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I-Team: Assisted Living Center Employees Forced To Break The Law

BOSTON (CBS) - Americans are living longer and that means many of us will live well into our 80's and 90's. But the older we get, the tougher it is to remain at home. That is part of the reason we have seen an explosion in the number of assisted living residences since the mid 1990's.

They are marketed as vibrant communities which provide at least one meal a day, activities and some extra assistance with dressing and bathing, all for as much as $6,000 a month. For many seniors and their families, they are the prefect mix of assistance and a sense of community.

Diane Ditullio Agosino of Milton thought assisted living was just the thing for her dad, but started to worry when her mother, his legal guardian was out of town and Diane had concerns about her dad's health.

"An assisted living residence with their nurses and their badges, I was under the impression that this was a medical facility, that they were medically caring for my dad," she said.

According to Massachusetts General Hospital Social Worker Sarah Langer, this is a common misconception.

"People think that because there's a nurse there, they are going to get nursing care and in assisted living, that's not the case. They are wellness nurses and they cannot touch the person," she said.

There are other important distinctions.

Since there is no nursing care at these facilities, residents must be able to take their own medication. Staff can remind them to take the medication and hand it to them, but anything more without hiring a nurse, is against the law.

The I-Team spoke with an employee and three former employees of an assisted living residence in Massachusetts. They told us nurse managers instructed them to crush pills to help patients who couldn't or wouldn't take their medication.

"This facility has us putting medicine in ice cream, yogurt, pudding," one worker told us.

Another worker told WBZ "You had to do what you had to do to get the medicine in."

According to the workers, it was all about helping the residents so they could remain at the facility and continue to pay the monthly fee.

Ann Hartstein heads up the Executive Office of Elder Affairs, the agency that oversees assisted living residences. She explained that crushing pills is a violation of state regulations.

Her office conducts compliance checks every two years to make sure these facilities are following the rules, like the limits on help with medications. However, the agency only has three people doing checks on 222 residences, housing more than 10,000 people.

"There's only so much we can do and we rely on the visits that we make and the staff that's there to tell us what's happening," she explained.

Secretary Hartstein also explained assisted living residences are more like a landlord than a caregiver and consumers should understand exactly what they are paying for.

Ultimately, she explained, the responsibility for the health care of a loved one falls on the family.

The Office of Elder Affairs does provide a consumer guide to help families understand exactly what they can expect from an assisted living setting.

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