At the ragged edge of the social safety net lie facilities for the long-term care of the elderly and disabled. Many of them depend on government reimbursements to cover their expenses and yield a profit for the owners.
The reimbursements, owners say, are never large enough. Costs must be carefully controlled. Sometimes residents pay the price, figuratively speaking, when the quality of care comes up short.
Assigning responsibility for mishaps involving residents' injury or even death is no simple matter. The state has a regulatory system, but to impose a fine so punitive that management can't just shrug it off as a cost of doing business may risk shutting the place down and forcing residents to be relocated. Interlocking chains of ownership may make it difficult to get at the people in charge.
Then there is the fact, as reported by The N&O's Thomas Goldsmith, that long-term care centers aren't required to carry liability insurance. The ramifications of that loophole became clear in a case described by Goldsmith on Monday.
A Superior Court judge ruled in 2006 that the owners of a Cumberland County assisted living facility should pay $1.2 million in damages because of "egregiously wrongful acts" that harmed the late Joe N. Cooper, a former Marine gunnery sergeant who had served three tours in Vietnam. But the facility's owners declared bankruptcy. With no liability insurance in force, Cooper's daughter may end up having to forgo the awarded damages.
Cooper suffered from dementia and other ailments, and the owners say he was a difficult resident. "We did our very best to give him care," said John Weeks. Judge James F. Ammons, however, also found that Cooper's condition reflected "a greater pattern of neglect" by Countryside Villa's staff, stretched thin and undertrained.
The facility's Weeks told Goldsmith that the bankruptcy filing came as he and wife faced a court hearing on whether they could be held individually liable in the Cooper case. The state's low reimbursements make hiring adequate staff nearly impossible, he said.
Assisted living facilities must not be expected to work miracles without adequate financial support. But they also must not be allowed to shield themselves from accountability for their mistakes. A growing population of North Carolina's most vulnerable residents counts on state legislators and officials to make sure both of those standards are met.
