With Floridas elderly population expected to boom in the next two decades, state regulators must crack down on rogue assisted living facilities by shutting down homes where residents die from abuse, slapping harsher fines on places that repeatedly break the law, and boosting the qualifications of people who run ALFs, a legislative study says
A report released by the state Senate calls for sweeping changes in oversight of ALFs, asking lawmakers to improve a state system thats woefully underfunded, allows caregivers to work with inadequate training and relies on deficient enforcement to protect thousands of frail residents.
The rotten apples need to be shut down, and [regulators] were not doing it, said Sen. Eleanor Sobel, a Hollywood Democrat and vice chair of the Health Regulation Committee, which headed the investigation. The Agency for Health Care Administration needs to step up to the plate and do the job theyre supposed to do.
The release of the interim project report is the latest effort by elected leaders to overhaul Floridas oversight of ALFs, which has been severely criticized for allowing some of the worst homes to stay open, despite decrepit and dangerous conditions.
The study, carried out by Senate staffers over the past two months, was prompted by a Miami Herald investigation in May that found that dozens of vulnerable residents died of abuse and neglect in homes nearly one a month since 2002 and that the worst facilities were still in business.
Among the studys key recommendations: strip AHCAs discretion to bargain down punishment when inspectors find the most serious abuse such as death or serious injuries from neglect and compel the agency to take tougher action to close homes.
ALF residents may be better protected if the AHCAs discretion to deny, revoke, or suspend a license were removed when a facility has committed the most egregious acts, such as when a death occurs due to an intention or negligent act for which the facility was complicit, the report said.
The report also recommended that AHCA be forced to impose severe fines, ban new admissions and suspend licenses when a homes negligence presents a threat to the health, safety or welfare of a client.
Among the reports findings:
• The healthcare agency is failing to keep up with inspections of the states 2,956 ALFs as required by state law nor is it collecting enough fees from homes to cover the costs of its visits.
• At least 23 other states require greater qualifications for people to operate an ALF including college degrees and gerontology coursework while Florida requires only a high school diploma and 24 hours of training.
• Regulators must ramp up inspections of Floridas most troubled homes, including those that care for residents with chronic mental illness, where many of the neglect and abuse deaths occur.
• Sixty percent of residents with severe dementia, such as Alzheimers disease, wander from homes, and caregivers are ill-equipped and inadequately trained to handle such residents.
The problems of the states enforcement come as the number of elders in Florida continues to increase from 3.3 million today to 4.5 million a decade from now with many of those seniors choosing to move to assisted living facilities, the report says.