Older and disabled Georgians have a serious problem that needs immediate attention. Too many personal care homes and assisted living communities aren’t following state regulations, despite charging high monthly fees. As a result, some of their residents are not receiving adequate care. Some are even dying, as a year-long investigation by The Atlanta Journal-Constitution documents. As advocates for Georgia’s elderly, it’s clear to us that the state’s political leadership must do what it takes now to ensure that licensed homes provide adequate care.
We at the Georgia Council on Aging are recommending policy changes to better protect older and disabled residents of the state’s more than 1,400 licensed personal care homes and more than 200 assisted living communities. Safeguards will be even more important in the next 10, 20 and 30 years as a much bigger percentage of Georgians will be 65 or older, bringing even more explosive growth in personal care homes and assisted living communities.
To better protect our elderly and disabled, Georgia needs a process for ensuring compliance with state regulations that’s far more transparent than the existing system.
State inspection reports can help consumers identify homes with few, if any, violations or complaints. That can be a critical component in any search for a safe place for seniors to live out their final years. But what the AJC uncovered was that many of these inspection reports are outdated, missing or almost impossible for consumers to find online. The newspaper reported that: “When consumers do find inspection reports, they’re often vague, confusing and use technical language.” The newspaper also monitored the state’s website for months in 2018 and discovered that it had no information available on dozens of facilities.
The state’s paper-based system of inspection reports is riddled with problems and time delays. We believe this could be fixed – or at least improved — if the state automated the report system and gave inspectors electronic tablets so that results of their inspections could be recorded in the field.
We’re also advocating that complaints about a facility be in plain language and aggregated for more effective monitoring and to detect potential trends. Annual reporting could include: the top five complaints by category, total number of complaints, how many complaints resulted in fines or sanctions and how many fines were paid or collected. We know from the AJC’s reporting that there were more than 600 allegations of neglect and 90 of abuse by caregivers in the past four years. We also know from the paper’s deep digging that, in many cases, the worst offense resulted in a $601 fine, the current maximum.
Now is the time to address the need for the Department of Community Health’s Healthcare Facility Regulation division to have more people on the ground conducting inspections of these facilities. Inspections could be done more frequently and DCH staffing could keep pace with a growing resident population. It’s a critical job – not only so the state can ensure compliance but also so consumers can identify and avoid making bad choices.
The AJC’s report underscores what we and our partners at the Coalition of Advocates for Georgia’s Elderly (CO-AGE) have been saying since 2017 – tougher fines and sanctions need to be imposed on facility operators who fail to follow state regulations. We’ve suggested a fine of $5,000 a day for each violation of the law, up to a maximum of $50,000. That’s more in line with the fines imposed in other southeastern states for serious violations, resulting in death or serious physical or emotional trauma.
Lastly, the staffing ratios of these facilities must be addressed. Clearly, a 1-to-25 staff-to-patient ratio in non-waking hours is insufficient. The AJC outlines why adequate staffing is important, finding that breakdowns in care were often rooted in facility staffing shortages, poor training of staff or high staffing turnover rates.
The senior population is exploding here in Georgia and across the nation. There’s data to suggest that Georgia has not kept up with other states in terms of care and service. According to a 2017 national report, Georgia ranks 48th in quality of life and care for long-term services and supports and 41st for choice of setting and provider.
Let this be a time for corrective actions. Georgia seniors deserve no less.
State lawmakers can be contacted directly through the CO-AGE Action Alert, an online messaging system: http://ciclt.net/sn/gre2/oc.aspx?ClientCode=gca&campid=8DgUQBOoRr
Vicki Vaughn Johnson is chair of the Georgia Council on Aging, which advocates for seniors.
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