Neglected to Death

State clamps down on 17 ALFs

At a Miami-Dade assisted living facility, a caretaker left a sick, 72-year-old stroke victim alone without air conditioning, locking the doors in the scorching heat so the man couldn’t escape the tiny home.

At a facility in Plant City, caretakers slaughtered goats in the rear of the home to cook meals, scaring the mentally ill residents inside.

In Tampa, 27 people were forced to leave a home after residents were found languishing in filthy rooms infested by German roaches, termites and beg bugs — their bodies covered in scabs and welts.

Those homes are among more than two dozen that state agents have targeted in the past three months — shutting down the Miami and Tampa facilities — in the most sweeping crackdown on assisted living facilities in years.

After failing to clamp down on the state’s worst homes, regulators have launched investigations into dozens of troubled ALFs, imposing thousands in fines and forcing the closure of eight homes.

So far, regulators have slapped the state’s harshest penalties on 17 homes — banning new residents and slashing Medicaid funding — more than triple the number of any other time in the past five years.

From Miami to the Panhandle, nearly 100 residents have been removed from shuttered homes and placed in other ALFs.

"I’m in a state of shock because I’m so used to living in those rat holes,’’ said Paul Encin, 62, a former resident of a now closed Lauderhill home. "I felt I was trapped there.’’

The action by the Agency for Health Care Administration was prompted by a Miami Herald investigation in May that showed widespread breakdowns in the state’s oversight of ALFs, leaving thousands to fend for themselves in dangerous conditions.

To Dan Reiter, a state ombudsman who provides help to seniors in Broward County group homes, the agency’s efforts have been needed for years as the number of facilities have boomed across the state.

"They’re finally doing what they should have been doing," said Reiter, who serves on the ombudsman statewide council. More than a third of the sanctions imposed in the crackdown — including cases against four South Florida homes — came after regulators found residents in danger.

At one home in Miami-Dade, a volunteer caretaker dead-bolted the door and left a 72-year-old heart patient alone without air conditioning while the caregiver ran errands.

By the time the caretaker returned to Angelica Gardens, William Reed — in the final stages of cerebral vascular disease — was groaning in pain, soaked in sweat. "Victim complained that his entire body was hurting him,’’ said a state Department of Children & Families report. “Staff left me alone,” he was quoted by state agents.

A hospice doctor who happened to be visiting the home that day said it was the second time his patient was left alone by caretakers.

Reed was rushed to North Shore Medical Center, where he was treated and later sent to another facility. Four other residents who were not home at the time were transferred to other ALFs on June 28 under state orders.

During the state crackdown, regulators invoked emergency orders several times to protect frail residents — sometimes pulling people from troubled homes during surprise visits.

The aging Hilcrest Retirement Residence in St. Petersburg was shut down in May after residents — some with severe mental illness — were found languishing in filthy rooms, their bodies covered with welts and scabs from bed bugs.

One AHCA regulator found at least five sets of bed linens stained with blood from where people were bitten in their beds. At least 27 residents, some sleeping in rooms with peeling paint, cracked walls and broken air conditioners, were pulled from the home after regulators said they were at risk of “serious injury and major health problems." Within 24 hours, the home’s license was suspended.

Regulators said they were forced to act quickly when they visited Sunshine Acres Loving Care in the Panhandle on July 8, finding sewage spewing onto the property from a busted septic tank, a broken air conditioner, and residents forced to sleep on broken-down beds with cardboard covering box springs.

Though a well serving the home was found to be contaminated, residents were forced to use the dirty water to take showers. Regulators also found the same water was being mixed into lemonade for the residents. The home — which racked up more than 115 violations in six years — was closed two weeks ago, said an employee.

“[They] let it just go to hell,” said Dewayne Anderson, 55, who lives next door to the now shuttered 52-bed facility. "They ought to just get out there and level that place to the ground."

Over the past two months, regulators have been forced to take extreme actions — ordering homes to stop dangerous practices or face more severe penalities, records show.

When residents at Pleasant Manor in Plant City complained a caretaker and others had butchered live goats in the rear of the home for the meat — a custom in the Philippines — regulators ordered the home in July to stop the practice.

At least two residents said they could hear the animals — a mother goat and at least one kid — being slaughtered on the grounds, reports stated. Owner Bernard Aragon said the home, now banned from taking new residents, has stopped the practice.

While regulators fanned out across the state during the crackdown, they kept returning to Lauderhill’s troubled Cannon Point neighborhood — home to 11 ALFs — dozen times.

Regulators took aim at two places, Briarwood and Shalom Manor, cutting off state dollars and imposing bans on new residents after finding numerous violations, including filthy, decrepit conditions.

Paul Encin, 62, who lived at Shalom four years before it closed in July, said he was always in fear. "People were treated in an inhumane way," he said. "You had absolutely no rights."

Encin and two former residents said they watched the same caretaker beat frail people with the end of a broom handle when they broke the rules, and threaten others. “When a resident got out of hand, she’d pull it out and bang it on the table,” said Albert “Doc” King, 54, a former Army Reserve medic now living in Good Hope Manor in Oakland Park.

King said the same caretaker and another employee dragged a woman with mental illness into the courtyard, stripped off her clothes and hosed her down after she urinated.

Encin said he was surprised the state took four years to impose tough sanctions. “I could not understand how they could have not known what was going on,” he said.

Over the past three years, AHCA turned up 59 violations at Shalom, including caretakers allowing residents to languish without crucial drugs and medical treatment.

In May, employees found a 46-year-old man not breathing in his room, but never performed CPR, instead tossing a blanket over his body, making breakfast, and waiting 37 minutes to call 911, police reports stated. He was pronounced dead by paramedics. Emmins Henry, the home administrator, did not return phone calls.

Former residents said they are relieved to be in new facilities. “I don’t think I could have stayed there another six months,” said Tony Willard, 72, who said he grew weary of the deteriorating conditions. “It was getting so bad.”

For he and others, the shuttering of Shalom was heartening, but for elderly advocates, the state’s crackdown is expected to pose more problems on a larger scale.

Karen Lakritz, a behavioral specialist on Florida’s West Coast who provides help to residents with mental illness in ALFs, questioned whether there would be enough homes for displaced residents in some areas.

“In some counties, there are no places for them to go,” said Lakritz, a licensed social worker who has worked 30 years in ALFs. In addition to disciplining bad homes, the state needs to “encourage decent people to go into this [industry],” she said. “Increase funding, education. The state bears responsibility on many levels, certainly for allowing them to get this bad.”

Kenny Malone with WLRN-Miami Herald contributed to this report.