Neglect Has Been Linked to Thousands of Assisted Living Facility Elopements, Deaths: Report

Assisted living facilities are not regulated in the same way as nursing homes, and have seen a growing number of elopements in recent years, often resulting in severe injuries when elderly residents wandered away unnoticed.

More than 2,000 long-term assisted living residents have eloped from facilities since 2018, resulting in nearly 100 deaths, according a recent Washington Post investigation, which links the incidents to nursing home neglect problems pervasive at facilities throughout the U.S.

The report was published on December 17, highlighting widespread issues with nursing home and assisted-living residents wandering away from care facilities unnoticed, often while suffering from dementia and Alzheimer’s disease. More than half of those who died were killed by exposure to extreme temperatures after being left in the care of these facilities by loved ones.

Nursing home elopement includes any situation where a resident wanders or leaves a long-term care facility unintentionally, or without the knowledge of the staff. These incidents are often the result of a nursing home’s failure to follow proper procedures or exercise the appropriate standard of supervision and care, and can result in serious injuries like fractures from falls, heat stroke, hypothermia and even pedestrian accidents.

It is generally accepted that preventative measures by a facility can eliminate or greatly reduce the risk of serious injuries from nursing home wandering.  Facilities can train staff, move high risk patients near the nurse’s stations, use door alarms and security cameras and lock sections of the nursing home where residents who are prone to wander are housed.

Washington Post reporters looked at inspection records, as well as incident and media reports, and found more than 2,000 cases of nursing home elopement reported at assisted living facilities specifically since 2018. While the report estimates nearly 100 people have died, 61% from exposure to harsh elements, it notes that number is uncertain, because there is no one official counting.

However, exposure isn’t the only cause of death in nursing home elopement cases. Some residents fell into ditches, others were hit by cars. In one case, a 77-year old man, Joseph Matthews, died of multiple organ failure from fire ant and yellow jacket stings in North Carolina.

In many cases, the assisted living facilities have door alarms, place memory-loss residents in special units, and have electronic devices that alert them when someone has left the facility. In addition, they are supposed to do regular checks on patients of concern.

However, despite those measures, residents who wander away from the facilities are often not missed for hours, which is frequently too late.

Assisted Living Facilities Mostly Unregulated

Assisted living facilities, which try to provide some level of independent living for their residents, are not regulated by the federal government in the same way as traditional nursing homes. The 30,000 such facilities across the United States are regulated by individual states.

The Washington Post estimates that more than 1 million U.S. residents now live in assisted living facilities nationwide, rivaling the 1.2 million living in nursing homes. It has since grown to become a $34 billion industry.

However, like many nursing homes, they have been linked to a lack of appropriate staffing levels, ignoring alarms, skipping bed checks and other acts of negligence and nursing home neglect.

Nursing Home Staffing Concerns

Concerns over assisted living facility staffing levels mirror those currently held regarding nursing homes, which also suffer from severe staffing problems.

In August, the Centers for Medicare and Medicaid Services (CMS) accidentally posted a draft nursing home staffing study, which warned that no mandatory staffing level could guarantee quality care in U.S. nursing homes.

The report indicated minimum requirements would increase the cost of care for most patients, leading to roughly 9,000 patients who would receive delayed care.

Additionally, more than 11,000 nursing homes in the U.S. would need to hire more staff to meet that level of care. But most nursing homes lost half their staff during the pandemic, leading to widespread staffing shortages and many facilities haven’t replaced their staff since then.

Since the Biden Administration proposal was released, the CMS received more than 40.000 public comments, both in favor of and in opposition to the proposed rules.