Neglected to Death

Leader’s departure ends tumultuous time for Florida’s program to protect nursing home, ALF residents

When Harold J. “Jim” Crochet, Florida’s top watchdog for residents of nursing homes and assisted living facilities, quietly submitted his retirement papers last week, it marked the end of a tumultuous administration that prompted widespread criticism Crochet had turned the Long-term Care Ombudsman Program into a rubber stamp for the powerful industry.

Because he had been placed on “indefinite” leave as the Department of Elder Affairs, which houses the Ombudsman Program, conducts an internal investigation into undisclosed allegations of wrongdoing, Crochet likely will never return to the agency he headed for more than two years.

Nevertheless, the inspector general’s investigation will continue, said Ashley Marshall, a Department of Elder Affairs spokeswoman.

Crochet, whose home number appears to be disconnected, could not be reached by the Miami Herald.

“I would like to see the governor, or the Elder Affairs secretary, appoint an ombudsman who brings the program back to the way it used to be, when it played a meaningful role in the state of Florida to help protect vulnerable seniors,” said Sen. Eleanor Sobel, a Hollywood Democrat who chairs the Senate’s Children, Families and Elder Affairs Committee. “I’d like them to appoint somebody who understands the [federal] Older Americans Act, which requires the independence of ombudsmen.”

Crochet, who submitted retirement papers Tuesday, is one of three high-level appointees of Gov. Rick Scott to leave under a cloud in recent weeks. Department of Children & Families Secretary David Wilkins resigned July 18 amid growing concern over the deaths of four small children his agency had failed to protect. (Since Wilkins’ departure, the number of deaths has risen to seven.) And Scott’s education commissioner, Tony Bennett, resigned Thursday after the Associated Press reported he had revised the Indiana school grading system to benefit a political donor while he was that state’s superintendent of public instruction.

Crochet was a controversial choice to lead the Ombudsman Program, which provides volunteers to advocate on behalf of nursing-home and assisted-living residents statewide. He was appointed after a popular predecessor, Brian Lee, was fired when he tried to use a provision of the federal Affordable Care Act to obtain ownership information on nursing homes throughout the state, angering the industry.

Largely regarded as cozy with the long-term care industry, Crochet was recommended for the job by the state’s largest association of assisted-living facilities. After he took the job, he set about dramatically limiting the power of his own volunteers, writing new policies that restricted ombudsmen from inspecting homes at all. Under Crochet’s leadership, volunteers were allowed only to visit long-term care residents and ask them how they felt about their living conditions.

Critics of the new policy said it would leave many residents unprotected: A large number of nursing home and assisted living residents, they said, suffer from dementia, and are not cognitively able to evaluate their care and express concerns.

“You can’t expect them to tell you what’s going on,” said Sobel. “You need volunteers who can look around, see if the sheets are clean, if there is food in the refrigerator and if there are insects in the bed.”

Other residents, critics charged, would be too afraid to speak up openly against their own caregivers.

In the wake of Crochet’s policy changes, many of the program’s most experienced volunteers resigned or were fired.

Industry leaders were delighted with the policy. They argued the Ombudsman Program was never designed to be a regulatory agency. The state’s Agency for Health Care Administration is tasked with inspecting homes, industry leaders said, making volunteer inspectors redundant.

One advocacy group for elders, Maryland-based Voices for Quality Care, called Crochet’s suspension – and the program’s general unraveling – “the last straw” in a letter to the U.S. Administration on Aging, which oversees state ombudsman programs.

“Not only are the residents of Florida being denied the full Long-Term Care Ombudsman support all U.S. citizens are entitled to, Voices volunteers trying to accommodate helpline callers from Florida are also being denied the ability to refer to this program with full confidence,” Chairwoman Kate Ricks wrote.

“With this latest weirdness, this program now just seems to us to be totally out of control. We cannot refer anyone to it with any degree of confidence until we receive some assurance that it is, indeed, functioning properly.”

Former ombudsman Lee, who now heads an advocacy group called Families for Better Care, said it will take time for the elder advocacy group to regain its power.

“He crippled it; he really crippled it,” Lee said of Crochet’s leadership.

Knowing that he had won the job with the support of the assisted-living industry, Crochet “took the program down a different path, and substantially weakened it,” Lee said. “It was not overnight, but incrementally he weakened the program and its oversight for residents. He just placated the interests of the industry.”

“I don’t know how it can recover,” he added.