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DCF chief inspects Miami Gardens nursing home where girl died

Florida’s top child-welfare administrator visited children Wednesday at a troubled Miami Gardens nursing home that is under investigation over its treatment of medically fragile children in state care.

Department of Children & Families Secretary David Wilkins flew to Miami Wednesday and led a team of child-welfare administrators and nurses who inspected Golden Glades Nursing & Rehabilitation, a 180-bed nursing home that was levied one of the harshest federal fines in recent history after the death of a 14-year-old Tampa girl who was taken to the home last year despite her mother’s emphatic objections.

DCF oversees three children at the home, who are among the 36 children with medical complexities who live there.

Along with the agency’s Miami chief and a local pediatrician, Wilkins delivered stuffed animals to the children, and spoke at length with the home’s administrators.

“It’s unfortunate to see any child there,” he told a reporter after leaving the home. “Our model now is to make it very hard for a child to be in this type of facility.”

Until the past few days, five DCF children lived at Golden Glades. But the state’s privately run foster-care agency in Miami, Our Kids, removed two children in its care — one was sent to a Broward medical center, and the other to a medical foster home licensed by Our Kids.

The state Agency for Health Care Administration began an investigation of Golden Glades last week after DCF leaders filed a formal complaint.

Inspections by AHCA staff last week and Monday found “no immediate concerns to the health and safety” of residents, AHCA’s general counsel, Stuart F. Williams, wrote in a letter Monday to a Miami lawyer, Matthew Dietz, who filed a lawsuit claiming the state was violating the civil rights of disabled children by forcing them into nursing homes.

Child-welfare officials, however, have registered serious concerns about the home.

After his tour of the nursing home at 220 Sierra Dr., Wilkins declined to discuss what prompted the agency to file a complaint with healthcare regulators other than to say that a nurse overseeing dependent children at Golden Glades became upset when detailed care-giving instructions for one or more children had been ignored. One of the home’s doctors resigned abruptly last week, as well.

DCF and Our Kids staff discovered that, although child-welfare bosses had been assured the children would be seen by doctors on a daily — or, at least, a regular — basis, the home’s pediatrician had not seen the children in weeks, sources told The Miami Herald.

That was when DCF and Our Kids began an effort to transfer dependent children either back to their parents, into medical foster homes or to other nursing homes.

Two dependent children might remain indefinitely, Wilkins said, because they are too frail to move.

Golden Glades, which used to be called Florida Club Care, came under heightened scrutiny in recent weeks after extensive coverage of the home in The Herald, including a story about 14-year-old Marie Freyre, who died less than 12 hours after she arrived at the home.

Marie, who had severe cerebral palsy and a seizure disorder, had been taken from her mother and sent by private ambulance to the home against her mother’s wishes. She was not given life-saving anti-seizure drugs, records show, and died of a heart attack.

The investigation of Golden Glades that began last week is taking place just after the home was credited with correcting problems identified following three complaints that were investigated only a month ago.

In one complaint, a child with a host of medical conditions and disabilities was sent by ambulance to a hospital for emergency treatment. Though the home is required to alert the child’s parents or guardians, it failed to do so, records show.

In another case, the agency concluded the nursing home staff failed to investigate how a resident broke a bone, as the law requires.

And in late June, the home was faulted for failing to adequately staff the children’s wing.

During a visit, inspectors found 17 children being cared for by only one staff member during “activities.” A report said a girl was repeatedly hitting herself on the head. The one staff member was trying to protect the girl “while other residents were calling her for assistance.”

Dr. Gwen Wurm, an Our Kids board member who runs the medical foster care program for Jackson Health Systems, joined Wilkins on Wednesday’s tour, and, although she believes parents should be able to choose where their severely disabled kids receive care, she favors removing children from institutions as much as possible.

All children in nursing homes, Wurm said, should have both an attorney and an “advocate” whose job it is to look for ways to return the child to a home or community setting whenever possible.

“The vast majority of children with severe disabilities can be cared for in a home environment with appropriate services in place,” Wurm said.