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A Pennsylvania continuing care retirement community agreed to a $215,000 Fair Housing Act settlement over allegations of disability discrimination, but the senior living owners and operators said that the finding represents a misunderstanding of the continuing care model.

In the case, RiverWoods Senior Living Community, a Lewisburg, PA, CCRC managed by Asbury Communities of Maryland and operated by Albright Care Services of Pennsylvania, was accused of discriminating on the basis of disability against Ruth Gural, an independent living resident who had progressive memory loss due to Alzheimer’s disease.

In January 2022, the US Department of Housing and Urban Development issued a determination and charge of reasonable cause that the two entities discriminated against Gural by failing to grant a reasonable accommodation request to allow her son Harry to remain as her live-in aide during the COVID-19 pandemic.

A consent decree filed in the US Middle District Court of Pennsylvania last week ordered the parties to prevent the alleged discriminatory conduct from occurring in the future, educate staff members on the Federal Housing Act and address policy revisions and notifications to residents.

Todd Andrews, president of community living for Asbury, told McKnight’s Senior Living that the company made a “business decision” not to pursue the case in court and that he was surprised by the administrative ruling. Resident safety and well-being is the company’s highest priority, he added.

“In keeping with our mission as a not-for-profit senior living and healthcare provider, we routinely accommodate and care for a wide range of physical and cognitive issues,” Andrews said. “From the outset, we offered multiple accommodations to the resident and her son and continued to seek ways to utilize the services our continuum provides, including outside caregivers.”

In accordance with the settlement, he said, Asbury is reviewing its policies and staff training to ensure compliance, but the organization sees the ruling as evidence of a “lack of understanding of the continuing care model.”

“In addition, we are concerned about the broader ramification of this decision for our senior living industry and resident contract provisions,” Andrews said. “We hold great responsibility to the older adults we serve, including those who are vulnerable, in exercising judgment in who is living on our campuses.”

Move-in was in 2017

Ruth Gural moved into RiverWoods in December 2017. Harry Gural, after two incidents in which his mother became disoriented and wandered around the campus, hired an aide to visit and assist with her care. He also temporarily used the community’s enhanced care services. 

When the community closed its campus to all visitors and outside private aides on March 15, 2020, due to COVID-19 concerns, Ruth Gural’s aide was barred from entering RiverWoods. The Gurals contended that the policy made it impossible for Ruth Gural to receive the assistance with activities of daily living that she needed.

RiverWoods made an exception to the no-visitor policy initially and allowed Harry Gural to remain at the property, but the community asserted that the exception was not indefinite and was made to allow him reasonable time to obtain and coordinate third-party care for his mother. Harry Gural said he did not want to hire a third-party aide given the COVID-19 transmission risks for older adults.

RiverWoods threatened to evict Ruth Gural in May 2020 over the living situation. The Gurals made a request for a reasonable accommodation in June 2020 that was denied the following month. The company said granting the reuqest would be both an administrative and financial burden as well as a “fundamental alteration of how the CCRC operates.” The company aruged that Ruth Gural would get the care she needed by moving into a higher level of care, using the community’s enhanced services staff, or hiring an outside qualified third-party caregiver.

The Gurals opted to file the discrimination complaint in August 2020.

The HUD investigation found that Ruth Gural’s need for ADL assistance continued and was exacerbated by the restrictions imposed during the COVID-19 pandemic. HUD also found that RiverWoods retained “only a limited number of staff in enhanced services,” which would not have made it possible for the team to provide support equivalent to a third-party caregiver.

HUD also found that the ongoing pandemic presented challenges that made it reasonable for Harry Gural not to want to enlist the care of a third-party aide, who could present a risk to his mother’s health. 

Ruth Gural moved out of the community in July 2022 and lived with her family until her death in September 2022.