ROCHESTER, Minn. (KTTC) – Assisted living is home for about 40,000 Minnesotans paying sky-high prices, many out-of-pocket. But because most facilities offer little or no medical care, they operate under less regulation than nursing homes.
Minnesota is the only state that does not license assisted living facilities; a fact that legislators and a coalition of eldercare advocacy groups believe has jeopardized the care of vulnerable adults living in these long-term care facilities. The Office of Health Facility Complaints, a division of the Minnesota Department of Health, receives an average of 430 elder abuse allegation reports a week.
In Rochester, there were 87 complaints filed with the state agency in long-term care settings between 2015 and 2018. Of those, 26 are substantiated, 42 were unsubstantiated, and 19 are inconclusive. These include sexual assault, financial exploitation, and death after neglect among many other cases.
Rep. Tina Liebling who chairs the House Health and Human Services Policy Committee says when people do research on assisted living options, “it’s kind of buyer-beware” because consumers don’t have many protections.
“We are dealing with a very vulnerable population. This kind of care costs a tremendous amount of care. Put those two things together and you have a mix that is right for some people to be abused,” said Rep. Liebling (DFL)-Rochester.
With baby boomers continuing to retire, the assisted living industry is planning to grow even larger. Increasingly, that demand is coming from seniors with complex medical problems, many of whom have Alzheimer’s and other forms of dementia.
Joan Murray lived a private life in Mississippi, but she retired to Rochester to be closer to her family. In her mid-70’s she became one of five million Americans suffering from dementia.
That’s when her niece, Joni Murray, and her sister-in-law began looking for a long-term senior facility with memory care services that could care for her.
“She really wanted a Catholic institution, and there’s really only one,” said Murray. The family decided the best facility for aunt Joan was the Madonna Living Community Benedict House. After some time, Joan discovered her aunt had a fall and was not getting the care she was promised.
“They’re [aides] signing that they brushed her teeth in the morning and night, they changed her, every two hours, they’re checking her. They’re not doing any of it! Her toothbrush would be dry in the morning,” said Joni. “The nurse would not bring her out for food, didn’t give her food or water for three days. Her towels and blankets and stuff are pulled up to her neck because she’s freezing but she’s all soaked in urine. How long has she been laying there wet and cold? All night?”
Christine Bakke has been leading the Catholic assisted-living community in Rochester since 2017. She would not comment specifically about Joan’s situation, citing confidentiality.
“We certainly don’t want people unhappy, that is not our goal,” said Bakke. “You have to tell us because the only way we’ll know is if you tell us. That is not okay. We will not tolerate that.”
But sometimes concerned residents stay tight-lipped, out of fear of staff retaliation for speaking out.
“I mean she’s worked her entire life. She has been a servant from the military to otherwise she just deserves better. This is her hard earned money. It just seems wrong,” said Joni.
Joan has since moved out of the Benedict House but is still a resident of the Madonna Living Community. Joni says they are still working with staff to ensure better care of her aunt.
Changes at the Capitol
At the state capitol, there’s now a push for a broad expansion of consumer protections for vulnerable adults. Eldercare advocacy groups and lawmakers are working on legislation that would give residents of nursing homes or assisted living facilities, or a resident’s designated representative, the explicit right to use electronic monitoring devices in the resident’s room – provided all residents in a room give consent.
In Gov. Tim Walz’s recent budget proposal, he is calling for more oversight of long-term care facilities.
State Health Commissioner Jan Malcolm says currently there is currently no particular frequency of inspection. Assisted living facilities are not often inspected unless there is a complaint.
Previously, if a complaint was reported to the Minnesota Dept. of Health, abuse victims and their families sometimes had to wait a year or longer for basic information from the agency. Under pressure from families and lawmakers, the OHFC instituted a new electronic system for processing new complaint.
“We’ve literally re-done almost all parts of our process. We’ve gotten rid of reliance on paper processes, automated some things. We’ve put a lot of effort into standardizing the work processes,” said Malcolm.
Eventually clearing a backlog of complaints and speeding up investigations. The agency says every allegation of maltreatment is examined within two days. State data shows the average time to complete investigations has dropped by nearly half, from 187 days in 2017 to 110 days last year.
Minnesota requires aids caring for dementia residents to complete at least eight hours of training every year.
“The staff in those places are not qualified to provide those higher-end services,” said Rep. Tina Liebling (DFL) – Rochester.
Madonna Living said they require their staff to complete 80 hours of training. This includes a combination of computerized and in-person classes. As well as a virtual reality simulation of what life would be like as a dementia patient.
Still, Joni doesn’t believe that’s enough. “If the aid giving the service is short staffed, frustrated, not well trained, so inexperienced, it’s just a paycheck,” said Joni.
“We rely on younger people, sometimes we rely on older workers, and they don’t always make the right decisions and that’s when we need to investigate, re-educate, and try to make things right,” said Bakke.
Being a caregiver or an aide is emotionally and physically challenging, one reason why many assisted living facilities to find it difficult to attract applicants.
“People are choosing it less and less as a career and more as a job, it’s a temporary thing. Part of that is, it’s not a high paying job,” said Bakke.
Malcolm said there’s no clear-cut solution to solve the issue of elder abuse and neglect, and that it goes beyond regulation.
“It’s a matter of really changing the culture and embracing a vision in our state that touches every community to better protect the health of elders and vulnerable adults,” said Malcolm.
When it comes to criminal abuse or drug diversion, “we really need law enforcement to come in because it’s bigger than what I as an employer and a provider can do,” said Bakke.
“If more people went to visit elders in these facilities, than it would probably improve the care because interacting with people, having people there watching and seeing what’s going on, that will improve life for those seniors living in assisted living and nursing homes,” said Liebling.
Families can ask providers about education and training requirement aids must complete. Facilities are required to disclose that in writing.
If you suspect or witness the abuse or neglect of a vulnerable individual whether they live in their own home, a nursing home or an assisted living/memory care facility:
This reporting line is confidential and your identity cannot be released without a court order.
Minnesota Elder Justice Center
Number: 651-440-9300. If the situation is an emergency please call 911 or your local law enforcement.