Its license revoked, ALF become dumping ground for homeless

Bay Gardens Retirement Village seemed to get worse every year.

In 2005, state inspectors found filthy, reeking bathrooms, a raccoon living in the ceiling and a patient whose genitals had been bitten by ants.

In 2007, they discovered a demented man, smeared in his own filth, plucking at his colostomy bag in a stinking, roach-infested room.

In 2009, cutting tools and toxic chemicals lay within easy reach of mental patients. The hallways smelled of cat urine and echoed with an intermittent beeping — the sound of batteries dying in the building’s smoke detectors.

For years, the state of Florida had an abysmal record of failing to discipline the operators of dangerous ALFs. A series of stories in the Miami Herald cited similarly bleak conditions around the state and documented more than 70 deaths and a host of injuries over a 10-year period. The series spurred Gov. Rick Scott to appoint two task forces to study the issue and recommend sweeping reforms — only to have lawmakers beholden to the industry reject proposals to beef up oversight.

But lackluster track record or no, the state did crack down on Bay Gardens, issuing 18 fines in five years, then stripping the Hillsborough County home of its assisted living license in 2010.

Now, a Tampa Bay Times investigation has found that, notwithstanding its lack of a license, county officials have steered scores of sick and dying homeless people to Bay Gardens.

Public records and interviews with more than a dozen former tenants show that the home became a regular stopover for people with disabilities, terminal illnesses or profound mental or physical ailments.

All of them spent their days at Bay Gardens unaided or forced to depend on untrained staff for help.

Since 2011, Hillsborough’s troubled Homeless Recovery program has sent at least 130 ailing men and women to Bay Gardens.

On Friday, County Administrator Mike Merrill responded to the facts laid out in this story by sending a memo to commissioners.

He wrote that his staff was unable to review the cases identified by the Times because of the way the county’s records were kept.

He noted that an internal audit — prompted by previous stories in the Times — was already under way.

Bay Gardens’ owner and administrator, Elsa Thomas, said the business has operated as a legitimate independent living home since losing its assisted-living license in 2010.

“We’re not warehousing people,” Thomas said. “The people who live here are cared about and cared for.”

Times reporters who visited this past month found clean common areas and hallways that smelled of disinfectant. Facing scrutiny by the county, Bay Gardens failed two recent code inspections, but passed a third in October.

Even so, experts in assisted living said Bay Gardens’ practice of taking in the sick and dying, paired with former tenants’ accounts of life there, paint a picture of a business operating on the edge of the law.

The people the county sent to Bay Gardens are in "immediate jeopardy of harm," said Brian Lee, executive director of Families for Better Care, a group that advocates for better conditions in nursing and assisted living homes.The state forced Bay Gardens out of the assisted living business in 2010.

Instead of closing the 25,000-square-foot complex, the owners found a way to take in even more sick people.

Florida’s Agency for Health Care Administration requires regular inspections of ALFs as part of licensing.

Unburdened by those inspections, Bay Gardens expanded from 81 beds to 101, putting as many as four people in a room. It began working with hospitals and aid agencies that pay small sums to house the poor.

One of them was the county’s Homeless Recovery program.

Today, Bay Gardens exclusively takes in men and women with medical problems, Thomas said.

According to Thomas, the key difference between Bay Gardens and an assisted living facility is this: All of her current residents are totally independent.

They need no help dressing, bathing or taking medicine, she said. They don’t need the monitoring that patients in assisted living are supposed to get.

“We kind of bridge the gap between living on your own and living in an ALF,” Thomas said. But Hillsborough County sheriff’s reports, interviews with former residents and visits to the home tell a different story. Several people sent to Bay Gardens by Homeless Recovery in the past three years have straddled the line between dependence and self-sufficiency.

Two were so overweight they had trouble doing simple tasks. Two were severely bipolar. Two had spinal injuries from car crashes. One was a terminal alcoholic with hepatitis, liver disease, colitis and a colostomy bag. One had Stage 4 colon cancer.

Five former tenants told the Times they saw employees of Bay Gardens hand out prescription drugs, something that, under state law, only should happen at licensed facilities.

They said the job most often fell to one employee — the janitor.

“There’s a little nurse’s office there,” said Curtis Kingcade, 58, whose blood-clotting disorder led the county to place him in the home three years ago. "Sometimes they would lock certain people’s medicine up there. They would give people pills."

Gina Abella, 50, who was sent to the home in March 2012, said she regularly saw residents sitting in full diapers. “Some of them were filthy.”

When Abella got there, one resident suffered from dementia so severe he didn’t know the year or who the president was, according to a nurse’s evaluation described in a sheriff’s report.

The 53-year-old strayed from the home one day in March 2012.

Police found him 12 hours later wandering the neighborhood.

In her interview with the Times, Thomas said the home turns away people who need constant medical care and does not operate as an assisted living facility. She said former residents who reported seeing staff hand out medications likely mistook visiting nurses for employees.

Former tenant Dane Bowen, though, said he was sure of what he saw during his 18 months at Bay Gardens.

The 48-year-old with severe bipolar disorder said the place was full of people whose health problems should have landed them in assisted living. “Everything from bad heart problems to torn ligaments, broken arms and legs or serious mental illnesses," said Bowen, who now lives in Plant City.

Eva Harrell, 54, was diabetic, stricken with heart problems and so overweight she couldn’t walk more than a few dozen steps at a time.

Dane Bowen, the bipolar resident who saw employees handing out medication, had an active case of tuberculosis in his eyes. “I wasn’t contagious, but they wanted me to keep a lid on it,” he said of his county caseworker and the staff at Bay Gardens.

Loretta Houck, 46, was admitted in October 2012 with a history of seizures and a diagnosis of hepatitis C, asthma, brain lesions, hypertension and rheumatoid arthritis. She died at Bay Gardens a month later of heart failure.

It’s unclear how county employees decided where to send sick homeless people.

County spokeswoman Lori Hudson has said they had no written policies to follow.

The two top managers who oversaw the troubled program aren’t around to answer questions: One resigned in September and the other was fired.

The founder and first owner of Bay Gardens was Tampa cardiologist Kiran Patel, a multimillionaire and philanthropist who made his fortune in managed care. Patel hired an experienced administrator who refused to cut corners.

But he sold Bay Gardens in the late 1990s to John Varughese, a fellow doctor.Varughese fired the home’s administrator of 10 years and died soon after of a heart attack. That left running the home to his wife, Ramani Thomas, whose prior business experience included operating a convenience store.

Soon, Bay Gardens’ spotless inspection reports were giving way to a string of citations for serious problems. In 2010, the business lost its license.

The home has continued to house the sick and disabled, only now they are not in the care of trained nursing assistants.

Today, the night manager is 51-year-old Kathryn Fuller, a Homeless Recovery client. She lives at Bay Gardens and runs the kitchen during the day. Sometimes she looks in on residents at night.

On a Saturday in August 2012, she called sheriff’s deputies and demanded they pick up a drunk resident who was breaking furniture in his room. Instead of jail, they took him to a hospital. He wasn’t drunk, a nurse told the deputies, according to a report. He might have been having a stroke, she said.

The day manager has his own problems. George Thomas, Ramani Thomas’ 34-year-old son, has been arrested 24 times since 1997 on charges ranging from theft to aggravated stalking.

In 2006, state regulators documented complaints about him from residents and employees alike. They said he propositioned tenants for sex, offered them drugs and berated staff members until they cowered in back rooms, neglecting the tenants who needed attention.

The state responded with an emergency order barring Bay Gardens from admitting new patients. Regulators lifted the moratorium only after the mother agreed in court records never to let her son near residents or staff again.

Now that the home is unlicensed, George Thomas is around tenants all the time.

Thomas was there to greet Keith Reck when the county sent him to Bay Gardens in June 2012.

In another life, Reck had been a successful car salesman. He had had a wife and a daughter and had delighted in his fishing poles, his football memorabilia, his flat-screen TVs.

By the time he got to Bay Gardens, though, the 55-year-old was helplessly ill. An alcoholic with liver cancer, colitis and a colostomy bag, Reck might have gotten extra attention at a licensed assisted living facility.

Instead, he passed the time at Bay Gardens driving back and forth to convenience stores, buying booze. His roommate found him dead in his bed about three months after he moved in.

The Miami Herald contributed to this report.