I asked AC Thompson the questions that maybe you wanted to ask him. He got the fundamental picture of assisted living mostly wrong.
The day after the FRONTLINE assisted living story aired, I reached out to see if I could get an interview with AC Thompson, the writer/reporter/investigator who did the bulk of the work on the series of video and print stories and who you saw on camera.
Last week we talked by phone and I asked the questions that many of you have wanted to ask. At the root of his reporting is a strong negative bias toward assisted living as it exists today. As a result, he got the fundamentals wrong in at least 6 areas:
1. He Believes There Are Big Problems in Assisted Living –My first question to AC was what he hoped to accomplish with this story. He is convinced there are big problems in the assisted living industry that need to be talked about. His believe is just plain wrong.
We deal with a very frail population and must juggle each day the frequently conflicting values of resident freedom and protection. We know, as a for instance, that falls can be all but eliminated using drugs or restraints, but the quality of life price is just too high.
It is not all roses, there are some bad operators and sometimes good operators accidently hire bad employees. The really bad operators are essentially never large multi building organizations, but rather small capitalized mom and pop organizations.
What is perhaps most discouraging is that if I were a researcher and went through the same data that AC used, then compared it with acute hospital data, frail seniors living at home with home health or family members and skilled nursing data, assisted living would be the star player. This would be true in quality of life and resident safety. This current article: “Elderly abused at 1 in 3 Nursing Homes” brings home this point.
2. AC Believes Bigger Fines Would Equal Better Care – When I asked him about this his response was to point out that if a resident dies (as the result of wrong doing on the part of the senior community) in California the fine is only $150. He then asked if I thought a life was only worth $150.
So sure, $150 is really nothing but is $1,000 or $25,000 somehow better? Is it the fines that makes senior communities take great care of their residents? When we look at the skilled nursing industry the one thing we know for sure is that bigger fines generate lots of additional work for attorneys who battle those fines. We don’t know that fines would in fact generate better care.
3. AC seems to believe there should be more Federal oversight of assisted living – It was difficult to figure out exactly what this would look like in AC’s ideal world, but in my conversation with him and on the video report, he talked about the lack of Federal oversight.
This is a huge philosophical difference about the kind of world we want to live in. I do know for sure that more Federal (or state) oversight will cost someone more money and that money will ultimately come out of the resident’s pockets which would make assisted living just a bit less affordable.
AC seems to have a sense that because different states have different rules that this is a bad thing. My view is that this is a great example of how states’ rights are supposed to operate and that if a state and the citizens of that state see a problem (which does not really seem to be the case except maybe in Florida), it is their right, their privilege and their obligation to deal with those problems in a way that makes the most sense for that particular state.
4. AC believes consumers should have more data available to them – This is a tough one for me. On one hand it makes some sense that people should have access to survey results, on the other hand, surveyors are uneven, some are too easy and some too hard. I rather think that consumer review sites like SeniorAdvisor.com, Google Places and Caring.com provide better more trustworthy feedback.
5. AC seems to believe consumers have limited personal responsibility for due diligence – Particularly with the level of assisted living that AC targeted, the care is essentially all paid for out of consumer pockets, which means these resident and their families have the ability and at least some obligation to do their own due diligence. This means they should show up at midnight and check things out.
6. Putting a loved one in assisted living is putting them in grave danger — The one consistent message that emerged from this series was that assisted living was a dangerous risky place for elders.
In talking to AC he acknowledged that there are in fact many good assisted living communities doing a great job of caring for residents and that somehow, that part of the story was never told. He told me that he had a family member who is or was in assisted living and it was a great experience for that family member.
I have been accused of keeping this story alive because it drives traffic to Senior Housing Forum and there is no doubt that there is some real truth in that charge. But the reason it drives traffic is because people are interested in the story and it in fact brings to the forefront some important questions and issues for our industry.
There are lessons for all of us here. I have believe the story will die a quite death with little if any regulatory consequences, and yet it raises some important questions about whether or not there are some things we can do to lessen the chance of another one of these stories ever happening.
Finally, I think we need to be very careful in saying “Oh that is just an Emeritus problem.” If you are an organization of any size, and you have been operating for any number of years, someone wanting to dish dirt on you . . . could no matter how good a job you are doing could done find disgruntled ex-employees and family members willing to trash you. This is a “there but for the grace of God . . . .” story.