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Assisted Living, Erratic Regulation

Dennis Camarata lost his father in a way no child could imagine.

At age 83, Mike Camarata was healthy and active — but dementia had turned him almost childlike. So his family placed him in an assisted-living facility in Michigan because it would feel more like home, CBS News chief investigative correspondent Armen Keteyian reports.

"They encouraged you to wander around," says daughter-in-law Mary Camarata. "He would go in the refrigerator and drink orange juice out of the jug."

In April 2004, Mike Camarata drank from a jug he found in an unlocked kitchen cabinet. But he wasn't drinking juice — it was a toxic, industrial dishwashing detergent containing lye.

"The chemical just literally burned his entire mouth and then burned him all the way down," says Dennis.

Four days later, Mike Camarata died what Dennis calls "a horrific death."

So how could a toxic chemical be stored, unlocked, in an Alzheimer's wing? One reason: Unlike nursing homes, the nation's 36,000 assisted living facilities — places designed for seniors who don't need constant medical attention, just a little extra help — are not subject to any kind of federal regulation. A CBS News investigation has found that state laws are literally all over the map.

Read Armen Keteyian's Reporter's Notebook
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For example, only 32 states require CPR and first aid certification. Just 24 require a nurse on staff, and Alabama is the only state in which the medical director must be a doctor.

"No real policies. No real sanctions. No accountability," says
Jules Olsman, an elder-care attorney.

And no way, say elder-care experts and industry insiders, to track what they say are a growing number of negligence cases.

In Pennsylvania, 69-year-old Angelita Torres was an Alzheimer's patient who wandered away from an assisted living facility. She was found drowned in a nearby canal.

In Georgia, 70-year-old Ann Wideman should have been moved from assisted living to a nursing home after she became bedridden. Instead, the facility kept her; she developed a massive bedsores and died from the infection.

"They knew and they didn't do anything about it," says Toni Godfrey, her daughter. "They let her die."

In Michigan, where Mike Camarata died, facilities outnumber inspectors 100-to-1. There is no requirement that staff members for Alzheimer's residents receive any special training. As for regular caregivers, they must be "awake and fully dressed."

Keteyian asked Marianne Udow, the woman in charge of assisted living in Michigan, who writes the laws that basically say "awake and fully dressed" is enough in some people's mind to provide resident care.

"Those are probably old regulations," she says. When told that they date from March 2006, she adds that the laws "probably been in place for many, many years and have not been updated."

When asked if families know what the quality or lack of quality of some of the care is in the state's assisted living facilities at the moment, she says, "I think they don't."

After Mike Camarata's senseless death, the state's only response was a letter, asking the facility if a "corrective active plan" was implemented.

"So you're father's death boils down to a 'don't do this again' memo?" Keteyian asks.

"Pretty sad, isn't it," says Dennis Camarata.

Correction: This story was updated Nov. 14, 2006, to reflect new information from the state of Minnesota. Minnesota recently implemented laws specific to assisted living that include background checks for all staffers and a nurse on-call at all times; last week the state confirmed to CBS News it had no staff requirements.
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