For months now there has been growing concern about the quality of care in assisted living facilities (ALF's) in Massachusetts. Many residents of these facilities move in when they are in relatively good health. They typically need some assistance with their activities of daily living but do not need to be in a nursing home. Nursing homes are health care facilities that are regulated by the federal government which delegates that responsibility, in Massachusetts, to the state's Department of Public Health (DPH).
Assisted Living Facilities are considered to "housing" not health care facilities and are regulated by law, by the Executive Office of Elder Affairs (EOEA). But as residents age and their physical and mental faculties deteriorate, their need for assistance sometimes outstrips the ability of ALF's to provide the care their residents need.
In October of last year(2014) Peter Antonellis, a former long-time employee at Elder Affairs was fired after speaking out publicly about EOEA's lax oversight of assisted living facilities. “Having only two ombudsmen to cover over 200 facilities throughout the state is absurd,” he says. “There is no way that just two people can do the job the way it needs to be done.”
Ann Hartstein, the secretary of Elder Affairs, insisted that the assisted living ombudsman program was operating properly. “All complaints are responded to,” she says. “I don’t believe that we need to make any improvements at this point.”
Antonellis, who had expressed concerns internally about the agency’s oversight of assisted living facilities for years, finally sent a memorandum in 2013 detailing his concerns to the state secretary of health and human services and the Elder Affairs general counsel.
In his seven-page memorandum, Antonellis said he believed poor management at Elder Affairs was endangering the safety of residents living in assistant living facilities. He noted, for example, that there are no procedures in place for how to handle incident reports from assisted living facilities dealing with such matters as falls, residents wandering off, abuse, and adverse medications. Antonellis said the agency does almost no analysis of the data it collects, which means any pattern of problems at a particular facility are likely to go undetected.
Whistleblower Fired for Speaking Out Against Lax Oversight of Assisted Living Facilities in Massachusetts When Antonellis’ assertions were rebuffed, he went public in a story published on the CommonWealth website in September. You can read Commonwealth’s expose about EOEA at the following link:
http://commonwealthmagazine.org/health-care/aging-in-place/ the detailed
After he continued to speak out, he was fired in November. The Patrick administration declined to comment on why he was fired, citing the confidentiality of personnel matters. Antonellis declined to release his termination letter on the advice of his attorneys.
Like Antonellis, many attorneys who focus on elder issues have raised concerns about poor oversight of assisted living facilities. Rebecca Benson, a Boston elder law attorney, says she supports the efforts of Elder Affairs to improve protections for residents of assisted living facilities, but she says the problem starts with the agency’s enforcement of current regulations.
“Its current regulations are quite solid, but the agency does not do a very good job of enforcing them. So why would anything be different with new regulations?” Benson asks. “What needs to happen is for Elder Affairs to vigorously enforce whatever the regulations are. Perhaps with a new administration that will happen.”