Straight Talk

CARR Initiates Petition To Require Mandatory Liability Insurance for RCFEs

From AHS Committee AB 1523 Moves to Appropriations

        On Tuesday, 8 April, the Assembly Human Services (AHS) Committee (Stone, Chair) heard many bills under its purview, one of which was AB 1523 - requiring RCFEs to carry and maintain liability insurance as a condition of licensure.   The bill, carried by Assembly Speaker-Elect Toni Atkins and Assembly Member Shirley Weber, and sponsored by CARR, was heard at 3pm.  

        Ms. Atkins addressed the committee, explained the need for RCFEs to carry liability insurance both as a best-practices for facilities, and a necessary tool to allow consumers to obtain accountability when adverse events occur to their loved ones.  Chris Murphy, CARR's ED gave testimony also on behalf of the legislation, referring to two local wrongful death actions against two RCFEs..  Faced with large judgments they were unable to pay, both facilities filed for bankruptcy protection; the state lost two facilities, and residents in each had to be relocated. Two additional testimonies on behalf of the bill were heard. Speaking in opposition to the bill was Denise Johnson, Consultant  for the Community Residential Care Association of California.  She expressed policy affordability issues for those facilities who care for SSI/SSP residents.  

CARR Contributes to California Healthcare Foundation Think Tank

California Healthline recently asked CARR and other experts in the field "How should California regulate its growing RCFE industry?".  Provided here is CARR's submission.  You can read all of the submissions by visiting

The Need for Data-Driven Practices

The primary focus surrounding California’s RCFE industry is policy reform.  In CARR’s view, modification of regulatory language may do little to affect the performance of facilities without accompanying improvements to the oversight and enforcement practices of California’s Department of Social Services (DSS).  CARR’s five years spent reviewing the public documents strongly suggests a department significantly weakened by the absence of evidence-based practices. 

DSS does not make use of facility compliance data or LPA performance data to inform their policies or practices.  CARR’s analysis of this data suggests this is a major shortcoming that impacts departmental operations and jeopardizes safety within RCFEs.  The resultant patterns, frequencies and trends reveal current compliance and accountability issues have just as much to do with outdated regulations as does the organizational culture of DSS.  This raises questions about the Department’s effectiveness as a regulator. Samples include:

CARR's Support for the San Diego County Board of Supervisors' RCFE Initiatives

CARR recently offered testimony before the San Diego County Board of Supervisors in support of Chairwoman Jacob and Supervisor Cox’s initiatives to improve the local RCFE industry.  CARR also participated in the press conference called by Chairwoman Jacob and District Attorney, Bonnie Dumanis to show our support for the creation of an elder abuse task force within the District Attorney's office. Read Chrisy and Chris' words of support:

C.L. Selder's Statement:   "On behalf of CARR, I applaud Chairwoman Jacob and Supervisor Cox for addressing the deficits within San Diego’s long-term care facilities.  The initiatives put forth are common sense strategies that will reduce risk for RCFE consumers.  CARR strongly supports the development of a rating system for RCFEs that relies on both qualitative and quantitative data; one similar to CMS’s national rating system for skilled nursing facilities.

CARR's Public Comment at the Joint Human Services Committee Oversight Hearing

CARR's advocates Chrisy Selder and Chris Murphy trekked to Sacramento to attend the 11 February oversight hearings called by Joint Chairs of the Human Services Committee: Senator Yee and Assemblyman Stone.  The legislators heard from 13 hand-picked individuals across the spectrum of stakeholders. 

The genesis of these hearings was a direct result of two events:  the constellation of investigative reports ("Deadly Neglect") on assisted living in San Diego published by the UTSanDiego on 9 September 2013, and the October bungled closure of a Castro Valley RCFE where CCL closed the facility but did not provide for the care or relocation of the residents; 48 hours after being abandoned by the licensee and the regulators, 19 residents were found still living in the facility, unattended and in squalor.  

Following three and a half hours of testimony by the witnesses, the floor was opened for public comment. Due to shortness of time, each member of the public was limited to about 1 minute, but our comments below were prepared for a total of 4 minutes.  Nine organizations and/or individuals spoke, including CARR. CARR's full remarks are provided below:

"Hi, I am Christina Selder, co-founder of Consumer Advocates for RCFE Reform or CARR for short. CARR is a San Diego based 501(c)3 which advocates for consumer protections related to assisted living facilities. 

THANK YOUS & KUDOS to our Volunteers and Donors


WOW!  This year CARR has received help, encouragement and money from a wonderful group of volunteers and donors who have identified with CARR's mission and the work we do.   Individuals have stepped up to the plate offering us donations, time, great ideas, and new strategies for our continued work.  Thank you! Thank you! 

Special Thanks to the members of our Board; without you we could not function. 

- - - - V O L U N T E E R S - - - -

Senior Transportation Resources



To inaugurate our LINKS LIBRARY for Senior Transportation Resources, we are adding "We Get Around!" an active senior transportation program for the Greater San Diego Area.  This is a useful resource for the active senior who just doesn't want to drive as much, or who is worried about the perceived lost independence if the driver has to give up the car keys.   In addition to the skills your senior will learn about navigating time schedules, fares, coordinating trolley schedules with bus schedules, the senior will benefit from increased socialization, brain health, low-impact fitness  and more.  You can also call We Get Around at (619) 742-3368.  Ask for Judi. You will be happy you made the call.  

ProPublica Article Spotlights Nationwide Risks to Assisted Living Residents

Visitors to CARR's site, and our Twitter and Facebook followers are encouraged to read the ProPublica article "Elderly, At Risk and Haphazardly Protected" by AC Thompson and Jonathan Jones.  The article is a litany of inadequate consumer protections and lack of meaningful state oversight for assisted living facilities throughout the US.    

Thanks in large part to the focus on CCLD failures in San Diego, covered by the collaborative investigative series between Center for Health Reporting and UT San Diego  "Deadly Neglect" (9/9/13), the time has never been better for consumers  to urge state legislators to "step up to the plate", "to do the heavy lifting", to "work for the little people" to develop meaningful and widespread reform to both Title 22 RCFE regulations,  and to the insular and opaque CCLD.  

CARR urges you to write your local state assembly member, and your state senator demanding much needed, long overdue, and totally necessary reform to how residents of assisted living care cared for, and to provide for meaningful reforms in the areas of accountability and criminal prosecution of elder abuse, including neglect that occurs in state RCFEs.

Facility Shopping? Take Along Your IPAD!

All you web-savvy users can now easily access using your ipad.  And because your ipad defaults to Safari as the browser, you will optimally see the site and all its contents.  So now, while you are out and about, taking tours of the RCFEs of interest to you, you are now able, with a login, to access the public documents on our site, in real time while.  Use our public documents to inform the questions you ask the facility administrator or licensee.  


A dramatic 9-1-1 audio clip documents the call made by a staff member of Glenwood Gardens (a Brookdale Assisted Living community in Bakersfield, CA) requesting an emergency response to help a resident – Ms. Bayless.  We hear the 9-1-1 dispatcher plead with the staff member to administer CPR to the resident.  The staff member refuses, citing facility policy.  The EMTs arrive, the resident is not breathing, and is pronounced dead at the hospital.  It is unfortunate it takes a disturbing event to capture our attention, but nonetheless, this single event has finally prompted a worldwide discussion about the care provided within assisted living* facilities.  All media forums have been buzzing about the legal, ethical, and practical implications of the staff member’s actions.  CARR was contacted by local media (Channel 6 (Chrisy Selder), and KPBS (Chris Murphy) to give context to the event. In sound bites we could not share enough for the consumer, so we conclude the commentary here.

California's FIRST & ONLY Online Assisted Living Public Record Search

CARR'S Facility Search is a novel approach to researching assisted living facility options.  CARR founders recognized the paucity of objective information available to seniors & their families and have worked since 2009 to configure a website that offers more than marketing material.  CARR's Facility Search for RCFEs (or Residential Care Facilities for the Elderly) is the first & only website in California to offer online, the actual public documents on assisted living facilities.  

Visitors using our site can locate a facility by name, zip code or city using the search bar to the left.   Each facility profile contains the following valuable information: