ATLANTA (AP) - An investigation into hundreds of senior assisted living and large personal care homes in Georgia turned up more than 600 allegations involving neglect and 90 of abuse by caregivers over the past four years.

In that time, at least 20 residents died and more than 100 suffered injuries after homes failed to provide care as required, the Atlanta Journal-Constitution found in examining reports issued by the Georgia Department of Community Health (DCH), which licenses and inspects long-term care facilities and investigates complaints.

The actual death toll may be much higher. In interviews with the newspaper, and in lawsuits, families have tied other deaths and injuries for which there were no state citations to improper care.

The newspaper examined thousands of regulatory citations and hundreds of police reports from 2015 through 2018, reviewed lawsuits and interviewed dozens of people. The investigation found breakdowns in care that often were rooted in inadequate staffing, poor training or efforts to cut costs.

In some cases, seniors tried to summon staff for help and got no response for hours, wandered away from facilities unnoticed, or languished in unsanitary and hazardous conditions. Others fell repeatedly, suffering bruises, bloody faces and broken bones. Some suffered in pain for days without treatment.

In some cases, caregivers physically, verbally and sexually abused residents.

Georgians seeking care for aging family members pay thousands of dollars a month to facilities that have popped up across the state in recent years promising luxurious amenities and top-flight attentiveness. Many offer to provide safe, consistent care.

But the reality, is that too often thin staffs are overwhelmed, seniors have been treated callously or ineptly, and safeguards have been ignored, the investigation discovered.

In a 2016 case, it took an aide at a Savannah facility 26 minutes to respond to an emergency call from a resident who had diabetes and high blood pressure. The resident was unconscious by that time. Another 19 minutes elapsed before anyone called 911. When the ambulance made it to the hospital, the resident was pronounced dead.

In October 2018, a 92-year-old woman was repeatedly bitten by ants at a facility in Sandy Springs. The upscale facility failed to eradicate the insects that had been reported in her room a week earlier. Then, over two consecutive days, ants attacked the woman in bed. She died days later.

Though abuse is less common than neglect, police and DCH records showed that more than 100 residents reportedly were abused by workers of assisted living and large personal care homes over the four years the newspaper’s investigation covered.

Records showed that at home near Athens, a worker in 2017 hit an 86-year-old woman with dementia who tried to leave the facility, bloodying her nose and bruising a cheek. The same worker was accused of pulling an 84-year-old resident’s hair and striking her.

A facility in Decatur received a state citation in March 2018 after an aide was accused of abusing a resident late at night. Nine months earlier, a separate allegation of abuse involving two other employees surfaced on the night shift.

Will Johnson, the elder abuse prosecutor with the Georgia Prosecuting Attorneys’ Council, told the newspaper that elder abuse and neglect is “not acceptable in our society, in our state, anywhere.”

“No one who has lived their life and reached 70, 80, 90 years of age, raised a family, contributed to society - they should never be left to rot in a bed or be bashed in the face or have all of the money that goes to their care squandered,” Johnson said.

State Rep. Sharon Cooper, R-Marietta, said, “I’m saddened for the people that were injured, and I’m appalled for humanity in general that our elders would be treated this way.”

“Certainly, as a state, we need to intervene,” said Cooper, who chairs the House Health and Human Services Committee.

Top officials at DCH refused repeated requests over several months to meet with the Atlanta Journal-Constitution. After the newspaper provided its findings to DCH, a spokesman again declined an interview, saying it wasn’t in their “best interest.” The agency would only answer questions submitted in writing.

While officials didn’t directly address some questions, DCH Commissioner Frank W. Berry said the agency manages a heavy workload and is always seeking ways to improve and carry out its mission.

“The health and well-being of Georgians is always our top priority,” Berry wrote.

A 2011 state law paved the way for assisted living communities, expanding choices for families whose only options previously were personal care homes, which serve seniors who need help with meals and medication reminders, or nursing homes for those requiring intense assistance. Assisted living facilities allow a higher level of care from staff who can administer medication and assist residents who need help moving around.

The 2011 legislation and the rapid graying of the population have led to facilities’ taking in more residents who in their 80s and 90s who have chronic care needs. While facilities market an active lifestyle, some have residents who can’t push their own wheelchairs or who need assistance to get out of bed, dress or eat. Some residents are unable to speak.

The state cited facilities 238 times for admitting residents with conditions and illnesses that staff could not handle.

At the same time, the for-profit companies that dominate the industry have incentives to keep their costs low, which translates to minimal staffing, said Catherine Hawes, Regents Professor Emeritus at the Texas A&M; Health Science Center and a nationally recognized expert on long-term care.

“It’s like - let me sit down and write a prescription for disaster,” she said. “You’re writing a prescription for abuse and neglect.”

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Information from: The Atlanta Journal-Constitution, http://www.ajc.com

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