of health, which would track cases of assault or abuse. Inspections, usually conducted by a state’s department of health, should ideally track everything from staff-training certificates to kitchen-refrigeration temperatures. Yet, Massachusetts and Oregon inspect every other year; Colorado inspects for health one year and safety the next; and California, with more assisted-living facilities than any other state, inspects only once every five years. Staffing and training requirements also vary. Georgia requires 1 person on duty for every 15 residents during the day; 1 for every 25 at night. But Alabama and Oregon require only “sufficient staff.” Also Oregon does not specify who may administer medication as long as the procedure is approved by a pharmacist, registered nurse, or physician. It’s no wonder that medication problems have been cited by many states in two National Academy for State Health Policy surveys of providers. Ethel Mitty, a nurse and project adviser at the Hartford Institute for Geriatric Nursing at New York University, points out,“You do not have the same controls on medication administration in assisted living that you have in nursing homes.” Consumers considering a facility aren’t likely to know whether it is properly staffed until a problem occurs. When police responded to a 911 call from a Sunrise assisted-living facility in Alexandria, Va., at 3 a.m. on July 31, 2004, they could not get staff to respond to the after-hours call button, phone calls, or their cruiser sirens, according to a court document. Officers gained entry through an unlocked rear door and found Harold Podall, a 79-year-old paraplegic. He had called 911 after trying to summon Elizabeth Thorpe-Saffa, a care manager on duty, for more than an hour for help with his catheter. On that same call, officers found an 87-year-old on the floor of his room, unable to get up. When police located Thorpe-Saffa, 54, who was in charge of the overnight care of residents on two floors, she admitted she had been sleeping. In November 2004 she pleaded guilty to one charge of neglect and was given a 45-day jail sentence, which was served at home with electronic monitoring. Sunrise was fined $500. Sarah Evers, a spokeswoman for Sunrise, says, “We had policies in place that required team members to be awake at all times while on their shifts. Thorpe-Saffa willingly violated this policy and was terminated. We assisted police in her prosecution.” The Virginia incident shows that assisted living has serious shortcomings. Whether federal regulation can correct them isn’t clear. At the very least, states should put standards in place that will--as they do not now--assure the safety and well-being of residents. Until that happens, consumers have to be ultra-cautious in choosing an assisted-living facility that can provide the care they need. And the facilities themselves need to be forthright at the beginning about the services they can render. |
