Though AHCA had turned up enough violations in prior years to shut down the home, it didnt do so even allowing the facility to operate without a valid license until reaching a settlement in 2006. Since then, it turned up 44 more violations, but it wasnt until the ombudsman program called fire inspectors last year that AHCA took action to close the home.
Bilmar Gardens would still be open today if not for the ombudsman program, said Gillespie, who resigned his job recently to work for the city of Orlando.
Differences between AHCA and local ombudsmen also erupted two years ago when AHCA refused to shut down the troubled Munne Center, a Miami-Dade facility where a 71-year-old woman suffering from Alzheimers disease was raped and other residents were found languishing with life-threatening conditions.
At one point, Hering threatened to hold a news conference to expose the states failure to act, but AHCA arranged a settlement with the home in 2009. In the ensuing years, however, conditions grew worse. Munne was finally shut down last month, following a scathing, 63-page report that uncovered a litany of violations: poor training of key employees, a failure to hospitalize residents with life-threatening pressure sores, scorching temperatures inside the building, foul odors, filthy bathrooms, stained floors and broken furniture, and the homes habitual inability to keep track of its residents.
During another inspection in Miami-Dade, Hearne said he found an elder had just been beaten up by another resident. No caregiver was in sight, and the ALF owner was at work elsewhere, unable to return to the facility.
We find these things out, Hearne said. AHCA does not see it, and we will not find it under the new policies and procedures going into effect.
Volunteer Joel Beyer drew applause from other South Miami-Dade council members last week when he attacked the new form: Residents, he said, need us.
In an interview with The Herald, Crochet dismissed the criticism, saying the overwhelming majority of volunteers throughout the state had embraced the new assessment process, and the Miami area represented but a small pocket of resistance.
That may be what youre hearing in Miami, Crochet said in the interview, but I can tell you that is not going on across the board.
But other councils have complained, as well.
In his comments to the Miami group last week, Hering acknowledged that the new assessment had become a bone of contention everywhere as he criss-crossed the state visiting local councils. The argument I hear across the board is we dont need to capitulate to the guys or gals who are after us, he said.
And in September, the Broward County Ombudsman Council drafted its own recommended assessment guide, which included a laundry list of items to inspect, including the safety of cleaning supplies, swollen or dented canned goods, evidence of roaches and rodents, medication carts, and the cleanliness of bathrooms and kitchens. The outline also encourages inspectors to look for signs of life-threatening pressure sores, bruises or other injuries, insect bits and rashes among residents.
Members were appreciative that the assessment is resident-centered, the council wrote, however, it was felt that there were areas of resident health and safety that the residents themselves would not be in position to be aware of unless or until tragedy strikes. These areas have been included in past assessments and have frequently uncovered egregious conditions that could impact resident health and/or safety.
Crochet insists the program has as many, if not more, volunteers than when he took office in May, and takes issue with the suggestion made by Miami council members that the programs new direction has led to a spate of firings and resignations. The firings, in particular, sparked criticism from members of the state Senates Children, Families and Elder Affairs Committee, who grilled the Department of Elder Affairs secretary at a meeting earlier this month.
One South Miami-Dade volunteer, Teresita Mestre, resigned in the middle of last weeks council meeting, eliciting an audible gasp. Mestre said she became an elder advocate after seeing her father treated poorly at an ALF at one point, she discovered caregivers had simply put a second diaper on her dad rather than clean him up. But changes in the ombudsman program, she said, will leave it crippled.
Some people are afraid to speak up to you because of retaliation, she said of the requirement that volunteers only investigate what residents tell them. Even caregivers are afraid to speak to you.
We are not respected anymore, Mestre added.
State Sen. Eleanor Sobel, a Hollywood Democrat who as vice chair of the Health Regulation Committee is helping draft a brill overhauling ALF oversight, said the programs woes go far deeper than a lack of respect.
Sobel said she is infuriated by the criticism of a volunteer corps that should be recognized as heroes, and instead, they are being attacked.
Theres a gag order on them, she said. This is not a totalitarian state.