Neglected to Death

Miami-Dade grand jury probes troubled ALFs

After years of rampant neglect at assisted living facilities, a Miami-Dade County grand jury has launched an investigation into conditions in the homes, including reports of frail elders dying from abuse and breakdowns in enforcement that allowed dozens of dangerous ALFs to stay open, The Miami Herald has learned.

The probe into the troubled industry marks the first time under State Attorney Katherine Fernandez Rundle that a grand jury has examined ALFs in the county, which has more than 900 facilities — the highest concentration in Florida.

The investigation was prompted by a Miami Herald series that showed elderly residents were dying nearly once a month from abuse and neglect in ALFs across the state, including the case of a 74-year-old woman in Miami-Dade who was strapped down so tightly the restraints ripped into her skin and killed her.

The newspaper series, Neglected to Death, also revealed that the state Agency for Health Care Administration found enough violations to shut down 70 homes in 2008 and 2009 — including ALFs where residents died at the hands of caretakers — but closed just seven.

“It will raise public consciousness even further than what’s been written,” said Joel Beyer, a retired Miami attorney and volunteer ombudsman for six years. “No one cared about this before.”

Prosecutors refused to comment on grand jury hearings, but sources familiar with the probe say witnesses include elder advocates, ALF owners, police and relatives of people who died from neglect.

The grand jury investigation “is great news,” said Alfredo Navas, whose 85-year-old mother, who suffered from dementia, drowned after leaving a Miami-Dade ALF where a caretaker fell asleep, the doors were unlocked and the alarms weren’t working.

The case was never investigated by AHCA — and the home, Isabel Adult Care III, never disciplined — after Aurora Navas was found floating in 18 inches of water in a pond behind the home in 2008. “When you really think about it, there was no accountability,” Alfredo Navas said.

Rundle’s investigation comes a month after a Florida legislative study called the state’s enforcement system underfunded and “deficient,” while saying AHCA needed to get tougher on rogue homes by imposing steeper fines and shutting them down.

The grand jury is expected to explore a cross section of ALFs from expensive waterfront facilities to aging, decrepit homes with long histories of neglect.

Based on other Miami-Dade grand jury investigations, the panel will more than likely look into the deeper problems undermining elder protection in Florida ALFs — once hailed as the most progressive in the nation.

More than a third of the state’s 2,850 assisted living facilities are in Miami-Dade, but the investigation could focus on the wider state policies and regulations as well.

“The reach of that grand jury will be statewide,” said Bill Dean, a former Miami-Dade assistant state attorney who now represents claimants in elder abuse cases. “ALFs are licensed by the state.”

Ironically, it was a landmark Miami-Dade grand jury investigation in 1980 into elderly abuse cases in nursing homes that led to much of the modern legislation that was passed in the ensuing years protecting residents in nursing homes and ALFs in Florida.

At the time, the grand jury found that 60 percent of the nursing homes investigated were found to provide “unacceptable or consistently very poor care.”

“It all goes back to that far-reaching grand jury,” Dean said.

Bentley Lipscomb, a former secretary of the state Department of Elder Affairs, said the current grand jury should not only investigate dangerous conditions in ALFs, but the roles of lawmakers who began stripping away crucial protections over the years and failed to intercede when regulators began cutting back on inspections.

“In the final analysis, all this is laid at their doorstep,” he said. “I want [Fernandez Rundle] to come up with a way to indict the Legislature because that’s who is causing all the problems.”

Lipscomb said he would prefer to see indictments of rogue ALF operators — not just a report.

“If Kathy Rundle comes up with a way to prosecute some people for doing bad things,” he said, it will be more difficult for the bad homes to stay open.