Gregoire calls for review of adult family homes

Gov. Chris Gregoire has ordered the Department of Social and Health Services to review its oversight of the adult-family-home industry, including each case of mistreatment detailed this week in a Seattle Times investigation.

The three-part series, Seniors for Sale, revealed that thousands of vulnerable adults have been exploited by profiteers and amateur caregivers inside adult homes — sometimes with deadly results.

The homes are a growing, little-regulated housing option for the state's aged and frail. DSHS licenses owners to rent out bedrooms and provide meals and care for up to six residents.

DSHS on Tuesday announced several reforms to address problems outlined in the series. Included in the changes:

• Homeowners, for the first time, must post any DSHS investigative reports about their homes so residents, family members and visitors are able to read them.

• DSHS will publish its investigations of adult homes on its Web site, allowing the public for the first time to compare homes. The agency said the posting will be available this year.

• During DSHS investigations or surveys of homes, each resident will be interviewed and evaluated. In the past, investigators selected just a few residents to review.

"We're looking at any and all ways we can improve the system," said Susan Dreyfus, secretary of DSHS.

About 11,200 people reside in 2,843 adult family homes across the state; three out of five residents are private pay. There are some 1,100 homes in King County alone, more than three times the number of Starbucks stores.

The Times uncovered accounts of elderly victims who 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 left without proper medical treatment for weeks.

At a Tacoma adult home with a decadelong history of serious violations, a woman died of a heart attack brought on by a pressure sore that went untreated for a month.

The state encouraged the growth of adult family homes by imposing few regulations. There are no requirements for a minimum level of employees.

The Times examined 15 years of inspection reports and found that, time and again, DSHS excused reports of abuse and neglect, even when it knew that violators lied to investigators, falsified medical records or contributed to preventable deaths.

Louise Ryan, the state long-term-care ombudsman, said the changes are "just a start."

"A license by the state should mean something," Ryan said Tuesday. "The standards to open an adult family home should be tightened and it should not be a system where providers get to fail — and harm residents — as the primary screening tool as to if someone should be in the AFH business."

The Times also found that some owners of adult family homes have marketed residents as separate assets to be sold in addition to the house.

Gregoire told DSHS to examine how adult family homes are sold.

Dreyfus said she will contact the Washington Association of Realtors and request that real-estate listings make it clear that buyers of adult family homes do not automatically qualify for a license to run the home.

DSHS requires new owners of adult homes to undergo training classes, including a 48-hour course; pass criminal background checks; and provide proof of financial stability.

Dreyfus also said she will request that language in real-estate listings does not suggest that investors can profit from the purchase of elderly residents.

"I want to be absolutely clear that seniors are not for sale in the state of Washington."

Dreyfus, in an interview Tuesday, said the agency has made many improvements in the past year, including a new computer system to track enforcement actions. However, the governor wrote in her Monday letter to Dreyfus: "While you have made many improvements there is more work to be done."

Members of the Washington Residential Care Council, which represents the adult-family-home industry, said they support the governor's request and the DSHS changes.

The Olympia-based council has estimated that fewer than one in 10 adult-family-home owners have faced serious sanctions such as license revocation or a ban on accepting new residents.

"One of the things I really hope comes out of this series is a heightened sense of awareness of family members, and all citizens, as we all look out for the most vulnerable," Dreyfus said.

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