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After years of lax regulation, state finally cracks down on ALFs

TALLAHASSEE — After years of failing to crack down on abuse and neglect in homes for the elderly and disabled, the state agency that regulates assisted living facilities quietly imposed sanctions and $125,000 in fines on 46 of the worst abusers in May in response to an investigation by The Miami Herald.

Gov. Rick Scott announced Tuesday that the Agency for Health Care Administration took administrative action against the assisted living facilities as part of his commitment to "making sure the people who rely on these facilities are protected."

The fines were first imposed on May 4, the final day of The Herald's three-part series "Neglected to Death,'' which detailed how sweeping failures in state oversight of Florida's ALFs had left thousands of elderly and mentally ill residents vulnerable to dangerous and decrepit conditions.

By May 13, the agency banned two homes, Hilcrest Retirement Residence in St. Petersburg and Family Traditions in Miramar, from admitting any new residents until it had corrected deficiencies.

On May 17, it suspended the license of Hilcrest for failing to address its rampant bed bug problem, treat its residents and separate its laundry to stem the infestation.

The Family Traditions facility in Miramar, which AHCA had cited for disabling its fire alarm, had no current residents when admissions were suspended, according to AHCA's order.

Several Tampa Bay area facilities also were fined: The Abigail in Tampa was fined $1,942, Clearview Manor in Tampa was fined $10,500, Loving Care of St. Petersburg was fined $16,500, Sullivan House in Hudson was fined $3,219 and Superior Residences of Brandon was fined $5,000

The intense focus on sanctions last month at the homes that serve the state's most vulnerable residents is in stark contrast to the pattern that emerged in recent years. According to data provided to The Herald earlier this year, AHCA has only levied two license suspensions since 2005.

The Herald report examined thousands of inspections carried out by AHCA, which is charged with licensing and regulating the state's 2,850 ALFs, and found that as the number of homes exploded in recent years, the agency failed to keep pace — slashing both the frequency and number of inspections while failing to punish operators who don't live up to state standards.

Between 2008 and 2009, for example, the state closed only seven homes, while there were at least 70 homes that, according to state records, had violations severe enough to warrant the loss of their license, including incidents in which elders died at the hands of caregivers.

At the time of The Herald report in early May, the governor said he had not read the series but had called AHCA Secretary Liz Dudek and concluded she was "very committed to making sure that they do a very good job." On Tuesday, Scott said he had ordered the agency to crack down "against any abuses or neglect" and said he was "happy they've answered that call."

In a statement Tuesday, Dudek said she will continue to work with other state agencies "to monitor these facilities closer than ever" and provide "vigorous enforcement to assure providers are held accountable to keep the residents in their facilities healthy and safe."

In addition, the governor's office said it had enhanced its searchable web site,, to provide more up-to-date information on assisted living facilities and agency inspections. The Herald report found that the AHCA website included few reports since 2007 and many reports were missing.

The governor's newfound commitment to enforcing the state laws against ALF violations was "a delightful shock" to Win Hoffman, the elected state representative for the Broward County Ombudsman Council, who learned of the crackdown on Tuesday.

"It's a shame it's taken this long and it's a shame that we've had so many tragedies occurring in so many facilities for this to happen,'' he said. "Hopefully a new page has turned and this has gotten statewide attention.''

He added that he hopes the attention to tougher enforcement will be a permanent shift in approach at the regulatory agency.

"I don't know how long this enthusiasm is going to last on the part of AHCA — whether this is something to just gratify the governor's concerns. But our long-term goal is to try and strengthen our role,'' he said. "We would like to see the ombudsman program be given a little more responsibility. We would like to have some teeth so that maybe we could relieve AHCA of some of their efforts."

Sen. Chris Smith, a Fort Lauderdale Democrat who was so outraged by The Herald report that he joined officials for a surprise inspection of a Lauderhill assisted living facility earlier this month, said the governor's announcement was a good start.

"The degree of misery, filth and squalor that was allowed to fester in these homes was beyond appalling," Smith said in a statement. He has agreed to work with Republican Sen. Ronda Storms of Valrico to overhaul the regulatory system that oversees the assisted living facilities.

Smith questioned whether Scott's enforcement actions go far enough. Many of the ALFs sanctioned by the agency have been cited for numerous deficiencies in the past, even by the governor's own admission, Smith said. And the $125,000 in fines levied on 44 facilities " pales in comparison to the millions in tax dollars Florida has paid to operate these facilities,'' he said. "That's a penalty of less than $3,000 per violator."

AHCA spokesman Shelisha Coleman acknowledged that several of the facilities have been fined before for failing to meet state standards, but said the agency expects the fines to get their attention.

"When you fine a facility it prompts them to take action and try to improve things in their facility and, if not, we will have to take further action, impose a moratorium or even revoke their license," she said. "It may seem like a slap on the wrist, but if we keep fining you, that continues to add up.''

WLRN-Miami Herald reporter Kenny Malone contributed to this report. Mary Ellen Klas can be reached at

After years of lax regulation, state finally cracks down on ALFs 06/14/11 [Last modified: Tuesday, June 14, 2011 7:57pm]
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