Five months after state shut down in-home care provider, problems persist

Oct 29, 2018

Five months after the state of Washington shut down a major provider of in-home care for the developmentally disabled, the company that took over care for most of the clients has been given 90 days to correct its practices or face decertification of its King County operation based on "serious non-compliance with the law and regulations." 

"These serious deficiencies have jeopardized clients' health, safety and welfare," wrote the director of Residential Care Services, Candace Goehring, in an October 22 letter to Kendra Ellis, the administrator of Aacres Washington of King County.

The letter cited more than two dozen deficiencies. They include:   

  • Failure to protect a client from multiple instances of verbal and mental abuse 
  • Restricted two clients from food
  • Failed to ensure that six clients made doctors' appointments
  • Failed to ensure a "safe and healthy" home environment for clients 
  • Did not properly monitor a client's blood glucose levels

In addition, one client died of aspiration pneumonia after Aacres staff allegedly failed to ensure that person didn't aspirate food. That case resulted in an $8,000 fine in July.

Since June, the state has taken enforcement action against Aacres Washington of King County five times and imposed fines totaling at least $39,700. 

Aacres Washington took over the care of approximately 200 developmentally disabled clients in King and Spokane Counties in late April after its sister company, Spokane-based SL Start, was decertified following repeated, serious violations of care standards. 

SL Start was one of the largest providers of in-home care in the state.

In April, Disability Rights Washington wrote a letter to Department of Social and Health Services Secretary Cheryl Strange citing "grave concerns" about the state placing SL Start's clients in the care of Aacres Washington because both are owned by the same company, Embassy Management.

"We are alarmed to the point that we're going out and doing our own monitoring and making sure that people know how to advocate for themselves, because we are afraid that our state has put them in a vulnerable position and we want to empower them," said Susan Kas of Disability Rights Washington at the time.

On Monday, Kas said Disability Rights Washington is "assessing and monitoring" the situation, but wasn't willing to comment further. 

Calls and emails to Aacres Washington and its parent company Embassy Management were not immediately returned on Monday. 

Previously, Kendra Ellis, Embassy Management's Washington and Idaho executive director, said she wanted clients and their families to have confidence in the company's ability to provide care. "We've taken ownership for our deficiencies, identified steps that we need to take to improve our systems, identified additional training that's needed [and added] oversight in the homes," Ellis said in April.

Washington's Developmental Disabilities Administration (DDA) justified allowing Aacres Washington to take over care of SL Start's clients because it had just two weeks to transition the more than 200 clients in King, Spokane and Yakima Counties and wanted to avoid an interruption of care and keep as many of them in their current homes. 

"The expertise that Embassy has shown and that Aacres has shown in running a supported living program give us confidence the SL Start residents will get the right service," said Don Clintsman, the deputy assistant secretary of the Developmental Disabilities Administration at the time. 

In a statement Tuesday, DDA said it has notified clients and their families that Aacres Washington of King County is on provisional status and will be meeting with them in the coming weeks. "As part of the response, DDA staff will visit the homes where our most vulnerable clients live to assure their health and welfare," the statement said. 

The statement also said that DDA is "developing contingency plans" to ensure that clients experience no interruption of care. 

Records show since April the state of Washington has paid Aacres Washington nearly $30 million for client care.

This story has been updated to include a statement from Washington's Developmental Disabilities Administration.