Massachusetts Assisted Living Facility Fire Raises Safety Concerns

When a fire tore through the Gabriel House assisted living facility in Fall River last July, dozens of residents — most of them older adults with mobility issues or cognitive impairments — were trapped.

By the time firefighters arrived, flames and smoke had engulfed the central hallway, cutting off escape routes. Many residents on the second and third floors had to be rescued using ladders. Complicating matters, air conditioners had been screwed into the windows, forcing firefighters to rescue many residents through smaller bathroom windows.

“It was total chaos,” recalls Michael O’Reagan, president of Fall River Firefighters Local 1314 and among the first emergency responders to arrive. Some rescues took six to 10 firefighters to maneuver a single resident through a window and down a ladder.

Firefighters rescued 53 people, but 10 residents died in the blaze. “We did the best with what we had,” O’Reagan says, “but what we had was not enough.”

In the months since, state officials have pledged to strengthen inspection and reporting rules for assisted living residences. But for families seeking safe care for aging loved ones, the tragedy raises urgent questions: How can you tell if a facility is a good match — and if it’s truly prepared for an emergency?

Nursing homes are federally regulated, inspected every 12 to 15 months and listed on Medicare’s Care Compare website. But there are no uniform federal standards for assisted living, says Edward Miller, professor and chair of gerontology at the University of Massachusetts Boston.

In Massachusetts, state regulations include requiring assisted living facilities to have a comprehensive emergency management plan to respond to disasters, including fire, flood, severe weather, and loss of heat, electricity or water.

Assisted living residences are designed for adults who can live mostly independently but need help with daily tasks such as meals, medication reminders or bathing. But Miller notes that today, “A lot of the folks that used to be in nursing homes are now in assisted living.” That shift, he says, raises new safety challenges.

The Gabriel House fire underscored ongoing concern around safety and care standards at such facilities. (As of press time, an investigation was ongoing, and the facility’s owner had not responded to a Bulletin request for comment.)

Jen Benson, state director of AARP Massachusetts, serves on the state’s Assisted Living Residences Commission, created by 2024 legislation to review how well facilities are meeting the needs of an aging population. The temporary commission was already examining oversight, staffing and safety standards when the Gabriel House fire occurred, Benson notes.

The group was expected to issue recommendations to the Legislature by the end of 2025.

VETTING A FACILITY

Kate Granigan, CEO of the Massachusetts-based care management firm Alder, formerly LifeCare Advocates, says families often start searching for assisted living after a crisis, such as being discharged from the hospital after a fall.

Many turn to Google, where paid listings and referral companies can steer people toward facilities that may not be a good fit. In other cases, hospital discharge planners recommend the highest level of care to avoid liability, Miller says.

“It’s okay to slow a process [down] and ask for more details,” Granigan says.

Her firm and others like it employ life care advocates who help individuals and families make care decisions. They assess needs, research facilities, review contracts, and coordinate moves. Fees typically range from $100 to $300 an hour, depending on the services and region.

Miller and Granigan offered the following advice for vetting an assisted living facility:

• Visit in person more than once. Tour facilities at different times of day, especially during mealtimes and evening shifts. Talk to staff, administrators and, most importantly, residents.
• Beware the chandelier effect. Granigan says some facilities invest in decor and amenities at the expense of care. “The reality is a lot of these places put a lot of money into the glamour ... at the cost of other things,” she says.
• Observe staffing levels and interactions. Ask how many caregivers are on duty per shift, including overnight, and how long they’ve worked there. How does the facility handle staff shortages? Are staff patient, respectful and engaged with residents?
• Ask about emergency preparedness. Request to see the facility’s emergency plan, including fire drills, evacuation procedures, backup power and policies for residents who use oxygen or can’t self-evacuate. Find out when drills were last conducted and how staff members are trained for night-shift emergencies. After the Fall River fire, state investigators found that medical oxygen likely fueled the blaze’s rapid spread.
• Balance location with quality. It’s natural to want your loved one nearby, but Miller notes that proximity shouldn’t outweigh safety and care quality. Visit multiple sites before deciding.
• Follow your instincts. Trust what you see, hear and feel. If staff seem evasive, residents appear withdrawn, or you sense neglect, those are serious warning signs.

Stacey Shepard covers health care, the environment and other issues. She has written for the Bulletin since 2023.

More on Assisted Living

• Assisted Living Checklist: Asking the Right Questions
• What to Know When Choosing an Assisted Living Facility
• Finding the Right Long-Term Care for Your Loved One