The real issue is that assisted livings operate in an environment like the Wild West,” said Richard Mollot, executive director of the Long Term Care Community Coalition.

When the deadly fire broke out Sunday night at Gabriel House in Fall River, Massachusetts, the assisted living facility had 70 residents and just two staff members working, according to the mayor and an employee.

The state Executive Office of Elder Affairs cited the facility for seven deficiencies, four of which were repeat problems.