Reluctant to punish

The agency, which would only respond to questions in writing, said pushing to revoke a home’s license is a “very harsh penalty” used as a last resort. Before doing so, it considers several issues, including the immediate danger to residents and the ability to relocate them to a new home.

Each penalty is considered based on “unique circumstances,” and other actions are explored “prior to the most serious sanction of revocation,” the agency wrote.

However, The Miami Herald found that AHCA repeatedly catches homes breaking the law but fails to act, at times with dire consequences.

At Hampton Court in Haines City, regulators caught caretakers 11 times in the past five years failing to give out medication, not keeping records of drugs given to residents and falsifying records to show drugs had been given when they hadn’t. The state could have imposed emergency measures, including a ban on new residents until the home cleaned up its practices, but never did.

Eventually, someone died.

Norman Dube, a 74-year-old retired postal worker suffering from diabetes and depression, went 13 days last March without crucial antibiotics — and several days without food or water. As he slipped into unconsciousness, he began telling people “things were crawling on his skin,” a state report said.

At the same time, the home failed to tell his doctor he wasn’t getting his drugs, which included blood pressure medications and anti-psychotics.

The next month, Dube died. A state Department of Children & Families investigation concluded the home committed medical neglect.

But the problems didn’t end. On June 25, two months later, state agents returned to the home and found two more residents languishing without their medication, despite doctor’s orders.

The home promised to correct the problems, but in August it happened again — this time, three more residents were not getting their drugs. Two months ago, the facility was taken over by a new owner.

When it comes to imposing fines, AHCA said it doesn’t routinely drop or reduce them, saying it only lowered fines by 7 percent this fiscal year.

But an analysis shows the agency rarely asks for what’s allowed by law. Consider: In 2009 — the same year lawmakers expanded AHCA’s power to levy fines — the agency could have imposed more than $6 million, but took in just $650,000.

Homes of horror

The law that empowered the state to discipline homes was passed three decades ago in response to a growing crisis: Elderly people moving to Florida were ending up in group homes run by abusive caretakers.

The state passed a celebrated Residents Bill of Rights in 1980 — championed by veteran Miami congressman Claude Pepper — pledging that people in those homes would be protected and treated with dignity.

The homes would shelter two of the state’s fastest-growing groups — the elderly and mentally ill — and at the same time offer an alternative to nursing homes.

Now, people who needed help with everyday chores but didn’t require 24-hour nursing care could live independently.

But as the industry boomed, the state began a series of crucial moves that would change the way it regulated homes.

Instead of inspecting ALFs once a year like most large states — including Arizona, Texas, Pennsylvania, North Carolina and Illinois — Florida cut inspections to just once every two years.