CHARLESTON, SC (WCSC) - People who want to put their loved ones in an assisted living facility cannot find out if a facility has a good or bad rating.
The State Department of Health and Environmental Control does not rate assisted-living facilities.
Earlier this year, residents at two Lowcountry assisted living facilities died after they are able to walk out without being seen.
Last July 90-year-old Bonnie Walker walked out of the Brookdale Charleston assisted living facility in West Ashley. A few hours later Walker's body was found in a retention pond behind the facility. The Charleston County coroner ruled that Walker was killed by an alligator.
Shortly after the incident, Brookdale released the following statement:
"We extend our deepest sympathy and condolences to Ms. Walker's family, as this loss is felt throughout our community. We are saddened by the situation, and the community's leadership is supporting our residents and associates during this time.
We are working closely with local police and authorities on this active investigation, and requests for additional details should be directed to them."
Two months earlier, 80-year-old Marie Duddy walked away from Savannah Place, an assisted living facility on James Island. Duddy, who suffered from severe dementia, was found dead the following day in the marsh in a neighborhood near the facility. The coroner said Duddy drowned.
"We were distressed to learn about the discovery of our resident's body late last night. This is a very difficult time for all of us at the community. We want to express our deepest sympathies to the family. Our thoughts and prayers are with them. We continue to cooperate with authorities on this matter and are continuing our own investigation into this."
In both cases, DHEC found the facilities at fault.
DHEC said at Brookdale, they found several violations. Among them; the facility didn't follow procedure when making night checks on residents. DHEC also said Brookdale failed to have a staff member available on each floor, and also failed to keep all equipment in good repair and operating condition.
The agency is still trying to decide what action to take. Brookdale released a follow-up statement Thursday:
We continue to support our residents and associates. The safety and wellbeing of our residents and associates are our highest priorities. We continue to take all appropriate action to address any necessary corrective action and are working with the South Carolina Department of Health and Environment Control on a plan of correction.
According to the state health department, the paging system that notifies staff of an open door wasn't working at Savannah Place. The facility paid a $4,200 fine.
Charleston attorney Matt Yelverton has represented several families in wrongful death lawsuits against assisted-living facilities.
One of his clients is Cecil Ringer. Ringer sued after his father, David, died while living at a combined nursing home and assisted living facility in Newberry County. He says his father suffered a massive heart attack and that the nurse on duty refused to give him nitroglycerin to treat it.
Nitroglycerine is used to treat chest pain when not enough blood is flowing to the heart.
Ringer's dad died four days later.
"One of his last words was, do whatever you can do to get that nurse not to be able to practice anymore," Ringer said.
Cecil set out to get some answers from the management. He says they told him the nurse was from a temp agency.
"They said well you know, it was just something that happened. We didn't have enough nurses and we never used this one before," Ringer said.
Ringer settled his lawsuit with the nurse and the facility before it went to trial.
Yelverton believes a lack of training at these facilities is a huge issue.
"If the facility had properly trained an adequate staff, these deaths would not occur," Yelverton said.
According to DHEC, the law requires all staff members at assisted living facilities undergo a criminal background check, and receive yearly training in several areas, including basic first aid and CPR.
Minimum staffing ratios have one employee for every eight residents during the peak hours, 7 a.m to 7 p.m. One employee is required for every 30 residents during off-peak hours of 7 p.m. to 7 a.m.
The agency says it conducts inspections of assisted living facilities and that all are surprise inspections.
One of those was held at Savannah Place in July, two months after Marie Duddy died.
DHEC's investigation found that the staff were aware of Duddy's repeated attempts to talk out of the facility and were instructed to know where she was at all times.
The investigation also revealed several reports of Duddy wandering into other residents' rooms.
In the last two years, DHEC has taken enforcement action against three of the 66 facilities in the Tri-County area. They are Agape Assisted Living in North Charleston, Antonio-Staples Residential in Summerville and most recently Savannah Place.
DHEC says Agape and Antonio-Staples have a history of repeated violations.
DHEC spokesperson Mary-Kathryn Craft said Agape was cited for failing numerous times to document staff training related to in-service training, basic first aid, contagious and communicable diseases, medication management, OSHA standards regarding blood-borne pathogens, resident records confidentiality, fire response, and emergency procedures and disaster preparedness. In addition, Craft said, Agape was cited for failing to document residents' notes of observations, failing to update residents' individual care plans, failing to timely complete resident physical examinations, and failing to keep the facility free of offensive odors. Lastly, Agape was cited for retaining a resident with pressure ulcers and retaining a resident who exhibited uncontrollable aggressive and inappropriate behavioral symptoms, she said.
Craft said Antonio-Staples was cited for failing numerous times to document staff training related to basic first aid, contagious and communicable diseases, medication management, specific person care, OSHA standards regarding blood-borne pathogens, resident records confidentiality, and fire response. She said Antonio-Staples was also cited for employing a staff member with a child neglect conviction, failing to properly document residents' individual care plans, failing to maintain equipment and building components in good repair, and failing to keep the facility free of vermin and clean in all areas.
We reached out to all three facilities for a comment, but only the director of Antonio-Staples responded, who said the violations were not having staff paperwork up to date and said all had been corrected.
While ratings for every nursing home are on the Medicare website because nursing homes are federally regulated, there are no ratings on DHEC's website for assisted-living facilities.
If you want to find out if an assisted living facility has had any violations or fines, it's a complicated process. You have to go on DHEC's website and file a Freedom of Information Act request and ask for specific information.
The deaths of the women at Brookdale and Savannah Place sparked a meeting in August of lawmakers and health care officials.
State Representative Wendell Gilliard pledged to strengthen the laws to protect residents in assisted-living facilities. He says one possibility is GPS monitor for residents who try to leave a facility.
"God knows we treat animals with dignity and respect. We ought to do that much more for our seniors," Gilliard said.
Yelverton agrees with Gilliard. He suggests families considering putting a loved one into an assisted living facility to do their homework.
"Ask the hard questions. Ask whether or not there's been issues with staffing. Ask whether there's been questions or issues with walkouts, assaults, with ulcers, with the things that you see happen when there's neglect or abuse," Yelverton said.
The health department denied Brookdale's request to have the violations removed that were found after Bonnie Walker's death.
After Walker's death, Brookdale installed a fence around the pond.