Over 20 years ago, a group of senior-housing executives created an algorithm-based system, called “Service Alignment.” The purpose of this algorithm was to create a streamlined approach to staffing at assisted living facilities that would help cut costs and raise revenue.

Brookdale Senior Living, which currently has over 652 facilities, making it the largest operator of assisted living homes, acquired this system. However, Brookdale employees have complained about this system, called “Service Alignment,” saying that it does not accurately capture staffing needs required for residents living at Brookdale. This failure has led to multiple instances of understaffing and compromised care at Brookdale facilities.

Brookdale Employees Voice Concerns About Service Alignment’s Shortcomings

Numerous Brookdale employees have voiced concerns about Service Alignment’s shortcomings, citing instances where the algorithm failed to accommodate unique resident needs.

Some of the nuances the algorithm is unable to account for include:

• Small, cramped elevators in a Chicago facility required staff to take more trips to accompany residents to meals, exceeding the time allotted by Service Alignment.
• Staffing shortages made it impossible for them to reasonably monitor the number of residents in New Port Richey, Florida.
• Staff at a Fort Worth facility found themselves unable to meet the 20-minute time period allotted by the algorithm to shower and dress residents.

Staff Complaints Largely Ignored by Brookdale Executives

The Washington Post report, which interviewed over 35 current and former employees of Brookdale, said there have been multiple complaints and concerns about the algorithm sent to executives at Brookdale. Facility managers at various locations have complained that the staff and time periods allotted to daily tasks make it impossible to meet patient needs.

Despite these complaints, Brookdale continues to defend its staffing practices. Jackie Dickson, a spokesperson for the senior living empire reportedly said that Brookdale gives autonomy to managers at local facilities, allowing them to set staffing levels as they deem necessary.

The continued argument against Brookdale’s algorithm-driven approach is that this system is unable to account for various nuances and complexities of caring for seniors. Many employees believe the continued staffing inadequacies put resident safety at risk.

Civil Lawsuits Filed Against Brookdale

Civil lawsuits against Brookdale highlight instances of alleged neglect and harm resulting from understaffing. Residents and their relatives have filed complaints, citing incidents ranging from medical neglect to fatal outcomes. Brookdale is under fire over its staffing practices, with allegations of prioritizing cost-cutting measures and profit over the well-being of residents in their care.

Some examples reported include:

• Louise Walker: An 89-year-old who died after she fell in her room at the Brookdale facility in Jacksonville. State inspectors who investigated Walker’s fall cited Brookdale for neglect due to lack of supervised care. Walker, who had dementia, was a known fall risk.
• Male resident in Destin, Fla.: A male resident at a Florida facility was found in a face-down position on Christmas Day. The man froze to death after being left unattended for over 12 hours.
• California resident: A woman living at a Brookdale facility in California had to be hospitalized after she became dehydrated. Staff had been leaving food and water outside her door for three days, yet never checked on her to see if she was eating or drinking anything.

Multiple Managers Objecting to Brookdale Algorithm Left or Were Fired

Managers who sought exceptions or raised concerns about the issues resulting from Service Alignment faced repercussions. This outcome only further magnified the disconnect between corporate directives and on-the-ground realities. Instances of resident neglect, including incidents of wandering residents, dehydration due to neglect, and fatal falls resulting from lack of care, underscore the consequences of understaffing in long-term care facilities.

Brookdale’s struggles reflect broader industry challenges regarding staffing and quality of care in assisted-living facilities. Congressional inquiries and legal proceedings underscore the urgency of addressing these issues.

As the nursing home industry grapples with ever-evolving demographics and increased resident needs, change is vital. A critical re-evaluation of current staffing strategies and regulatory oversight at long-term care facilities is imperative to ensure the well-being of elderly residents.

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