New Fire Rules at Senior Care Homes Sought

If a fire broke out at a residential care facility for the elderly, would residents be able to get out safely?

That question has consumed Phyllis Indianer, a volunteer advocate for the elderly, for more than a decade.

The Tarzana resident is leading a group of concerned citizens who want to toughen laws regulating fire safety at the state-licensed facilities also known as board and care homes.

“The residential care facilities are operating within the law,” Indianer said, “but the law is not operating in the elderly’s best interest.”

Advocates say that facilities should be required to house senior citizens who use wheelchairs or walkers in ground-level apartments. Trying to escape down a flight of stairs in an emergency could be deadly, they say.

And even some fire officials acknowledge that larger staffs are needed to handle nonambulatory residents in case of an emergency evacuation.

Although Los Angeles fire officials say there have not been any fatal fires at local residential care facilities in recent memory, officials and advocates for the elderly say blazes across the nation show that the threat exists:

* In Arlington, Wash., eight senior citizens were fatally injured in a fire at a residential care facility April 27. Officials blamed a careless smoker for the tragedy.

* Two days later in Seattle, a burning mattress in a room at a board and care home forced the evacuation of some 120 residents, many of whom were elderly. Firefighters found candles and incense that may have caused the fire to start near a bed.

* In Palmdale last week, a bathroom exhaust fan ignited a fire that spread to the attic of a senior citizens’ apartment building. No injuries were reported, however, Los Angeles County firefighters temporarily evacuated about 40 elderly residents.

“We are all concerned about fire safety,” said Harold Sherman, president of the residents’ council at Encino Hills Retirement Hotel in Encino.

“I happen to be legally blind,” said Sherman, 75. “There are people who are in wheelchairs and those who are disabled in other ways. We need information about what to do to save our lives.”

National statistics show that the very old suffer the highest fatality rates in house fires. Those 65 and older accounted for about 37.9% of all house fire fatalities nationwide in 1996, according to the National Safety Council’s latest figures.

Indianer forged a meeting in Encino with state and local officials earlier this month and said she received a pledge to explore the possibility of drafting new legislation.

Brendan L. Huffman, an administrative assistant for state Assemblyman Wally Knox (D-Los Angeles), told concerned residents that state officials would try to determine what could be done to help.

Group members plan to review regulations in early August with representatives from the Los Angeles Fire Department, Knox’s office and the state Department of Social Services, which regulates the facilities through its community care licensing division.

Residential care facilities for the elderly provide housing, meals and activities for people age 60 and older. Most residents are capable of caring for themselves although some nonambulatory residents may be assisted by staff.

Unlike nursing homes or convalescent homes, which are medical facilities, the residential care facilities are not required to have physicians or nurses on staff.

Some 30,318 senior citizens live in 1,113 licensed facilities in Los Angeles County, according to state figures.

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Indianer’s mother was among the tens of thousands of elderly people in institutionalized care before she died in 1992 after suffering from severe Parkinson’s disease.

It was her mother’s illness that gave Indianer, now 51, an insider’s view of the elderly housing system and some residents’ need for an advocate.

She later earned a master’s degree in family environmental studies from Cal State Northridge, joined the state’s volunteer Long-Term Care Ombudsman Program in 1987 and is now elderly activities coordinator at Valley Storefront Jewish Family Service in North Hollywood.

“By the time elderly people end up in these places their dignity and independence are gone,” she said. “They are like children, they don’t have a voice and they don’t want to make waves.”

Advocates are concerned about a state law that allows nonambulatory elderly people to live on upper floors of retirement homes as long as the units pass fire safety inspections.

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Group member Jack Berman is worried that in a fire his girlfriend’s mother, who uses a walker, might not be able to get out of her second-floor unit at a retirement home in Encino.

“I asked a fire inspector how she would get out,” Berman said. “He said that she should go to the exit, sit on the stairs and bounce down one stair at a time. Can you picture a 90-year-old doing that?”

The image of an elderly woman struggling to get to the ground floor as flames and smoke spread through a retirement home, Indianer said, strengthens her resolve to push for a state law to limit the number of nonambulatory residents in the facilities.

Before 1994, local laws stipulated that the facilities could only have a maximum of six nonambulatory residents and restricted them to first-floor units near exits.

“As the number of nonambulatory elderly people increased, there was nowhere for them to go, except to a nursing home,” said Karen Perkins, a spokeswoman for state social services. “Just because they couldn’t walk, didn’t mean they needed to be in a nursing home.”

The retirement home operators petitioned their legislators for a state law that allowed greater numbers of nonambulatory residents.

But advocates contend that the new rules have created unnecessarily dangerous circumstances.

They want to see increased staffing at the facilities, particularly during night-time hours.

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Between 10 p.m. and 6 a.m., facilities with 101 to 200 residents are required to have one employee on duty; another on-call while on the premises; and a third on-call and capable of responding to the facility within 10 minutes.

But Indianer said the staffing arrangement would be inadequate if a fire broke out in a multistory building filled with seniors.

“A retirement home could be licensed for 150 residents--all of whom could be nonambulatory living on upper floors--and overseen by two workers at night,” she said. “In the case of a fire, how could two people take care of 150 nonambulatory people?”

The situation could occur because fire officials are not required to take staffing into consideration when inspecting the facilities, said Eric M. Carlson, a lawyer advising the group and director of the Nursing Home Advocacy Project of Bet Tzedek Legal Services in Los Angeles.

“The problem is that . . . fire inspectors give their approval without any idea of staffing, and licensing takes that as a stamp of approval for nonambulatory people to be allowed on upper floors,” Carlson said.

City fire officials inspect building construction, fire alarms, sprinkler systems, smoke detectors, generators, exit doors and fire doors to make sure they are working properly.

“I agree that staffing should be increased [because] some of these residential care facilities are licensed for more nonambulatory people than skilled nursing facilities,” said Inspector Lee Craven of the Los Angeles Fire Department’s Bureau of Fire Prevention.

Advocates are anxious to see a coordinated safety effort between fire inspectors, licensing officials and facility operators.

Said Indianer: “I can’t think of anything more scary than hearing an alarm go off and not being able to move or not knowing if someone is coming to help.”