NEW PORT RICHEY — The state reports painted a troubling picture of life at Hillandale: Clients stumbling and drooling in the haze of powerful medications, unruly residents locked in a tiny isolation room — sometimes for hours.
"It's like you're in jail," Karen Westfall, who lived at Hillandale for five years, told the Miami Herald, which published a special report last month describing neglect at Hillandale and other assisted living facilities around the state.
Then came the arrest last month of a former Hillandale worker accused of having a sexual relationship with a resident. The New Port Richey assisted living facility houses 18 residents, all younger people with mental health issues.
The state Agency for Health Care Administration decided last week to cut off Medicaid funding to Hillandale and two sister facilities in Pinellas, all owned by Mapleway Communities.
But Mapleway administrator John Ross said all three facilities plan to remain open. He said most of their revenue comes from residents' Social Security disability income. The Medicaid funding is minor, he said — about $9 a day per resident.
"That will not put us out of business," he said.
Nor should it, he argued. Ross vigorously disputed the Herald report about conditions at Hillandale, and he said the staff responded aggressively when questions surfaced about an employee's relationship with a 26-year-old resident.
Ross said he suspended Orlando Baez, 57, last month after a co-worker saw Baez kiss the resident on the cheek. Baez told him it was an innocent gesture, Ross said. But when the resident came forward several days later alleging there had been sexual contact, Ross fired Baez and directed staff to call the abuse hotline, launching the investigation that led to Baez's May 20 arrest on sexual battery charges. Deputies say Baez confessed.
"An individual makes a bad decision," Ross said, "but when we heard about it, everything was done appropriately, knowing full well the exposure we were bringing on ourselves."
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What about the conditions at Hillandale?
The Herald cited state reports of a small isolation room where agitated residents were placed in time out. The metal door magnetically locked from the outside.
Residents suffering from mental retardation, hearing impairment and other disabilities were left in the room for "sometimes hours," former resident Karen Westfall told the Herald. She recalled one incident in which a friend was thrown in the closet. "They split her head open," she said. "All I could hear was a big, loud thud."
Former resident Tommy Drinnenberg, 45, described the room to Herald reporters through a sign-language interpreter. "Dark. Can't see," said the deaf man. "Hated that … Bad."
A former office manager who phoned in a complaint to AHCA about the room told the Herald she kept a log of what she saw, including scratch marks around the door frame — where residents tried to claw their way out — and footprints on the walls.
Ellen Rothermel's notes from February 2005 also say she heard screams, and she remembers one incident in which a female resident was ordered to remove her clothes before being dragged into the room by the home's administrator.
Though ordered by AHCA to stop using the room — which was linked to a spate of injuries — state agents quoted Ross in one report saying: "I don't care how many times they cite me for this."
In a Times interview, however, Ross said the "time out room" was used "one time" six years ago, when state rules allowed them in facilities serving the developmentally disabled. When AHCA officials told him not to lock anyone in that room, Ross said Hillandale stopped.
"We never used it again," he said. "That room was converted to something else."
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The Herald also cited state reports of heavily medicated residents at Hillandale.
In 2007, a psychiatrist working for the state found people at the home were so overmedicated — one resident was on at least 18 mind-altering drugs — that they drooled and slept most of the day. The doctor said the drugs placed residents at "significant risk," and appeared to be "an attempt to chemically restrain" them.
In April 2010, the Herald reported, a disabilities advocate visiting the home found a 47-year-old man — clad in a woman's blouse and mismatched shoes — so overmedicated he was drooling and couldn't hold up his head. When state workers tried to remove him, records show, a "mob" of residents shouted and blocked their path.
After that incident, Agency for Persons with Disabilities behavioral specialist Ken Winn noted that "clients were visibly overmedicated" and the home lacked proper supervision. "This represents an escalating pattern," he wrote.
Ross emphasized that the facility only administered the medications that were prescribed by doctors. And AHCA — the sole state agency with regulatory authority — took no action, saying it "did not find rules or laws were being violated."
But AHCA did cite Hillandale for failing to safeguard its residents, the Herald reported. More than a dozen times, deputies found resident Co Dang, who suffered from paranoid schizophrenia, wandering the streets.
In the pre-dawn hours of August 2007, Dang left the facility at 6333 Langston Ave., tripping the exit alarm. Records show the lone caretaker shut off the device and did nothing until authorities called an hour later asking if anyone was missing.
It took two more hours before staff members learned that Dang, 50, was dead, struck by a car as he walked in a lane of Ridge Road nearly 2 miles away.
Ross said Hillandale's hands are tied: Residents are not inmates. They have the freedom to come and go as they choose.
"We cannot prevent anybody from leaving the building," he said.
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When AHCA sent its letter last week cutting off Medicaid funding to Hillandale and its two sister facilities, it did not allege any violations or wrongdoing.
Instead, it cited a provision that allows either side to cancel the contract without giving a reason. Mapleway has no way to appeal AHCA's decision.
The agency gave 30 days' notice that Medicaid payments will stop to Hillandale, as well as Mapleway in Safety Harbor and Amelia's House in Pinellas Park. Altogether the assisted living facilities house 49 people, 40 of whom qualified for Medicaid payments, AHCA spokeswoman Shelisha Coleman said. For 2010, those three facilities received more than $500,000 in Medicaid payments, she said.
Is AHCA taking any disciplinary steps that might affect the license for Hillandale or the other Mapleway facilities?
"Regulatory licensure actions will be public once final and served," is all Coleman would say.
But Ross said the company is determined to keep its doors open.
"We feel the only ones really penalized by this are the clients who need the kind of care we provide," he told the Times.
Ross said the Mapleway facilities provide a stable home for people who need mental health services. "Our goal is to do the best we can for the clients we're serving," he said.
This story drew from the extensive reporting of the Miami Herald's Carol Marbin Miller, Rob Barry and Michael Sallah, whose series "Neglected to Death" ran last month. For the full series, visit www.miamiherald.com/neglected_to_death.