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.

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

Nine people were killed and one was critically injured in a fire at an assisted living facility in Fall River, Massachusetts, authorities said. Fall River Fire Chief Jeffrey Bacon called the fire at Gabriel House "an unfathomable tragedy.