California needs to take ‘walkaway deaths’ and senior care oversight more seriously

Earlier this year, the U.S. Senate Special Committee on Aging announced it will be investigating “walkaway deaths” at assisted living facilities across the country. Walkaway deaths occur when a resident wanders away from a facility or is left unattended, resulting in death. Deaths can be caused by exposure to inclement weather, pedestrian accidents, lack of access to vital medicine and other situations where elderly people are especially vulnerable.

Committee chairman Sen. Bob Casey, a Pennsylvania Democrat, sent letters to three of the largest corporate owners of American assisted living facilities, requesting their response to reports of “workforce shortages and expensive and inadequate care.” Each of these CEOs oversees numerous facilities in California.

The oft-overlooked issue of walkaway deaths, tied to dangerous staffing shortages, should be of great importance for Californians. There are more than 6.1 million residents over the age of 65, and the so-called gray wave is just beginning.

The number of Californians who will enter assisted living facilities is expected to increase dramatically over the next few years. According to Justice in Aging, 10.8 million Californians will be over the age of 60 by 2030, accounting for 25% of the state’s total population. While the needs of this population will differ, it would be detrimental to ignore how this will affect assisted living facilities, family members and thousands of health care workers across the Golden State.

There is a fundamental misconception about assisted living facilities. They are not only members of the housing industry but also critical members of the health care industry – and should be treated as such. In fact, the level of care provided at some assisted living facilities can be indistinguishable from skilled nursing facilities. However, the staffing and training requirements for assisted living facilities are significantly lower than those for skilled nursing facilities.

Combine this with an ever-increasing workload placed upon facility staff, and it is a recipe for disaster. Walkaway events and placing patients in jeopardy will not be an anomaly, but an increasingly common occurrence.

Adding to the pressures of health care services is an all-encompassing priority for investors and shareholders: profitability. Elder care is a booming business and private equity firms are looking to make a huge profit. Since 2015, major private equity funds focused on real estate acquisition have increased their investments in assisted living communities.

This includes funds managed by major private equity firms such as KKR, Bain Capital, Harrison Street and Kayne Anderson. In 2022, the U.S. Census Bureau reported that skilled nursing facilities made a whopping $130 billion in revenue in 2020, and assisted living facilities made over $33 billion in revenue that same year – a 34% increase from 2013.

When private equity firms get involved in health care, patients pay the highest price – in more ways than one. In December, a study led by researchers at Harvard revealed that patients’ risks of falling, contracting new infections or encountering other types of harm tend to increase when they are hospitalized in facilities that have been acquired by a private equity firm.

Medicare patients experienced a 25% increase in hospital-acquired complications at facilities acquired by a private equity firm. If 88% of Medicare recipients are 65 years or older, what will happen when private equity strengthens its investment in assisted living facilities?

Californians have long prioritized access to quality health care. We need to encourage federal, state and local governments to take a vested interest in the required quality of care at assisted living facilities, and advocate for the rights of those who are no longer able to advocate for themselves.