Neglected to Death

State moves to shut down money to ALFs

Florida health administrators are slashing hundreds of thousands in taxpayer dollars to a troubled Tampa Bay assisted living facility chain in a move that could jeopardize the homes’ ability to keep their doors open.

The action by the Agency for Health Care Administration leaders to stop Medicaid dollars to the homes comes two weeks after a caregiver at one of the facilities was arrested for rape, and one month after The Miami Herald profiled the homes in a series, “Neglected to Death,” which showed the state had allowed scores of problem homes to remain open — sometimes for years — despite a litany of abuses.

In a letter dated June 13, the state agency informed the owners of the Mapleway Communities ALF chain that, beginning in 30 days, they will no longer be able to bill for services under Medicaid, the state and federal insurance program for needy and disabled people. Medicaid pays for a variety of services for people with developmental disabilities at the homes.

“AHCA has determined that it is no longer in the best interest of the Medicaid program for these providers to continue participating,” an agency spokeswoman, Shelisha Coleman, said Wednesday. Coleman said AHCA employees hand delivered the termination letters to Mapleway Tuesday, and are working with staff at two sister agencies — the Department of Children & Families and the Agency for Persons with Disabilities — to counsel residents who will be affected by the action and may need to find new living arrangements

The three Mapleways Communities homes in the chain are Hillandale in New Port Richey; Mapleway in Safety Harbor, near Clearwater; and Amelia’s House, in Pinellas Park, near St. Petersburg.

“Prior to the termination, Medicaid coordinated with Agency for Persons with Disabilities and other state agency partners to evaluate the impact of the termination actions including available beds in other facilities and identification of case managers,” Coleman wrote in a short statement to The Herald.

John Ross, the chain’s administrator, declined to comment to a Herald reporter Wednesday.

The health care agency’s action came a month after The Herald’s series about AHCA’s failure to supervise Florida assisted living facilities, which once were hailed as a national model of care for elders who require some assistance, but do not need to live in a nursing home. In recent years, some of the state’s ALFs have become a magnet for abuse and neglect.

The series included significant reporting on the Hillandale ALF, the largest of the three homes in the Mapleway chain, and the most troubled: Caregivers have been caught forcing residents into locked closets, doping them with powerful tranquilizers and physically restraining them with violent takedowns.

While AHCA administrators last month declared that Hillandale had resolved its problems and was not under any sanctions, the state disabilities agency has refused to send thousands in housing dollars to the facility since 2005, citing ongoing concerns. A decade’s worth of records showed Hillandale had been plagued by violence among residents and staff, including two reported rapes and a death that elder abuse investigators attributed to caregiver neglect.

In May, just weeks after the series was published, police in Pasco County arrested 57-year-old Orlando Baez, who admitted to sexually abusing a 26-year-old woman living at Hillandale. The reported victim told deputies that Baez coaxed her out of view of the facility’s security cameras and sexually abused her, including one incident when he told her to meet him in a bathroom and disrobe.

Baez was initially suspended and later fired from the home.

The arrest was the second of a Mapleway Communities employee for sexually molesting vulnerable residents under their care: another man, Richard Langford, was charged and convicted of sexual battery in 2005 after he enticed a disabled woman into allowing him in her room by offering her colored markers, then forced himself on her.

On Monday, AHCA took one of the strongest steps available to it short of yanking the homes’ license to operate.

Under Florida law, the state may terminate a Medicaid provider’s agreement with the state for any reason. Without the agreement, health care providers cannot bill the insurance program for services, and many practitioners find they can no longer remain in business.

“Under the circumstances, with no ability to bill Medicaid, you would think they would not be able to have the finances to provide services,” said Michael Messer, who heads the Association for Retarded Citizens of South Florida, a program for children and adults with disabilities. “They should not be allowed to continue to operate, period.”

Without a Medicaid agreement, Mapleway could continue to house clients who either can pay out-of-pocket or through private insurance, though few ALF residents with such disabilities are capable of paying privately, Messer said. “Why the state doesn’t just yank their license, or put pressure on them to go out of business or find someone else to operate the facility, I don’t understand,” he said.

Shelisha Durden, another AHCA spokeswoman, said she could not answer questions from a reporter late Wednesday, among them how many Mapleway residents might be affected by the action, and why AHCA did not act against the homes’ license to operate.

Meanwhile, a separate state department, the Agency for Persons with Disabilities, is already seeking new homes for 10 agency clients who live in the ALFs – six in Hillandale and four in Mapleway, said Jeff Saulich, an APD spokesman in Tallahassee.

Specialized social workers, called support coordinators, “have begun the process of counseling our clients and researching other residential options for them,’’ Saulich said.

Deborah Linton, an advocate for disabled people who heads the ARC of Florida, praised heath care administrators Wednesday for taking action against the ALF chain, which had drawn the ire of state disability administrators and advocates for several years.

“I’m so happy this chapter is closing,” Linton said. “But our main concern is there are others who need to be protected. We all need to be vigilant so that some of the state’s most vulnerable citizens are protected.”