Posted on Sat, Feb. 02, 2013

When Doug Coffey took over one of Florida’s most notorious assisted-living facilities, the home was on the verge of collapse.

Narcotics were being looted from the facility, drug dealers were sneaking onto the grounds to sell crack and its manager had just been hauled away by Pinellas County sheriff’s deputies on neglect charges.

With prosecutors mounting a campaign to shut Rosalie Manor, Coffey was forced to confront a host of problems that had been building for a decade at the string of cottages near downtown Dunedin on the west coast of Florida.

“It was uncontrolled chaos,” said Coffey, a former reserve deputy with the Pasco County sheriff’s office. “I don’t understand why this place wasn’t shut down earlier, but it’s mine now. We got to do something.”

In the next two years, the 59-year-old administrator instituted a series of changes to provide unprecedented care to the residents while struggling to keep the doors open.

In time, the home was not only allowed to keep its license, but it incurred just a fraction of the violations that had once made it one of the state’s most dangerous facilities.

“I didn’t think he was going to make it,” said Karen Lakritz, a leader of a state-funded team that places people with disabilities in homes. “The place was a disaster. It was god-awful. But he managed to do it.”

Experts say the changes at the 40-bed home that caters mostly to people with mental illness represents a dramatic turnaround at a facility where police were regularly rounding up residents and investigating crimes.

Coffey’s first crisis emerged weeks after he bought the home in 2006, when the man still in charge — former owner Erik Anderson — was arrested for endangering the lives of residents, including leaving a former psychiatric patient in charge of dispensing narcotics.

With Anderson out of the picture, Coffey was faced with the specter of cleaning up the home, including stopping drug dealers from coming onto the property and keeping residents from running away.

Several times during his first year, he said he was forced to jump into his truck to track down residents with mental illness who had wandered away.

Though he had owned five assisted-living facilities in the past, he said turning Rosalie around was “the hardest thing I’ve ever done in my life.”

He began by changing the name to Dunedin ALF, partly to get away from the bad publicity that overshadowed the home after Anderson’s arrest.

Then, he faced clearing up more than two dozen regulatory violations incurred before he took over, including residents failing to get crucial medications, untrained staff and a woman using a dirty syringe to inject herself with overdoses of painkillers. “I was looking at 88 pages of deficiencies,” Coffey said.

He fired three troubled staff members and canceled the home’s arrangement with the jail diversion program, clearing the way for eight new residents. His staff began cleaning grime from the walls and floors and putting on a fresh coat of paint. The worst problem: an infestation of German roaches.

He invested in new furniture for residents, throwing away urine-soaked mattresses and torn bed linens.

Next, he said he got training for his staff on dealing with people suffering mental illness, and imposed new rules, including a ban on physical punishment. “There has to be an underlying level of compassion,’’ he said. “They’re people.”

Throughout the transition, he was under heavy scrutiny by sheriff’s deputies, who he said were skeptical he could tame the facility. Just a year before he bought the home, police had arrested a staff worker for striking an elderly woman in the face.

When Coffey called deputies shortly after he took over to report that one resident had injured another, he said officers turned their interrogation on him.

“I was having to try to prove that I’m a different person,” he said.

Within a year, the changes were taking root: Violations found by state regulators dropped dramatically, from 34 in 2006 to just two a year later, state records show.

Over time, he said he developed a “network” of specialists, including a psychologist, doctor and psychiatric nurse to come to the facility at least once a week.

He stopped accepting people with substance-abuse problems and certain types of psychiatric disorders whom he didn’t have the ability to care for.

“If we take someone in that’s not in our scope, that’s not good for me or them,’’ he said. The same with staff members: He said he loses 40 percent of all applicants through criminal background checks.

After his second year, he said he finally felt he had the right mix of people and staff to believe the home was going to stay open.

“We had the head turned around,’’ he said.

To this day, Coffey said he believes one of the big differences in improving the facility was a new policy of not accepting every resident, even when rooms were vacant.

Too many owners fail to screen residents because the homes are guaranteed money from the state — including an average of $674 a month from Social Security and a daily stipend of $9.28 for residents with mental illness, Coffey said.

That kind of warehousing is dangerous, he said. “A lot of caregivers forget that that person’s life is their responsibility.”

Coffey said he tries to spend time with the residents, so he is able to recognize changes in their behavior — signs that a mental crisis may be brewing. “Mental health is a different beast,” he said.

He also has to spend time with his employees to know how they’re interacting with the residents. “There is no way I could do this without my staff,” he said.

On a recent afternoon, he made his way to the dining room, where Starla Kennedy was dispensing medications, checking with her on the most recent prescriptions for a resident. Before Coffey took over, Kennedy said she dreaded coming to the facility.

“I hated it. I did not like to show up here,” said Kennedy, a registered nurse who works for a state-funded mental health team. “It was dirty, it was awful.”

“Now they get their meds,” she said.

For Rodney Cochran, the home offers a shelter he’s never known before. The 34-year-old, who has lived at six other ALFs, said Coffey’s approach to him and others puts him at ease. “This is the best [home] I’ve ever lived in,” said Cochran, who has been diagnosed with schizophrenia.

By late afternoon, Coffey was back in his office. Amid a flurry of phone calls with staff and vendors, he pulled out a plastic bag full of candy.

Passing out the sweets throughout the day, Coffey said, can sometimes reverse the mood of an angry resident before it impacts others. “It costs about $20 a week,” he said.

“They don’t have anything,” he said. “They come here with a Hefty bag — that’s if they’re lucky.”

Things aren’t perfect at the home. Over the years, Coffey has been cited for minor problems, including dirty floors, torn seat covers and broken furniture.

But since he took over, he has averaged just four citations a year — less than a quarter of the home’s record under Anderson.

Also down: emergency hospitalizations of residents suffering psychiatric breakdowns, as well as police and emergency calls to the home, said Diane Carpenter, regional manager of the state Department of Elder Affairs ombudsman program.

“He’s making the changes to correct the issues,” Carpenter said. “When the residents are telling you they are no longer afraid, that speaks a lot.”