DSHS seeks crackdown on adult family homes

To better protect the elderly in adult-family homes, the state Department of Social and Health Services has recommended nearly a dozen new laws and launched reforms to rein in the growing industry.

DSHS officials outlined their plans in a report to Gov. Chris Gregoire, who had ordered the agency to look into the findings of a Seattle Times investigation, "Seniors for Sale," which found that thousands of elderly and frail adults had been exploited by profiteers or abused by inadequately trained caregivers in adult-family homes.

"We plan to address the growing issue of financial exploitation, which we are increasingly concerned about," DSHS Secretary Susan Dreyfus said Thursday.

Adult-family homes are a growing, lightly regulated housing option for seniors. Homeowners, after paying a $100 license fee and taking some classes, provide meals, a room and daily care for up to six residents, typically charging from $2,000 to $5,000 a month. Nursing-home care usually costs much more.

The Times found numerous cases in which elderly victims were imprisoned in their rooms, roped into their beds at night, strapped to chairs during the day so they wouldn't wander off, drugged into submission or denied medical treatment for weeks.

There are 2,858 adult homes statewide, with nearly half in King County.

DSHS wants to increase fines for violations; limit the number of homes a person can operate; and prevent owners from opening a second home if they already have a violation history.

The agency wants laws that require owners to prove financial solvency and that give the agency more power to deny licenses.

And DSHS wants to require that owners and their resident managers be literate in English.

The Times investigation revealed the 2007 death of a 58-year-old woman at a Whatcom County adult-family home that was linked to the owner's inability to call 911 and speak English well enough to explain the health crisis to a physician.

As part of its reporting for "Seniors for Sale," The Times cataloged 10 years of DSHS violation records and built a comprehensive database that tracked case histories.

In its report, DSHS acknowledged that its computers could not count or track abuse victims or even tally the overall population in state-licensed homes. It proposed installing a better computer system but did not provide specifics or a cost estimate.

DSHS also put in place several reforms that don't require changes in law:

• Adult-home providers must publicly post copies of violations and deficiencies found in the homes. They must make inspection reports available to anyone interested. Many families told The Times that providers often failed to disclose violations.

• DSHS will post all enforcement letters on its Web site later this year. In the past, when the public requested such information, the agency took weeks to reply.

• DSHS investigators will be required to interview all residents at a home during a complaint investigation. The Times found the agency sometimes conducted superficial investigations that missed evidence of abuse or neglect.

DSHS officials said the agency is proposing these new laws for the 2011 legislative session.

The governor's proposed budget, still stalled in the Legislature, contains a tenfold hike in license fees for adult homes.

If passed, owners will pay a $1,100 license fee to open a new home, and $900 to renew the annual license.

DSHS officials said the added revenues are necessary to avoid reducing enforcement levels.

"It's important that we tighten up state regulations and better protect residents," said Louise Ryan, the state's long-term-care ombudsman.

Many adult-family homeowners criticized the proposed fees as unnecessary and unfair. The Washington State Residential Care Council, which represents the homes, predicted that dozens of owners will go out of business.

On average, the state issues a new adult-home license every day. Costlier license fees are expected to slow that pace, which has been driven, in part, by speculators. Adult homes have been marketed by some as surefire investments that can yield six-figure incomes.

In the new report, DSHS officials glossed over its conduct in certain cases detailed in the Times' series.

For example, the report defended DSHS' decision to allow a Tacoma home operated by Arlie Leno to remain open after a woman there "developed serious skin breakdown."

The report did not note that the woman, Nadra McSherry, 74, died from a bedsore on her back that had burrowed to the bone and went untreated for nearly a month.

The report also did not mention that DSHS supervisors ignored their own investigators' pleas to shut down the Leno home, which had amassed more than 135 serious violations since 1990.

Michael J. Berens: mberens@seattletimes.com or 206-464-2288.