Protect seniors in assisted living centers

By The Des Moines Register

Assisted living centers are not like other businesses. As the name implies, they provide “assistance” to seniors with health problems. Residents rely on the homes for meals or medication or help with daily tasks.

These homes shouldn't be able to suddenly “give up” state regulation. It's troubling that they are able to evict elderly residents who rely on Medicaid after spending all their money on care and rent in a center. Iowa can't have the hundreds of assisted living centers in this state flying under the regulatory radar.

But that's what Assisted Living Concepts seems intent on doing around the country, including in Iowa.

The Wisconsin-based company owns more than 200 care facilities for seniors in 20 states. It reported a profit of $11.1 million in 2010. Meanwhile, it has been forfeiting state licenses to avoid regulatory requirements and inspections. In the state of Washington, the company attempted to evict a 99-year-old woman after she spent about $350,000 - her life savings - for care in one of its homes, according to a Dec. 13 article by the Register's Clark Kauffman.

New Jersey is putting up a fight.

The state started keeping a close eye on the company after it was alleged it was improperly discharging patients who became eligible for Medicaid. Assisted Living Concepts surrendered its state licenses at four facilities and then discharged 18 more seniors. The state has imposed hefty fines on the company - more than $260,000 for providing unauthorized care - and passed legislation to protect seniors from being forced out of the centers.

The fight is raging on in Iowa as well.

Assisted Living Concepts forfeited state licenses for five homes here after regulators imposed more than $75,000 in fines for poor care. The company took advantage of a loophole in the law that allowed it to essentially turn the homes into unregulated apartment complexes. Its wholly owned subsidiary, Swan Home Health, offers health services to residents.

By separating housing from health services, the homes can continue to do what they've been doing, but without any oversight. If residents - some with dementia and other serious health problems - have complaints, they can't turn to the state for help. .

Lawmakers need some backbone, too. Last session, the Legislature failed to address obvious problems, sending a message to hundreds of centers in Iowa: You can slip through the cracks, and we'll look the other way. When the Legislature reconvenes, lawmakers should seek more stringent requirements for facilities seeking to operate without state regulation.

For example, centers should have to give residents more than 30 days' notice before a change in status.

And when unregulated homes advertise themselves as assisted living centers, they should be severely penalized.

Iowa seniors move into assisted living centers with an understanding that an outside entity is providing some oversight. Iowa lawmakers should ensure these businesses aren't able to simply change the rules when they tire of state regulators and reprimands.

---