Winfrey's state license had already been revoked for previous abuse and neglect. He did not return numerous phone calls to his home. In a letter to the Dade County medical examiner, he said HRS had exaggerated the charges against him.

* Nicholas Gutierrez, who died at 75 after developing nine severe bedsores. He lived in the Snapper Creek Nursing Home. Investigators from the Long-Term Care Ombudsman Council concluded he was neglected and that the home waited to send him for treatment until one day before his Medicare benefits lapsed. By then, he was already near death.

Andrew McKillop, administrator at Snapper Creek, said doctors at the home did everything they could for him, treating him on several occasions for the sores. "From what I can see, he got the treatment he needed," McKillop said.

"Is this kind of care adequate? I'm not a medical professional, but I have my doubts," said Al Ackerman, head of South Florida's regional Medicaid Fraud Unit, which investigates abuse in nursing homes. "And I'm concerned that most of the population has no idea how the elderly are living or dying."

More than 100,000 elderly and disabled people live in Florida's nursing homes and foster-care and boarding facilities. Many of them are alone, without family to supervise their care closely. Even when family members are involved, they often don't detect the warning signs that lead to neglect, abuse and, too many times, death.

Other disabled and elderly end up inappropriately placed, living in state-licensed homes that aren't required to provide the kind of critical care they need. Only nursing homes are required by law to provide skilled care, and far more elderly need it than get it.

The Herald found several cases in which boarding homes and foster homes became a dumping ground for impoverished, desperate and difficult-to-place elderly, whose delicate conditions quickly deteriorated.

When Idora Smith, a church-going, Georgia-born widow, went to live at Edith Bryant's foster home in Miami, she couldn't walk, eat or bathe by herself. What she needed was more specialized care.

Instead, she got sicker and died after four months. A confidential Department of Health and Rehabilitative Services abuse report concluded after her death four years ago:

"Investigation evidenced that client was accepted into the foster home in nonambulatory condition, unable to take her own medicines, which were in turn administered by Edith Bryant. Client progressively deteriorated to the point that her admission diagnosis at Palm Springs Hospital included anemia, gram negative sepsis (overwhelming infection) . . . malnutrition, dehydration, urinary tract infection, mild diabetes . . . and arteriosclerotic heart disease."

Martin, Smith's granddaughter, said HRS referred her to Edith Bryant's in the first place because the family could no longer care for her.

Martin said she visited her grandmother as often as she could, but usually Smith was covered with sheets. She didn't notice her grandmother was failing until the day of her last visit to the foster home, four weeks before her grandmother's death.

When Martin pulled away the sheet that covered Smith, she found her 105-pound body was riddled with bedsores so deep and infected that bones and raw tissue were exposed. She was starved and sick, doped up on Haldol, a psychotropic medication that leaves patients lethargic and lifeless.