(Updated Jan. 3, 2023) A new Washington Post investigation has detailed dozens of incidents where senior living residents have wandered away and died as well as “bare-bones” staffing levels at communities across the country.
In one article published over the weekend, the Post examined thousands of cases since 2018 where senior living residents wandered away from their communities, resulting in nearly 100 deaths in that time. Another article details how these and other issues are exacerbated by staffing shortages or poor training in assisted living communities.
The articles underscore the challenges senior living operators will surely have in the coming years, in terms of both staffing and managing communities and maintaining positive perceptions among the public.
Senior living industry professionals — including spokespeople for several provider associations and real estate investment trust Welltower (NYSE: WELL) — were quick to push back on Sunday after the Post’s stories were published. They expressed concerns with the Post’s data and took issue with some assertions made in the newspaper’s articles in comments shared with Senior Housing News.
A spokesperson of the Washington Post told SHN that the publication stands by its reporting.
‘Pattern of neglect’ in resident elopements, deaths
More than 2,000 older adults have wandered away from senior living communities since 2018, with 98 of them having died as a result of those incidents, according to the Post’s investigation. The publication based its analysis on data from state inspections, police, lawsuits, obituaries and local media reports.
Oftentimes, residents who died succumbed to exposure after long periods in hot or cold weather. In some cases, residents wandered from their community and were killed by injury, such as being hit by a car or drowning.
Elopements and deaths often occurred as a result of not following regulations or procedures, such as not locking doors or heeding door alarms, the Post found.
Those and other cases indicate “a pattern of neglect by an industry that charges families an average of $6,000 a month for the explicit promise of safeguarding their loved ones,” the story’s authors wrote.
And the publication believes its reporting is an undercount of the total number of residents who have wandered from their senior living communities, given that 19 states do not provide reports the public can download. Exacerbating the issue is the fact that many states do not have regulations requiring licensing for assisted living.
In response, Argentum President and CEO James Balda noted that senior living is popular with millions of older adults, and pointed to positive surveys from companies like J.D. Power as proof.
“Nothing is more important than our residents’ safety, and any fatality is one too many,” Balda said. “Any community in which an incident occurs is subject to appropriate state regulatory penalties, up to, and including, loss of license.”
He continued that the industry association has “serious concerns about the validity of the Post’s data,” though the organization didn’t share its concerns in detail.
“Even taking it at face value, fatalities due to wandering are 0.0015% of the more than 6.2 million assisted living residents served in the last five years,” Balda wrote.
A spokesperson for senior housing and care industry association LeadingAge told Senior Housing News that “older adults and families need and deserve a strong national aging services system that supports and sustains providers of high-quality assisted living, including adequate and well-trained staff.”
“Our association has participated in multiple efforts to build sector consensus on assisted living quality measures and other topics,” reads the organization’s statement. “Our engagement in those, as well as our advocacy, educational and research efforts to improve care throughout aging services, are ongoing and, given the stresses of our country’s current approach to long-term care financing, increasingly urgent.”
The American Seniors Housing Association (ASHA) did not comment on the most recent Washington Post articles, but said it would issue a joint statement with other industry associations soon.
A representative for the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) said that the organization and its members are “steadfast in constantly improving and adapting to meet the needs of their residents, including those living with dementia. “
“The stories reflected in this reporting are tragic, and we sincerely express our condolences to those who were impacted. However, these rare incidents are not indicative of the life-affirming experience that 99.9% of assisted living residents typically receive,” the organization said in a statement. “Caregivers make the safety and well-being of every resident their utmost priority, and their passion for serving seniors is evident through the high levels of satisfaction that residents and their family members report each year.”
The Washington Post is not the only national media organization putting new scrutiny on the senior living industry. The New York Times also recently wrote about the high cost of assisted living.
In response to that article, ASHA President David Schless wrote this week that “policymakers need to think broadly for ways to incentivize saving for retirement, reactivate the market for long-term care insurance, expand Medicare benefits and much more.”
“The senior living industry has devoted considerable resources to exploring solutions to the issues raised and stands ready to continue working diligently to find innovative ways to provide for the needs of the aging American population,” he wrote.
‘Symptoms of deeper problems’
The Washington Post also studied staffing challenges at assisted living communities across the country.
The analysis centered on a community managed by Balfour Senior Living and owned by real estate investment trust Welltower in Boulder, Colorado, where a resident died in 2022 in freezing temperatures after allegedly being locked out of the community where she lived.
The issue at hand was a lack of staffing, and the resident’s death, among others, point to “symptoms of deeper problems” in the industry, according to the Post.
As the senior living industry has grown in recent years, it has attracted investors such as private equity companies and ownership groups including REITs. That has over the years helped infuse the industry with capital, resulting in a $34 billion market for assisted living and memory care.
But it has also potentially contributed to cost-cutting that has left communities understaffed as these companies look to grow their returns, according to the story’s authors, who reviewed 160,000 state inspection reports and interviewed more than 50 assisted living employees and residents’ families.
“Hundreds of properties change corporate owners every year, and staffing and pay are often the first expenses trimmed by investors focused on profits, according to interviews with industry experts and current and former employees at multiple companies,” they wrote.
Welltower, which formed a new relationship with Balfour in 2019, was a force in the operator’s quest to trim its expenditures, according to the Post. The company “began holding regular calls with Balfour management geared toward reining in spending,” they wrote, having spoken to several “former managers.”
A spokesperson for Welltower denied opposing wage increases for Balfour employees at the property in question. They also said the Post article contained “numerous inaccuracies, hearsay from anonymous sources and demonstrates a general lack of understanding of the industry.”
“Welltower did not oppose wage increases for Balfour employees at the property in question. Additionally, Welltower itself is innovating and investing in technology and tools to improve the resident and employee experience,” a Welltower spokesperson wrote in an email to SHN. “We operate in the competitive private-pay seniors housing market. Ensuring that our operating partners are able to provide residents with high-quality care and a fulfilling experience are the key factors that result in residents choosing to move into our properties, in turn driving our long-term success.”
The company’s spokesperson added that “since 2019, compensation expense per resident has increased over 23% across the Welltower portfolio with compensation at the Balfour properties increasing by a comparable amount.”
A representative for The Washington Post said the publication stands by its reporting. The story’s authors also note that they gave the companies involved “numerous” chances to correct the record prior to the story’s publication.
In a recent interview with SHN, Welltower CEO Shankh Mitra noted that he was in favor of eliminating “excess” in senior living communities in the form of barriers to staff efficiency. But he did not advocate for cutting staffing levels or oppose raising wages for workers.
“We’re making hard choices, because we want to show the industry that if you start from the beginning with a fresh approach — nothing fancy, just common sense — you can get to a viable model,” Mitra told SHN in October.
Other senior living companies have come under scrutiny over staffing in recent years, as well. Brookdale Senior Living (NYSE: BKD) was the subject of a lawsuit in 2017 alleging understaffing, with the case set to go to trial next year. Brookdale has denied the understaffing allegations.