As birth rates fall and life-extending healthcare improves, California’s population is aging rapidly. At the same time, traditional family support systems are being eroded. With fewer multi-generational households caring for their elderly relatives, the burden of age-related healthcare increasingly falls on corporate-owned assisted living facilities that don’t always provide the level of care families expect for their loved ones. Regulations are failing to keep pace with the growth of assisted living centers that lack the training, expertise and staffing to provide appropriate medical interventions or round-the-clock care. As a result, cases of elder abuse and negligence are on the rise, with complaints of abuse at more than twice the national rate, according to the California State Senate.

The cost of assisted living in California now compares to a hefty home mortgage payment, and often can run as high as $8,000 to $10,000 a month. In their bid to win lucrative business, assisted living centers are looking less like health care facilities and more like comfortable senior-living complexes, with prospective residents and their families enticed by social activities and luxury amenities. Such perks can give the impression of a well-run, resident-focused facility, especially to those who arrive in relatively good health.

But too often the focus on domestic creature comforts comes at the expense of adequate health care delivery. By the time families realize their relative can’t enjoy the amenities because their basic health needs aren’t being met, it may be too late.

As an elder abuse lawyer, I’ve seen firsthand what happens when powerful corporations fail vulnerable people by putting profits before care. I recently represented the family of a 77-year-old woman who choked to death while under the care of Eskaton, a mega-provider with long-term-care facilities throughout Northern California. Her death was attributed to the improper administration of Ativan, a powerful sedative used as a chemical restraint. A Sacramento jury later awarded a record $42.5-million verdict against Eskaton. The case raised serious questions about inadequate training and insufficient staffing levels. It also highlighted wider concerns about subpar corporate oversight and regulations.

Assisted living programs should enforce standards of care capable of averting such tragic outcomes. They need to require employment of onsite physicians and nurses. Powerful drugs like Ativan should not be administered by staff members who are untrained, underpaid, and overworked.

California Gov. Gavin Newsom’s Master Plan for Aging, which is scheduled to launch in 2020, presents an opportunity to implement long-overdue reform of the 1985 Residential Care Facilities for the Elderly Act to focus more on the delivery of quality health care and less on issues of /financial liability and licensing. If profits take a hit, so be it. Corporate assisted living facilities can no longer be allowed to make the bottom line a bigger priority than the wellbeing of their residents.

Ed Dudensing is a former Deputy District Attorney for Sacramento County who represents victims of elder abuse and neglect.