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.
What should concern consumers is the anomaly: the very reason seniors move into a facility is to have the care, supervision and assistance that would not otherwise be available to them if they remained living at home, alone. Yet for Ms. Bayless, the outcome would have been no different whether she stopped breathing in her dining room, or in the facility’s. It appears this was acceptable for her family, but what about yours? Here is your opportunity to consider the facts:
The assisted living facility, under California regulations, is nothing more than a housing alternative. The state licenses assisted living facilities as NON-MEDICAL FACILITIES. Specifically this means:
- No skilled medical professionals (SMP) are required to be employed by an assisted living facility.
- Consumers should have zero expectation of receiving medical care or medical attention from the caregivers, administrator or licensee. Medical experience is not a prerequisite for employment or licensure.
- If medical care is needed, it is outsourced either to first responders or the family must hire a SMP (RN, CNA or LVN) to deliver medical care to the resident. The hired SMP may spend as little as 1 hour a day with the resident; then leaving the remaining care and supervision to untrained caregivers.
- Some facilities do hire SMP, but this guarantees nothing according to the public record. Many facilities owned by RNs or with RNs on staff, still have serious compliance issues regarding medically compromised residents, (i.e stage 3 & 4 bedsores resulting in sepsis; medication errors; elopement; suspicious deaths; and neglect.
- Because these are non-medical facilities, and caregivers are only deliver assistance with activities of daily living, they receive only 10 hours of initial training and must have a current First Aid Certificate. The state does not require an additional certification in CPR or AED (automated external defibrillator).
The contradictory caveat here, however, is that despite the above, the state allows (through regulation and waivers) facilities to take on the responsibility of caring for medically compromised residents (bedridden, hospice, total care, diabetes, oxygen administration, dementia, etc.). CARR’s research, using the public records, shows this dichotomy (non-medical facilities caring for populations of medically needy residents, is posing serious health and safety risks for unsuspecting residents and their families.
So while Bayless and her family may have accepted the risk, and been pleased with the outcome, you need to ask whether you would be? And if not, we implore you to speak up: To state legislators, the Department of Social Services, California Assisted Living Federation of America (CALA), individual facilities and/or CARR.
The benefits of Bayless are two:
- a platform to understand the realities of Assisted Living of policy in California, and
- an opportunity to have your voice heard on important subject.
* News reports state Ms. Bayless was a resident in Brookdale’s Independent Living units; despite the descriptor “independent living,” an RCFE’s licensed capacity includes the independent living bed count.