The attacks on Assisted Living continue. Why we need to set our own standards.

This morning one of my readers sent me a link to a new story about a family that is suing Sunrise Senior Living in which  family members allege Marie-Rose Demkowicz had a series of falls and then at some point in time developed pressure ulcers and died.  Here are some of the allegations:

  • “But a pending lawsuit filed by the family charges Marie-Rose fell about 14 times at the Sunrise facility. The family says most of the falls happened after she used a call button to request help when she had to go the bathroom.”

This reinforces the need to talk about assumed risk, what we can and cannot do and quality of life.  In addition, while the lawsuit alleges the staff did not respond quickly it is hard to know what that means.  I cannot imagine that Sunrise or any assisted living or skilled nursing community would promise instant response.

Perhaps even more frustrating is that it appears they are not suggesting these falls resulted in any actual harm to the resident (I have not read the lawsuit).  The issue of falls is tough, but the only way any senior community could possibly have zero falls is to heavily drug or physically restrain residents, which would mean a terrible quality of life.

  •  “Some staff  would reset the call button after they did come so that records would reflect an acceptable response time. But they would tell his mother, “I’ll be right back and it would be another 20 minutes.”’

On the face of it this seems unlikely at least with respect to being helped in or out of the bathroom.  It is inconsistent with basic human compassion and it is inconsistent with how a company like Sunrise operates.

  • “Marie-Rose developed a Stage IV pressure sore that became infected, required surgical treatment and other procedures, “all of which caused or contributed to causing her death.”’ . . . . ‘“What’s shocking about this case,” says Attorney Steve Levin, who filed the suit, “is that once they were Stage Three and Stage Four pressure ulcers, they kept her as a resident in direct violation of the law.”’

Again this is one is an attorney speaking in a fashion that generates maximum outrage.  Is it possible this happened?  Maybe . . . and if it did that is a terrible thing.  But I would sure want to hear Sunrise’s side of the story before stoning them.

  • Finally the news article contains a short laundry list of other area lawsuits where Sunrise is named.

There is no way to know the merit of any of these legal actions, but is does serve to smear Sunrise.

What We Know

There are some things we all know, and often don’t want to talk about but should:

  • We know that attorneys and news outlets love anything that generates outrage and both sides are more than happy to tell only one side of the story.
  • Attorneys are always on the lookout for deep pocketed easy pickings targets to sue and it appears that assisted living is moving to front and centered.
  • There is a vast amount of variability in the regulatory rules from state to state.
  • There are some bad operators out there that need to be punished or shut down.
  • While some states have fairly specific standards it is largely up to each company to figure to establish their own training, staffing and care standards.
  • The industry is in significant danger of more regulation at the state level and possibly even a push for some level of federal regulation or oversight. While it is clear that in some states like California better regulations are needed, overall more regulations will make care more expensive and counter intuitively it will lower the bar for what good care looks like.

Our Own Gold Standard

I am convinced that ALFA, LeadingAge and AHCA need to convene a blue ribbon panel of large, medium and small operators to create some guidelines (maybe even a certification process like The Eden Alternative has) for assisted living.  It should include things like:

  • Initial training
  • On-going training
  • Staffing ratios
  • Medication guidelines
  • Satisfaction surveys
  • Emergency call response times

If we as an industry are unwilling to do this you can be sure there will be more lawsuits, more regulations and the whole industry will be damaged. Steve Moran

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