Many smaller assisted living programs are called group homes. Others are called adult family care homes or community residential group facilities. The recent nightmare involving one in Detroit, Michigan USA: (Click here for full news story) is not totally unheard of but somewhat avoidable.
It appears the owner of this unlicensed group home literally locked residents inside, limiting how they could escape in the event of a fire. At least one resident had pressing medical needs, being recently discharged from a hospital with an IV tube but no medical professional appears to be involved in her day-to-day care or monitoring.
Refrigerator and freezer were locked with padlocks and there appears to be outstanding criminal warrants for the owner of the home for everything from code violations to drug charges. While it is true that regulators would have caught these warrants during the normal licensing process this home is not licensed and in some states would not have to be.
In Michigan for example a group home is expected to house residents for at least 14 days before licensing is required. So if someone, like this wanted criminal, opened a home and offered respite care, or short-term stays for family caregiver relief and limited each stay to 12 days, licensure could possibly be avoided. I believe whether its a 2-day stay or 14 days, if this person has special needs the home claiming to be qualified to care for those needs should be properly regulated. Not only would a standard for care have been established but the good moral character standard might have kept this person from being able to own the facility.
Hospitals making referrals to the home instead of through a reputable case manager must also bear some of the blame.
This is why when litigation starts to fly around state governments often get included as defendants if for no reason other than to force legislative change.
Every category of life comes with some nightmares but it is the responsibility of a civilized society to try and avoid them when human lives are involved. Sometimes oversight has lifesaving and life-enriching advantages.