After years of ineffective action in the face of abuse and neglect of elderly and disabled Floridians, the Agency for Health Care Administration has finally become more aggressive when confronted with clear evidence of egregious mistreatment. Since a Miami Herald investigation in May laid bare the poor treatment of residents in many of the state's assisted living facilities, the agency has upped fines and other sanctions against the worst abusers, including cutting off one chain of Tampa Bay assisted living facilities from Medicaid payments. Gov. Rick Scott should be given credit for pressing his agency chief, Liz Dudek, to go after the worst offenders. The governor is no fan of government regulation, but this suggests he recognizes government's role in protecting these vulnerable residents from harm.
The Herald investigation found that the AHCA had known for years about shocking levels of abuse and neglect at assisted living facilities around Florida but had not been cracking down. Residents at facilities experienced beatings, sexual abuse and were drugged into a stupor or held in inappropriate restraints. Over the past eight years, 70 people died in these facilities due to the actions of caretakers, often as a result of terrible neglect.
The AHCA was so feckless that in 2006 Pinellas County sheriff's deputies took matters into their own hands. After the death of a resident, charges were brought against the owner of Rosalie Manor in Dunedin. The facility had been a perennial problem, with 400 emergency calls — often for illegal drug use and assaults — coming from the site in the previous five years. Yet state regulators refused to shut it down. The criminal prosecution took care of what the state agency wouldn't.
Finally, after the newspaper probe and an intervention by Scott, the agency seems to be using the tools at its disposal to cull bad operators. The Mapleway Communities chain of assisted living facilities in Tampa Bay, where caregivers were found to restrain residents with violence and drugs, has been given notice that in 30 days it will no longer be able to bill for services under Medicaid. State regulators are working to counsel residents affected in the chain's three facilities in New Port Richey, Safety Harbor and Pinellas Park. Medicaid payments are often a financial lifeline for assisted living facilities, and loss of those funds may affect the chain's continued operations.
Also in May, the AHCA imposed sanctions and $125,000 in fines on 46 of the state's worst abusers, including suspending the license of Hilcrest Retirement Residence in St. Petersburg for a rampant bedbug problem. Now the AHCA needs to start shuttering the worst of the worst.
Aggressive regulatory enforcement and frequent inspections are the only way to keep the state's assisted living facilities operating at legal standards. Florida was once held up as a model in its protections against the abuse of the elderly and disabled at these facilities. It can be so again, if Scott continues to make it a priority.