Neglect in WA long-term care facilities must end. How to stop it | Opinion

Complaints about conditions in long-term care facilities are common, not rare. Too often, the need for care means our individual rights as citizens to exercise our freedom to choose, to be autonomous and independent are threatened. An imbalance of power between the bureaucracy of the long-term care system and vulnerable adults known as “residents” is inherent.

But, long-term care residents have the same civil and legal rights as all American citizens, plus a basic set of legally-protected resident rights that cover all aspects of their stay, from admission to discharge. These rights, legally-protected under federal nursing home laws and extended by Washington State to all types of licensed long term care homes, are meant to equalize that balance of power.

However, frequent under-staffing and the drive to maximize profits on the part of some long-term care companies can result in a failure to respect residents’ rights and provide the quality of care residents deserve.

Whether you are paying tens of thousands of dollars out-of-pocket in the most expensive assisted living community or qualify for residential long-term care paid for by Medicaid, your rights are the same. So, when a facility disregards those rights, breaking the law, who holds them accountable?

Washington Attorney General Nick Brown recently announced the resolution of an investigation into complaints by residents of ten long-term care homes operated by Bonaventure Senior Living. Residents had filed complaints about a number of serious issues, from medication mismanagement to inadequate food service, infection control, housekeeping and facility maintenance. The investigation resulted in the company’s agreement to pay $7 million to improve its services and provide a $250 credit to each of about 800 residents who were impacted.

Residents and their families are often uncomfortable about filing a report with the state for the real fear of retaliation. In Washington state, the Department of Social and Health Services is responsible for inspections and oversight for licensed long-term care homes. Enforcement is complicated and often does not seem enough to deter future non-compliance or violations. When the state confirms a violation of a licensing law, the state has options for what kind of action to take as part of a “progressive enforcement” system.

Enforcement can be a penalty (financial fine) or an action that impacts the business such as requiring re-training of the staff, or placing a pause on all new admissions or something more serious such as suspension of a license. Or it can be a combination of many actions. Licensed providers can appeal all enforcement actions. Fines can be per instance, capped at $3,000, and can be applied daily, which is a rare event.

When I hear from a long-term care provider, “We’ll take the fine,” rather than making changes to be in compliance, that sends a message: the enforcement didn’t inspire long term compliance. Penalties and preventable harm to residents are too often considered just a cost of doing business.

The mission of the long-term care ombudsman program is to protect and promote the rights of vulnerable individuals living in licensed care homes. Paid and volunteer certified ombuds have a proven track record of helping to resolve the majority of complaints we receive. If you feel your rights as a long-term care resident, or the rights of a loved one in long-term care, have been violated, file a complaint with the long-term care ombudsman or call 800-562-6028. Our regional staff and volunteers will work to resolve the issue.

If you believe you or a loved one in long-term care is the subject of deceptive marketing, unfair debt collection, junk fees, issues with insurance claims or other threats to your rights as a consumer, you can file a complaint with the Washington’s Attorney General Office. We can all hope the recent action taken by the Attorney General’s Office sends a message to other long-term care providers: promises made, contracted and paid for must be fulfilled. Those who fail to meet residents’ needs will have a price to pay.

Patricia Hunter is Washington state long-term care ombudsman and president of the National Association of State Ombudsman Programs.

This story was originally published December 10, 2025 at 5:00 AM.