It is hard to know exactly where to start, so here are my initial random thoughts, bullet point style:

  • The very worst thing about this story is that it suggests assisted living residents across the nation should be very afraid.  It suggests that frail seniors would be better off anyplace but assisted living. 
  • In effect they are suggesting these residents would be better off in skilled nursing or at home alone and isolated . . . they would be better cared for and happier.
  • If only they had actually done a comparison for injuries, falls and deaths with 40,000 frail seniors living at home or in nursing homes.  I am thinking Emeritus and assisted living across the board would have looked pretty good.
  • I know a bunch of Emeritus people mostly in California and the ones I know are all striving to provide great care to their residents.  This report does great damage to those people who pour their hearts and souls into caring for these frail seniors each day.
  • Hearing statements suggesting all Emeritus cares about are heads in the beds and profits is ridiculous.  If that were the case, one of two situations would be true; there would be hundreds of similar law suits or Emeritus would not have let this happen, because a $23 million dollar judgment would pay for a lot of additional staff with money left over.
  • For all of that, at least with Joan Boice Emeritus screwed up.  It is hard to know how to react to her falls, because falls do happen with frail residents unless they are restrained physically or with drugs, but the pressure wounds are incredibly damning.  While I suppose from a legal point of view they had to take a public position that they were providing great care, in truth it is impossible to swallow.
  • I wish I knew where it broke down.  Was it the executive director? Did it go higher to the regional or state level? or . . . does it really source all the way back to the corporate office?  It would do a lot for Emeritus and for the industry for them to talk about lessons learned and how they have changed their culture to make sure this will not happen again.
  • It was hard to watch Frontline use Pat McGinnis a California anti-nursing home gadfly as an expert who suggests we need more regulations.   First: the attorney for Joan Boice made the point that Emeritus broke regulations, which if true, demonstrates more regulations do not automatically make for better care.
  • Secondly, nursing homes are incredibly regulated intuitions and still no one wants to go to one.  Given the choice of a typical nursing home or a typical Emeritus assisted living community, assisted living would win 98 times out of 100.  
  • There is risk in all of life including living in an assisted living community.  The question is what level of risk is acceptable for us as individuals and as a society?  Even if we had one-on-one care there would still be falls, and medication errors and deaths.  We already have a huge affordability problem; we need a serious debate about this trade off.
  • The attorney for Joan Boice claims that she is typical of today’s assisted living residents.  This is simply false.
  • There was a claim that most assisted living communities are not “prepared”/equipped to deal with the frail seniors that comprise the current assisted living population.   It is nuts to say this.  Assisted Living residents and their families are overwhelming extremely happy with the care they are getting and it is not because they are being duped.
  • The Medication aid suggested that she alone was dealing with thousands of medications for 80 residents, seriously ?  This speaks to credibility.
  • They found more than a dozen ex-employees to trash Emeritus for an enterprise of their size, it is rather a small number.
  • I am fearful this will put a tremendous amount pressure on politicians to pile on new regulations that will ultimately make assisted living more expensive and will not make residents safer.

These are my initial reactions: what do you think?  What questions do you wish you could ask PBS? Here is the video if you missed it.

Steve Moran

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