Strict rules on assisted living gain supportDeaths, beatings and neglect cases have focused attention on improving facilities. Legislation would set a standard of quality. (PA)

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By Nancy Phillips and Craig R. McCoy
Inquirer Staff Writers
The Rendell administration is drafting legislation that would toughen state oversight of assisted-living facilities, establishing for the first time rules that would define the level of care such homes must provide.

The bill is designed to close a loophole in the state’s regulations: Now, the same set of rules applies to the array of homes for the elderly and the disabled, ranging from small personal-care homes providing modest help to facilities offering more intensive supervision and care.

Welfare Secretary Estelle B. Richman has called for legislation that would give her department more oversight of assisted-living facilities and a broader ability to ensure quality care.

The Inquirer reported last month that at least 55 residents of assisted-living facilities had died since 2000 under circumstances raising questions about the quality of their care and whether their deaths could have been prevented. Uncounted others were beaten or neglected in these state-regulated homes. At least five were raped.

State regulation of the homes has been so lax that until recently, many problem-ridden facilities continued to operate without penalty. In some cases, health and safety violations went unchecked and residents suffered injuries and, in severe cases, death.

Experts in elder care have called the situation one of state government’s worst failures.

Richman has said she inherited a department riddled with problems in 2003. But she concedes that she did not move quickly enough to make improvements.

In a hearing last week in Harrisburg, lawmakers cited The Inquirer’s findings and asked Richman what she was doing to address the problems.

“It is my responsibility to assure that things get done as early in an administration as possible, and, clearly, at that I did not succeed,” Richman replied. “I failed at being able to protect a large group of people.”

In recent years, she said, her department has increased enforcement efforts and added staff to oversee and inspect the homes. Even so, Richman said, there is more to be done.

“I certainly don’t want to say I think we’ve fixed all the problems,” she said, “but I think all the problems are on the plate, and we are trying to make sure we are addressing each of them.”

Even though her state agency’s staff level has fallen, Richman said, the number of employees assigned to inspect and regulate personal-care homes has increased.

Moreover, she said, the agency would again boost staff dedicated to those tasks in the next fiscal year, which starts July 1.

Richman said the state needed to focus on “folks who need a higher level of care whose option is not to be in a nursing home.”

She added: “More needs to be done. One of the things I think would help significantly is having an assisted-living bill.”

At the hearing, State Sen. John Rafferty (R., Montgomery) questioned Richman about the failures of oversight.

“To her credit, she said, ‘The buck stops with me,’ ” Rafferty said in an interview Friday. “She took responsibility. She said, ‘I’m sorry.’ ”

Rafferty said legislation was needed to give Richman’s agency “more teeth and better enforcement.”

He added: “We can’t have this situation where people’s lives are threatened.”

State Sen. Pat Vance (R., Cumberland) questioned Richman about overdue inspections at personal-care homes. Vance said some homes in her district were 10 months overdue.

State regulators have acknowledged that, in their attempts to investigate complaints more thoroughly, they have fallen behind on routine inspections.

“That’s not a good-enough answer,” said Vance, a nurse who once worked in a nursing home. “It’s not enough to admit it. You have to do something about it.”

Vance, chairwoman of the Senate Aging and Youth Committee, said she, too, would support stricter regulations covering assisted-living facilities. As in the past, she said, the move would likely face industry opposition.

State Rep. Mauree Gingrich (R., Lebanon County), a supporter of tighter regulation, said she was hopeful that legislation that stalled in previous sessions would become law this time.

In the last session, Gingrich introduced a measure to tighten oversight on personal-care homes with four or fewer residents. She also pushed without success to increase penalties for abuse and neglect in the homes.

She is advocating those measures again this session.

“I walk around carrying your articles, waving them in people’s faces,” she said.

Administration officials declined to provide details of the proposed legislation Friday, saying it was still being drafted.

“We are working on it, and we’ll be happy to talk when it’s complete,” said Stacey Ward, a spokeswoman for the welfare department.

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