Opinion: Act now to safeguard Ga. seniors

A senior care assisted living facility in metro Atlanta. Curtis Compton/ccompton@ajc.com
A senior care assisted living facility in metro Atlanta. Curtis Compton/ccompton@ajc.com

Haphazard. That word comes to mind when reading The Atlanta Journal-Constitution’s latest installment of “Unprotected.”

It should be nigh-impossible for reasonable people to reach a different conclusion, given this newspaper’s ongoing, detailed reporting into problems that’ve harmed seniors at some Georgia assisted-living places and large personal care homes.

Each chapter of “Unprotected” has built toward a keystone theme that should be impossible to miss – that Georgia does far too little to help protect our vulnerable seniors from instances of abuse and neglect that have too often contributed to, or caused, physical injury — or death. Worse yet, even when the state does act, its steps are too often too feeble or too late to be of much effect on either past incidents or future ones.

This manner of benign neglect of our elders or those with disabilities requiring professional care should be unacceptable to human decency and the high sense of morality that our state leaders are often quick to publicly proclaim.

We’ve offered our opinion on this page with each offering of “Unprotected” reporting, and we’ll repeat it today. Georgia can, should and must do better than this. Our state’s elderly deserve far more than what Georgia currently does – and does not do – on their behalf.

The AJC’s reporting does not paint a gauzy, impressionistic rendering of the problems found with elder care in this state. That might make it difficult to see the scope of the problem and subsequently reach firm conclusions. Far from it. The shortcomings we’ve found comprise a high-definition picture that laypeople, experts and state officials alike should be able to see clearly.

Our reporters analyzed Georgia Department of Community Health inspection reports from 2015 through 2018 for every assisted living community and every personal care home with 25 or more beds.

They examined the state’s records of fines and other enforcement actions against these facilities. They pored over hundreds of other records, including regulatory appeal documents and applications for new care facilities. They reviewed lawsuits and criminal case files and sat in courtrooms during legal proceedings. AJC journalists reviewed laws governing senior care homes in all 50 states.

Our team spent hour upon hour interviewing family members, home operators, trade groups and policy experts.

This work identified 600 allegations involving neglect and 90 allegations of abuse in assisted living and large personal care facilities across the state. The numbers include 20 deaths and more than 100 injuries in instances where facilities appear to have failed to provide adequate care.

And, given incompleteness or other inadequacies of records in Georgia, it’s very likely that the number of those harmed is even higher.

The main “Unprotected” story today sums up things this way: “Without a strong system in Georgia to check for compliance and hold operators accountable, Georgia’s seniors remain unprotected from risks that threaten their comfort, dignity and safety.”

Some of the instances of suspected abuse or neglect we found came to light not because of state efforts at transparency, but rather because the AJC filed Georgia Open Records requests to obtain information.

That itself is an indicator, we believe, that Georgia’s mechanism for monitoring these facilities and sharing information with consumers is not nearly what it should be.

Timely and thorough disclosures of information about conditions of these facilities should be a significant part of an adequate system of state oversight and regulation.

Georgia’s piecemeal, incomplete and dated public disclosures from the Department of Community Health are far from that reasonable expectation. This inadequacy was part of the reason the AJC built its own web site to offer consumers in one place available public data from inspection reports.

Compare this one-stop site against DCH’s proposed new rule in light of our reporting that would require assisted living facilities and personal care homes to post on their own websites a copy of any inspection in the previous 18 months and you should begin to see how’s Georgia’s falling short.

This rickety and inadequate state of affairs here must change. We’ve offered our opinion here before that Georgia’s substandard supervision of these places seems consistent with a widespread belief that “regulation” is always as harmful as being “business-friendly” is invariably a good thing. That overly simplistic attitude leaves too-little room for commonsense oversight that can protect vulnerable Georgians while simultaneously leaving space to operate businesses in a profitable manner as capitalism requires. The two don’t have to be mutually exclusive, as some state leaders seem to think.

AJC reporting repeatedly has pointed out that many other states, including those with conservative, pro-business leanings akin to Georgia’s, seem to be doing a better job of regulating assisted-living and large personal care homes.

Today’s lead story on this issue reports that, “Other nearby states, including North Carolina, Tennessee and Alabama, have forced facilities to close or barred them from admitting new residents after serious incidents.”

Some other states also do a better job of quickly alerting residents and the public to potential problems. Florida’s website, for example, offers details on fines over time and ready access to details about settlement documents related to fines. Its website also offers details on owners of facilities and amenities or features they provide.

Better disclosure, while good, is not enough. Staff shortages, both within the care home industry and the government agencies charged with overseeing them, have no doubt adversely affected the overall situation.

Georgia should move quickly to increase the number of workers at DCH who’re responsible for facility oversight. They’re spread too thinly, we believe. Only 28 DCH workers are charged with monitoring 2,675 care facilities – and two of those jobs were vacant when we checked. A little math shows that, even fully staffed, the workload equals about 95 facilities for each oversight worker. Add in the responsibility of investigating hundreds of complaints annually about unlicensed care homes, and it’s easy to see how the system can be overwhelmed.

As a result, more than a year can pass between routine inspections, our reporters found. That’s unacceptable. Enough people should be added to DCH to significantly improve these important numbers.

Adequate penalties for violations are another valuable part of ensuring compliance as well. The AJC’s found that, even the worst care-related violations, including cases with death or harm, rarely result in significant fines, if fines were issued at all. The maximum fine issued for the most serious violations is typically $601. That amount is too easily absorbed as a cost of doing business and is far too low to serve as a fiscal incentive to change serious situations for the better. State lawmakers should address this critical shortcoming in the upcoming legislative session.

With the Georgia General Assembly set to begin its work in about two weeks, the problems uncovered by the AJC should serve as Exhibit A in underpinning fast, thorough work toward passing into law a comprehensive package of reforms intended to correct shortcomings in oversight of assisted-living and large personal care homes.

It’s encouraging that some lawmakers and other state officials seem to be recognizing the need for these changes. That’s an encouraging development that should gain more steam, we believe.

The elderly people we’re all called to watch over as a decent society should wait no longer for lawmakers and the rest of us to step up. Georgians who’re concerned about shortcomings in care of our seniors should make their voices heard to state legislators in coming days.

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