Lax Regulations And Vulnerable Residents 'A Recipe For Problems' In Eldercare Homes Assisted living-type facilities often are subject to less scrutiny than nursing homes. Investigations in Vermont and elsewhere have revealed patterns of poor care and deaths.

Lax Regulations And Vulnerable Residents 'A Recipe For Problems' In Eldercare Homes

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MARY LOUISE KELLY, HOST:

Some states call them assisted-living facilities; others, personal care homes or residential care communities. They all promise peace of mind for families whose elders require long-term care. But in Vermont and at least two other states, investigations into state-licensed facilities have revealed lax oversight and injuries, even deaths. As Vermont Public Radio's Emily Corwin reports, these problems are more widespread than you might expect. And a warning to our listeners - this story details abuse and neglect.

EMILY CORWIN, BYLINE: Marilyn Kelly was energetic. She loved to go fishing, but she had dementia. And at 78 years old, she was making unsafe decisions, so her family decided to move her to a 13-bed facility in Rutland, Vt., called Our House Too. It advertised its memory care expertise. Over the next eight months, almost everything went wrong that could.

JUNE KELLY: It was like a calamity of errors, one right after the other.

CORWIN: June Kelly, Marilyn's daughter, had power of attorney. She says her mother was sedated without their knowledge. According to court filings, staff gave Marilyn an antipsychotic daily despite a black box warning against its use for dementia symptoms.

KELLY: Well, there was one day we walked in and she was air fork feeding herself and not getting the food to her mouth. And she was in her pajamas, and there was excrement on her arm.

CORWIN: Kelly says Marilyn was neglected. Her tooth rotted. She got lice. And then she was assaulted. A staffer shoved Marilyn to the floor and left her there. The person later pleaded guilty in court. A month after the incident, Marilyn died of pneumonia. Now the Kelly family is suing the care home and Marilyn's prescribers, alleging neglect and wrongful death. The defendants have denied all allegations. Paula Patorti, the owner of Our House Too, wouldn't comment on the case, but she says this.

PAULA PATORTI: We're almost 19 years old, and I'm still as passionate today as I've always been about the work that we do and the way that we do it.

CORWIN: In an investigation, Vermont Public Radio and the newspaper Seven Days found the kind of ordeals Marilyn Kelly endured are not uncommon in Vermont. In nearly six years of complaints and inspection reports, we found inadequate care had led to injuries, indignities and at least five deaths. The majority of homes had severe infractions. One home's owner told regulators it was easier to accept a citation than to give staff their 12 required hours of annual training. Vermont has one of the oldest populations in the nation. People with dementia like Marilyn Kelly can wait months for a placement. That capacity problem is one reason Monica Hutt, Vermont's top long-term care regulator, gave when we asked why her office rarely levies fines or closes homes that violate the rules.

MONICA HUTT: You know, we need to ensure that there is capacity across the state of Vermont to care for Vermonters. We need to ensure that it's of the highest quality. There is an enormous amount of balancing that happens to make that true.

CORWIN: The state is updating its regulations, however, and Hutt says she will incorporate changes based on our investigation. But when it comes to long-term care, Vermont is not an outlier.

LORI SMETANKA: It could have been any state.

CORWIN: Lori Smetanka is the executive director of the National Consumer Voice for Quality Long-Term Care, a D.C. advocacy group. She says our findings in Vermont are not surprising. Nursing homes were designed for high needs residents and are heavily regulated by the feds for that reason. But increasingly, families are trying to avoid nursing homes, choosing assisted-living-type residences for vulnerable loved ones. And Smetanka says these state-licensed facilities are lightly regulated and receive little oversight. Taken altogether...

SMETANKA: That is a recipe for problems.

CORWIN: Smetanka does have suggestions for future consumers. First, she says, plan ahead. You don't want to be choosing a facility in a crisis. Visit at different times of day. Watch the interactions and try the food.

SMETANKA: Don't be wowed just by, like, the fancy chandeliers or the pretty decorations or things like that. Like, really look at what's going on in that facility.

CORWIN: Smetanka says you should check the contract for pricey add-ons and read the inspection reports.

For NPR News, I'm Emily Corwin in Vermont.

KELLY: And this investigation was a collaboration between Vermont Public Radio and the alt weekly Seven Days.

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