State oversight

Inside a nursing home: cartoons, tunes and tears

 

A recent inspection at one nursing home caring for children found significant shortcomings.

cmarbin@MiamiHerald.com

A day in the life of a children’s nursing home:

•  8:15 a.m.: Resident 2 is parked in the hallway in a stroller. The 3-year-old’s head is in a “slightly arched” position, and his eyes roam the hallway. His lips are chapped.

•  8:45 a.m.: A baby is wheeled into the hallway in an infant carrier next to Resident 2. A mobile is strapped to the baby’s carrier, but no one turns it on.

•  10 a.m.: Resident 1, a teenager, screams “out” from his room, and he is wheeled into the hallway and parked next to Resident 2 and the baby. He reaches over to touch one of them. In what appears to be the children’s first interaction with staff, a caregiver plays nursery rhymes on a CD player.

•  11 a.m.: Residents 1 and 2, the baby and six other youngsters are brought into an activity room. For 30 to 40 minutes, the children are given physical and occupational therapy, watch Dora the Explorer cartoons, and listen to music. A toddler is rocked back and forth by the nursing home’s activities director. Resident 2 cries inconsolably and is sent back to his room.

•  11:35 or 11:40 a.m.: Activities end, a nurse cleans the mats where the children were playing, and the youngsters return to their rooms or a hallway.

Such is the scene described after a recent investigation of Lakeshore Villas Health Care Center, a 179-bed Tampa home with a 15-bed pediatric wing. The March report was the result of a complaint to the state Agency for Health Care Administration.

In response to the inspection, Lakeshore said it had “immediately” revised the activities schedule for Residents 1 and 2, and initiated an audit of the pediatric wing, in general, “to ensure that each resident receives structured activities in which to promote stimulation and learning opportunities.”

The inspection comes at a time when Florida’s practice of raising severely disabled children in geriatric nursing homes already was under a harsh spotlight.

The survey is the most recent of several critical reports by the healthcare agency and others involving nursing homes that also house children. In it, AHCA administrators accuse the home of violating state laws that require nursing homes to provide stimulating activities to frail children, some of whom are physically disabled but intellectually sharp.

The complaint comes six months after AHCA’s top administrator, Liz Dudek, insisted to reporters that pediatric nursing homes were “warm, nurturing” places with a host of enriching activities — and even take children out on field trips, such as excursions to farms to ride horses.

“These reports that they throw somebody in a back room somewhere, where it’s not at all child-based, where they don’t talk to the child, that’s not true at all,” Dudek said.

The Lakeshore Villas report suggests otherwise.

“The facility,” AHCA wrote, “failed to provide meaningful, chronological age and developmentally appropriate structured activities” for two of the three children the agency observed closely on March 7, the day of the inspection.

Entire days went by, the report said, without any documentation of activities staff entering the pediatric ward. One visit lasted less than 30 minutes.

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