Deadly Massachusetts fire highlights the minimal regulations that govern assisted-living facilities
'The real issue is that assisted livings operate in an environment like the Wild West,' said Richard Mollot, executive director of the Long Term Care Community Coalition, a nonprofit that advocates for improved care in nursing and assisted-living facilities. 'They can pretty much do what they want with impunity, and that results in a lot of, I would say, mini-catastrophes every day, frankly.' The fire that tore through the three-story structure late Sunday raised a host of questions about conditions at the dilapidated facility and put the spotlight on the growing number of assisted-living centers in the state and nationwide. Created in the 1980s, assisted living has been marketed as an option for older adults who need some assistance but not as much help as a nursing home. Advocates argue that regulations for the facilities have not kept up as more locations have opened. Nursing homes, for example, are governed by federal regulations because they receive Medicare and Medicaid, while there are no federal regulations for assisted-living facilities. Nursing homes must have a minimum number of staffers and trained medical professionals such as doctors and nurses, but assisted-living facilities have no such requirements.
'The regulations are minimal,' said Liane Zeitz, an attorney who is also a member of the state Assisted Living Residences Commission, a body created to make recommendations about the sector. She has advocated for more regulations for assisted-living facilities. 'The facilities were lightly regulated because initially they were regarded as residential with lower levels of care and less oversight,' she said. 'But now those facilities are caring for a population that is much frailer, and the population is growing.' Not only are the regulations weaker for assisted-living facilities, but advocates argue that the enforcement of the existing rules is often lax. Paul Lanzikos, a former Massachusetts secretary of elder affairs and co-founder of the advocacy group Dignity Alliance, described a patchwork of regulations across the country with different agencies involved depending on the state. 'Some of the states are much more regulated. Some are regulated as a health care entity. Others, as we do here in Massachusetts, are considered a residential housing model,' he said.
US Sen. Elizabeth Warren, a Massachusetts Democrat, has been advocating for increased oversight for years, particularly after the release of reports about health and safety problems in 2018. 'These are serious problems that have been going on for years,' she said at a hearing last year. 'But we hear so much less about what's going in assisted-living facilities than we do in other facilities like nursing homes.' At that hearing, Mollot noted that scandals in the nursing home industry pushed Congress to act in the 1970s and 1980s and that such a reckoning could be coming soon for assisted living. He described two major risks: increasingly sick and vulnerable assisted living residents and financial exploitation by owner investors. Speaking Wednesday after learning about the Gabriel House fire, Mollot said the problems that plagued that facility are not unique to Massachusetts. 'Unlike nursing homes, assisted living has no federal state requirements, no requirement for staffing, no requirements for staff training, no requirements for safety protocols, no requirements for inspections,' he said. 'That falls to the states, and the states have overall very weak rules.'
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Al Arabiya
5 days ago
- Al Arabiya
Deadly Massachusetts fire highlights the minimal regulations that govern assisted-living facilities
The Massachusetts assisted-living facility where a fatal fire killed nine people was caring for dozens of aging residents reliant on wheelchairs and oxygen tanks, but it lacked the safety measures and most of the staffing requirements that are commonplace in nursing homes. As an assisted-living center, Gabriel House in Fall River, about 50 miles (80 kilometers) south of Boston, offered a type of housing for older residents that has expanded nationally in recent decades. But advocates argue that the absence of any federal regulations and spotty state rules mean the sector is largely left to police itself. 'The real issue is that assisted livings operate in an environment like the Wild West,' said Richard Mollot, executive director of the Long Term Care Community Coalition, a nonprofit that advocates for improved care in nursing and assisted-living facilities. 'They can pretty much do what they want with impunity, and that results in a lot of, I would say, mini-catastrophes every day, frankly.' The fire that tore through the three-story structure late Sunday raised a host of questions about conditions at the dilapidated facility and put the spotlight on the growing number of assisted-living centers in the state and nationwide. Created in the 1980s, assisted living has been marketed as an option for older adults who need some assistance but not as much help as a nursing home. Advocates argue that regulations for the facilities have not kept up as more locations have opened. Nursing homes, for example, are governed by federal regulations because they receive Medicare and Medicaid, while there are no federal regulations for assisted-living facilities. Nursing homes must have a minimum number of staffers and trained medical professionals such as doctors and nurses, but assisted-living facilities have no such requirements. 'The regulations are minimal,' said Liane Zeitz, an attorney who is also a member of the state Assisted Living Residences Commission, a body created to make recommendations about the sector. She has advocated for more regulations for assisted-living facilities. 'The facilities were lightly regulated because initially they were regarded as residential with lower levels of care and less oversight,' she said. 'But now those facilities are caring for a population that is much frailer, and the population is growing.' Not only are the regulations weaker for assisted-living facilities, but advocates argue that the enforcement of the existing rules is often lax. Paul Lanzikos, a former Massachusetts secretary of elder affairs and co-founder of the advocacy group Dignity Alliance, described a patchwork of regulations across the country with different agencies involved depending on the state. 'Some of the states are much more regulated. Some are regulated as a health care entity. Others, as we do here in Massachusetts, are considered a residential housing model,' he said. US Sen. Elizabeth Warren, a Massachusetts Democrat, has been advocating for increased oversight for years, particularly after the release of reports about health and safety problems in 2018. 'These are serious problems that have been going on for years,' she said at a hearing last year. 'But we hear so much less about what's going in assisted-living facilities than we do in other facilities like nursing homes.' At that hearing, Mollot noted that scandals in the nursing home industry pushed Congress to act in the 1970s and 1980s and that such a reckoning could be coming soon for assisted living. He described two major risks: increasingly sick and vulnerable assisted living residents and financial exploitation by owner investors. Speaking Wednesday after learning about the Gabriel House fire, Mollot said the problems that plagued that facility are not unique to Massachusetts. 'Unlike nursing homes, assisted living has no federal state requirements, no requirement for staffing, no requirements for staff training, no requirements for safety protocols, no requirements for inspections,' he said. 'That falls to the states, and the states have overall very weak rules.'
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Al Arabiya
6 days ago
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Assisted-living home cited for late reports of safety incidents years before fatal fire
A Massachusetts assisted-living center, Gabriel House, where nine residents died in a fire, was cited for failing to immediately report more than two dozen health and safety incidents, according to regulators' most recent review of the facility. Five men and four women were killed, and at least 30 others were injured Sunday night at Gabriel House in Fall River, about 50 miles (80 kilometers) south of Boston. Some of the 70 residents were rescued by ladder after screaming for help from the windows of the three-story building. The cause of the blaze is under investigation. The 100-unit facility, which opened in 1999 in a former motel built decades earlier, was last inspected by the state on Oct. 31, 2023, according to a report from the state Executive Office of Elder Affairs. The report cited the facility for seven deficiencies, four of which were repeat problems. After the facility responded with a corrective action plan, it was re-certified through November 2025. Most of the issues involved missing documentation. For example, seven resident files that were reviewed were missing documents to indicate that their service plans were reassessed within 30 days of moving in, as required. The plans outline the services each resident receives, including whether they need help with medication and meals. The review also found problems with the reporting of safety incidents. Facilities are supposed to submit reports of incidents that could have a significant negative effect on residents' health, safety, or welfare within 24 hours, but the review found 26 reports that were sent later than that between May 5, 2022, and Oct. 31, 2023. The report did not specify the total number of incidents or provide any details about what they involved. The state also watched two staffers provide medication assistance to seven residents and found several problems, including failure to document when eye drops were opened, loose tablets in medication storage areas, and partially opened medication. Some residents said only two or three staffers were working at the time of the fire, and they offered little help. 'They left us alone and ran out into the parking lot,' said Lorraine Ferrara. 'I was hanging out the window – 'Help! Help!' – and they just kept running.' Paul Lanzikos, a former Massachusetts secretary of elder affairs and co-founder of the advocacy group Dignity Alliance, said the group was concerned about reports on the lack of fire drills, the small number of staff members for a highly dependent population, and safety issues such as a broken elevator and air conditioners in the windows. 'It's a terrible tragedy that should have never happened,' Lanzikos said. Richard Moore, another co-founder of Dignity Alliance, has asked the attorney general to investigate based on similar concerns, as well as the facility owners' history. Dennis Etzkorn, owner of Gabriel Care LLC, was indicted on medical assistance fraud and kickback charges in 2012, though the charges were dismissed three years later. 'The fact that it happened in the past and that this now happened suggests that there should be a more thorough investigation of that,' said Moore, former head of the Massachusetts Assisted Living Association and a former state senator. He said the assisted-living industry overall needs more rigorous regulation and oversight. And while it's too early to say what went wrong at Gabriel House, he said the staffing levels and training appear to have been inadequate. Current regulations do not require a specific number of staff members, but the rules say facilities shall have a plan to secure staffing necessary to respond to emergencies. 'There should have been more staff. They should have been trained in the case of fire or other emergency,' Moore said. 'Quarterly, they should have been doing fire drills. It seemed like residents didn't know what to do.' Etzkorn declined to comment to The Associated Press. He told the Boston Globe in a statement Monday that he and his family were devastated by the tragedy and that he will continue to cooperate with authorities. By Tuesday morning, the facility's broken windows had been boarded up, and bouquets of flowers and a rosary were set on the ground against a post wrapped with yellow police tape. Ann O'Neil-Souza, chief of staff for the mayor, said city officials expect to find homes for the survivors from Gabriel House by the end of Tuesday. She said most were being placed with other facilities in the city and with family, and hospitals have been asked to work with social workers to ensure patients find housing when they are discharged. The dead ranged in age from 61 to 86, authorities said. The Bristol County District Attorneys Office identified seven of the deceased as Rui Albernaz, 64; Ronald Codega, 61; Margaret Duddy, 69; Robert King, 78; Kim Mackin, 71; Richard Rochon, 78; and Eleanor Willett, 86. The office said the names of a 70-year-old woman and a 77-year-old man had not been released pending notification of family.
