''Not a Place to Leave a Relative'' [Nov. 17] was a disturbing commentary on the systemic abuse of our elderly and disabled. As an elder care specialist, I am appalled with the continuing problems with management, building maintenance and patient care at the A. Holly Patterson Extended Care Facility. Why do substandard facilities continue to operate at the expense of their vulnerable residents? It seems that only when financing is threatened do changes start to occur.

Although plans for a new facility improving the physical environment are necessary, the care and supervision of staff should never return to the old physical or administrative structure.

TERI KOFF, LCSW, CMC

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