Five areas of concern to advocates

1. State fines

Even the worst violations, including cases with death or harm, rarely result in significant fines, if fines are issued at all. The maximum fine issued for the most serious violations is typically $601.

“I think our fines are ridiculously low,” said Rep. Sharon Cooper, R-Marietta. “If it doesn’t hurt enough financially, people seem to just take this as a part of doing business. And so that you have to make the fines enough, that they hurt enough, that they’ll get people’s attention.”

2. State inspectors

The Department of Community Health (DCH) doesn’t have enough inspectors to effectively do its job. More than a year can pass between routine inspections, and the agency can be slow to respond to complaints and fail to thoroughly investigate them.

“DCH needs more people conducting surveys of facilities and investigating complaints so that the work can be done more promptly,” said Vicki Johnson, chair, Georgia Council on Aging. “It’s a critical job, not only so the state can ensure compliance but also so consumers can identify better facilities and avoid making bad choices.”

3. Caregiver staffing

Some of the most harmful problems at facilities stem from staffing shortages and poor training, the AJC found. Staffing ratios mandated by the state are too often inadequate, particularly if facilities have a significant number of frail residents or those with dementia.

“We’re working with the associations to figure out best national trends,” said DCH Commissioner Frank W. Berry,“making sure we’re in compliance with what those are.”

4. Transparency

The state’s regulatory website is cumbersome, and it can take months before inspection reports are posted. Even then, reports are often difficult to understand, and if the state doesn’t substantiate a complaint, there’s no information. A state proposal calls for reports to be posted on facility websites, but there’s still more to be done to help families make informed decisions.

“It is important for consumers to know the results of official inspections ... Results should be provided in a way that consumers and providers can understand, to show that the facility is in compliance when it is, and to detail the ways it is not in compliance when it is not. Consumers cannot make good choices for themselves and their loved ones when they don’t have a clear picture of the facility’s compliance,” said Melanie McNeil, Georgia’s long-term care ombudsman.

5. Reporting gaps

Allegations of abuse and neglect in assisted living facilities and large personal care homes routinely fail to get reported to police and prosecutors, the AJC investigation found. Also, facilities regularly fail to report serious allegations involving harm or injuries to state regulators. These reporting gaps concern law enforcement officials and advocates for the elderly. They worry that too many cases of elder abuse and neglect may not get scrutiny, including some suspicious deaths. The Prosecuting Attorneys’ Council of Georgia said it supports efforts to close gaps in reporting potential crimes at senior care facilities to law enforcement and prosecutors.

“We are happy to work with our partner agencies and associations to create a simple, standardized and efficient way of reporting and developing training to make sure everyone

knows the importance of safeguarding residents against abuse, neglect and exploitation,” said Pete Skandalakis, the council’s executive director.