Watchdog pressures state to provide inspection reports on adult day centers

May 07--Caring for an aging spouse or parent can be an around-the-clock job that leaves little time to accomplish anything else, including earning a living. That's where adult day centers come in.

They provide services and a safe environment for an aging family member during the day, giving caregivers a break or a chance to work or run errands. With the older population growing, the centers should become a more valuable resource, and attendance statewide has been increasing.

Until late last week, though, the state Department of Aging offered little peace of mind to families trying to take the responsible route and investigate a program before enrolling a loved one. The department inspects adult day centers annually but hadn't been sharing the findings with the public.

Last Wednesday, most of the inspection reports published on its website were from 2014 and there were no reports for 109 centers.

By Friday, after I asked why reports were missing or old, the department added many more from last year and some from this year, significantly reducing the number of centers for which no information was available.

Spokesman Drew Wilburne told me the department is keeping up with its required inspections and plans to have the most recent summaries for all adult day centers online by Friday.

"While the department is not required to post the reports to the website, we do see great value in doing so," Wilburne told me in an email. "Reports are posted as staff time allows. Ensuring that licenses do not expire and that inspections are completed annually is a priority."

Still, many reports are missing. There are nine centers in Lehigh and Northampton counties. As of late Friday afternoon, a current report was posted for only one of them, Senior LIFE Lehigh Valley in Hanover Township, Northampton County. It passed an abbreviated inspection in January with no violations.

Seven of the local centers have outdated reports and one has no reports.

This comes seven years after the department promised to do a better job of sharing that information. In 2010, I criticized it for not publishing the reports at all. The department assured me it would get with the 21st century and make the reports more accessible. For a few years, it did.

As Wilburne said, the law does not require the Department of Aging to publish inspection reports. But it should be doing it as a public service, just as the state Department of Health publishes nursing home inspections and the Department of Human Services publishes personal care home inspections.

Wilburne told me the department is evaluating technology to improve the efficiency of inspections and to automate the posting of reports to the website. They now are uploaded manually, one at a time.

The department initiated a review of its website two weeks ago, he said, "to identify any outdated or missing information," and updating the adult day center reports is part of that plan. After I asked about the outdated and missing information -- there were no inspections on file for about a third of the state's centers early in the week -- Wilburne said the department prioritized those reports.

Information on adult day centers is needed now more than ever before, with the senior population growing exponentially. The U.S. Census Bureau predicts the number of people age 65 and older is expected to balloon to more than 83 million nationwide by 2050.

Families can use the inspection reports to monitor an adult day center a relative attends, or to find a facility. People may be looking for those reports because the annual inspections are mentioned in a department guide on how to select an adult day center.

I did not review all of the new reports statewide that were added to the Department of Aging website Friday afternoon. I looked at about 60. Some had issues, but nothing eye-popping. Violations included failing to obtain criminal history reports for employees, have a current fire safety inspection, secure poisons such as cleaning supplies, train employees and have sufficient medical records on file for clients and employees.

Local aging officials told me adult day centers are a valuable but underused resource.

They give caregivers a break while offering seniors an opportunity to socialize in a regulated setting that provides care and services.

"The caregiver can have some time to themselves," said John Mehler, administrator for the Northampton County Area Agency on Aging."It's a big help ... they know that their loved one is going to be safe and cared for but they don't have to be on the job."

The time apart can benefit everyone.

"If it's just you and your mom, that relationship can get a little bit frayed more quickly," Mehler noted.

Pennsylvania has 284 adult day centers, also known as adult day services centers or adult daily living centers. That's 11 percent more than in 2012, when there were 255 centers.

They are open to residents 60 or older who need help with basic activities and have transportation to and from a center. Attendees often have a cognitive impairment, though some suffer only from physical limitations. Younger adults may attend if they suffer from dementia or a similar condition.

Most centers are open weekdays, though some operate Saturdays or have extended evening hours, Mehler said.

The centers can be an affordable care option, costing less than in-home care from a visiting aide, said J.R. Reed, executive director of the Lehigh County Office of Aging and Adult Services. County aging offices may be able to provide financial assistance. Medicaid and long-term care insurance may pay, too.

Adult day centers shouldn't be confused with senior community centers, where people go for meals and socialization. There is no charge to go there, where staffing levels are much lower and care and assistance aren't provided.

Adult day center staff can administer medicine, help with personal hygiene and provide programs to improve physical and mental health, or to slow cognitive loss.

According to the Department of Aging guide on selecting a center, all of them offer personal care, nursing and social services, therapeutic activities, meals and emergency care. Optional services can include physical therapy, podiatry and cosmetology.

Adult day centers must develop a care plan for each attendee. The state requires at least one staff member for every seven people receiving services and staff must be trained and cleared through criminal background checks. Centers must meet cleanliness and safety standards.

In 2016, the centers served 16,404 clients, a 34 percent increase from 2012. But more people could be using them.

"I think there's still a lack of knowledge on the part of the public that these things are available," Mehler said.

I will be checking the latest reports on the Lehigh Valley area's centers as the state updates them over the next week, and will share that information with you if I find any serious violations.

The Watchdog is published Thursdays and Sundays. Contact me at watchdog@mcall.com, 610-841-2364 or The Morning Call, 101 N. Sixth St., Allentown, PA, 18101. I'm on Twitter @mcwatchdog and Facebook at Morning Call Watchdog.

GET INFO

View reports at www.aging.pa.gov under "Your Local Resources"

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