Largest Assisted Living Chain In U.S. Sued For Poor Care Of Elderly

Twenty residents of an assisted living complex in Palm Springs, Calif., missed their medications in a single day because no medical technician was on duty. A woman in a Paso Robles home for seniors pushed her emergency call button after falling in her room and waited 22 hours on the floor with broken bones until staff members responded.

A class-action lawsuit filed last month in a federal district court in Northern California details those incidents and other similar ones, which allegedly occurred in facilities owned by Brookdale Senior Living, the nation’s largest assisted living provider.

The complaint alleges that inadequate staffing, poor worker training and rising fees are part of a “callous and profit-driven approach” that has had “devastating” consequences for Californians living in Brookdale assisted living homes. Residents, it claims, “are left without assistance for hours after falling, they are given the wrong medications, they are denied clean clothing, showers, and nutritious food, and they are left in their own waste for long periods of time.”

Relatives of the seniors involved in the lawsuit declined to comment. The California Assisted Living Association, an industry group, also declined to comment.

Brookdale spokeswoman Heather Hunter said in an email that the lawsuit is “without merit” and the company will defend itself “vigorously.”

Tennessee-based Brookdale, which operates 1,121 facilities serving about 100,000 patients in 47 states, has encountered similar complaints elsewhere in the country. A class-action lawsuit filed earlier this year in federal court in Fort Lauderdale, Fla., alleges that the company does not adequately staff its assisted living facilities and is not providing the care it promises residents.

The plaintiff in that lawsuit, Gloria Runton, claimed the Brookdale home where she lives had assured her she would get personal care services based on an assessment of her individual needs, but that as those needs grew over time, the level of her care did not increase. At the same time, Brookdale nearly tripled her fees, she alleges.

The California lawsuit, believed to be the first class-action claim against an assisted living company under the Americans with Disabilities Act (ADA), was filed on behalf of four people currently residing in assisted living homes that Brookdale operates in the state. If the judge certifies the case as a class-action suit, the outcome could affect all residents of Brookdale assisted living facilities in California.

The lawsuit cites not only the federal disabilities law but also several California statutes, including ones that protect against unfair business practices and financial abuse of elders.

Because the goal is to win the case, good lawyers often file a number of claims, said Stephen Rosenbaum, a lecturer at the University of California-Berkeley’s law school and a directing attorney for California Rural Legal Assistance, which is not involved in the lawsuit. “Whether the ADA is the strongest claim is unclear from a strategic standpoint,” he said.

Rosenbaum said case law has not established exactly how the federal disability law applies to assisted living facilities. It is “ironic” that the attorneys in this case are using the disability law to sue Brookdale, given that the company by definition serves people with some kind of disability, he said.

The California lawsuit alleges that some of Brookdale’s facilities don’t meet federal and state accessibility standards. Some of their bathrooms can’t accommodate wheelchairs, and the company doesn’t have an evacuation or emergency plan for disabled residents, the suit claims. Of the four plaintiffs named in the complaint, three require wheelchairs.

If the case is certified as a class-action lawsuit under the ADA, that would be “big news,” said William Goren, a Decatur, Ga.-based attorney and consultant who helps clients comply with the law. That’s because of the nature of the law itself, he said.

The ADA is designed to address the disabled as individuals whose disabilities can be accommodated in different ways, Goren said. But a class-action lawsuit requires the “class” of plaintiffs to show that they’ve been injured in the same way.

“It’s very, very unusual that you could go in and get a class-action certified under the ADA,” Goren said. “It can happen, but not often.”

In California, Brookdale Senior Living runs 89 homes and serves up to 5,000 patients, offering various combinations of independent living, assisted living and skilled nursing.

In 2014, the company acquired another large assisted living provider, Emeritus, which expanded its presence in California. But the $2.8 billion deal left publicly traded Brookdale with significant staff turnover, declining occupancy and a shaky stock price. A Chinese real estate conglomerate’s recent bid to buy the company reportedly has stalled, creating more uncertainty for Brookdale and the people living in its senior homes.

Residents of Brookdale’s assisted living facilities don’t require the kind of specialized medical care provided in skilled nursing facilities, but they may need help bathing, using the toilet, taking medications, eating or walking. Some residents need walkers or wheelchairs, while others have mild cognitive impairments or dementia. Seniors who require less care and can cook their own meals often choose independent living homes, which Brookdale also operates.

Like many assisted living companies, Brookdale typically charges monthly room and board fees, plus separate charges for additional care, such as help with medications. Its average monthly rate for assisted living, including rent, food and some personal care services, is about $4,000, according to the company’s website.

Both the California and Florida lawsuits claim that to keep its occupancy levels up, Brookdale accepted assisted living residents who might have required higher levels of care, then failed to provide enough staff to meet their needs.

The consequences of leaving residents unsupervised can be severe. In one case, a wheelchair-bound resident of the Brookdale assisted living facility in Elk Grove, Calif., rolled herself out an open door and fell off a curb, breaking her neck, according to an investigation by the California Department of Social Services, which regulates assisted living facilities. The April 2 incident merited a civil penalty, still to be determined, according to the agency’s investigator. That episode was not mentioned in the lawsuit.

Tony Chicotel, a staff attorney at California Advocates for Nursing Home Reform, which is not involved in the suit, said inadequate staffing is a problem at many assisted living facilities.

Assisted living salespeople tell seniors they can meet all their current and future needs, Chicotel said. “But … the facility will only staff based on revenue they’re getting … at least at the big facilities.” The bottom line, he said, is that residents “don’t get the care they need.”

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Largest Assisted Living Chain In U.S. Sued For Poor Care Of Elderly