Neglected to Death

Troubled Tampa nursing home loses funding, will close

Federal health regulators are cutting off all Medicaid and Medicare payments to a Tampa nursing home that was accused earlier this year of failing to provide “meaningful” activities to the severely disabled children who live there — making Lakeshore Villas the second pediatric nursing home to close this year amid controversy over the warehousing of frail children.

The U.S. Centers for Medicare and Medicaid Services — which foots the bill for the vast majority of frail elders in nursing homes, and almost all the children — will cease payment to Tampa’s Lakeshore Villas on Aug. 12. After that date, residents can only remain at the nursing home if they have private insurance or can pay on their own.

But the home’s problems don’t end there: the Florida Agency for Health Care Administration, which inspects and regulates nursing homes, informed Lakeshore on May 22 that the state would not renew the home’s license “based on the regulatory history of the facility,” said Michelle Dahnke, an AHCA spokeswoman. Though Lakeshore’s state license expired on June 29, the facility remains open during an appeal by its owner, Senior Care Group, Inc.

In a short statement, the home’s administrator said Lakeshore will shut its doors on Aug. 12.

“Lakeshore Villas is currently notifying the nursing home residents, their families and the employees of the pending closure,” the statement said. “Lakeshore Villas Health Care Center has provided many years of care in Hillsborough County and it has been a privilege to serve the local community in this way,” said Jacqueline Hurt, the interim administrator.

Hurt said the home’s staff “worked diligently” to correct a host of deficiencies identified by health care regulators, and administrators believe the home “is in compliance with all regulationsThe nursing home will remain operational until all residents have been safely transitioned to alternate settings.”

Since about 2010, Lakeshore Villas has remained one of the state’s worst nursing homes, according to its state regulatory history. The Tampa home had been given 14 severe deficiencies by the health care agency, including 10 citations for deficiencies that left residents in “immediate jeopardy,” and another four that documented “actual harm” to residents.

Lakeshore, which is licensed for nearly 180 total beds, has been fined by the state five times since 2007, for a total of $81,000. The home has spent much of the last six years on a “watch list” of marginal homes, with only a “conditional” license to operate. Since 2011, federal regulators have imposed an additional $292,298 in fines, making Lakeshore one of the highest-fined homes in the state.

Neither the federal cutoff nor the state’s license revocation will “result in immediate transfer for all residents,” AHCA’s Dahnke said, “though it may be the facility’s decision to close as a result of losing their Medicare and Medicaid eligibility.”

Lakeshore Villas was thrust into the spotlight last fall when the U.S. Justice Department’s civil rights division accused the state of cutting community services for medically fragile children so deeply that many families had no choice but to institutionalize their children in nursing homes. At the time, Lakeshore was one of six nursing homes across the state that accepted pediatric patients. With the home’s closure, only four homes will remain. Golden Glades Nursing & Rehabilitation, a 180-bed Miami Gardens home, closed its pediatric wing earlier this year amid similar regulatory scrutiny.

AHCA, which administers the state’s Medicaid program for needy and disabled Floridians, long has defended its policies for the treatment of frail and disabled children, and the agency’s secretary has insisted repeatedly that children in nursing homes are well-cared for and are given a meaningful education and stimulating activities.

But an AHCA inspection last March found that Lakeshore “failed to provide meaningful, chronological age and developmentally appropriate structured activities” for two of the three children the agency observed closely on March 7, the day of an inspection.

Entire days went by, the report said, without any documentation of activities staff entering the pediatric ward. One visit lasted less than 30 minutes

Elders at the home often fared no better, AHCA records show.

Federal regulators fined Lakeshore $225,837, the second-highest federal fine in recent memory — in addition to a $43,500 state penalty — in 2011 when a “vulnerable” 83-year-old woman was repeatedly sexually assaulted by another resident. The 83-year-old suffered from blindness, senile dementia, failure to thrive and muscle weakness. “After the first event,” an AHCA report said, “the facility failed to protect [the other resident] from future continued sexual assaults.” Staff had been put on notice, records say, that the 84-year-old assailant had been aggressive toward the 83-year-old, and had failed to protect the alleged victim nonetheless.

The home also was faulted for failing to call police after the assault, as the home’s resident abuse policy demands.

Brian Lee, who heads the elder advocacy group Families for Better Care in Tallahassee, said he views Lakeshore’s closure as “bittersweet.”

“Hopefully,” Lee said, “residents will get better care” if they are moved to a different nursing home.

Still, being forced to leave a nursing home, especially one that has been home for many years, often presents serious challenges to elders and others with dementia and other cognitive disorders.

“Whether it’s children in nursing homes, or elderly adults or disabled adults, this type of relocation — emergency relocation — can cause psychological, and potentially physical, harm to residents,” Lee said. “As bad as Lakeshore Villas is, residents call this their home, and they are used to this place.

“It’s going to be hard for them to adjust,” Lee added. “If they are trying to find their way to the bathroom to brush their teeth, or even just knowing where the mirror is, it will be a whole different environment. This can cause emotional distress.”