As the founder of the nation’s only assisted living consumer advocacy and education organization (the Consumer Consortium on Assisted Living), the recent series of articles that shine a headlight on the pervasive care problems in many assisted living facilities is helpful and informative for prospective assisted living consumers. The series of articles in USA Today, The Washington Post and Newsday heartbreakingly detail the fact that too many assisted living facilities are simply not prepared to care for the special needs of their frail and vulnerable residents despite marketing claims to the contrary.

Many of the tragic incidents cited in the articles happened to residents with dementia. The problems in caring for this vulnerable population are typically rooted in staffing. All too often there are insufficient numbers of staff to meet promised resident care needs and staff frequently are not adequately trained or prepared to handle the challenging needs of individuals with dementia. This same issue plagues quality of care in nursing homes. A manicurist, for example, in New York must complete 250 hours of classroom training and preparation and pass a written and practical exam before they can begin working. A caregiver working in assisted living in New York only needs 40 hours despite the fact that they are responsible for much more intimate and complex care. Is it any wonder that there are care problems?

The remedy would appear to be simple – better train and prepare all staff. However, assisted living providers claim there is sufficient staff and they are adequately trained despite overwhelming evidence otherwise. Newspaper articles about tragic resident care outcomes have proliferated over the past 10 years. The U.S. General Accounting Office has issued several studies that found problems with care in assisted living. Recently, researchers at the University of North Carolina, Chapel Hill’s Program on Aging, Disability and Long-Term Care found that residents with Alzheimer’s are not getting adequate care in assisted living facilities. Indeed, a national study on assisted living funded by the U.S. Department of Health and Human Services found “the majority of staff members were almost completely unaware of what constitutes normal aging.”

There is a culture of denial among facility owners that pervasive care problems exist. Typically these individuals are not hands-on managers, and are more likely familiar with a hospitality business model. However, providing a safe, caring environment for vulnerable assisted residents requires more than clean sheets and good food. Many owners and managers see adding extra care staff and their training as a drain on corporate profits. This perpetuates a cycle of substandard care.

If it was easy to care for assisted living residents, they would most likely continue to live at home. It is not easy and is the most significant reason people move their loved ones into facilities. To admit residents and not have enough well trained staff simply invites disaster and essentially amounts to corporate malfeasance.

According to a study conducted by a fellow of the American Academy of Nursing, good quality care actually costs less than poor quality care in nursing homes to the tune of over $13 per resident per day. Although the study was conducted in nursing homes, the general concept applies to assisted living. This amounts to a cost savings of over $350,000 annually for each Sunrise-sized facility. Add in the fact that facilities providing consistent, quality care do not have to defend against litigation by families suing over tragic outcomes.

The Consumer Consortium on Assisted Living proposes a solution to all assisted living owners that would benefit everyone: invert their current business model by hiring enough staff and training and preparing them thoroughly, and wind up with greater profits by delivering quality, consistent resident care. The money saved by not defending against law suits triggered by poor care could instead be used for subsidies to low-to-moderate income individuals. Not only do assisted living owners, consumers, and communities win, but America wins by being assured that its assisted living facilities consistently provide quality resident care. Indeed, assisted living owners could share this success with their nursing home brethren and revolutionize how America cares for its elder citizens needing residential long term care – and just in time. Older adults will soon outnumber children for the first time in our nation’s history. Individuals 85 and older are currently the fastest growing sector of our population, and the tidal wave of aging baby boomers will soon follow.

This excellent series of articles is a call to action to institute effective change. If people don’t speak out to fix the present problems, we are doomed to live with the consequences in the future. Will we endure all too often substandard care in ‘chandeliered’ facilities or will we have the courage to speak out and demand change? The choice is ours.

Karen Love, a former assisted living administrator and family member of an assisted living resident, is the founder and chair of the Consumer Consortium on Assisted Living (CCAL). CCAL was founded in 1995.