During a complaint investigation that same year, AHCA inspectors found a child slumped in a stroller in front of a television, with a helmet on in case the child fell. Administrators told the healthcare agency the child’s wheelchair was “out in the shed,” and that an order for a new wheelchair was supposed to have been made months earlier. No one in the nursing home’s physical therapy department had evaluated the child to secure funding from Medicaid, a state insurance program for the needy. Inspectors faulted the home for failing to provide physical therapy for some of the children in the pediatric unit.

Last May, Disability Rights Florida, a federally funded advocacy group, wrote a detailed report on a 3-year-old foster child who has spent his entire life at a small nursing facility in Orlando. Disability Rights has recommended the boy be removed from the home and placed with an adoptive family. While the institution is in a “wonderful community setting,” a report says, the home’s staff does “not take the children to the park, or for walks around the block to meet other children.”

An investigator who visited the little boy earlier this year “observed no books, flash cards, blocks, puzzles, educational DVDs, coloring books, painting items, and limited interactive toys” in the boy’s room. The boy and other youngsters in the home were placed in front of a TV “watching cartoons for several hours.”

The advocacy group said the boy was at great risk of developing Reactive Attachment Disorder, an often severe psychiatric condition that leaves children unable to form emotional bonds.

Late last June, AHCA inspectors found 17 sick and disabled children being supervised by one adult at the Golden Glades Nursing and Rehabilitation Center, the home formerly known as Florida Club Care. One little girl was punching herself in the head “with both of her hands” as the sole caregiver attempted to intervene. The 16 other children, a report said, were yelling at the aide for attention.

The home was supposed to have two other staff members assisting the activities director that day, but they both had the day off, a report said.

In September, a team of inspectors from the Department of Children & Families as well as Miami’s private foster care agency visited Golden Glades again. They found that very little had changed: “The children did not have toys in the rooms and minimal toys in the playroom,” the team wrote.

“There is an activity board by the nurses’ station that lists daily activities, however, our assessment is that there did not seem to be structured activities at the time we were there,” the team wrote

AHCA inspectors faulted Florida Club Care in 2009 when they found nurses had placed orthotic splints — designed to improve the use of a child’s hands — on the wrong hands. The devices were important, a report said, to protect the child’s “skin integrity” as well as range of motion.

Failure to protect

Healthcare administrators filed a complaint against Westminster Community Care, where the pediatric unit is called Grandma’s House, in 2007, claiming the Orlando home’s “failure” to protect a severely disabled child led to life-threatening respiratory distress. The child, whose gender a report does not specify, was blind, intellectually disabled, couldn’t speak or eat and breathed with the aid of a tube in the child’s windpipe. In July 2007, the child was diagnosed with double pneumonia, had foreign objects lodged in his or her lungs, and a temperature of 103 degrees.