While his caretakers watched him die, William Hughes shivered under the covers in a cramped and dirty bedroom.

They didn’t give him food. They didn’t give him water. Despite doctor’s orders, they never gave him the very medicine that would have saved his life.

Instead, they let him languish for days at the Tampa assisted-living facility where he lived in 2006 — vomiting and defecating in his bed — refusing to clean him because the stench was too strong.

Despite pleas from residents that he desperately needed help, caretakers never called paramedics to try to save the severely diabetic man.

“They let this man just die,” said resident Kevin Conway. “It just boggles my mind to this day.”

His body was sent to the Hillsborough County morgue and cremated at state expense — his ashes sent to his mother in Ohio, the state investigation closed.

The 55-year-old musician was among dozens who died at the hands of their caretakers in assisted-living facilities across Florida.

One starved to death; another burned in a tub of scalding water. Two were fed lethal doses of drugs. Three died from the ravages of gangrene when their wounds were ignored for weeks.

The state Agency for Health Care Administration — the entity entrusted with overseeing ALFs — refuses to release the records of more than 300 questionable deaths during the past decade, citing state law.

But The Miami Herald obtained confidential records of 70 people who died in the past eight years from the actions of their caregivers.

The records from the Department of Children & Families, another agency tasked with investigating deaths, show people are routinely abused and neglected to death in assisted-living facilities — but in the end, few are ever held accountable.

“There comes a point when you need to say people’s lives are in danger and we need to do more,” said Nick Cox, a former DCF regional administrator who is now Florida’s statewide prosecutor.

Though Florida boasts one of the toughest elder-abuse laws in the country, The Miami Herald found few caretakers are ever charged in the deaths of the people they are supposed to protect.

In an analysis of each of the deaths, including a review of police and autopsy reports, medical records, and interviews with relatives, residents and employees, The Miami Herald found:

• An average of nearly once a month, law enforcement agents were called to investigate cases of residents who died from abuse or neglect — with caretakers even admitting to breaking the law — but almost never made arrests. In at least five cases, caregivers were fired from homes after people directly under their care died from neglect, but none were charged.

• In the two cases in which arrests were made, caregivers were granted plea agreements, never spending a day in prison. One owner was given probation in the death of a 74-year-old woman who was strapped so tightly to her bed that she suffered blood clots and died. The charges were later expunged from the caretaker’s record.

• Four caretakers were caught forging and shredding medical records during death investigations — concealing key evidence. None was charged.

• Records of deaths at the homes are kept secret by the state — hidden even from family members — allowing facilities to conceal the critical mistakes that took the lives of their residents.