Senior-care homes refuse to pick up fallen residents, dial 911

— The 911 call came just before 8 a.m., and Ladder 5’s four-man crew scrambled to the truck just as their overnight shift was about to end. It was the kind of call that veteran firefighter Chad Callison said he dreaded.

It was not a heart attack, or a car crash or a building fire.

It was a “lift assist” at Heritage Woods, a local assisted-living facility.

Lift-assist 911 calls from assisted living and other senior homes have spiked by 30 percent nationwide in recent years to nearly 42,000 calls a year, an analysis of fire department emergency call data by The Washington Post has found. That’s nearly three times faster than the increase in overall 911 call volume during the same 2019-2022 period, the data shows.

The growth has infuriated first responders who say these kinds of calls — which involve someone who has fallen and is not injured but can’t get up — unfairly burden taxpayers and occupy firefighters with nonemergencies that should be handled by staff at facilities that charge residents as much as $7,000 a month.

Illinois is a hot spot for the controversy: Lift assists here accounted for 1 in 20 of all 911 fire calls, the highest proportion of any state, the data shows. In Rockford, a city of 150,000 residents about an hour outside Chicago, five assisted-living facilities — including Heritage Woods — called for noninjury lift assists 233 times last year, triple the number of calls in 2021.

When firefighters arrived at Heritage Woods that morning, caretakers at the facility directed them to an elderly resident lying on the floor. She was perfectly fine, she said, she just couldn’t get back on her feet by herself. The facility’s staff wouldn’t lift her. So two firefighters helped her up and made sure she was okay, Callison recalled and fire records show. Ten minutes after arriving on the scene, Ladder 5 was back in service.

“It doesn’t make sense,” Callison said. “Why are they calling us?”

The answer, according to industry critics and fire officials, is that companies want to avoid the risk and expense associated with picking someone up off the floor. Like many cities, Rockford provides lift assists free.

Some senior-care homes say they don’t have the ability to lift fallen residents. Many have adopted “no lift” policies to avoid the risk of back injuries for staff and other potential liabilities. But firefighters and other experts say there are tools to make lifting easier and safer, ranging from $70 cloth straps with handles to $1,500 hydraulic lifts.

Heritage Woods, which accounted for the highest number of lift-assist calls to 911 in Rockford last year, is owned by GardantManagement Solutions, the 10th largest assisted-living provider in the nation.

Co-president Julie Simpkins declined to answer specific questions, but said in a statement that the company works “to create a collaborative approach to the over utilization of nonemergent lift assist calls” through “cross training, resource availability discussions and collaboration.”

A nurse who worked at an assisted-living facility in Greensboro, N.C., who requested anonymity because she was not authorized to speak with the media, said her company required caretakers to call 911 even if a resident had just slid harmlessly out of a chair.

“If you’re on the floor, period, you’d have to call,” said the nurse, who left her position last year. She said residents were often embarrassed by the lift-assist calls. Some begged her not to dial 911. She said she had no choice.

Fire officials point out they bring no special skill to such situations — it’s just a matter of who’s doing the work.

The dispute over lift assists comes as improvements in fire safety and the nation’s aging population have changed the nature of a firefighter’s job. Today, fire and EMS agencies are more likely to deal with an older adult fall victim than a fire victim.

Lift assists are now the seventh most common type of 911 call, with an average of 1,800 lift-assist calls every day nationwide, according to an analysis of the National Fire Incident Reporting System, which collects emergency calls from more than 23,000 fire departments. The data does not include calls to about 13,700 EMS agencies, although there is significant overlap in calls between the two databases.

The calls come often from elderly people living both at home and at facilities. While both situations strain resources, fire officials said senior-care homes should be equipped to handle these calls.

“You go in there, and they have staff all over the place,” said Kevin Joles, an EMS division chief in Lawrence, Kan. “It’s part of our job that’s being taken advantage of, and we’ve mostly stayed quiet about it.”

A growing number of cities and towns — from Rocklin, Calif., to Naples, Fla., to Lincoln, Neb. — have started pushing back with special fees of $100 to $800 for senior lift-assist calls. Most of the fees are targeted at what fire officials call “the frequent fliers” — assisted-living and senior-care facilities.

In Anchorage, the fire department introduced a lift-assist fee to “prevent assisted-living facilities from understaffing, or having inadequate resources, for people under their care,” Josef Rutz, fire department administrator, said in an email. The first lift is free, but a facility’s second lift assist within 12 months costs $250.

Kansas City, Mo., added a lift-assist fee to discourage “repeat offenders,” said Battalion Chief Michael Hopkins. The amount is flexible and set to be “reasonably calculated to defray the costs,” according to city code. The department also contacts facilities to tell them they “need to hire some orderlies,” he said.

In Mequon, Wis., the fee is billed directly to the facility to emphasize that it’s the company’s responsibility, said Deputy Fire Chief Kurt Zellmann.

“We tell them they can’t pass that onto the patient,” he said. But they can’t prohibit it.

Industry groups have largely opposed being singled out.

“Why should assistance to a resident in a care facility — which is their home! — be held to a different standard?” Matt Hartman, president of the Illinois Health Care Association and Illinois Center for Assisted Living, said in a statement to The Post.

In a letter opposing one town’s proposed lift-assist fee, the American Seniors Housing Association, which represents all levels of senior-care communities, called it “a fee-forservice charge for emergency service calls to residential care facilities for seniors.” The association dismissed the unidentified town’s proposal as “illogical” and “illegal.”