What an Injured Resident Should Know When Pursuing Litigation of an Assisted Living Facility

Residents in assisted living retirement communities may have less infirmities and fewer care needs than traditional nursing home residents, but these facilities still possess many of the same risks—along with a few additional ones. The primary focus of the assisted living industry is quality of life for seniors and their families. However, residents of assisted living facilities (ALFs) often have far more dismal experiences in reality. Disabling fractures, medication errors, resident assaults, avoidable pressure ulcers (bed sores), and elopements are common occurrences in assisted living facilities, as well as in more highly monitored skilled nursing facilities.

To perceive assisted living facilities as “supervised hotels for the healthy elderly” is wrong. Not only do residents of assisted living facilities require and contract for supervised care that addresses identifiable, chronic, and problematic impairments, they also become vulnerable to harm when supervised care is not provided.  Pure and simple, an assisted living facility is a place that provides care to those who possess diminished physical, mental, and self-care capacities.

Although the occurrence of an injury of an ALF resident may be obvious, identifying the reasons it happened can be difficult. However, these factors that contribute to liability are crucial to pursuing the case.  They include inappropriate admissions or retention of a resident; lack of regulatory oversight and compliance; minimal training, education, and skill in the staff; diminished availability of medical and licensed nursing care; and contract claims.

Inappropriate admission or retention. A potential ALF resident must first be examined by a physician and certified as eligible for the level of care the facility offers in order to be admitted. ALF care may not be suitable enough for people who are unable to ambulate (either by walking or in a wheelchair), who possess advanced pressure ulcers, or who need nursing services such as tube feeding and respirators. Even if such residents are appropriately admitted, many will experience gradual loss of their ability to safely reside in the ALF’s less intensive environment.

Medicare and Medicaid do not pay for assisted living in all cases.  The lack of government funding gives ALFs economic incentives to keep private pay or long-term care insurance residents in the facility.

While supplemental health services are occasionally provided at the facility, due to the degenerative process of aging, certain residents’ care needs surpass the facility’s abilities to meet them, as they are simply not designed to serve those with advanced illnesses.

Residents who are in need of a higher level of care but are not moved may be vulnerable to avoidable, detrimental harm. An inspection of the facility records will often show either an inadequate, hackneyed completion of the annual certification or a failure to reevaluate a resident following an unfavorable change in condition that renders continued residency unsuitable.

Lack of regulatory oversight and compliance. Unlike skilled nursing facilities that are universally federal and state regulated and accept Medicare or Medicaid reimbursement, ALFs operate free of federal regulations or uniform state regulations. All states possess their own regulations and laws governing ALF operations, but consistency is a major issue throughout the country.

In most instances, ALF regulations are not as extensive or demanding as those for skilled nursing facilities. Over the past 5 to 10 years, however, new sets of regulations have been authorized due to the expansion of ALF populations to people who are in need of greater supervision and care management.

Unlike skilled nursing facilities in every state, assisted living facilities are seldom visited, scrutinized, and penalized for violating regulations and providing substandard care. State regulators rarely catch substandard practices and regulatory violations or escape their scope of scrutiny and powers.

Inadequate staffing. Often, one needs no more than to have attained the age of 18 and a high school education to become an ALF staff member. Generally, staffing levels are not mandated by regulators, although they may be scrutinized on their adequacy. Nonetheless, inadequate staffing levels and training are easily overlooked due to less extensive government oversight of ALFs.

Lessened availability of medical and licensed nursing care. Facilities that do not operate with a permanent licensed nurse on staff is common. Often, the person who serves as “director of wellness” and oversees and scrutinizes residents’ health has no formal medical training.  Although physicians, physician assistants, and registered nurses are occasionally present in facilities, they are not required to be stationary consistently. Staff who attend to residents’ medical care needs are often untrained or undertrained.

This care approach is incongruous with the realities of an elderly population with longer lifespans and more “managed” chronic illnesses. Not only do residents need care and services compatible with their functional capacities and health care conditions, they are entitled to them.

Client Reviews
Excellent staff and the epitome of genuine, honest, and beyond helpful. I was lost and running out of time until I found Yeroushalmi law office. I am beyond grateful and had the pleasure of working with such amazing people who look out for your best interest. Anonymous review
Ben Yeroushalmi accepted my case with much understanding and patience. He went above and beyond with the defense lawyers to reach a fair settlement. He explained the complete case process (as I had never filed a case with anyone) Ben kept my sister and I notified of every email or correspondence he had with the opposing council. Gloria
Ben is an outstanding litigator, and human being. He took on our case, as if it was his own. He paid close attention to details. His guidance was invaluable. He was very clear and concise, in explaining all potential scenarios to us. He spoke eloquently, and straight to the point at all times. Ben is a true professional, with a passion for his craft. Anonymous review
I had a heartfelt and memorable experience with Ben , very genuine and I can tell he loves what he does. His determination shows beautifully and it is amazing. In my opinion it is very rare you find people who love what they're doing and it shows. Not wanting to get religious on an review but, God introduced me to Ben for a reason. Summer
Ben was wonderful. He took our case when no one else was interested or wanted way to much money. We would highly recommend Ben because he really listens and takes your situation into consideration. We settled our case and we were only unhappy with one thing and that was the confidentiality clause but that was not Ben's fault it came with the deal. June
All around GREAT experienced under the circumstances. Special thanks to Devon Wright she did exceptional work for our case. Anonymous review
Mr Yeroushalmi was our lawyer for a case involving my mother who was a victim of elderly abuse while in a nursing home. He and his team did an excellent job. My mother was able to live comfortably for the remaining years of her life due to the results of our case. I highly recommend Mr Ben Yeroushalmi. Danny
Mr. Yeroushalmi had provided his legal services for my father's medical injury case. Through mr. Yeroushlmi's excellent services, my family could make informed decisions during the entire course of legal proceedings. Thanks for the professional and responsive services. I strongly recommend Mr. Yeroushimi as your legal advisior. He is the one you can rely on. Thanks. Samuel
Mr. Yeroushalmi provide excellent representation After my husband passed away from complications due to Alzheimer's. It was a complex case and I was always informed of the progression of the case. The office staff offers the personal touch and patience with my constant phone calls and questions. I highly recommend Ben and his staff if you are looking for an aggressive attorney with high ethics and great attention to details. Terry