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If Information is Power, Assisted Living Residents are Powerless.

When Lorchid Macri was searching for an assisted living placement for her 91 year-old mother, she was faced with a dilemma. She saw the marketing materials touting wonderful care in idyllic settings. She heard from admissions coordinators who raved about the quality care her mother would receive. But she was unable to find whether the facility had a record of enforcement action by the state. Even an internet search, the vaunted tool for accessing all modern information and consumer empowerment, yielded nothing.

Enforcement actions and complaint and survey information about Residential Care Facilities for the Elderly (RCFEs – also called assisted living facilities) in California are not posted on the internet nor otherwise made widely available to potential residents or their family members who wish to learn more about whether a facility has a history of poor care. The Department of Social Services’ Community Care Licensing Division (CCL), charged with monitoring RCFEs has a “my ccl” website (http://www.myccl.ca.gov/). Under the link “find licensed care,” one can enter a facility name and then learn the facility’s licensure status and some contact information. That’s it.

The only way a person can see a facility’s enforcement file is to physically travel to the local CCL district office and ask for it. For potential residents who are often medically frail or have cognitive disabilities, or their family members who need to find a placement quickly, traveling to a district office is likely challenging. For family members who live out of state, traveling to a district office is not practical.

Having personally observed the challenge of finding good information about RCFEs as she researched public records for work pursuing her Master’s degree in gerontology, Chris Murphy was inspired to make the information truly public – by posting it to a website for anyone to access. In her research, Chris recognized the process for requesting and obtaining the public documents for any given RCFE was cumbersome and lengthy. She also found the file documents to be unfamiliar, out of context and therefore, difficult to understand. Having been through the process of placing her mother in a local RCFE several years earlier, she realized that if she had access to the information she was seeing in the public file, her placement decision may have been different.

Obtaining, scanning, and posting every public file for California’s 8,000 RCFEs proved daunting for Chris and her limited resources, so she limited her postings to San Diego and Imperial County facilities. The public file excerpts Chris has made available are one of the cornerstones of her organization, California Advocates for RCFE Reform (CARR) and its website, www.rcfeguide.org.

For family members of potential RCFE residents like Lorchid Macri, the inability to research potential facilities is very disappointing, particularly after making the gut-wrenching decision to place a loved one’s care with strangers. Compounding the lack of information is the fact that her mother lacked the capacity to report on the quality of her care herself. As an out-of-state resident, Lorchid was unable to go to a local CCL office to see facility files had she even known that she had that option.

The lack of information available proved damaging to Lorchid’s mother. The facility she selected did not have sufficient staff to provide her mother with basic care. Her mother was not showered and dressed regularly. She was inadequately supervised. She had to be moved, which can be an exceptional setback to the health of someone with cognition problems due to the attendant confusion and stress. As Lorchid stated, “if this is a constant situation in this particular facility, and complaints were filed and could be searched by those looking for a place for their loved ones, we would have known about these issues.”

Aside from San Diego and Imperial Counties, there is no way to access a facility’s public file without traveling to a local district office. CANHR’s RCFE Guide web site (www.rcfeguide.org) has some basic information regarding facilities such as whether nonambulatory residents or residents with dementia are allowed but additional information is only available if the facility has completed a questionnaire sent out by CANHR.

The lack of access to an RCFE’s public enforcement record is a considerable barrier to good assisted living care in California. Consumers deserve to know what the State knows about a facility’s performance, especially when a loved one’s health, safety, and well-being are at great risk. In this age of information, the State’s glaring omission deprives potential RCFE residents and their families of material vital to protecting themselves. .

Page Last Modified: March 11, 2013