Tracking assisted living ‘incidents’

Massachusetts assisted living facilities reported 305 cases of abuse, neglect, and exploitation involving residents in 2015 – and half of the reports were filed late.

Reports are supposed to be filed with state officials within 24 hours of the incident, but the data indicate 155 came in late. Most came in fairly quickly after the deadline – 40 percent were one day late and 43 percent were between two and 10 days late.

The remaining 17 percent came in much later – 3 percent were 11 to 25 days late and 14 percent were between 40 and 301 days late.

It took seven months to obtain all the data under an appeal using the state’s Public Records Law, as officials were reluctant to release some of the information due to privacy concerns. Ultimately, the state’s Executive Office of Elder Affairs, which regulates assisted living facilities, summarized the data on compliance times and provided incident reports with names and other information redacted.

Alice Bonner, the elder affairs secretary, declined interview requests. Her spokeswoman issued a statement saying that late incident reports were cited as one factor among others in seven certification modifications or suspensions of assisted living facilities over the last year-and-a-half. A suspended assisted living facility cannot accept new residents and must display the notice of suspension in a prominent place. Officials ignored a request for the names of facilities that were disciplined.

David Hoey, an attorney who specializes in nursing home and assisted living law, raised concerns about the more lengthy reporting times. “I can understand that on occasion it may take more than 24 hours to get an incident report in,” he said. “But delays of 80 days, 90 days, 300 days?  That’s totally unacceptable.”

Richard Moore, the president of the Massachusetts Assisted Living Association, said the delays probably occurred because of confusion about what is meant by an incident with a “significant negative effect.”

“I believe that most of the facilities are complying, but there’s some serious outliers out there, and my guess is it’s because they don’t understand what the regulation means and why it’s important,” he said.

State regulations define an incident with a “significant negative effect” as an event that is “the consequence of a situation in which a resident experienced a significant risk of death or serious physical injury or emotional harm.”

Kindred Living at Laurel Lake reported 14 incidents at its location in Lee, Ashland Farm reported nine at its North Andover location, and Haverhill Crossings reported 10 at its Haverhill facility. Epoch reported 23 events at six of its locations and The Arbors had 20 at eight locations.

The Sugar Hill assisted living facility in Dalton, which is owned by BaneCare, took 39 days to report an incident involving a resident and an employee that was characterized as being “sexual” in nature, and 71 days to report the unauthorized use of a resident’s credit card.

The sexual incident at Sugar Hill involved a certified nursing assistant telling a resident that he/she looked “hot,” looked good from behind, and didn’t need to go to a gym, according to the incident report that was eventually filed.  It also noted that the nursing assistant put his/her hand in front of the resident’s pants while the resident was sitting in a chair.

Officials at Sugar Hill did not respond to a request for comment.

The longest delays in filing incident reports occurred at Ruth’s House, an assisted living facility in Longmeadow.  It took the operator, JGS Life Care, 252 to 301 days to report 13 episodes of theft of residents’ property by an employee.  The stolen items included cash, credit cards, diamond rings, a clock radio, and a box of chocolates.

“We were not aware that we needed to report thefts to Elder Affairs,” says Joelle Tedeschi, who was executive director of Ruth’s House at the time of the thefts, even though the required incident report form specifies theft as being a reportable event. Ruth’s House has been a certified assisted living facility for nearly 20 years.

Darlene Warner, who replaced Tedeschi recently, declined to put a dollar amount on the value of the stolen items, but she said that some restitution was eventually made to the victims as a result of the prosecution of the perpetrator.  She also said that Elder Affairs was quickly notified once the problems were identified and corrective policies were put in place.

It took Brookdale Cushing Park, a Framingham assisted living facility, 47 days to report an incident in which one resident assaulted another. When asked for an explanation, Heather Hunter, an official at Brookdale’s headquarters in Tennessee, issued a written statement saying “Brookdale strives to comply with all regulatory requirements.”

It took the Sunrise assisted living facility in Arlington 80 days to report an incident involving one resident assaulting someone who was taking care of another resident. Jenn Clark, an official at Sunrise’s headquarters in Virginia, said in a written statement that no resident was injured. It wasn’t clear whether the caretaker of the second resident was injured.

Assisted living facilities offer housing, meals, and assistance with personal care needs and medications to seniors who can no longer live safely on their own, but who do not need intensive, 24/7 medical attention such as found in nursing homes.

In Massachusetts, there are about 15,171 people living in 239 certified assisted living residences, according to a 2015 report (the latest available) issued by Elder Affairs.  Monthly rents generally run from $3,000 to $6,500 and can go as high as $10,000, depending on such factors as resident needs, unit size, and location.

–COLMAN M. HERMAN