IT IS CALLED "assisted living," yet in an astonishing, depressing number of facilities across Virginia, it is little more than neglected suffering and dying: squalid conditions, woefully policed, ill-funded and getting worse. Such is the grim barrage of horror stories bared in an 18-month investigation conducted by The Post's David S. Fallis, assisted by staff researcher Bobbye Pratt and database editors Sarah Cohen and Dan Keating. In their four-part series this week are accounts of shameful mistreatment of residents unable to fend for themselves, intolerably poor oversight and underfunding, and solicitation or placement of mentally ill residents who have violent criminal backgrounds in houses with more vulnerable residents, including those with mental retardation or dementia.
The series points out that hundreds of assisted-living facilities have operated free of complaints over the years, that families have found homes that care well for their ailing relatives and that industry leaders say that most homes are run by dedicated, well-intentioned people who work long hours for low pay. In addition, most of the problems found in Virginia are by no means exclusive to the state. Still, it is the only state in which all the homes were disqualified from a federal program after inspectors in 1999 found "medical and physical neglect" of residents. Regulations and enforcement tools are weaker than in most other states. In Maryland, the series notes, officials can impose a $10,000 fine when a home violates standards; the maximum fine in Virginia is $500 per inspection.
Records show thousands of incidents of harm in Virginia's 627 licensed facilities, which care for more than 34,000 residents. In 51 deaths over the past eight years, according to the series, "records raise questions about the quality of care. . . . In more than 135 other cases, residents suffered sexual assaults, physical abuse or serious injuries, including head wounds, broken bones, burns and life-threatening medication errors. About 4,400 residents have been victims of abuse, neglect or exploitation since 1995."
Many states that 30 years ago began moving mentally retarded and mentally ill patients from huge warrens to smaller facilities have run into problems finding and overseeing their networks of housing. But with fewer than 30 inspectors overseeing more than 34,000 beds in Virginia, the state cannot possibly do a credible job. Yet even though state officials and advocacy groups agree that regulations need strengthening, that funding should increase and that oversight ought to be bolstered, the political will to act has been feeble.
The series has stirred some fresh concern. Gov. Mark R. Warner (D) is seeking recommendations from top aides, and his commissioner of social services, Maurice A. Jones, said Wednesday that he will push to improve conditions, oversight, sanctions and public information on homes. Legislators, too, need to join in addressing this longstanding disgrace.