It is one of the hidden risks in Georgia assisted living and personal care homes. In more than 50 cases over the past four years, residents reportedly physically or sexually assaulted others living at the facilities, The Atlanta Journal-Constitution found.

Most of the assaults involve residents with dementia, who can suddenly become aggressive. But homes are supposed to train staff to spot warning signs of aggressive behavior, and if abuse occurs are required to take steps to ensure a safe environment, such as increasing supervision or seeking medical assessments. Facilities are also required to immediately transfer residents whose continuing behavior threatens other residents.

Reports by police and state regulators, however, show that some facilities seem unable to prevent repeated attacks.

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At an Evans home, a woman told deputies that her mother had been attacked three times by a resident who barged into her room and hit her. The daughter said she had spoken to the facility director about the attacks, but no remedial action had been taken. At a Columbus home, fights broke out repeatedly between two men who were roommates when one kept exposing his genitals and trying to initiate sex. In a series of incidents at a Smyrna home, one resident attacked other residents and a caregiver. At a Newnan home, a resident suffered a concussion after an attack by another resident, then six months later was assaulted again by the same person.

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Hospice workers demanded action after a woman in an Augusta home’s memory care unit was sexually assaulted by a male resident on multiple occasions, law enforcement reports show.

The case came to light in July 2018, when a hospice worker told the Richmond County Sheriff's Office she had learned about three incidents in which the woman had been touched inappropriately by the man at Augusta Gardens Retirement Residence, and that administrators knew.

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When deputies investigated, the home’s director said she was trying to figure out what to do and had planned additional training. A representative for the male resident had spoken to the man’s physician to make sure he was on proper medications. The hospice worker said she would file a report with state regulators so they could investigate.

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But the final straw came two weeks later, after the man was left unsupervised in the facility’s sunroom and then was found masturbating with the female resident’s hand while she slept on a couch. A hospice nurse who called deputies said that because the home wasn’t ensuring her patient’s safety, her firm would provide around-the-clock protection.

Until recently, the Department of Community Health hadn’t posted any records on the assaults. Now its website shows an investigation of nine complaints in July 2018. The facility was cited for insufficient staffing to supervise residents and for failing to report a resident’s inappropriate sexual behavior with another resident. An administrator told DCH she didn’t think the reporting was required because there was no intercourse.

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That administrator, who was in an interim role at the time of the incidents, is no longer at the facility, said Brook Wilson, the current executive director. Wilson told the AJC the male resident involved in the incidents is no longer there, either, and that the victim’s family is very satisfied with the care she’s receiving now.

Wilson said that after she was hired in September 2018, she made sure staff was trained properly to recognize issues that could harm residents.

The facility has had no allegations of abuse since she arrived, but if anything surfaced it would be reported to authorities, she said.

“From my perspective, it’s not difficult to discern abuse and neglect and how to make a report,” she said. “So people that are appropriately trained on abuse and neglect should be able to make that judgment and make the appropriate state reports to protect the resident.”