'they Are Putting Residents' Lives At Risk': Behind The Scenes At An Assisted Living Facility

We've all seen and heard ads for assisted living facilities in newspapers and online and on the radio and television.

But until a family member has a stroke or some other physical or cognitive impairment, most of us don't know very much about how assisted living, senior living or memory care facilities work. Or, to be specific, how they are supposed to work and what red flags look like.

I sure didn't either, until "Julie," a close family friend, became the victim of medical malpractice. Following a "simple" operation, the 62-year-old retired teacher's electrolyte chemistry wasn't properly monitored, resulting in dangerously low blood calcium levels that triggered muscle spasms, convulsions, seizures, a coma and brain damage.

She now can't walk or use the bathroom without assistance, needs someone to help her eat and has significant cognitive impairment. For the past three years, she has been living in a studio room at an assisted living facility that is part of a nationwide operation.

The facility claims to provide, among other things, 24-hour care and support, food prepared by a chef, an on-site restaurant where families are welcome to dine as well and much more.

These amenities are common in the industry. But in Julie's case, the reality appears far different. Each time we visit, we see a care facility for older people and the infirm racing downhill while monthly charges are increasing.

How cost-cutting harms residents

"It is more than a reduction in the services for people like Julie, who is effectively bedridden. They are putting residents' lives at risk," said "Suzanne," who works at Julie's facility. With my assurance that she could speak freely and confidentially, she described what happens when profits and cost-cutting come first.

I learned from Suzanne that what is happening here is not a rarity in this business and that red flags are everywhere — if you know where to look and ask questions.

'They stopped caring'

"I have been in this field for over 25 years, and this is the third assisted living facility I've worked at, some from opening day," Suzanne said. "Most start out in full compliance with all the promises listed in their contract and then gradually limit services.

"When Julie first came here, things were top-notch. But over the past year, the lack of contractually promised care has fallen dangerously."

Suzanne told me about:

• Residents who push the emergency call button they wear around their necks and wait over an hour for someone to respond: "Some have fallen, can't get up, and it is so sad to see this."
• A failure to conduct frequent, daily checks on patients: "Recently, one gentleman had been dead in his bed for hours."
• While contracts and brochures described chef-prepared meals, some meals were actually cooked by a handyman. The menu, which offered a variety of meals catering to all sorts of residents, has been slashed by over half, and people are upset. Portion size has been reduced because of cost-cutting, leaving many residents hungry.
• Most of the servers have been fired from the restaurant where families could have meals with residents. People are told to immediately leave the premises after eating, and tips left on the table are being taken by managers.
• Managers routinely take cash donations from families that are intended for holiday and other staff parties. One spouse became furious when they asked a staff member, "So how was the party we all paid for?" and heard, "What party?"

Before you sign a contract

When an assisted living facility's sales department gives you the opportunity to visit, make sure you look closely at three primary areas:

• Residents' well-being
• Staff interactions
• Cleanliness

Red flags include:

• High staff turnover
• Residents who appear unkempt
• Management who will not give you a straight answer

After speaking with Suzanne and seeing the situation for ourselves, it's clear you should also try to make unannounced visits by yourself and with other family members, at different times of the day, observing how staff interact with residents.

Speak with residents and their families if possible. Ask them what they like — and what they dislike.

There is a massive amount of highly useful information available online. You should print out the AARP Assisted Living Checklist and go through it with the sales staff at every facility you visit.

Each time we visit Julie, many of the other residents of the facility seem to be longing for human contact. Yes, science and medicine keep them all alive. But are they?

Dennis Beaver practices law in Bakersfield, Calif., and welcomes comments and questions from readers, which may be faxed to (661) 323-7993, or e-mailed to Lagombeaver1@gmail.com. And be sure to visit dennisbeaver.com.

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This article was written by and presents the views of our contributing adviser, not the Kiplinger editorial staff. You can check adviser records with the SEC or with FINRA.