Nine elderly residents are dead and more than 30 hospitalized following a devastating fire that ripped through the Gabriel House assisted living facility on Oliver Street in Fall River, Massachusetts on Sunday night, July 13. The harrowing accounts from survivors reveal a tragedy long in the making, rooted in economic decline and an elder care industry that prioritizes profits over human lives.

A thriving textile manufacturing center until the early 20th century employing thousands in its mills, the southeastern Massachusetts city of 94,000 now ranks 344th out of the state’s 350 municipalities in per capita income. More than 17 percent of Fall River residents aged 65 and older live below the poverty line, and 14.2 percent of this age group live alone.

Firefighters responding to the Gabriel House around 9:30 p.m. on Sunday found heavy fire at the main entrance of the building. The scene was immediately described as tricky and chaotic, with multiple residents seen hanging out of windows and doorways, screaming and begging for help. 

More than four dozen firefighters, including 30 who were off duty, joined the rescue effort, entering the smoke-filled building, breaking down doors, and physically carrying out approximately a dozen non-ambulatory residents to safety. Five firefighters were treated at a local hospital for smoke inhalation and released.

Many residents were in bed or just about to go to sleep when the fire broke out. Many were in wheelchairs, immobile or dependent on oxygen tanks, making self-evacuation nearly impossible. Neal Beck, a 78-year-old resident, told the Boston Globe he was pulled by firefighters from his third-floor window, fearing he would have to jump. Another resident, Lorraine Ferrara, 71, said she was blown back by smoke when she opened her door and had to yell for help from her second-floor window until a firefighter broke it to rescue her. Michael Pimentel, 72, who has two prosthetic legs, described to the Globe breaking his own window after struggling to get out of his smoke-filled room, witnessing flames 10 feet tall.

Ignored warnings at Gabriel House

According to some residents, the Fall River fire was a disaster waiting to happen. Michael Pimentel and his friend Russell Silvia stated they had called news stations multiple times urging investigations into the Gabriel House. They told the Globe the facility “smelled like urine,” had “mice in beds” and 'cockroaches.”

Most damningly, Pimentel stated the elevator at the facility was broken for eight and a half months and had just recently been fixed a couple of weeks before the fire, only to break again a few days prior to the tragedy. Aside from the obvious safety risk, this is particularly alarming given that many residents were in wheelchairs and unable to go outside for prolonged periods due to the broken elevator. Fall River Mayor Paul Coogan acknowledged reports of a broken elevator but stated the elevator was last inspected on July 8, 2025.

Pimentel reported that during the inferno lights and exit signs were not illuminated when the fire alarms sounded. These allegations, if proven true, point to egregious safety failures. The fact that the owner of Gabriel House, Dennis D. Etzkorn, was previously indicted for paying kickbacks to improperly procure over $2 million from MassHealth, the state’s form of Medicaid, raises further questions about the facility's operational integrity and focus on profit over resident well-being. The charges against Etzkorn were only dropped due to financial records having been illegally obtained.

The Gabriel House tragedy brings into sharp focus the alarming lack of regulation and oversight in Massachusetts’ assisted living industry. Unlike at nursing homes, which have specialized though often ignored regulations, owners of assisted living facilities are regulated more like landlords. John Ford, director of the elder law project at the Northeast Justice Center, has described assisted living residences in Massachusetts as “kind of the Wild West,” with few standards and little protections for residents.

A class action lawsuit was filed in October 2024 against HallKeen Management, which operates seven assisted living homes in Massachusetts, for allegedly charging low-income residents illegal “ancillary fees” that left them with little or no money. These fees were reportedly charged even though MassHealth programs already funded essential services, amounting to double billing. The lawsuit exemplifies the systemic exploitation of vulnerable seniors in a weakly regulated industry.

The attorney general claims that designing regulations to protect seniors at assisted living facilities is a “cornerstone” of her office, but this comes after years of recognized issues at the homes. A state investigation in 2024 found “systemic failures” leading to “serious harm and in some cases death of residents” in as many as seven elder care facilities across Massachusetts, resulting in fines and closures. 

Elder neglect and prohibitive costs across the US

The senior living crisis extends beyond Massachusetts. Elder abuse and neglect in US nursing homes and elder care facilities are not only alarming and prevailing problems but also often go unreported. Statistics suggest up to 2 million American senior citizens aged 65 or older might have been affected by elder abuse, and one report found that as many as one in three elder care institutions were responsible for instances of neglect and abuse.

The cost of assisted living in the US is astronomical, further highlighting the economic pressures placed on seniors and their families. As of 2025, the estimated median cost of assisted living in the US is $6,077 per month, or $72,924 per year, according to SeniorLiving.org. In Massachusetts, the median monthly cost is even higher, standing at around $9,330. These costs are prohibitive for all but the wealthiest seniors, who can afford country-club-style accommodations in their “golden years.”

Original Medicare does not cover room and board or assistance with daily living tasks in assisted living facilities. Medicaid coverage varies by state and generally prohibits using funds for room and board. This leaves most families to pay out of pocket, often by draining retirement accounts, savings or selling their homes. The alternative for many seniors is to remain with relatives who are ill-equipped to provide or pay for care. With the growing number of older adults in the US—expected to reach 83.7 million by 2050—the demand for assisted living is outpacing available beds, exacerbating the crisis.

The median annual cost for assisted living in the US, ranging from $70,800 to $72,924, dwarfs that of other developed nations. For example, assisted living costs in Canada are $24,000–$60,000 per year, with provincial subsidies available, while in Japan, costs are $18,000–$42,000 per year, with national long-term care insurance available. Austerity measures implemented by governments globally will inevitably raise costs in these countries as well.

The Gabriel House fire is not an isolated incident but a tragic consequence of a society and healthcare system that has long failed to provide adequate protections and support for its most vulnerable citizens, especially the elderly.