Perils in personal care homes

Perils in personal care homes

Georgia hasn’t done enough to rein in an “epidemic” of mistreatment of vulnerable people by personal care home operators, an Atlanta Journal-Constitution investigation has found.

Growing demand, combined with a convoluted, overstretched system of oversight, leaves the door open for abuses of elderly, mentally ill or developmentally disabled residents, many experts say. There are about 100 licensed homes for every state inspector, and for years unlicensed homes have operated with impunity.

Georgia Bureau of Investigation Director Vernon Keenan calls the maltreatment of at-risk adults an “epidemic.” Unscrupulous operators, he said, look at potential clients and see dollar signs, readily available as Social Security and other government checks.

“With that adult comes a lot of money,” Keenan said. “The person is a commodity. That’s the tragedy with this.”

About half the state’s 2,000 licensed personal care homes are in metro Atlanta. The great majority of them are small businesses operating out of a home in a neighborhood, caring for a handful of people.

A personal care home falls somewhere between a boarding house and an assisted living facility. In addition to food and lodging, personal care homes offer help with eating, bathing, toileting, grooming or dressing, and they can supervise administration of medication. However, they are not authorized to provide any medical services.

A series of recent cases across metro Atlanta illustrates what regulators and police are up against:

-- A DeKalb County woman pleaded guilty in September to trolling a downtown Atlanta homeless shelter for people who appeared old or disabled. She would cash their government support checks in return for lodging them in deplorable conditions — locking one man for five months in a windowless, roach-infested basement with no toilet.

-- Last month, Gwinnett County police arrested the operator of two licensed and five unlicensed homes. She is accused of subjecting as many as 70 residents to dangerous conditions and siphoning off their money for personal luxuries such as a fancy car and foreign travel.

-- In Barrow County, two women who operated unlicensed homes were arrested in November for allegedly moving four mentally ill adults into a vacant house with nothing but some fast food and a cellphone.

Reid Wilson is vice president of the Georgia Association of Community Care Providers, which includes owners of personal care homes and advocates that all homes be licensed.

“Most people in the business are trying to do a job that helps people,” Wilson said. At the same time, he added, “You’re always going to have those thieves and vagabonds.”

Over the course of two weeks, top officials of the licensing agency, the state Department of Community Health, could not find time for interviews, according to department spokeswoman Pamela Keene.

In response to written questions, Keene wrote: “There is certainly more attention being paid to this problem, as the percentage of vulnerable, aging ‘baby boomer’ adults is growing in our population.”

One source of problems, said state Sen. Renee Unterman, R-Buford, is that the law regulating personal care homes has long lacked teeth. Another, according to Keenan, is widespread confusion over which agency people can turn to with complaints.

If, that is, they aren’t afraid to complain.

Jeanita Sampson, 48, and Kay Sandler, 51, are recovering from strokes. They sometimes went for three or four days without their medications, they told The Atlanta Journal-Constitution, because the operator of their Lawrenceville personal care home, Seema Vijayi, was late in delivering it.

Despite that and other problems, they said, they didn’t complain because they had nowhere else to go.

Vijayi, who lives in Snellville, was arrested last month on charges that she skimmed money from the several homes she ran and diverted it to personal use. Her attorneys, Harold Holcombe and Richard Ryczek, did not respond to inquiries about this story. However, in a statement following Vijayi’s arrest, they said: “We categorically deny the allegations.”

To prevent vulnerable adults from coming to harm, Keenon has convened a GBI-led working group of law enforcement and social service agencies. It includes representatives of several state agencies as well as the DeKalb and Gwinnett police departments, the governor’s office, the Criminal Justice Coordinating Council, the Social Security Administration and the FBI.

On July 1, a new law will stiffen the penalty for operating a personal care home without a license, making repeat offenses felonies.

Personal care homes are required to abide by a number of detailed regulations covering the kinds of residents they can accept, employee screening and training and the environment they must provide. But there are only 19 state inspectors to monitor compliance.

Data obtained through an Open Records request revealed 18 personal care homes that have received at least 100 notices of violations from state regulators over the past five years. However, 14 of the businesses continue to operate.

Some operators avoid oversight altogether by not getting licensed. If they are caught, they may just close their doors, shuttle their residents to another location and reopen under a new name, officials said.

They can do that because it’s a growth industry. The number of licensed personal care homes in metro Atlanta has grown from no more than 50 in the mid-1990s to more than 900 today.

One thing driving the growth is a dramatic increase since 2000 in the number of people 65 and older — a surge of 44 percent across the metro Atlanta region.

Another impetus is the federal government’s push to get mentally ill and developmentally disabled people out of mental hospitals and place them in a community care setting. A 2010 settlement between the state and the U.S. Department of Justice requires state hospitals to discharge all developmentally disabled and many mentally ill residents by 2015.

A third factor is the recession, which has driven down housing prices, making it less expensive to open and operate a personal care home.

“It’s the economy,” said Unterman, who heads the state Senate Health and Human Services Committee. “As people are searching to make a dollar, they see the door is open.”

At least four state departments or divisions have some responsibility for personal care homes or the people who live in them.

The Department of Community Health’s Division of Healthcare Facility Regulation inspects, licenses and regulates personal care homes and other health care facilities that provide services to elderly and disabled adults. Adult Protective Services helps relocate victims of abuse.

The Department of Behavioral Health and Developmental Disabilities provides treatment and support for people with mental illness, mental retardation or other developmental disabilities. The Department of Human Services does the same for elderly or physically disabled Georgians.

“It’s an octopus that oversees this,” said Cynthia Wainscott, vice chair of public policy for Mental Health America of Georgia. “People don’t know where to call.”

Even when local authorities do take a hand — often because of complaints from neighbors — their efforts may be inconsistent and uncoordinated. Police officers are often unfamiliar with the applicable law.

Capt. Lisa Angell of the Warner Robins Police Department said she investigated crimes against vulnerable adults for years before she learned that a Georgia law specifically addresses the issue. “Officers just don’t know about it,” said Angell, who is on the GBI working group.

A task force created a year ago by Adult Protective Services also seeks to educate public safety workers about the signs of abuse, the roles of various agencies and the resources available to them.

In the face of complaints from people about unsupervised residents of personal care homes wandering their neighborhoods, local governments have tried a variety of tactics.

DeKalb County limited the number of clients that can live in personal care homes in residential areas. Henry County imposed a temporary moratorium on new homes to give officials time to come up with a policy on where they can operate.

“There is concern that they [state officials] do not have the resources to monitor those facilities adequately,” said Henry County spokeswoman Julie Hoover-Ernst.


-- Newsroom data specialist Kelly Guckian contributed to this article.



Whom to contact if you suspect an elderly or disabled adult is being abused, neglected or exploited:

-- If it occurs in a private residence: Division of Aging Services, Adult Protective Services, 404-657-5250 (or 911 in an emergency).

-- If it occurs in a personal care home or nursing home: Healthcare Facility Regulation complaint line, 404-657-5726.

-- If it occurs in a specialized facility for those with mental illness or developmental disabilities: Department of Behavior Health and Developmental Disabilities, Consumer Services, 404-657-5964.

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