The perils of Assisted Living.

Peer into the files of Pennsylvania’s assisted-living industry and confront a catalog of horrors.

Betty Trainer, 81 and suffering from dementia, died of heat exhaustion in 2005 after wandering off from her Bucks County care home during a fire drill. They found her body near her husband’s grave.

June Loth, 74, who raised her family in Levittown, succumbed to complications from when she was raped in 2004, authorities say, by a live-in handyman in a home outside Pittsburgh.

In December, John Lambert, 95, tumbled down an unsecured basement stairwell at a sparkling Main Line complex and broke his neck. At the same home a few years before, a resident killed another resident.

I suspect one could reasonably say this is true of every state.

Quick growth,

looser oversight

The personal-care industry mushroomed after state mental institutions began closing in the 1970s. Small homes sprung up as housing of last resort for many with mental illness.

Then, after scandals beset nursing homes in the 1980s, corporate-run assisted living came to be seen as a more humane alternative.

Assisted-living residents tend to be elderly, disabled, mentally ill, or some combination of the three – a population extremely vulnerable to abuse, neglect and exploitation.

These residents live in a gray area: They are infirm enough to need help with daily living, but legally they are not supposed to be sick enough to qualify for more elaborate and expensive nursing-home care.

Unlike nursing homes, which are subject to federal regulations, assisted living operates under less stringent state-by-state rules. For years, Pennsylvania had some of the country’s weakest regulations. A recent update put the state in the middle of the pack, experts say.

In 1999, a federal study of assisted living in four other states – California, Florida, Ohio and Oregon – found that state regulators had cited more than a quarter of the facilities for five or more serious deficiencies, including poor care, understaffing and medication errors.