The Miami Herald

Finding more filth, abuse, state moves to shut ALFs

At a Vero Beach assisted-living facility, a 300-pound caretaker was accused of yanking a frail, 89-year-old woman from a wheelchair, shaking her in the air and then throwing her on a bed, shattering the woman’s hip.

In Miami, a caretaker refused to call police after a 59-year-old woman with mental illness said she was raped by another resident in her room.

At a Port Charlotte ALF, a former Wisconsin county commissioner languished in bed for weeks, his body ravaged by bedsores so deep and infected he died from the wounds.

The homes are among three dozen probed by state agents — shutting down the Miami and Vero Beach facilities — in the longest crackdown on Florida’s assisted-living facilities in a decade.

For five months, state regulators have been slapping the state’s harshest actions on dozens of homes, forcing the shutdown of 10 troubled facilities.

To Mary Dumas, sister of the elderly woman whose hip was broken, the closing of the Vero Beach home “is a blessing,” said the Arkansas resident. “It needed to be closed down. They can’t hurt someone else.”

Prompted by a Miami Herald series showing the state was failing to close bad homes, the Agency for Health Care Administration began cutting state dollars and banning new residents from a dozen facilities.

Now, the state is moving to strip the licenses of at least 34 homes — nearly doubling the rate before the crackdown — after finding that residents were in danger.

“People did not have to suffer like that,” said Broward County mental health court Judge Ginger Lerner-Wren. “It’s been a long time in coming.”

State inspectors have been sweeping across Florida to investigate a wave of complaints, including caretakers starving residents, failing to give them crucial drugs and in one case, beating them.

At Rapha Manor in Vero Beach, the 89-year-old woman had been attacked by her caregiver and forced to lie in pain for two weeks until a former employee showed up at the home and called an ambulance, police said.

Detectives said 56-year-old Vernita Bailey yanked Rosemary Taylor from a wheelchair after she complained, shaking her “like a milk carton” before heaving her on a bed in a rage.

By the time Taylor arrived at the hospital, her left hip was shattered and her body withered to 82 pounds. “Chronically wasted,” said an AHCA investigation in June.

CASE FALLS APART

Though Bailey was charged with aggravated battery of an elder, the case was later dropped by the state attorney’s office in the 19th Judicial Circuit. The reason: Taylor, who suffered organic brain damage, was not considered a reliable witness and two other residents were afraid to talk, said Detective Jeremy Shepherd.

The home was shuttered, and weeks later, Taylor died on July 24 — her autopsy results still not released pending toxicology test results from the medical examiner in Indian River County.

At least a dozen times during the state crackdown, inspectors found caretakers breaking the law, including two stealing from mentally ill residents, one altering medical records, and two others running homes so filthy and decrepit they were unsafe.

When agents arrived at Kipling Manor in July, they found a frail woman roaming the halls soaked in urine and a man suffering from depression and multiple sclerosis shaking and pleading for help after caregivers failed to give him crucial drugs to relieve the disease symptoms.

They also discovered a home administrator failed to pass a background screening, but was still allowed to work — and was later caught stealing money from a resident.

It wasn’t the first time AHCA turned up problems at the Pensacola facility. During the past five years, inspectors found major violations — enough to press for a shutdown in 2008 — but settlements were later reached letting it stay open. A hearing is set in November on the latest action.

At Mily Home Care in Miami, a caretaker refused to call police after a 59-year-old woman with mental illness said she was raped. Even after inspectors called Miami-Dade detectives, the caretaker continued to let the suspect live there — against police orders.

Police ended up dropping the case after the woman refused to testify, and days later, suffered a psychiatric breakdown and was hospitalized. Mily was not allowed to renew its license in August.

In nearly every case of AHCA moving to pull a home’s license, inspectors found major violations, including caretakers leaving frail elders in danger.

When relatives of Richard Truax, 86, placed him in European Manor in Port Charlotte early this year, they were told he would get the care and service he needed to live out the rest of his days, reports said.

But caretakers failed to treat the gaping pressure sores that filled his body with deadly toxins.

By the time the onetime county commissioner from Pierce County, Wis., was rushed to the hospital, it was too late: His body was shutting down. Eight days later, he was dead.

Relatives said they were told by an administrator that she was a nurse — but investigators later found there were no licensed nurses on staff. A state hearing is set for December.

Time and again, inspectors found dangerous practices and hazards during the clampdown on homes, including Sunshine Acres Loving Care in the Panhandle, where raw sewage was spewing onto the property and residents were forced to shower with contaminated well water. The 54-bed home was shut down in July after a long history of neglect and abuse.

Though AHCA is now trying to revoke dozens of licenses, the cases could drag on for months, causing some elder advocates concern about whether the top regulator will settle cases.

In five homes now being targeted, AHCA had filed notices to strip the homes’ licenses in prior years, but backed off, letting them keep their doors open.

Lerner-Wren said the agency’s history of settlements weakens its efforts to close rogue homes. “A strict liability standard — without bureaucratic discretion” is needed, said Wren, who has long pushed for bad owners to be criminally charged. “There’s due process, and then there’s enabling a culture of indifference and neglect … they have to get tough.”

Though AHCA found enough violations to shut down 70 facilities in 2008 and 2009, the agency closed just seven. The Herald also found that 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.

HARD, FAST LINE

In an interview with The Herald last month, AHCA Secretary Elizabeth Dudek said she agreed with a recent legislative study that says her agency should take harsher actions, like suspensions, when it finds egregious abuses. “A hard and fast line sometimes might be a good thing,” she said.

Last month’s closing of the Munne Center in Miami-Dade, one of the state’s most notorious ALFs, came after years of lobbying by ombudsmen who say the state took too long.

“We spent years begging AHCA to close it, and what did they do? Nothing,” said Don Hering, deputy secretary of the state Department of Elderly Affairs, during a meeting in Miami two weeks ago

Bentley Lipscomb, former secretary of Elder Affairs, said AHCA needs to take a hard line, but in the end, the Legislature needs to accept responsibility.

“[The Legislature] needs to establish standards, and they need to make people live up to them,” said Lipscomb. “In the final analysis, this is laid on their door step.’’




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