Despite City Law, Few Assisted Living Centers Licensed
Monday, March 3, 2008
Most assisted living centers in the District have not been licensed or inspected eight years after the D.C. Council mandated government oversight of the facilities and set standards for such matters as dispensing medication, training staff and providing adequate bathrooms.
As a result, consumer advocates say, some of the District's most vulnerable residents have been left at greater potential risk for abuse and neglect as an industry that offers housing and daily care for the elderly has taken root in the city.
The city has sought to rectify the problem in the past year under the stewardship of a new mayor and in response to a court order. But as of last month, only the Knollwood military retirement home and the Lisner-Louise-Dickson-Hurt Home, both in Northwest Washington, had obtained a license. The Health Department estimates that seven others will apply by an April 1 deadline.
Technically, the 2000 D.C. law prohibits assisted living centers from operating without a license. Such licenses are standard in most states, including Maryland and Virginia. The centers cater mainly to elderly people who cannot live on their own but do not need the specialized medical care provided in nursing homes.
"D.C. is far behind the ball," said Lydia Williams, who works for the D.C. Long-Term Care Ombudsman Office, a federally mandated advocate for the elderly. "As long as the government doesn't have it together, the bad providers will take advantage of it."
The ombudsman's office, which over the years has fielded complaints about assisted living centers including alleged thefts from residents and questionable discharges, has no power to enforce regulations. The D.C. Health Department does have such authority but has only recently exercised it.
"It simply was not a priority of the previous administration" of Anthony A. Williams, said D.C. Council member David A. Catania (I-At Large), chairman of the Health Committee.
The council did not intervene because it had larger public health issues on its agenda, he said, adding that his committee is now focused on long-term care.
LaShon Seastrunk, a Health Department spokeswoman, said the department began to implement the assisted living regulations a year ago, after Mayor Adrian M. Fenty (D) appointed Feseha Woldu as senior deputy director of the Health Regulation and Licensing Administration. Woldu formerly oversaw the District's licensing of physicians and other health-care professionals.
She said Woldu revived a dormant advisory committee and looked at national best practices in outlining how the regulations would be enforced. "It was his task to get the District compliant," she said.
A D.C. Superior Court judge gave a further push in September, ordering the government to carry out the regulations in response to a lawsuit from the ombudsman.
Assisted living centers are designed for people who are fairly active but may have difficulty bathing, remembering which pills to take or preparing nutritious meals. Under the law, residents have the right to stay in the facility if they are paying their bills, if their level of care has remained relatively stable and if they are not a threat to themselves or other residents. But the ombudsman's office has investigated several reports of questionable discharges, including the case of Margery Arrowood.