Neglected to Death

Chased by watchdogs, ALF bites back

While members of the Pinellas County ombudsman program were inspecting conditions at the Peacekeepers Den assisted-living facility, administrators were watching the watchdogs.

In late August, operators of the St. Petersburg ALF created an Internet blog with the stated purpose of allowing ALF administrators and operators to discuss their shared concerns “during this time of political turmoil in our industry.”

“We are in the middle of a political struggle,” the site said, referring to conflicts between the state’s Long-term Care Ombudsman Program, a group of volunteer elder advocates, and the Agency for Health Care Administration, which inspects ALFs to ensure they comply with state law.

In the three months since the Ombudsman Watch Group was created, the site has lobbied for greater training for volunteers, complained that volunteer inspectors have a “political agenda” and a “lack of good judgment,” called for the firing of Natalie Clanzy, the ombudsman program’s Pinellas manager, and reported with glee the firing of a key volunteer from Broward.

“The Ombudsman organization has for too long overstepped their boundaries and lost sight of their role,” a Sept. 9 blog post said. “They are walking into facilities without fully understanding the laws and rules and making public statements that are unverified by any regulatory agency.’’

The ombudsman program, the blog suggests, is less about oversight than mounting a “witch hunt.”

The blog is largely an extension of a dustup between the operators of Peacekeepers Den and Clanzy, who made unflattering statements about the facility following an August inspection, and has been lobbing healthcare regulators for months to seek improvements at the home. The ALF’s operators also were angry that Clanzy took a state lawmaker on a tour of the home without making clear to administrators who the man was.

“We view her actions as a direct violation of our residents’ rights,” said a formal complaint to the ombudsman program that was posted on the blog. Demands that Clanzy be dismissed were rebuffed by the head of the ombudsman program, Jim Crochet.

The blog fails to mention: Peacekeepers Den has been fined $9,000 by AHCA since May. This year, AHCA surveyors cited the home for failing to maintain an accurate medication record — though the home has a special license for mental health consumers — failing to ensure residents’ clothes did not get stolen, failing to document staff training, failing to document background screening for all employees, inadequate staffing and failing “to provide a safe and decent living environment for residents.” Among the problems: feces and toilet paper left in a toilet for months, and lack of hot water.

One resident, ombudsmen said, was evicted from the home due to “constant complaints.” Her gripes: The resident “stated she won’t eat the food at Peacekeepers Den since it makes her sick.” Another resident told the volunteer in May “the food also makes him sick.”

The home’s most serious problem was its roof, which, AHCA wrote, left residents “at risk of death or serious harm.”

The source of complaints about Peacekeeper’s roof problems: Clanzy, and local ombudsman volunteers, who filed two complaints to AHCA about it.

“Residents,” a June AHCA administrative complaint said, “report items getting wet due to roof leaks and ceiling material falling on them.”

AHCA has issued the home a notice that the agency intends to deny the renewal of its license. In a letter to owners dated May 24, the agency cited 52 separate violations at the home since September 2010.

“Some rooms’ ceilings had brown stains and holes, were cracked and buckled, and [were] falling onto residents,” the letter said. “The surveyor reported the facility was unable to present a plan to address the damaged roof and protect residents from further leaks or falling ceiling material.”

AHCA administrators’ displeasure was not directed only at the home, however. They also were angry at volunteer ombudsmen.

In May, AHCA’s director of field operations, Polly Weaver, complained to Crochet that volunteers in St. Petersburg created a controversy when they told Peacekeeper residents the home was going to be closed. That’s not happening, AHCA administrators said — at least not any time soon.

“The notice of intent to deny gives [the home] the opportunity — they have 21 days — to request a hearing. If they do, we will wait for the court date, and, once it’s heard, if the judge decides to uphold the denial, we’d then need to wait for a final order. Once we have this, the facility will need to close and residents will have to move. They usually enclose a stay of 30-45 days to give residents time for a safe relocation,” AHCA inspector Kathleen Varga wrote July 7 to Crochet.

“This process can take up to a year,” Varga added.

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