They did not have the staterequired training, they didnt have the emeritusrequired training. And examining the care this forprofit chain provides to tens of thousands of seniors. The biggest thing i always heard was, we need 100 . Fill the building, 100 . Correspondent a. C. Thompson interviews insiders who are telling their stories for the first time. Did you worry, hey, ive got an Impossible Task here. I could do something that leads to somebodys death . All the time. Tonight ofrontline, life and death in assisted living. The head of the state Licensing Agency told me, assisted living is the rock we dont want to look under. Frontline is made possible by contributions to your pbs station from and by the corporation for public broadcasting. Major support for frontline is provided by the john d. And catherine t. Macarthur foundation. Committed to building a more just, verdant, and peaceful world. More information is available at macfound. Org. Additional funding is provided by the park foundation. Dedicated to heightening Public Awareness of critical issues. The wyncote foundation. And by tfrontline Journalism Fund with a grant from Millicent Bell through the millicent and eugene bell foundation. A. C. Thompson so this is 1940, is that right . Yes, this was the championship game. Oh, look, there he is. There he is. Carrying the ball. Thats daddy, number five. Right in the middle, with his curly hair, yeah. Thompson is that him . Right there . Yes, hes got the ball right there. There he goes. Yeah, he just intercepted that and now is just running and making his way through and just scored. Scored a touchdown. I believe this is when they scored. The score was 73 to nothing. It was a game that daddy talked about the most, i think. Thompson George Mcafee had a remarkable life. In the 1940s and 50s, he was the star running back for the chicago bears. He won three nfl championships and was inducted into the pro football hall of fame. He didnt really talk about that that much. In fact, our mother wanted to place plaques of his in our den, and the only place he would let her put them was behind this door so that when the door was open, you couldnt see them. Thompson i see all these photos and he seems like hes just loving his later years. He enjoyed being around his family. He would just light up when he saw the grandkids, the greatgrandkids. Thompson but in his 70s, george became one of the more than five million americans suffering from dementia. I guess we first started noticing that there were some changes in daddys behavior. He would go to the bank and he could get there, but once he got there, he couldnt remember why he was there. Thompson his daughters began searching for a facility that could care for their father. They chose cypress court, an assisted living home that charged more than 4,000 a month. When i saw the court, a couple things impressed me. The residents were free to access the outside and walk or sit. I thought we had just struck gold as far as a home for him. Thompson but then the facility was bought by the emeritus corporation, a nationwide chain. The sisters say they began to see changes. His room would be dirty and he would just be unkempt, like he hadnt showered. I know for a fact that his sheets werent being changed. His laundry was not being done. I would come home with his laundry, do his laundry myself. I would clean his room. Many times when i would go over, he looked like a dirty old man. Thompson one night, george left his room and went wandering through the facility. Records show that for almost half an hour, there was no one on duty in his wing of the building, and workers had failed to lock away a bottle of industrial strength dishwashing liquid. At some point that night, george picked it up and drank it. It contained a highly caustic chemical which severely burned his lips, esophagus and lungs. When he was in the hospital, his face almost looked like what you picture in a horror story of a death mask. And i hope that he wasnt aware of what was going on, but we certainly were afraid that he was just in horrific pain because he would almost try to sit up. Well, one time he did sit up. He did sit up. And opened his eyes, yes. And we said, daddy, were right here. Thompson the hospital couldnt save george, and on march 4, 2009, he died. The state of georgia found emeritus negligent in georges death. The sisters sued the company and settled with them. Now theyre speaking publicly. For the first time. He suffered a horrific death, and our children saw it, our husbands saw it, we saw it, and. I remember just sitting by his bedside praying that god would just go ahead and take him, because he wasnt going to get any better and i just felt like he was suffering so horribly. Thompson after your father died, the state did an investigation, and the state said, were going to fine this facility 601. Well, in my opinion, i think they just got a slap on the wrist. And ive said all along, had this been a daycare facility that, where a child died, the place would have been shut down, and to only get a fine of 601, i just think is outrageous. It means nothing. Nothing. Thompson the emeritus corporation is headquartered here in seattle, washington. We asked the ceo, granger cobb, about what happened to George Mcafee. The incident with. The tragedy, i should say, with mr. Mcafee was devastating for all of us, and it was a situation, it was human error. We had a staff member that failed to secure a locked cupboard. Mr. Mcafee got access to this dishwashing liquid, drank it and had absolutely tragic results, and our heart goes out to the family. When youre dealing with this many residents, particularly a population that can have unpredictable behavior or is frail and is kind of a highrisk population to begin with, we will have situations from time to time, but they are the vast, you know, minority. I mean, it is really the exception to the rule. Welcome to emeritus, where youll find all the comforts of home. Thompson cobb heads a company that has long been at the forefront of the assisted living industry. You can teach the skills, but you cant teach the passion. You have to have a passion for seniors. Thompson assisted living was created to offer seniors who could no longer live on their own a more homelike environment than Nursing Homes. And since most facilities offered little or no medical care, they were loosely regulated. Seniors can enjoy their golden years to the fullest. Thompson assisted living blew up in the 1990s. It grew very rapidly. Do you think that companies were attracted to this sector of senior care because it had less regulation than Nursing Homes . Oh, im sure, and particularly the forprofit companies. When you look at the system, you dont have to worry about federal government, you dont have to worry about rules and regulations like you have to with a nursing home, for example, and you can charge whatever the market can bear. I mean, if there are people who are willing to pay 5,000, 6,000, 7,000 a month for care, you can charge that, and theres no limitation on fee increases. Thompson with those kind of prices and the enormous cash flow they generate, emeritus has been embraced by wall street. The companys shares trade on the new york stock exchange. Last year, it took in nearly 1. 6 billion in revenue. cheering thompson and with the baby boomers starting to retire, emeritus is looking to grow even bigger. So the 75plus demographic is growing by about 400,000 individuals per year, so theres this increasing demand. And frankly, out 15 years when the baby boomers start hitting, its going to grow by a million a year. And so theres this huge demand that is already here, and on the horizon, is going to increase. And i think that, you know, what were looking at is to be able to service that demand as it continues to grow. Thompson but increasingly, that demand has been coming from seniors with complex medical problems. When we were trying to figure out what assisted living is or was, i had this image that it was apartmentstyle buildings where people had a lot of independence, they didnt need a lot of assistance. Thompson Catherine Hawes studies the assisted living industry. Then we did the First National study, and of course that wasnt what assisted living was. People showed up in wheelchairs and walkers. It wasnt the well elderly who are out golfing, you know, on the weekends. And, you know, there was this big, is there a parking place for every resident . These are not people who can drive and there were these spiral staircases, which no one ever uses. Because if all you need is hospitality, you dont leave your home. Most of us want to stay in our home as long as we can. Thompson in her study for the department of health and human services, hawes found that while residents in assisted living didnt have as many physical limitations as people in Nursing Homes, many suffered from alzheimers and other forms of dementia. When you go into assisted living, you see a lot of cognitive impairment. So theres a lot of early memory loss, shortterm memory loss, a lot of impaired decisionmaking. Thompson Newer Research shows that the number of residents with dementia is rapidly increasing. We found that about twothirds at any point in time have dementia. So the majority. The implications, therefore, are anybody who operates assisted living needs to know that dementia is the major player. Its the major condition that leads to People Living there. Thompson to meet the growing demand for dementia care, emeritus has been opening memory care facilities across the country. Understanding how alzheimers disease affects the brain. Thompson but though residents now need much more care, assisted living remains loosely regulated. The overall needs of each resident. We pretend assisted living facilities are not medical facilities. Theyre nonmedical. And yet, the people who are in these facilities today have acute medical needs. The same people who are in assisted living today are the people who were in Nursing Homes ten years ago. And this is not to say that all the facilities arent prepared to deal with them, but id say the overwhelming majority certainly arent prepared to deal with that. Thompson emeritus invited us to come to one of their facilities in san diego. It has a memory care unit where seniors pay upwards of 5,000 a month to live. Five, six, seven, eight thompson so were in the memory care unit, or memory care community. We call it the memory care neighborhood. Thompson memory care neighborhood, in carmel valley. Thompson kelly scott runs emerituss memory care program. So this is our program, we call it our join their journey program, and this is where were caring for folks with dementia. And its really a Specialized Program to meet their needs. We find out a lot about who they are as individuals, and then the day is set up around what is purposeful and meaningful to them as individuals. 10 30, 350. Thompson but some question whether memory care units like this one provide enough care. Has anyone got a shovel . Youre going to have a memory care unit. Thats a good Marketing Tool for families. A theres demand and youre trying to keep occupancy up. B you can charge more for memory care. I mean, all youve really done is created rooms around a courtyard, but still, thats nice, and its much safer. But then they say theyve got staff who are trained to do memory care, and thats where it starts to kind of fall apart, because the staff are generally not well trained to do dementia care. Thompson lay out for me, if were here in carmel valley, were at your facility, what would the typical training consist of for somebody in this facility . Whos working particularly in memory care . Thompson in the memory care unit. For our staff that works in memory care, theyre going to go through what we call general orientation which everybody in the community would go through, and then we have an eighthour class thats the join their journey class, and thats really where we cover everything from disease process to how we serve a meal slightly differently to folks who have dementia, to how to engage, how to approach, how to communicate, you know, overcoming some communication barriers at times. Thompson so the eighthour intro is sort of the minimum. Thats our Company Standard is going to be the eight hour. Eight hours . Thats nothing whos going to explain, this is what the disease is, this is the impact that it has on peoples physical health and on their behaviors. Youve got to know how to interpret nonverbal cues that somethings going on with this resident, because they cant tell you verbally, you know, in the same way that a twoyearold cant tell you or a oneyearold. I mean, youve got to do a lot of training for memory care units. You can do great care. Youve just got to know how. Thompson for the past year, propublica and frontline have been examining assisted living and emeritus, the industrys biggest chain, which is home to more than 40,000 seniors. Resident was assaulted by another resident due to lack of care by facility; substantiated. Theres no National Data on assisted living, so we focused on california, the state with the most assisted living facilities. During the last three years, emeritus had more substantiated consumer complaints per bed than any of its major competitors. Facility has insufficient staff to monitor residents. Thompson we found authorities in other states have cited emeritus for numerous legal violations, from a shortage of staff to taking in seniors too sick to legally live in their buildings. Go to that one. You just have somebody apparently falling out of a secondstory window. Thompson and we identified more than two dozen questionable deaths, many of which have never been reported on. So she froze to death. Thompson she froze to death. On christmas day. Thompson on christmas day. Her name was mabel austin, and she suffered from dementia. One night, she wandered out of an emeritus facility in texas and froze to death. In colorado, Herbert Packard was beaten to death by a resident with brain damage. In massachusetts, angenette stewart was repeatedly sexually assaulted. An investigation found that emeritus workers knew about the attacks and didnt stop them. In florida, richard borrack, who had alzheimers, slipped out of a facility one day and was never seen again. When we asked emeritus to comment on these incidents, the company refused. But granger cobb did agree to comment generally on the problems wed found at his company. Its a fact of life and its not peculiar to assisted living versus any other business, but from time to time, human beings will make mistakes. Thompson but some things are pretty cut and dry. In some states, if you have a particular condition, you cant be in a facility. In some states, if you are posing an immediate harm to yourself or others, you cant be in an assisted living facility. What are the risks of having somebody who has a prohibitive condition, something that should keep them out of assisted living, living in this kind of environment . Well, if we cant adequately care for the resident, we shouldnt have them. If we cannot care for them sufficiently, we will not jeopardize their health or their condition by keeping them in our community. Thompson but in our reporting, we came across a revealing incident near jackson, mississippi. It involved a woman with dementia named merle fall. Merle went to live at emeritus at Ridgeland Pointe at the end of a long, happy life. She was a lot of fun to be around. Our friends all loved her. She said whatever came to mind and she was always the life of the party. Everybody always loved her. Thompson in the early stages of her dementia, merle lived with dianes sister, linda. But when linda felt she could no longer keep merle safe, the sisters called emeritus. The company sent a nurse to evaluate merle. She came in, she sat down right there on the couch with mother, mother was sitting there too, she reached over and held mothers hand, and she never asked any questions. As a matter of fact, it was only later that i understood she was here to evaluate mother, to find out whether she was suitable for Ridgeland Pointe, because all she did was talk about what a great experience it was going to be, mother was going to get a lot of oneonone attention, she says shes going to get so tired of seeing my face, you know, were going to give her. Were going to take care of her just like she was our mother, is what they said. Thompson and so merles daughters moved their mom in at a cost of about 3,500 a month. She went in on thursday afternoon, february 25. They had suggested that we not come by for a few days to get her used to it. Sunday, i finally said, we want to see her. We got there, she was drugged, drooling, we couldnt wake her up, she had on the same clothes she had on when we took her there thursday, she smelled of urine. I mean, she looked like she had just been drugged the whole time. Thompson the sisters discussed taking merle home, but in the end decided not to move her. She was miserable where she was and she wanted to go home. And it was really hard to leave her there. But we truly thought it was the best thing for her, we truly thought it was a way to keep her safe. Thompson but just days later, merle stuffed her clothes into a suitcase and told a caregiver that she was leaving. Soon after, she apparently pried open an upstairs window in the memory care unit, and forced herself through it. Then she plunged to the ground. I got a call on saturday, march 6, nine days after she was admitted there, about ten til 8 00 that morning, said. The lady identified herself and said, your mother got out. I said, what do you mean she got out . She said, she went out the window. I said, she went out a second story window . And she said, yes. I said, is she breathing . Is she alive . Shes on the ground, crawling around. She wont get up. We probably got there in less than ten minutes. As a matter of fact, they were still putting her in the ambulance when we got there. There was not one living soul from Ridgeland Pointe out there with her. Nobody from Ridgeland Pointe ever came outside and said anything to us, nobody expressed any regret because they never walked out the front door, we never saw them. Thompson at the hospital, doctors discovered that merle had bleeding in her brain. Three days later, she died. Soon after, the sisters filed a lawsuit against emeritus. Some cynical people will say, diane and linda, theyre suing b