Some Colorado assisted living providers are under an unflattering spotlight from an article in the general media, but a senior living advocate tells McKnight’s Senior Living that the industry already is working to improve the quality of care and training of staff members for the benefit of residents.
The Denver Gazette on Thursday said that its examination of state records had found 110 documented deaths classified by the state as “unexplained or suspicious” at assisted living communities between Jan. 1, 2018, and Oct. 28, 2022. And the media outlet added that its analysis also found three dozen more deaths, or incidents of abuse or neglect that later resulted in death, and that “[i]n some of those cases, the deaths were found within state records classified as something other than death.”
Cases described in the article, titled “‘Unexplained or suspicious’ deaths pile up among residents of Colorado’s growing assisted-living industry,” included a man who died after not getting his medication for several days, a resident who had an untreated wound and later died with sepsis, and a woman with dementia who died after wandering outside, where she spent six hours in heat.
“The situations described in this article are heartbreaking and tragic,” Colorado Health Care Association & Center for Assisted Living President and CEO Doug Farmer told McKnight’s Senior Living. “We work with Colorado providers and regulators to improve care quality and to eliminate unintended outcomes for Colorado’s senior living residents.”
Some technical language and statistics may be open to misinterpretation or lead to confusion for those outside of the industry, he suggested.
For instance, Farmer said, the state’s requirements to report deaths under the definition of “unexplained or suspicious” are broad and can include deaths that have “little or nothing to do with the care a resident has received” in an assisted living community.
“The definitions are intentionally broad to ensure that regulatory and law enforcement officials can review any case that is in any way concerning,” he said.
Also, Farmer said, “Reportable deaths include those that are related to a reportable event or any death that is ‘unexplained or suspicious.’ So if a resident passes away and is not undergoing hospice care, it automatically falls into the ‘unexplained or suspicious’ category since the facility would not have an attending physician at bedside to determine cause of death.”
The fact that a death is “reportable” does not necessarily imply that abuse or neglect was involved, he said.
“They include times when a resident experiences an accident with injury that is unrelated to their interactions with facility staff, solely because they are considered residents of that care provider,” Farmer said. “Reportable deaths also include deaths that occur while the resident is not on the grounds of the assisted living facility or while under the care of a hospital.”
The CEO said that assisted living operators trust that the investigations conducted by law enforcement officials and the Colorado Department of Public Health and Environment of reported deaths are thorough and that individuals are held accountable as warranted.
Colorado has the country’s third-fastest growing population of people aged 65 to 84 as well as a “burgeoning” assisted living industry that has grown from 562 communities to 665 over the past decade, according to the report. Assisted living communities in the state now outnumber licensed nursing homes almost 3:1, according to the Gazette.
The article states that when mistakes occur, criminal prosecutions are rare, as are facility license suspensions, which have happened five times since 2019.
“More typically, though, violations — including those that led to a death — are met with citations and fines along with a demand to fix deficiencies,” according to the Gazette, which notes that under current state law, the maximum fine is $2,000 per year per facility, regardless of the number of violations, although fines are set to increase next year.
Farmer said that CHCA/CCAL “do not believe that exorbitant fines are a means to improving quality, safety or security, as they remove scarce resources from care communities and the residents living there.”
But the association “actively participated” in the effort to craft regulations related to the recently updated state fine structure, which gives the Health Department “greater discretion, particularly in cases of resident harm,” he said.
The regulations, Farmer said, “make clear what will result in higher fines and how to define the potential for resident harm.” Fines will increase from $2,000 per year to $10,000 per violation, and the department will be required to impose a fine for “an egregious violation that results in death or serious injury”—and there are no limits to fines for those violations, he said.
“The Colorado Department of Public Health and Environment has the authority to hold providers accountable for their actions, up to and including revocation of licensure,” Farmer added.
Qualifications for assisted living administrators and staff members are not as stringent as they are for nursing home workers, according to the Gazette, which reported that administrators currently are not required to be licensed.
But Farmer said that the industry is working to implement new legislation that increases memory care training requirements for all assisted living personnel and increases the qualification training for assisted living administrators.
“It is our hope that tragic events such as those described in the article never happen again,” he said.
Read more state news here.
