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FRONTLINE: Life And Death In Assisted Living

Airs Tuesday, September 24, 2013 at 10 p.m. on KPBS TV

Above: Cheryl Morgan (pictured), whose story is featured in "Life And Death In Assisted Living," holds a photo of her late father, who had dementia. He died after drinking unsecured toxic dish washing liquid at a Georgia assisted living facility.

With America’s population of seniors growing faster and living longer than ever before, more and more families are turning to assisted living facilities to help their loved ones age in comfort and safety. But are some in the loosely regulated, multibillion-dollar assisted living industry putting the lives of those loved ones at risk? FRONTLINE and ProPublica explore that question in "Life And Death In Assisted Living," a yearlong investigation premiered Tuesday, July 30, 2013 on PBS.

From the Texas assisted living resident who froze to death on Christmas morning to the Hall of Fame football player who drank unsecured toxic dishwashing liquid and died 11 days later, this major investigation raises questions about fatal lapses in care and a quest for profits at one of America’s best known assisted living companies.

“One of our interview subjects told us, ‘Assisted living is the rock America doesn’t want to look under,’” says FRONTLINE correspondent and ProPublica reporter A.C. Thompson. “It’s one of the most important and difficult decisions anyone can make: Who should we trust with the care of our aging parents?” Thompson says. “But again and again, the families we spoke with described struggling to find the facts they need to make informed choices about the care of their loved ones.”

“This investigation,” Thompson says, “adds a new dimension to conversations about the best place for Mom and Dad.”

As FRONTLINE and ProPublica report, the once-promising concept of assisted living took shape two decades ago, an earnest effort to create an alternative to nursing homes for America’s aging population.

Today, nearly 750,000 people live in assisted living facilities across the country. National for-profit chains, concerned both about caring for their residents and pleasing their shareholders, have come to dominate the industry.

Standards for care and training—and even definitions for the term “assisted living”—vary from state to state. Assisted living facilities, unlike nursing homes, are not regulated by the federal government. Meanwhile, those winding up in assisted living, year after year, are sicker and more frail, and many of them are afflicted with dementia.

Case in point: Emeritus Senior Living, the country’s largest assisted living operator and one of its largest dementia care providers. As "Life And Death In Assisted Living" reports, Emeritus has the ability to house some 37,000 elderly Americans in more than 400 facilities across the country.

Wall Street likes its cash flow. Its top executives have made millions. The company likes the country’s demographic trends—elderly Americans in poor health willing to spend tens of thousands of dollars for the chance at safety and care. Indeed, Emeritus holds itself out as the industry leader, one eager to expand further, even internationally.

But in some states, regulators have cited the company in the deaths of residents. Other officials have regularly found the company’s facilities to be understaffed and their employees to be inadequately trained. Some current and former executives say the push to fill facilities and maximize revenues has left staff overwhelmed and the care of residents endangered.

“There are, of course, skilled and dedicated individual caregivers working in the assisted living industry—professionals who are absolutely committed to providing our parents and grandparents with the best possible care,” Thompson says. “But Emeritus’ history— its explosive growth, its move to take in more and more residents with greater and greater health problems, its desire to reward investors—makes for a perfect study of what’s taking place in this rapidly expanding corner of the country’s health care business.”

On the same day that "Life And Death In Assisted Living" premiered on FRONTLINE, ProPublica published a text investigation about the assisted living business.

Past episodes of FRONTLINE are available for online viewing. FRONTLINE is on Facebook, and follow @frontlinepbs on Twitter. ProPublica is on Facebook, and you can follow @ProPublica on Twitter.

Video

Frontline: Life And Death In Assisted Living Preview

Above: More and more elderly Americans are choosing to spend their later years in assisted living facilities, which have sprung up as an alternative to nursing homes. But is this loosely regulated, multi-billion dollar industry putting seniors at risk? In a major investigation with ProPublica, FRONTLINE examines the operations of the nation’s largest assisted living company, raising questions about the drive for profits and fatal lapses in care.