Two decades ago, a group of senior-housing executives came up with a way to raise revenue and reduce costs at assisted-living homes. Using stopwatches, they timed caregivers performing various tasks, from making beds to changing soiled briefs, and fed the information into a program they began using to determine staffing.

Brookdale Senior Living, the leading operator of senior homes with 652 facilities, acquired the algorithm-based system and used it to set staffing at its properties across the nation. But as Brookdale's empire grew, employees complained the system, known as "Service Alignment," failed to capture the nuances of caring for vulnerable seniors, documents and interviews show.

At a Brookdale facility in Chicago, tiny elevators prevented residents from being herded en masse to dinner, necessitating more trips and more time than Service Alignment allotted. At a facility in New Port Richey, Fla., the algorithm recommended fewer caregivers than buildings, making it impossible to monitor all residents at all times. And at a facility near Fort Worth, residents often could not undress, shower and get dressed again within the allotted 20 minutes — constantly putting caregivers behind in their tasks.

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